Purpose

This Departmental Instruction provides information about the policy and system changes impacting on the eligibility and payability to Commonwealth Seniors Health Card (CSHC) holders.

Background

In the 2001-02 Federal Budget the Government announced:

• from 1 July 2001, increased income limits for the CSHC; and
• from 1 September 2001, telephone allowance would be extended to eligible CSHC holders. 

All other eligibility criteria for CSHC remain the same.

Previous DI

This departmental instruction incorporates information from departmental instructions:

• C14/2001 – Issues of 2001/02 Commonwealth Seniors Health Card (CSHC);
• C23/2001- Commonwealth Seniors Health Card: Changes to Claims Management System and Death Processing System;

and provides additional information.

CSHC eligibility

Section 118V of the Veterans' Entitlements Act 1986 (VEA) states that a person is eligible for a CSHC if the person:

• is an Australian, Commonwealth or allied veteran who has rendered qualifying service; or
• is an Australian, Commonwealth or allied mariner who has rendered qualifying service; or
• is a partner (including widow/ers) of a veteran or mariner who has rendered qualifying service; or
• is a war widow/er.

To qualify you must also:

• have reached pension age; and
• not be receiving a service pension; and
• not be receiving a social security pension or benefit; and
• not have a Centrelink CSHC; and

• satisfy the CSHC income test.

Pension Age –

Veteran

Section 5QA of the (VEA).

The pension age for a veteran is:

• Men – 60 years
• Female pension age for veterans is subject to age equalisation and is set out in the table below.

Period within which woman was born (dates inclusive)

Pension Age

1.

From 1 July 1935 to 31 December 1936

55 years and 6 months

2.

From 1 January 1937 to 30 June 1938

56 years

3.

From 1 July 1938 to 31 December 1939

56 years and 6 months

4.

From 1 January 1940 to 30 June 1941

57 years

5.

From 1 July 1941 to 31 December 1942

57 years and 6 months

6.

From 1 January 1948 to 30 June 1949

58 years

7.

From 1 July 1949 to 31 December 1950

58 years and 6 months

8.

From 1 January 1951 to 30 June 1952

59 years

9.

From 1 July 1952 to 31 December 1953

59 years and 6 months

Pension Age –

Non-Veteran

Section 5QB of the VEA.

The pension age for a non-veteran partner is:

• Men – 65 years

• Female pension age for non-veterans is subject to age equalisation and is set out in the table below.

Period within which woman was born (dates inclusive)

Pension Age

1.

From 1 July 1935 to 31 December 1936

60 years and 6 months

2.

From 1 January 1937 to 30 June 1938

61 years

3.

From 1 July 1938 to 31 December 1939

61 years and 6 months

4.

From 1 January 1940 to 30 June 1941

62 years

5.

From 1 July 1941 to 31 December 1942

62 years and 6 months

6.

From 1 January 1943 to 30 June 1944

63 years

7.

From 1 July 1944 to 31 December 1945

63 years and 6 months

8.

From 1 January 1946 to 30 June 1947

64 years

9.

From 1 July 1947 to 31 December 1948

64 years and 6 months

Pension Age –

War Widow/er

Sub Section 45(2) of the VEA states that pension age for a war widow/er is as if they were a veteran.

Contents of this Departmental Instruction

This Departmental Instruction includes information on the following topics:

• Increased CSHC income limits
• Extend telephone allowance to CSHC holders
• System  -  Telephone Allowance
• System changes  -  VIEW
• System changes  - EATERS + CMS
• System changes  - DPS

State Office Contact Officers

The State Office contacts are:

NSW  Lyn Firth

QLD   Jacki Stevenson

VIC    Gavin Inglis

SA      Stuart Campbell

TAS    Bryon Kelly

WA     John Gliddon

Contact

Contact officer for enquiries relating to this topic is Glen Yeomans on (02) 6289 6445

Start Date

From 1 July 2001 the income limits applying to CSHC holders were increased.

Increased CSHC income limits

The new income limits are as follows:

• Single - $50,000
• Partnered - $80,000 (combined)
• Illness separated - $100,000 (combined)

Plus an additional $639.60 per year for each dependant child.

CSHC Income Test

The CSHC income test equals:

Taxable income

+

net losses from rental property

+

target foreign income

+

employer provided benefits

Note: the income test has not changed.

Start Date

From 1 September 2001 CSHC holders who are eligible telephone subscribers are eligible to receive a quarterly payment of Telephone Allowance (TA).

Legislation

Sections 118Q – 118U of the VEA cover the eligibility and payability criteria for telephone allowance.  As part of the Family and Community Services and Veterans' Affairs Legislation Amendment (Further assistance to older Australians) Act 2001, sub section 118Q(3AA) was inserted to created TA eligibility for CSHC holders.

Eligibility for telephone allowance

Sub section 118Q (3AA) of the VEA.

