ESBD_356196_1713883676648_Texas Specific Reports.pdf

Procurement Library Page 1 of 164 HHS0013138

Cecile Young, Executive Commissioner

Request for Offers (RFO) for Electronic Benefit Transfer (EBT) Services

RFO No. HHS0013138

Procurement Library, Texas Specific Reports

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Contents

1. INTRODUCTION TO TEXAS SPECIFIC REPORTS

1.2 GUIDELINES FOR USE

1.2.1 REPORT NAMING STRUCTURE

1.3. STANDARD REPORTS

2. FINANCIAL REPORTS

2.1 ACH ACTIVITY – MERCHANT - EBTDS103-5

2.2 ACH TRANSMITTAL LETTER - EBTDS904-1

2.3 AGENCY RECONCILIATION REPORT - EBTDS106-1

2.4 AMA BATCH ISSUANCE REPORT - EBTDS406-1

2.5 AUTHORIZATION BY BENEFIT - EBTDS101-5

2.6 CASH ISSUANCE REPORT - EBTDS409-1

2.7 CLEARING STATEMENT - EBTDS104-1

2.8 CLIENT PAYBACK REPORT - EBTDS118-1

2.9 DAILY ASAP BALANCING - EBTDS408-1

2.10 DELUXE BALANCING STATEMENT - EBTDS105-1

2.11 EBT ACCOUNT ACTIVITY DAILY REPORT - EBTDS119-1

2.12 EBT ACCOUNT ACTIVITY MONTHLY REPORT - EBTMS119-1

2.13 FEE BILLING DETAIL REPORT - EBTMS550-1

2.14 FEE BILL PROCESSOR SUMMARY - EBTMS550-3

2.15 FNS BATCH REPORT - EBTWS905-1

2.16 FNS RETAILER ACTIVITY REPORT (STARS) - EBTWS901-1

2.17 FOOD RETURN TRANSACTION REPORT - EBTMS412-1

2.18 MONEY MOVEMENT ACTIVITY REPORT - EBTDS125-1

2.19 MONEY MOVEMENT SUMMARY REPORT - EBTDS125-2

2.20 PENDING BENEFITS REPORT - EBTDS117-1

2.21 PROGRAM SETTLEMENT BY ACTIVITY - EBTDS127-1

2.22 SETTLED ADJUSTMENTS REPORT - EBTDS221-1

2.23 THIRD-PARTY PROCESSOR SETTLEMENT REPORT - EBTDS126-1

3. SUPPORT REPORTS

3.1. 7 DAYS BENEFIT USE OUT OF STATE – EBTDS134-1

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3.2. ACCOUNTS RECEIVING BENEFIT WITHOUT CARD - EBTDW010-1

3.3. AGED AUTHORIZATION DETAIL - EBTDS279-1

3.4. AGED AUTHORIZATION SUMMARY – COUNTY/LOCAL OFFICE - EBTDS279-2 ..58

3.5. AGED AUTHORIZATION SUMMARY – AGENCY – EBTDS279-3

3.6. AGED AUTHORIZATION ACTION REPORT – EBTDS279-4

3.7. BENEFIT ISSUANCE EXCEPTION REPORT - EBTDS205-1

3.8. CARD ORDER REPORT - EBTDS502-1

3.9. CARD REPLACEMENT EXCEPTION REPORT - EBTMS209-2

3.10. CARDHOLDERS WITH EXCESSIVE RETURNS REPORT - EBTMS577-4

3.11. EXCESSIVE LARGE BALANCE REPORT – EBTMS204-1

3.12. EXPUNGED ACTIVITY REPORT - EBTDS279-5

3.13. MAILED EXCESSIVE CARD NOTICES - EBTMS209-1

3.14. MONTHLY CARD & PIN STATISTICS REPORT - EBTMS211-1

3.15. MULTIPLE CARDHOLDERS TO SAME ADDRESS REPORT - EBTMS577-2

3.16. NET ISSUANCE BY EFFECTIVE DATE - EBTDS135-1

3.17. OUT-OF-STATE CARD REPLACEMENT REPORT - EBTMS212-1

3.18. PIN MAILER REPORT - EBTDS502-2

3.19. VOUCHER ACTIVITY REPORT – CASH - EBTDS124-1

3.20. VOUCHER TRACKING REPORT – CASH - EBTMS440-1

4. STATISTICAL REPORTS

4.1. BORDER STATE SHOPPING SUMMARY REPORT - EBTMS443-2

4.2. FULL FOOD BALANCE WITHDRAWAL REPORT - EBTMS412-2

4.3. MONTHLY PROCESSOR STATISTICS REPORT - EBTMS106-1

4.4. MONTHLY RETAILER ACTIVITY REPORT - EBTMS104-1

4.5. MONTHLY STATISTICAL REPORT - EBTMS444-1

4.6. OUT-OF-STATE SHOPPING SUMMARY REPORT - EBTMS443-1

