This section defines what changes an individual must report and when those changes must be reported. (For information on how to treat reported changes, see section 804.)
An individual, or an individual acting on behalf of an individual, is responsible for repaying any incorrect benefits received if the individual:
intentionally provides false information,
fails to report changes timely, or
fails to provide verification timely. (See Section 806)
Reportable Changes During the Certification Period
The individual must report the following changes that occur anytime during the certification period within 10 days of the date of the change.
A member begins to receive coverage under a group health plan or other health insurance coverage.
A member begins to have access to coverage under a health insurance plan offered by an employer.
A member begins to be covered or gains access to coverage under a state employee’s group health plan due to a parent’s or legal guardian’s employment with the state.
A member leaves the household or dies
A member or the household moves out of state.
A member or the household changes their address.
A member enters a public institution or an Institution for Mental Disease.
Change in non-citizen status.
Reportable Changes at Review
At each review, members must report all changes that occurred during the current certification period up to the start date of the new certification period. In addition to the changes in section A, report the following changes for each household member. (See Section 804 for treatment of changes.)
Income source (new source, loss of previous source)
Gross income of $25 or more
Tax filing status
Pregnancy or termination of pregnancy
Number of dependents claimed as tax dependents
Earnings of a child
Marital status
Student status of a child under the age of 24
Date of Report
The date of report is the date the individual tells the eligibility agency through an online reporting process, in person, by telephone, by fax or by mail about a change when that report is received by the close of business.
The agency will date change reports received anywhere other than an outreach location after the close of business as received on the next business day.
Change reports delivered to an outreach location at a time when the office is closed will be dated as received on the last business day that an outreach staff person was working at that location.
When an individual mails information, the business day the agency receives the mailed change report is the date of report.
Timely Reports
Changes reported by the due dates defined in A. and B. are considered timely.
If a due date for reporting a change falls on a Saturday, Sunday or state holiday, the individual has until the close of business on the next business day to report the change.
Change reports delivered to an outreach location at a time when the office is closed will be dated as received on the last business day that an outreach staff person was working at that location. Based on the date the change report is dated as received at an outreach location, timeliness then follows the rules in A. and B.
If the agency cannot give 10-day notice for an adverse action, it must continue benefits to the following month. See Section 803 for exceptions to advance notice requirements.
Verifications
Individuals who provide reports, forms, or verifications by any one of the dates listed below have provided the information on time:
When the local office receives the information by 5:00p.m. on the due date; or
When the due date is on a Saturday, Sunday or State holiday, the local office receives the information by 5:00p.m. of the first working day after the due date; or
When the individual faxes in the information and the fax date shows it was faxed by 5:00p.m. on the due date.
If the agency cannot give 10-day notice for an adverse action, it must continue benefits to the following month. (See Section 803 for exceptions to the advance notice requirements.)