Changes in a customer's circumstances and effect on concession card entitlement 102-05040000

A customer with a Commonwealth Seniors Health Card (CSHC), Low Income Health Care Card (LIC) or ex-Carer Allowance (child) Health Care Card (EHC) notifies of a change in circumstances.

If the customer is notifying:

• separation from their partner, go to Step 2
• becoming partnered/ a member of a couple, go to Step 3
• requesting cancellation of their concession card, go to Step 4
• that their and/or their partner's income details need updating, see Step 4 in Table 2
• that their address and/or telephone number need updating, see Step 1 in Table 2
• of an update to an existing account-based income stream or a new account-based income stream, see Step 8 in Table 2
• of imprisonment (except EHC) and has a CSHC or LIC, see Step 9 in Table 2

For EHC only customer notifying of:

• leaving Australia
• ceasing becoming a full-time student
• imprisonment

See Step 3 in Table 3.

Before updating any personal details, see Separating safely – protecting personal details to ensure personal information is kept safe.

Obtain the following details:

• date of separation
• any new address
• any changes to telephone contact number
• any changes to income
• for CSHC only, check if there has been a change in payment destination for the customer to be any quarterly supplement
• discuss with the customer the key tasks they should consider to protect their personal information
• once all details are supplied, go to Step 6

Some customers may wish to cancel their entitlements to the concession card and not provide details of their partner.

Does the customer wish to test their continued eligibility (at the couple rate) to the concession card or cancel the card?

• Yes, to test continued eligibility to concession card (at the couple rate), go to Step 5
• No, to cancel concession card, go to Step 4

If the customer advises of becoming partnered and the partner has confirmed the relationship:

• update the Marital Status (MS) screen
• cancel the concession card, go to Step 7

For voluntary cancellation requests:

• for EHC customers, see Step 3 in Table 3
• while in customer's record in the SHC system for CSHC or LIC system for LIC, go to Benefit Action (BA) screen and cancel card, see:
• Cancellation of CSHC ,or
• Cancellation of LIC for more information
• prior to finalising the cancellation action, discuss the decision with the customer
• finalise activity
• record details on a DOC
• procedure ends here

If the contact is by phone, and the partner is present get the following details:

• date the member of a couple relationship commenced
• any new address details
• any changes to telephone contact number
• tax file number (TFN) for partner
  for CSHC - advise customer to provide their partner's TFN in writing, or if they do not know/have TFN, issue a Tax file number application or enquiry for an individual form (NAT1432). Advise customer that the TFN/form is to be provided within 28 days otherwise CSHC will be automatically cancelled
• any changes to income for customer

If the partner is not present or cannot provide all the required details, request a Partner details (MOD P) form. The form will get confirmation of the relationship and income details for the partner. See Requesting information (CLK).

Income details for partner

CSHC only

If partner is currently in receipt of CSHC, use existing details as long as information coded relates to the same financial years and is no older than the 2 years prior to the current financial year.

If partner is not current:

• Request partner’s last Notice of Assessment (NOA) plus other supporting documents. The NOA and documents must be within the last 2 years prior to the current financial year. Customer may be required to provide this up to date information if current coding is more than 2 years prior to current financial year. Note: the ATI details cannot be updated through the telephone. A copy of the NOA and other supporting documents must be supplied
• If not required to lodge, obtain details of income and request relevant supporting documents
• Request a schedule or SA330 for any account-based income streams not already recorded for partner on SUPS. See Requesting information (CLK)
• Check if any changes in payment destination are required for customers who may be paid energy supplement

LIC only

If partner is currently in receipt of LIC, use existing income details.

If partner is not current:

• Request proof of income over the last 8 weeks, see Low Income Health Care Card (LIC) income test
• Request a schedule or SA330 for any account-based income streams not already recorded for partner on SUPS. See Requesting information (CLK)

Have full details of any changes for customer and required details of partner been supplied?

• Yes, go to Step 7
• No, see Requesting information (CLK). Tell the customer that CSHC or LIC will be cancelled if details are not provided within time allowed to respond as continued entitlement must be determined.
  Procedure ends here

While in customer's record in the SHC system for CSHC or the LIC system for LIC, update the Relationship Status field to 'SEP' on the Marital Status (MS) screen. Use the date of separation for the Date of Event. Complete Source and DOR details.

Are there any other changes that need updating?

• Yes, see Step 1 in Table 2
• No, finalise activity. Prior to finalising the cancellation action, if the update results in cancellation, discuss the decision with the customer.