4.7. OUT OF STATE TRANSACTION REPORT – 060 DAYS - EBTMS415-1

4.8. OUT-OF-STATE TRANSACTION REPORT – 60 DAYS - EBTMS436-1

4.9. TRANSACTION PROCESSING STATISTICS – CASH - EBTMS105-2

4.10. TRANSACTION PROCESSING STATISTICS – FS - EBTMS105-1

5. ON DEMAND REPORTS

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5.1. ADMINISTRATIVE TERMINAL USER REPORT - EBTDS303-1X

5.2. ADMINISTRATIVE TERMINAL USER SUMMARY REPORT - EBTMS303-1

5.2.1 USER ACCESS REPORT - EBTMW304-3

6. BILLING REPORTS

6.1. BILLING AUDIT REPORT - EBTMS516-5

6.2. BILLING CASE SUMMARY - EBTMS516-3

6.3. BILLING DETAIL REPORT - EBTMS516-1

6.4. BILLING EXCEPTION DETAIL - EBTMS516-4

6.5. BILLING SUMMARY - EBTMS516-2

6.6. PEBT BILLING SUMMARY REPORT - EBTMS525-1

7. BATCH REFRESH REPORTS

7.1. BATCH RECORDS ERROR REPORT - EBTRS002-2

8. MANUALLY GENERATED REPORTS

8.1. EBT CALL CENTER WEEKLY CALL SUMMARY REPORT – CLIENT

8.2. EBT CALL CENTER WEEKLY CALL SUMMARY REPORT – RETAILER

8.3. FNS RETAILER REPORT

8.4. MONTHLY SUMMARY – CLIENT AND RETAILER IVR AND HELP DESK CALLS . 139

8.5. PROGRAM MONITORING MANAGEMENT REPORT

8.6. REPORT CARD

8.7. RETAILER MANAGEMENT MONTHLY STATUS REPORT

8.8. ROOT CAUSE ANALYSIS REPORT

8.9. SYSTEM AVAILABILITY REPORT

9. AD HOC REPORTS

9.1. CLIENT STATEMENT

9.2. MERCHANT TRANSACTION SEARCH – DATA WAREHOUSE

9.3. MERCHANT TRANSACTION SEARCH – CURRENT VENDOR AT

10. CODE TABLES

10.1. AT TRANSACTION TYPES

10.2. BENEFIT GROUP / TYPE CODES

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1. INTRODUCTION TO TEXAS SPECIFIC REPORTS

This document provides a sample of each specific Electronic Benefit Transfer (EBT) report for the Texas Health and Human Services Commission (HHSC), along with a description of each report’s structure and use. It also includes a list of the fields for each report and their descriptions.

Some reports outlined in this document are system-generated and are presented here under the reporting category. Other reports presented in this document are generated manually and are presented to the state in Microsoft Excel or other formats.

1.2 GUIDELINES FOR USE

1.2.1 REPORT NAMING STRUCTURE

The EBT reports generated through the Administrative Terminal (AT) follow a set naming structure. Listed below is the breakdown of the codes used within this report naming structure:

Code Description EBT Constant DS Daily report DW Daily Web report MS Monthly report MW Monthly Web report RS Report generated on request RW Web report generated on request WS Weekly report WW Weekly Web report 999 Report number

Note: Transactions completed at a POS are reported in the acquirer’s local date and time. All other transaction times are reported in Central Time (CT).

1.3. STANDARD REPORTS

In addition to the state-specific reports described in this Exhibit, HHSC has also been provided standard vendor reports. The standard reports table below lists the standard current reports that the state has received.