A person is eligible for a telephone allowance if:

(a) either:

(i) the person is the holder of a seniors health card; or

(ii) the person is absent from Australia and was the holder of a seniors health card immediately before leaving Australia; and

(b) the person is a telephone subscriber.

Definition of telephone subscriber

As per section 118Q of the VEA, a person is considered to be a telephone subscriber if the telephone at their home is connected in either the person's name, joint names, or the person's partner's name.  That is, a person does not have to be listed on the telephone account to be considered a subscriber.

In cases where the telephone is connected in the name of one member of a couple, it is not correct to pay base rate TA to that person and no TA to the partner.  In that circumstance, each member of the couple is entitled to, and should be paid, ½ base rate of the allowance.

Telephone allowance rate

The rate of telephone allowance is indexed annually each September.  As at 20 September 2001 the base rate of telephone allowance is $18.00 per quarter.

TA rates: Disability pension only

For some people, including war widows, EDAs and TPIs not on income support, the rate of TA is determined by their disability pension.  These people are entitled to a base rate payment of TA, regardless of their marital situation.

For people in this group with a partner on CSHC, the couple will now be entitled to receive an additional payment of ½ base rate TA.  This is correct and has been addressed by the revised TA rate calculator.

Information required

In order to determine the correct rate of telephone allowance payable to a CSHC holder, information not previously requested is now required.

Additional information not previously stored for CSHC holders is:

• marital status;
• whether the partner has a CSHC/PCC at Centrelink;
• if yes, the Centrelink reference number.

Information to be entered into existing fields is:

• telephone subscriber details;
• bank account details (for people not already receiving a DVA payment).

CSHC Claim form

To capture the additional information, a new CSHC claim form is being developed.  In the interim a supplementary form is to be used (see attachment 1) in conjunction with the current CSHC claim form.  States will be notified when the new CSHC claim form is completed.

Partners at Centrelink

In some cases, one member of a couple will receive TA from DVA and the other member of the couple will receive TA from Centrelink.

In cases where a partner is identified as having a CSHC at Centrelink, their Centrelink Reference Number (CRN) is required.  This information will be used to inform Centrelink that the person's partner is receiving TA from DVA and therefore the Centrelink payment should be reduced to ½ base rate.

Auto grant –

Partner at Centrelink

Where a veteran, who has a partner receiving a Centrelink pension or benefit, is automatically granted a CSHC (due to their service pension being reduced to nil) the partner's details will need to be data collected prior to granting the CSHC.  This will ensure a telephone allowance overpayment does not occur.

In most cases, both members of the couple will be at DVA and both will be granted CSHC.  In these cases no additional data collection is required.

Centrelink cancellations – CSHC claims

Through the data collection process for this project, many people were found to have one CSHC from Centrelink and another CSHC from DVA.  As this card now entitles the holder to a payment, such situations will lead to double payments - one by each agency.

Section 118X of the VEA states that the holder of a Centrelink CSHC is ineligible for a DVA CSHC.  It is now essential that people claiming a CSHC, who indicate that they already have a Centrelink card, are told that they can only be issued one card.  The Centrelink card must be cancelled upon grant of the DVA card.

Centrelink cancellations – other claims

The issue of double payments of TA also applies to grants of income support pension to the holder of a Centrelink CSHC.  All claim forms will be updated shortly to request CSHC information so cancellations at Centrelink can be made.  States will be advised when these form changes are implemented.

An income support claimant with a CSHC from either Centrelink or DVA must have their CSHC cancelled upon grant of income support.

Cancellations from Centrelink

Currently, Centrelink do not request information on DVA CSHC from claimants.  Therefore, there is no procedure in place for cancelling DVA card entitlements.  This issue, and the potential for double payments, is currently under discussion with Centrelink.  States will be advised of any development in this area.

Factsheets

IS13 (Telephone Allowance) factsheet has been updated to include the CSHC rates of payment and to correct some existing errors in rates of telephone allowance

IS126 (CSHC) factsheet has been updated to include telephone allowance.

Consolidated Library of Knowledge

Consolidated Library of Knowledge (Clik) has been updated to reflect the changes made to CSHC eligibility and payability.

TA payability

The system did not previously have the ability to create a Telephone Allowance (TA) payability for a CSHC holder.  From 12 September 2001 a new CSHC TA payability type was created.  There is no need to create a manual payability for any grants processed with an effective date later than 20 September 2001.

TA arrears

Manual arrears will be required where a CSHC (with TA eligiblity) is processed after a quarterly payday TA with an effective date prior to the TA payday.

The new CSHC TA payability will need to be used to create a manual payment for the relevant payday in “unauthorised manual assessments”.  This will then create an arrears payment for that TA payday, to be paid in two working days.

TA calculation

As part of this project, existing problems in the TA calculator have been corrected.  The calculator will now accurately reflect legislation.

Additional VIEW folder

An additional folder has been added to VIEW.  The folder, “Commonwealth Seniors Health Card Eligibility” can be found in the “Eligibility” tab in VIEW.  The folder will appear as follows:

CSHC Eligibility tab

This tab will enable the recording of data necessary for creation of the TA payability.  This screen will not determine CSHC eligibility; eligibility will continue to be determined off line as previously.