Note: if customer's income is now too high due to the change in relationship status the card will automatically cancel. Record details on a DOC. Procedure ends here

Before linking the customer to the partner, the partner must confirm the relationship via:

• online claim lodged by the partner which includes a Temporary Access Code (TAC) completed by the customer
• signed a paper claim form or MOD P, or
• over the phone

Has the partner confirmed the relationship?

• Yes, go to Step 8
• No,
• If the partner is present, read the privacy statement and declaration. If accepted, go to Step 8
• If the partner is not present, make 3 genuine attempts to contact the partner to confirm the relationship
  - If contacted, read the privacy statement and declaration. If accepted, go to Step 8
  - If they cannot be contacted or a verbal declaration cannot be obtained, issue a MOD P, see Requesting information (CLK). Procedure ends here

Privacy statement and declaration

Your personal information is protected by law (including the Privacy Act 1988) and is collected by the Australian Government agency Services Australia for the assessment and administration of payments and services. Your information may be used by the agency or given to other parties where you have agreed to that, or where it is required or authorised by law (including for the purpose of research or conducting investigation). You can get more information about the way in which the agency will manage your personal information, including our privacy policy, at servicesaustralia.gov.au/privacy

Do you declare that the information you have provided is complete and correct and understand that giving false or misleading information is a serious offence?

While in customer's record go to the MS screen:

• update the new relationship status, using the actual date the customer commenced the relationship for the Date of Event
• code the permitted to enquire (PPE) indicator as 'N' unless written or verbal permission has been given by each member of the couple
• complete Source and DOR details. Press [Enter]
• the activity will flow to the Link Partner (LP) screen. Search for and link the record to the partner's record by confirming selection if a record is found
• if no record is found after a thorough search, add the new partner by completing details provided by the customer on the Add Partner (AP) screen. The Customer Details Task (CDTS) screen will be presented. Update all details supplied for partner. Press [Enter]. See Adding a customer to the system for more information

If the partner receives an income support payment follow the required process for the partner, based on the payment they receive. See Change in relationship status from single to partnered.

Check if other changes need updating, for example income details, address, telephone details, email, TFN or customer's bank account details.

• Yes, see Step 1 in Table 2
• No, finalise activity. Record details on a DOC. Procedure ends here

Does the customer's address and/or telephone number need updating?

• Yes, update new details. See Changing address (CLK). Go to Step 2
• No, go to Step 2

Does the customer's TFN need updating?

Note: this is for CSHC only.

• Yes, see Tax File Number (TFN) for Commonwealth Seniors Health Card (CSHC). Go to Step 3
• No, go to Step 3

Does the customer have a CSHC and their payment destination requires updating for energy supplement?

• Yes, update new details. See Changing payment destination, then go to Step 4
• No, go to Step 4

Do the customer's and/or partner's income details need updating?

• Yes,
• for CSHC, go to Step 5
• for LIC, see Step 1 in Table 3
• No, procedure ends here

A customer may supply new ATI details for CSHC. This can be a new NOA plus other verification of income documents to verify their ATI or a NOA plus other verification of income documents and a current year estimate.

Note: Prisoner of War Recognition Supplement from Department of Veterans' Affairs is not taxable income. It is also exempt income for social security purposes. However, it should still be coded on the Veterans Affairs Pension (DVA) screen.

Is the customer providing a NOA plus other verification of income documents advising of new ATI details and the customer has a continuing entitlement to CSHC?

• Yes:
• if trained, update the SHC Income Details (SHID) screen in the SHC system using the date of the NOA as the DOV and record the NOA plus other income details on a DOC. See Lodgement of the Notice of Assessment (NOA) and other evidence of income for Commonwealth Seniors Health Card (CSHC)
• if not trained, scan the supporting documents and a written statement from the customer if they are supplying an estimate for the current financial year (See Step 6) and send an open Fast Note to SEN, using the Service Reason SHC for correct work allocation to be made
• Procedure ends here
• Note: advise the customer to provide their NOA plus other supporting documents as verification within14 days, see Requesting information (CLK). Advise the customer that failure to supply this information will result in the CSHC being cancelled as continued entitlement cannot be determined
• No, go to Step 6

If the customer has had a change in circumstances that can be satisfactorily demonstrated and is an acceptable condition for using an estimate of income for the CSHC income test, the customer may provide an estimate of CSHC income for the current financial year. In addition to the NOA plus other verification of income documents, the customer should be advised to provide a statement detailing the change of circumstances that has occurred, as well as supporting evidence.

Make a request for information:

• Select Information to be supplied within 14 Days + Delivery
• Advise the customer that failure to supply this information will result in the CSHC being cancelled as continued entitlement cannot be determined
• See Requesting information (CLK) for more information

When the required information has been received, go to Step 7.