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Current Vendor Standard Report Name Report Number Batch Refresh Total Report EBTRS003-1 ACH Activity Merchant Overdrafts (EBT-only) EBTDS103-4 ACH Activity Summary EBTDS103-3 Adjustment Transaction Activity Report EBTDS230-1 Adjustment Transaction Activity Summary EBTDS230-2 Adjustment Transaction Detail EBTDS220-1 Daily Activity – Authorization EBTDS101-1 Daily Activity Summary EBTDS101-3 Daily Activity – Terminal EBTDS101-2 Repayment Summary (Daily) EBTDS112-2 Store and Forward Activity Report EBTMS434-1 Terminal Activity Report EBTDS102-1 Terminal Activity Summary – Merchant EBTDS102-2 Terminal Activity Summary – State EBTDS102-3 04 Cards Issued in twelve (12) Months – County EBTMS206-1 Admin Activity – Authorizations EBTDS201-1 Admin Activity Summary – County/Local Office EBTDS201-2 Admin Activity Summary – State EBTDS201-3 Balance Inquiry/Withdrawal – FS EBTMS218-3 Card Re-Issue Analysis Detail EBTMS417-1 Card Re-Issue Analysis Summary EBTMS417-3 Card Re-Issue Monthly Summary EBTMS417-2 Card Status Report County Local Office EBTDS210-1 Card Status Report Undelivered – County EBTDS210-4 Card Status Summary EBTDS210-2 Card Status Summary – Agency EBTDS210-3 Denial Code Breakdown Report EBTMS205-1 Denial Code Breakdown Summary EBTMS205-2 Excessive Large Dollar Transactions – FS EBTMS218-1 Manual Card Entry Report – County EBTMS416-1 Manual Card Entry Report – Merchant EBTMS416-2 Multiple Cash Transactions Within 2 Minutes EBTMS422-1 Multiple Withdrawals Same Day – FS EBTMS218-2 PIN Select Month to Date Totals EBTDS202-2 PIN Selection Report EBTDS202-1 Voucher Activity Report – FNS EBTDS122-1

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Batch Refresh Total Report EBTRS003-1 ACH Activity Merchant Overdrafts (EBT-only) EBTDS103-4 ACH Activity Summary EBTDS103-3 Adjustment Transaction Activity Report EBTDS230-1 Adjustment Transaction Activity Summary EBTDS230-2 Adjustment Transaction Detail EBTDS220-1 Daily Activity – Authorization EBTDS101-1 Daily Activity Summary EBTDS101-3 Daily Activity – Terminal EBTDS101-2 Repayment Summary (Daily) EBTDS112-2 Store and Forward Activity Report EBTMS434-1 Terminal Activity Report EBTDS102-1 Terminal Activity Summary – Merchant EBTDS102-2 Terminal Activity Summary – State EBTDS102-3 04 Cards Issued in twelve (12) Months – County EBTMS206-1 Admin Activity – Authorizations EBTDS201-1 Admin Activity Summary – County/Local Office EBTDS201-2 Admin Activity Summary – State EBTDS201-3 Balance Inquiry/Withdrawal – FS EBTMS218-3 Card Re-Issue Analysis Detail EBTMS417-1 Card Re-Issue Analysis Summary EBTMS417-3 Card Re-Issue Monthly Summary EBTMS417-2 Card Status Report County Local Office EBTDS210-1 Card Status Report Undelivered – County EBTDS210-4 Card Status Summary EBTDS210-2 Card Status Summary – Agency EBTDS210-3 Denial Code Breakdown Report EBTMS205-1 Denial Code Breakdown Summary EBTMS205-2 Excessive Large Dollar Transactions – FS EBTMS218-1 Voucher Tracking Report EBTMS420-1 X Cards Issued in Y Months EBTMS206-2 Balance Verification Report EBTDS405-1 Daily Database Value EBTDS404-2 Daily Statistical Report EBTDS404-1 Management Statistics Report EBTMS409-1 Network Statistics Report EBTMS408-1

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Batch Refresh Total Report EBTRS003-1 ACH Activity Merchant Overdrafts (EBT-only) EBTDS103-4 ACH Activity Summary EBTDS103-3 Adjustment Transaction Activity Report EBTDS230-1 Adjustment Transaction Activity Summary EBTDS230-2 Adjustment Transaction Detail EBTDS220-1 Daily Activity – Authorization EBTDS101-1 Daily Activity Summary EBTDS101-3 Daily Activity – Terminal EBTDS101-2 Repayment Summary (Daily) EBTDS112-2 Store and Forward Activity Report EBTMS434-1 Terminal Activity Report EBTDS102-1 Terminal Activity Summary – Merchant EBTDS102-2 Terminal Activity Summary – State EBTDS102-3 04 Cards Issued in twelve (12) Months – County EBTMS206-1 Admin Activity – Authorizations EBTDS201-1 Admin Activity Summary – County/Local Office EBTDS201-2 Admin Activity Summary – State EBTDS201-3 Balance Inquiry/Withdrawal – FS EBTMS218-3 Card Re-Issue Analysis Detail EBTMS417-1 Card Re-Issue Analysis Summary EBTMS417-3 Card Re-Issue Monthly Summary EBTMS417-2 Card Status Report County Local Office EBTDS210-1 Card Status Report Undelivered – County EBTDS210-4 Card Status Summary EBTDS210-2 Card Status Summary – Agency EBTDS210-3 Denial Code Breakdown Report EBTMS205-1 Denial Code Breakdown Summary EBTMS205-2 Excessive Large Dollar Transactions – FS EBTMS218-1 Network Statistics Summary EBTMS408-2 Out of State Activity Report EBTMS413-1 Transaction Frequency Report EBTMS410-1 Transaction Statistics by Hour EBTMS409-2 Transaction Summary by Day EBTMS409-4 Transaction Summary by Hour EBTMS409-3 Access Definition Report EBTMW304-2