Centrelink reference number

Where a CSHC claimant identifies that their partner has a CSHC at Centrelink, DVA will pay ½ base rate TA to the DVA claimant.  The other ½ is paid to the partner by Centrelink.  The Centrelink reference number will be used to ensure that an overpayment does not occur in such cases.

Any cases involving the cancellation of a Centrelink entitlement should not have the reference number recorded in VIEW.  Where a CSHC claimant has an existing Centrelink CSHC, that card will need to be cancelled upon grant of CSHC from DVA.  Therefore, standard Centrelink clearance procedures will be necessary

EATERS

The EATERS function for recording CSHC eligibility has been disabled – all CSHC grants will need to be recorded using the new VIEW functionality.

Claims Management System (CMS)

Enhancements to CMS were introduced during the week commencing 10 December 2001.

Previous Processing

The recording of and all changes to a CSHC registration were totally manual.

The following table provides the steps that were required.

Step

Action

1

Register a CMS case via CM.CI screen in “Await Prepare Record” stage.

2

Update case attributes via CM.UA.  Note either of the mandatory attributes; “Successful claim” or “Unsuccessful Claim”, must be set.

3

Update the stage via CM.SC screen.

If the stage is progressed to:

1. “Prepare Recording” then move to Step 4.
2. “Case Finalisation” then moves to Step 5.
3. “Case Withdrawn” Then moves to Step 6.

4

Update the stage from “Prepare Recording” via CM.SC screen.  Note that the stage can only be progressed back to “Await Prepare Record”.

5

The case if now finalised and will be included in the appropriate CMS reports.

6

The case has been withdrawn.

Changes

There is no interaction between CMS and the new CSHC recording facility in VIEW.  The enhancements introduced provide automatic case progression functionality as a part of the VIEW recording process.

New Processing

Following the introduction of the enhanced functionality there are two options with regard to CMS actions.  These two options are:

• Manually registering a case via CM.CI in “Await Prepare Record” stage.
• No manual interaction at all.

If a CMS action ...

... been manually registered then when the CSHC eligibility is recorded in VIEW...

Has

•     the attribute will be automatically updated according to the claim's success.
•     the stage will be automatically progressed to “Case Finalised”.

Has not

•     a “Senior's Card” action will be automatically created with a receipt date equal to the date of processing.
•     the attribute will be automatically updated according to the claim's success.  Eg.  if the CSHC eligibility is recorded as “On” then the mandatory attribute, “Successful Claim”, will be set to “Y”

• the stage will be automatically progressed to “Case Finalised”.

Points to note

There are several points to note regarding then new functionality:

• If a case is manually registered then it can still be withdrawn if required.
• If a case is automatically registered the CMS reporting will not reflect the correct time taken to process and, therefore, it is still preferable to manually register the claim upon receipt.

Introduction

A new DPS facility has been introduced to ensure that upon the death of a client their CSHC eligibility is set to “off”.

Previous Processing

Previously the CSHC eligibility was only recorded in the database as a “SHC” BELI type.  The recording of a date of death (DOD) for a CSHC holder triggers:

• DPS to “Off” the “SHC” BELI (as well as any other BELI) for the DOD
• the card system to remove the card eligibility.

Changes

The introduction of the new CSHC recording facility in VIEW and the (possible) eligibility of CSHC holders to telephone allowance has necessitated the introduction of extra database records.  Unfortunately, technical issues with system environments preclude DPS from being able to update these new records upon a client's death.

New Processing

A new program has been introduced to run immediately following DPS each evening.  DPS will provide the same functionality as it previously did with the new program providing the required updates to the new records.

For each CSHC client that has a DOD recorded and is processed by DPS the following will occur:

• The CSHC eligibility recorded in VIEW (specifically in the CL_BEN_ELIG O* table) will be set to “Off” with “Effective Date” equal to the DOD and “Decision Date” equal to the date of processing.
• A check is made to ensure that the BELI has been turned off.
• If the deceased client has not been reassessed (with a corresponding new DPS assessment) then the file number is inserted into the TA reassessment trigger table (specifically CL_TO_RECORD_TSI).  This is because a DPS reassessment will reassess TA for the deceased and any partner but if this has not occurred the TA reassessment trigger must be set.

DPS Reports

A new section has been added to the daily DPS report which lists the file number, client suffix and unique identifier for any client who has had the CSHC record turned off and TA recalculated.

Points to note

There are several points to note regarding then new functionality:

• This functionality will ordinarily be fully automatic.
• If the case is not processed by DPS automatically then the CSHC record should be checked and set to “Off” in VIEW manually if required.  These cases will appear on the existing DPS report as requiring manual processing.

Attachment 1: Supplementary Claim Form

Commonwealth Seniors Health Card

Telephone allowance:

Surname:_____________________

Given name/s: ____________________