Financial Services Administration (FSA)

Created on: 
Jun 08 2016

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.

What is the Financial Services Administration (FSA) interface?

The FSA interface is the exchange of information regarding premium data for the following medical programs:

  • N13 - MAGI - CHIP Federal
  • N33 - MAGI - CHIP State
  • S08 - HWD

How often is information exchanged?

ACES sends data to the Financial Services Administration (FSA) interface once per month during the Monthly Issuance weekend. For specific dates of Monthly Issuance, see the ACES Production Calendar.

FSA sends ACES delinquent premium information on the 16th of each month. The file contains Assistance Units (AUs) with an outstanding balance for each of the past three months.

FSA sends ACES a daily interface that includes households that have paid their delinquent premiums.

Online Processing

What happens when ACES receives delinquent premium information?

N13 (MAGI - CHIP Federal) and N33 (MAGI - CHIP State) Assistance Units (AUs) AUTO close for Reason Code 342 - Termination/Denial Due to Non-Payment of Premium and system posts the delinquent premium amount to the Premium Amount - Children's Medical and Premium Payment Status page.

If the child’s SANC screen in ACES Mainframe has a Sanction Reason of 200 - Delinquent Premium Amount and exception code of DE - Departmental Error, FH - Fair Hearing or MD - Mandatory (System Generated), the following occurs;

  • DE - The system resets the field to blank and AUTO closes the AU.
  • FH - The system does not reset this code and the child remains active.
  • MD - System generated code when mandatory conditions apply, such as pregnancy or when the client has a Race Code of 597 (American Indian / Alaskan Native), 935 (Eskimo) or 941 (Aleut), system does not AUTO close the AU.

For more information on N13 or N33 unpaid premiums, see What happens if a premium is not paid?

S08 AUs with a delinquent premium paying for 120 days, AUTO generates Alert 235 - PREMIUM PAYMENT 120 DAYS OVERDUE. For more information, see Premiums - What happens if the S08 premium is not paid?

What happens when ACES receives notice that the client has paid their delinquent premiums?

For information on what happens when delinquent premiums are paid, see What happens when a delinquent payment is received late?

Mainframe Processing

What happens when ACES receives delinquent premium information?

N13 (MAGI - CHIP Federal) and N33 (MAGI - CHIP State) Assistance Units (AUs) AUTO close for Reason Code 342 - Termination/Denial Due to Non-Payment of Premium and system posts the delinquent premium amount to the PREM screen.

If the child’s SANC screen has a Sanction Reason of 200 - Delinquent Premium Amount and exception code of DE - Departmental Error, FH - Fair Hearing or MD - Mandatory (System Generated), the following occurs;

  • DE - The system resets the field to blank and AUTO closes the AU.
  • FH - The system does not reset this code and the child remains active.
  • MD - System generated code when mandatory conditions apply, such as pregnancy or when the client has a Race Code of 597 (American Indian / Alaskan Native), 935 (Eskimo) or 941 (Aleut), system does not AUTO close the AU.

For more information on unpaid N13 or N33 premiums, see What happens if a premium is not paid?

S08 AUs with a delinquent premium paying for 120 days, AUTO generates Alert 235 - PREMIUM PAYMENT 120 DAYS OVERDUE. For more information, see Premiums - What happens if the S08 premium is not paid?

What happens when ACES receives notice that the client has paid their delinquent premiums?

For information on what happens when delinquent premiums are paid, see What happens when a delinquent payment is received late?

 

See ACES Screens and Online Pages for an example of pages or screens used in this chapter.