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Batch Refresh Total Report EBTRS003-1 ACH Activity Merchant Overdrafts (EBT-only) EBTDS103-4 ACH Activity Summary EBTDS103-3 Adjustment Transaction Activity Report EBTDS230-1 Adjustment Transaction Activity Summary EBTDS230-2 Adjustment Transaction Detail EBTDS220-1 Daily Activity – Authorization EBTDS101-1 Daily Activity Summary EBTDS101-3 Daily Activity – Terminal EBTDS101-2 Repayment Summary (Daily) EBTDS112-2 Store and Forward Activity Report EBTMS434-1 Terminal Activity Report EBTDS102-1 Terminal Activity Summary – Merchant EBTDS102-2 Terminal Activity Summary – State EBTDS102-3 04 Cards Issued in twelve (12) Months – County EBTMS206-1 Admin Activity – Authorizations EBTDS201-1 Admin Activity Summary – County/Local Office EBTDS201-2 Admin Activity Summary – State EBTDS201-3 Balance Inquiry/Withdrawal – FS EBTMS218-3 Card Re-Issue Analysis Detail EBTMS417-1 Card Re-Issue Analysis Summary EBTMS417-3 Card Re-Issue Monthly Summary EBTMS417-2 Card Status Report County Local Office EBTDS210-1 Card Status Report Undelivered – County EBTDS210-4 Card Status Summary EBTDS210-2 Card Status Summary – Agency EBTDS210-3 Denial Code Breakdown Report EBTMS205-1 Denial Code Breakdown Summary EBTMS205-2 Excessive Large Dollar Transactions – FS EBTMS218-1 Failed Logon Report EBTDW301-1 Logon/Logoff Report EBTDW503-1 Session Activity Monthly Report EBTMS302-1 Session Activity Monthly Summary Report EBTMS302-2 Session Activity Report EBTDS302-1 Session Activity Summary Report EBTDS302-3

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HHS0013138

2. FINANCIAL REPORTS

This section provides a detailed description of each Financial Report specific for HHSC. The Financial Reports are used to audit money movement and settlement of the Contractor EBT system.

2.1 ACH ACTIVITY – MERCHANT - EBTDS103-5

The daily ACH Activity – Merchant EBTDS103-5 report identifies all EBT-only merchant deposits for each merchant Business Day. An EBT-only merchant is a retailer that has contracted directly with current vendor for POS terminal services and support and includes both Food and Nutrition Services (FNS) Exempt and Non-Exempt retailers. This is a state level report.

Report Frequency Daily.

Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

b. Current vendor Management – Federal Reporting

c. Current vendor Management – Accounts Payable

d. Inspector General

e. Lone Star Business Services

* The primary report user is listed in bold type.

ACH Activity-Merchant

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Field Name Description

Setdate The business date of the report.

Rundate The date the report was created.

Merchant The name of the retailer receiving the ACH deposit.

Merch ID Merchant ID. A unique number assigned by the processor to identify the retailer.

FNS

Number

The retailer’s unique 7-digit FNS number that was assigned by the FNS. The FNS number identifies the retailer.

Location The retailer address location of record.

Avail Date The date the ACH deposit is available at the retailer’s financial institution

Post Date The date the deposit was submitted to the ACH

Deposit Amount

The dollar amount to be deposited to the retailer's account. If a retailer has overdrawn their account, a negative (-) amount is shown. An overdraft occurs when the dollar amount of the retailer’s return transaction exceeds the dollar amount of their sales.

Total The total count and dollar amount of deposits made through the ACH for the Business Day.

2.2 ACH TRANSMITTAL LETTER - EBTDS904-1

The ACH Transmittal Letter EBTDS904-1 summarizes the ACH files sent to the Contractor’s bank to initiate the transactions with the banking system at the Federal Reserve for Merchant Deposits, Fee Reimbursements, and State Funding. The report is created daily for Merchant Deposits. Fee Reimbursements are reported on the same report with the daily Merchant Deposits on the 7th calendar day of the next calendar month, when Fee Reimbursements are paid for the previous calendar month’s activity. State Funding is reported daily, but on its own separate ACH Transmittal Letter report.

Report Frequency Daily. (Fee Reimbursements are reported monthly.)

Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

b. Current vendor Management – Federal Reporting

c. Current vendor Management – Accounts Payable

d. Inspector General

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ACH Transmittal Letter This ACH Transmittal Letter was created on the seventh (7th) calendar day of the month and includes Fee Reimbursements for the previous calendar month.

