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West Virginia Income Maintenance Manual Chapter 9

West Virginia Income Maintenance Manual Page 32 Chapter 9 Client Notification

APPENDIX B: ELIGIBILITY SYSTEM NOTIFICATION FORMS

DOHS Official Form Code DOHS Official Form Name Chapter Reference System Generated Notice Code Worker Generated Notice Code Eligibility System Form Name DFA

1095-B MEC Form 6.5 E095 ED9C Verification of Minimal Essential Coverage DFA NL-5 Waiver of Advance Notice 6.3,C,2

NMRM Waiver of Advance Notice DFA NL-6 Notice of Withdrawal of Application 6.2,B CRD2

Withdrawn RFA ES NL-A

6.2,C EDA1, EDA4 NNAP WV WORKS/SNAP Approval

EDA7, EDA9 NNAP Medicaid Approval

EDA8 NNAP CHIP Approval

EDAA NNAP LIEAP Approval

EDAB NNAP EA Approval

EDAE, EDAF NNAP MAGI Approval

EDAC NNAP NEMT Approval

EDAM NNAP DCA Approval

EDAP NNAP Expedited FS Approval

EDO6 NNAP SCA Approval

EDD1, EDD3 NNDN Denial WV WORKS/ SNAP/MA – MAGI Denial

EDDA NNDN Deny LIEAP

EDDB NNDN Deny EA

EDDC NNDN Deny NEMT