An estimate should only be accepted if it is considered reasonable. An estimate is reasonable if:

• the applicant's explanation of how they calculated the estimate is consistent with the estimated amount, and
• the reason for the change in income is an acceptable condition for using an estimate of income for the CSHC income test, and
• supporting evidence has been provided

Note: if the customer's income (either verified or current year estimate) is above the threshold, this procedure does not apply. See Cancellation of CSHC. Procedure ends here.

• If the customer is providing a current year estimate that is accepted as reasonable and is below the threshold:
• update the SHC Income Details (SHID) screen in the SHC system using the date of notification as the DOV for the estimate, and
• record the NOA using the date before the estimate DOV (DOV minus 1 day), then see Step 2 in Table 2

LIC holders: From 1 January 2015, deemed income will be calculated from the current balance of account-based income streams. There are no grandfathering provisions. See Adding or updating an account-based income stream. Procedure ends here.

CSHC holders: From 1 January 2015, deemed income will be calculated from the current balance of account-based income streams. Deeming will be applied to account-based income streams:

• purchased or changed on or after 1 January 2015
• purchased before 1 January 2015 by customers who commence receiving a Commonwealth Seniors Health Card (CSHC) on or after 1 January 2015
• owned by a card holders partner who is aged 60 or more and not the holder of a CSHC

Is the CSHC customer wanting to update an account-based income stream recorded on SUPS or providing a schedule or SA330 for an account-based income stream not already recorded on SUPS?

• Yes, update the account-based income stream. Procedure ends here
• No, make a request for information using Request Documents in Process Direct, advising the CSHC customer to provide a schedule or SA330 for the account-based income streams as verification within 14 days. Advise the customer that failure to supply this information will result in the CSHC being cancelled as continues entitlement could not be determined. Select Information to be supplied within 14 Days + Delivery to follow up the return of information. See Step 2 in Table 3

Go to the Benefit Action (BA) screen in the SHC or LIC system to auto cancel the CSHC or LIC respectively.

Prior to finalising the cancellation action, discuss the decision with the customer.

Note: if the customer is receiving an income support payment (for example, Youth Allowance), see the appropriate procedure for their income support payment.

Use the reason code:

• GAO to auto cancel CSHC
• IMP to auto cancel LIC

Finalise the activity and record all details on a DOC.

Procedure ends here.

The customer and/or partner must provide verification of gross income for the 8 weeks ending on the Date of Event. Acceptable forms of evidence of income include:

• pay slips
• last superannuation notice, showing current rate
• latest tax return or NOA (if self-employed or involved in a business)
• bank statements, and/or
• letter from employer on the employer's letterhead

See Low Income Health Care Card (LIC) income test.

Has proof of income been supplied?

• Yes, while in the customer's record go to the Low Income Health Care Card Task Selection (LITS) screen and select the appropriate income screen/s that need updating. For more information about recording income for LIC, see LIC income test. Go to Step 2
• No, formally request income verification from customer. See Requesting information (CLK). Advise the customer that LIC may be cancelled if verification is not supplied. Procedure ends here

For further changes:

• update any other changes
• finalise activity
• record all details on a DOC

For CSHC customers and/or their partner who have been formally asked to supply:

• an NOA plus other supporting documents, or
• an NOA plus other supporting documents and documents to support their current year estimate, or
• a scheduled or SA330 for the account-based income streams

All changes to ATI for CSHC holders should be coded on the SHID screen in the SHC system and account-based income streams are coded in SUPS.

Procedure ends here.

To utilise the EHC system, code 'SVEHC' in the Nxt field and 'ISS' in the System field.

Prior to finalising the cancellation action, discuss the decision with the customer.

If customer is advising of imprisonment, cancel EHC via the BA screen in the ISS system. Code:

• 'EHC' in the Svc Rsn field
• 'CAN' in the Action field
• 'IMP' in the Reason field
• Date of Event in the Effect Date field

If customer is advising cessation as a full-time student, cancel EHC by updating the Ex-CA (child) HCC Assessment (EHCA) screen in the ISS system. Code:

• Date of Event in the Date of Event field
• 'N' in the Full Time Student Y/N field
• 'I' (insert) in the Action field

If customer is requesting a voluntary cancellation, manually cancel EHC via the BA screen in the ISS system:

• finalise activity
• record all details on a DOC

For overseas absences, the EHC will cancel automatically if the absence is permanent. As long as the customer meets all other eligibility requirements, EHC will continue during any temporary absence overseas.