ACH Transmittal Letter for State Funding State funding is reported daily on its own ACH Transmittal Letter.

Field Name Description

Setdate The business date of the report.

Rundate The date the report was created.

Origin The date the report was created.

Company The creator of the file; eFunds.

Transmission Date

The date the ACH file was created.

Transmission Time

The time the ACH file was created. The time is expressed in 24-hour format hh:mm:ss.

File Name The filename of the ACH file transmitted to the Contractor’s Bank.

Batch The ACH transactions are grouped together into like transactions called batches.

Each batch in the ACH file is assigned a sequential batch number.

Descriptive Information

Describes the group of transactions batched together. Possible types are:

a. MERCHANT DEPOSITS – EBT settlement to the EBT-only retailers that have contracted directly with the current vendor for POS terminal service and support.

b. FEE REIMBURSEMENTS – Cash fees paid to EBT-only retailers and TPPs for cash withdrawal fees. Fee reimbursements are paid once a month and are reported on the seventh (7th) calendar day of each month for the

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c. STATE FUNDING – ACH debit to the State Comptroller’s bank account for all Cash Settlement for the day for TPPs and retailers that have contracted directly with the current vendor for POS Terminal service and support.

Eff Date Effective Date. The date that the benefits should be credited or debited to bank accounts.

Entry Count The number of entries in the batch file.

Total Debits The sum of all debit records in the batch file.

Total Credits The sum of all the credit records in the batch file.

Total for File Batch

The number of Batch files in the ACH File

Entry Count Number of entries in the ACH file.

Total Debits Sum of all the debit records in the ACH file.

Total Credits Sum of all the credit records in the ACH file.

Blocks on File Number of records on the file divided by 10.

2.3 AGENCY RECONCILIATION REPORT - EBTDS106-1

The Agency Reconciliation Report EBTDS106-1 provides the settlement amount, previous suspense, current suspense, and daily activity for the State of Texas by benefit type.

Report Frequency Daily.

Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

b. Current vendor Management – Federal Reporting

c. Current vendor Management – Accounts Payable

d. Inspector General

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Agency Reconciliation Report

Rundate The date the report was created.

Benefit Type The name of the benefit type. Refer to Section 10.2, Benefit Group/Type Codes of this document for a list of the state-identified benefit types.

Settlement The total amount of all approved transactions from the store's settlement for the previous Business Day until the store's settlement for the current Business Day.

This total also summarizes the daily activity. This is the amount of money that is moved for the EBT-only retailer or TPP. This amount can also be found on the current day’s Clearing Statement EBTDS104-1.

Previous Suspense

The total that was reported in the Current Suspense field on the previous day's report. This total must be removed from the settlement total when calculating the Daily Activity total. If this is the first activity for a terminal, the count and net amount will be zero.

Current Suspense

The total for the transactions that took place after the store's settlement for the current day (ACH cutoff 7:10 p.m. ET). This total must be added to the settlement total when calculating the Daily Activity total.

Daily Activity The total of all transactions listed on the report. It is also the total of activity at the terminal during the Business Day. These reports are for HHSC.

Total The sum of the benefit type totals.

2.4 AMA BATCH ISSUANCE REPORT - EBTDS406-1

The AMA Batch Issuance Report EBTDS406-1 summarizes food benefit authorization activity by effective date to allow easier tracking of the automated entries made to AMA. This report contains the data contained in the AMA batch issuance file.

Report Frequency Daily.

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Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

b. Current vendor Management – Federal Reporting

c. Current vendor Management – Accounts Payable

d. Inspector General

Rundate The date the report was created.

File Sequence Number

The sequence number assigned to the AMA Batch Issuance file by the current vendor.

Letter of Credit The default Letter of Credit is SNAP, however if the state has more than one Letter of Credit for food benefits, the AMA Batch Issuance data for each Letter of Credit will be listed on a separate page with the corresponding Letter of Credit description. This will enable a state to recognize which AMA Batch Issuance Report Data corresponds to which Letter of Credit.

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Transaction Date

The date the AMA batch issuance file was transferred.

Transaction Time

The time the AMA batch issuance file was transferred.

Tran Code • IS – Issuance The amount of benefits placed in recipient accounts. This is the total amount of benefit authorizations, by benefit effective date, received during the processing day.

• IO - Issuance Other Reserved; to be used in the event FNS needs to separately identify a particular type of issuance. This category is currently not used by the current vendors AT system.

• RC - Return Coupon Amount removed from the recipient EBT account when converting benefits to coupons. This category is used for food benefit conversions to coupons and for food benefit conversions to cash.

• RE - Return Expungement Amount removed from the recipient accounts when expunged due to inactivity. Benefit authorizations that reach the final aging period and are sent back to the state.

