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3.2.1 Administrative Renewals Introduction Based on federal requirements, health care eligibility must be redetermined once every 12 months based on information available to an agency. Agencies cannot require information from health care members during an annual renewal unless the information cannot be obtained through an electronic data exchange or the information from the electronic data exchange is not reasonably compatible with the information on file. The process of using electronic data exchanges for renewals is referred to as an administrative renewal. If information from electronic data exchanges validated information about the member’s income as currently recorded in CARES, additional information about income cannot be requested from the member at renewal. This includes member-reported information about earned income that is found to be reasonably compatible with earned income information obtained from the State Wage Information Collection Agency (SWICA) and Federal Data Services Hub (FDSH) data exchanges, as well as any information about unearned income verified through the Social Security Administration (SSA) or Unemployment Insurance Benefits (UIB) data exchanges. Unless reported otherwise, it is assumed during the administrative renewal process that household composition has not changed. 3.2.2 Administrative Renewal Selection Criteria To be considered for an administrative renewal, a member must be due for renewal in the following month and have eligibility in one or more qualifying BadgerCare Plus, Family Planning Only Services (FPOS), or Elderly, Blind, or Disabled (EBD) Medicaid assistance groups (AGs) open, including members open with a suspended status. Some members in a household may have their eligibility administratively renewed while other members in the household must complete a regular renewal to continue their eligibility. A member's health care eligibility can be administratively renewed if all of the information necessary to determine the member's eligibility is on file and their income and assets can be verified through a data exchange (for example, income with a SWICA match or Equifax match through FDSH, Social Security income, Unemployment income). A member’s health care eligibility cannot be administratively renewed if they meet any of the following criteria: • Have income on file that cannot be verified through a data exchange, such as self-employment income, in-kind income, income from trusts, and other types of countable income for Medicaid. • Are age 14 or older and have a missing or unverified SSN. • Are pregnant and the due date is on or before the renewal month. • Are enrolled in Medicaid after having met a deductible. • Are enrolled in Institutional Medicaid. • Are enrolled in Group A Community Waiver based on 1619(b) or EBD Medicaid Eligibility. • Are enrolled in Group B/B+ Community Waivers. • Are already in the process of completing a regular renewal. • Mail was returned for the member's household with no forwarding address, and an up-to-date address has not been received.