Effective Date The availability date of benefits.

Amount The total dollar amount of each transaction code listed above. These amounts can also be found on the Daily Statistical EBTDS404-1 report.

IS (Auth) Total The sum of all benefit authorizations in the batch file.

IO (Other) Total

The sum of other benefit issuances in the batch file. This value is not currently used in the vendor EBT system.

RC (Conv) Total

The sum of food benefits converted to coupons or cash in the batch file.

RE (Aged) Total

The sum of expunged benefits in the batch file that were returned to the state.

Batch Total The aggregate total of all totals listed above. The aggregate total is the sum of the numbers; it includes debits and credits. This amount correlates with the total amount listed in the AMA Batch Issuance file sent to the Federal Reserve.

Net Insurance Amount

The net SNAP issuance for each Effective Date, as reported in the AMA Batch Issuance file.

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2.5 AUTHORIZATION BY BENEFIT - EBTDS101-5

The Authorization by Benefit - EBTDS101-5 report lists benefit transactions that have occurred for cases (by county) on the reporting day. Benefit transactions affect the entire benefit authorization, so this report includes both initial authorizations (i.e., new benefits) and expunged authorizations (i.e., benefits that are being removed from the client’s account).

Report Frequency Daily.

Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

Rundate The date the report was created.

Case Number A unique number provided by HHSC that identifies each client. Also known as the state EDG number.

Transaction Benefit

Date The date of the benefit authorization.

Time The time of the benefit authorization.

Type The name of the benefit type. Refer to Section 10.2, Benefit Group/Type Codes of this document for a list of the state-identified benefit types. Each Benefit Type is configured as either cash or food benefits. All food benefits

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Terminal ID The identification number of the terminal where the transaction occurred.

User ID User Identification. The user identification number of the person using the Terminal.

Transaction SRC (Source) The source of the transaction. Possible values are:

a. AGE – Aging Process

b. REF – Refresh File

Refer to the Transaction Source Codes table in Section 10, Code Tables of this document for a complete list of these values.

TYP (Type) Valid transaction types for this report are:

a. AU – Authorization

b. AGE – Cancellation of authorization through the aging process

Refer to the Transaction Type Codes table in Section 10, Code Tables of this document for a complete list of these values.

Auth No. Authorization Number. The number assigned by the state under which the benefit authorization was issued to the client.

Available Date The date the benefit was made available to the client.

Available Time

The time the benefit was made available to the client.

Amount The dollar value of the benefit authorization.

Total The total count of transactions and total dollar amount by benefit type.

Total The grand total count of transactions and total dollar amount.

2.6 CASH ISSUANCE REPORT - EBTDS409-1

The Cash Issuance Report EBTDS409-1 summarizes cash benefit authorization activity for the reporting day by effective date. The totals reflect all cash authorization activity for the reporting day regardless of whether the transactions were processed online, through batch or as part of system processing. Totals on this report match the current day’s cash benefit totals on the Daily Statistical Report EBTDS404-1 and the Database Value Report EBTDS404-2. The transaction detail for the totals reported on this report can be found on the Daily Activity – Authorization Report EBTDS101-1. State EBT staff can use this report for cash balancing and reconciliation.

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Report Frequency Daily.

Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

b. Lone Star Business Services

Rundate The date the report was created.

Tran Code a. Issuance The amount of benefits placed in recipient accounts. This is the total amount of benefit authorizations, by benefit effective date, received during the processing day.

b. Cancellations Benefits that were previously issued by the state and now canceled. Canceled benefits are no longer available to the recipient and are removed from the value of the database. The effective date of a cancelation is the date they are canceled on the system.

c. Expungement (Aged Benefits) Amount removed from recipient accounts when expunged due to inactivity. Benefit authorizations that reach the final aging period and are sent back to the state. The effective date of an aged benefit is the day that it is expunged on the system.

d. Repayment Benefits removed from recipient accounts as a voluntary claim repayment. The effective date of a repayment is the date it is processed on the system.

e. Expiration Benefits that have hit their expiration date and have been swept off the database. The effective date is the date they are swept; when they reduce the value of the database.

Effective The availability date of a benefit (Auth) or the date the transaction is processed

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Date (Cancellation, Expungement, Repayment and Expiration).

Amount The cumulative total amount for each transaction code by effective date.

Total The cumulative total for each transaction code for the reporting day. These amounts can also be found on the Daily Statistical Report EBTDS404-1 and the Database Value Report EBTDS404-2.

2.7 CLEARING STATEMENT - EBTDS104-1

The Clearing Statement EBTDS104-1 recaps all financial activity for which funds must be transferred by the state or federal government agencies to offset money moved to various settlement endpoints (pay for cash and food provided to clients). This is a state level report.

The Clearing Statement is used to create the Automated Standard Application for Payments (ASAP), also referred to as draw-down. It is also used by the state to transfer funds for the cash transactions. Totals on this report can be verified from the ACH Activity Summary EBTDS103-3 and Terminal Activity Summary - State EBTDS102-3 reports.

The EBT staff or the financial staff can use this report to review the financial activity and the draw-down for the Business Day.

Report Frequency Daily.

Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

b. Current vendor Management – Federal Reporting

c. Current vendor Management – Accounts Payable

d. Inspector General

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Clearing Statement

This sample report page shows daily totals.

Field Name Description

Setdate The business date of the report.

Rundate The date the report was created.

Benefit Type The name of the benefit type. Refer to Benefit Group/Type Codes table in Section 10, Code Tables of this document for a list of the state-identified benefit types.

Each Benefit Type is configured as either cash or food benefits. All food benefits must be authorized by the state and are paid from external sources (usually withdrawn from a Letter of Credit). All cash benefits are administered by the state and paid from state accounts.

Cash The amount of authorized funds for payment by the state. Negative amounts are indicated by a trailing minus sign (-). A positive amount represents a deposit to the merchant or network.

Food The amount of authorized funds for payment by the Letter of Credit. Negative amounts are indicated by a trailing minus sign (-). A positive amount represents a deposit to the merchant or network.

Total The sum of the Cash and Food fields. Negative amounts are indicated by a trailing minus sign (-).

EBT

Gateway

The current vendor EBT Gateway for EBT transactions coming from third-party processors (TPPs).

Merchant The transaction coming from EBT-only retailers, both state-supported and non-

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ACH exempt.

ACH Total This field is the sum of the cash and food benefit Merchant ACH totals.

Total Settled (Texas

HHSC,

Letter of Credit - SNAP, and Total Settled)

A total is calculated as a sum for each of the columns, adding the EBT Gateway total and the ACH total. These totals are shown for cash as payment from the Texas HHSC, for food benefits as payment from the Letter of Credit, and for Total as Total settled. Points A, B, C, and D marked on the sample report above are described below:

a. The total for EBT Gateway is the amount of money moved to TPP accounts.

b. The ACH Total is the amount of money moved to EBT-only retailer accounts.

c. The amount listed for the department is the total amount of money to be moved to a current vendor account for cash transactions to be paid by the state.

d. The Letter of Credit is the amount of money to be moved to a current vendor account for food benefit transactions funded by the FNS. This is the amount of money to be transferred via ASAP.

Totals The summary, by benefit type, of what is settled to both the EBT Gateway (for network and TPPs) and the EBT-only merchants

MTD Totals The summary by month, by benefit type, of the totals settled. The monthly totals are reset on the first of every month.

YTD Totals The summary by year, by benefit type, of the totals settled. The yearly totals are reset on January 1 of every year.

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2.8 CLIENT PAYBACK REPORT - EBTDS118-1

The Client Payback Report EBTDS118-1 provides a list of the benefits (by benefit type) that have been retrieved by the state from clients as a repayment transaction each Business Day. The report also includes the total count and dollar amounts retrieved for each benefit type and the cumulative count and dollar amount for all benefit types.

Report Frequency Daily.

Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

b. Current vendor Management – Federal Reporting

c. Current vendor Management – Accounts Payable

d. Inspector General

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Field Name Description

Setdate The business date of the report.

Rundate The date the report was created.

Benefit Type The benefit type for each overpayment. Refer to the Benefit Group/Type Codes table in Section 10, Code Tables of this document for a list of the state-identified benefit types.

Ben Month Benefit Month. The month of qualification for the benefit.

Ben Avail Date

Benefit Availability Date. The date the benefit was made available to the client.

Case Number A unique number provided by the state that identifies each client. Also known as the state EDG number.

SNN The last four (4) digits of the Social Security Number of the client associated with the case number.

Case Name The name of the client associated with the case and card number.

Auth Number Authorization Number. The number assigned by the state under which the benefit authorization was issued to the client.

Amount The authorized repayment amount.

Balance Remaining

The dollar amount remaining in the client’s account after the repayment is processed.

Date Time The date and time of the repayment transaction. The date is provided in mm/dd/yyyy format. The time is provided in twenty-four (24) hour format hh:mm:ss.

Type The Type code indicates the reason for the repayment.

a. Client Error.

b. Agency Error.

c. Fraud.

Benefit Type Total Count and Amount

The total number of transactions and the total dollar amount overpaid for the benefit type.

Total Count and Amount

The cumulative number of transactions and the cumulative dollar amount overpaid for all benefit types listed on the report.

2.9 DAILY ASAP BALANCING - EBTDS408-1

The Daily ASAP Balancing EBTDS408-1 report summarizes food benefit activity on the current vendor’s system, providing the state with the ability to validate that the food benefits on the current

Procurement Library Page 25 of 164 vendor’s EBT system, by available date and total outstanding liability, balance to the State’s Letter of Credit in the Federal Reserve’s ASAP System. It further summarizes daily and previous month totals for issuance, cancellations, expungements, repayments, conversions, and expirations. This is a state level report.

Report Frequency Daily.

Report Output Format CSV, PDF, TXT.

User Groups a. Comptroller’s Office*

b. Current Vendor Management – Federal Reporting*

c. Lone Star Business Services

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Field Name Description

Setdate The business date of the report.

Rundate The date the report was created.

Issuance Availability Date Balance to ASAP

This field provides a means for the state to balance the Issuance (issuance, cancellations, expungements, repayment, FS conversions and expirations) and settlement recorded on the current vendors AT to the State’s Letter of Credit in the Federal Reserve’s ASAP System based on effective date.

ASAP

Beginning Balance

This amount represents the ending balance in ASAP for the calendar date of the Setdate of this report (i.e., the report Setdate of 01/06/xx equals the ASAP ending balance on 01/06/xx). This amount is the previous day’s ASAP Ending Balance.

Tran Code a. IS Issuance.

b. PY Payment.

AMA Rpt Setdate

This is the date of the AMA Batch Issuance Report EBTDS406-1, which lists the supporting detail for this entry.

Clearing Stmt Rpt Setdate

This is the date of the Clearing Statement EBTDS104-1, which lists the supporting detail for this entry.

ASAP

Applied Date

The date which these entries should be applied to the Federal Reserve’s ASAP System’s LOC for the state. This is the availability date for which we are balancing the current vendors AT to the state’s ASAP Account. This date will be the report’s Setdate plus 1 (i.e., the report Setdate of 01/06/xx equals the ASAP Applied Date of 01/07/xx.)

Benefit Eff Date

If the Tran Code of the line item is IS, this is the benefit effective date assigned to issuance, cancellations, expungements, repayments, and FS conversions.

This date will be the report’s Setdate plus 1 or just the Setdate (i.e., the report Setdate of 01/06/xx equals the Benefit Eff Date of 01/07/xx.)

If the Tran Code of the Line item is PY, this is the drawdown entry for settlement. This is the date this entry should be applied to the Federal Reserve’s ASAP system’s LOC for the state. This date will be the report’s Setdate plus 1 (i.e., the report Setdate of 01/06/xx equals the Benefit Eff Date of 01/07/xx.)

Increase This is the credit amount that should be applied to the Federal Reserve’s ASAP System’s LOC for the state, which represents the net amount of issuance, cancellations, expungements, repayments, and FS conversions for the ASAP Applied Date for the business date that coincides with the Setdate on the AMA Report.

Decrease If the Tran Code of the line item is IS, this is the debit amount that should be applied to the Federal Reserve’s ASAP System’s LOC for the state, which

Procurement Library Page 27 of 164 represents the net amount of issuance, cancellations, expungements, repayments and FS conversions for the ASAP Applied Date for the business date that coincides with the Setdate on the AMA Report.

If the Tran Code of the line item is PY, this is a debit amount that should be applied to the Federal Reserve’s ASAP System’s LOC for the state, which represents the amount of settlement for the Setdate of the report.

ASAP Ending Balance

The ASAP Ending Balance is the sum of the ASAP Beginning Balance plus the Increase Amounts, minus the Decrease Amounts. This amount is compared to the ASAP Account Statement Inquiry balance in the Federal Reserve’s System for the date equal to the Setdate plus 1 of this report. These figures should agree.

Note: These figures will not agree on weekends or federal holidays when ASAP transactions are not processed. Any other discrepancies should be investigated immediately.

Issuance Availability Date Totals for (Date = Report

SETDATE)

Lists the issuance, net issuances, cancellations, expungements, repayments, FS conversions, and expirations processed on the current vendors AT for the listed availability date. The Issuance Availability Date is set by HHSC. The Availability Dates for cancellations, expungements, repayments, and FS conversions are based on the date the transaction is processed on the current vendors AT.

Note: If an issuance is processed after the Setdate of the report, it will not be reflected in this total.

Net Issuance The net amount of issuances and cancellations based on the benefits available date, regardless of the date the benefit cancellation transaction was processed.

(For example: A benefit with an available date of 01/06 and cancelled on 12/28.) The Issuance and Cancellations are netted in the total reported for 01/06.

Previous Month Issuance Availability Date Totals

Lists the issuance, cancellations, expungements, repayments, FS conversions, and expirations processed on the current vendors AT with availability within the previous month. The issuance availability date is set by HHSC. The availability dates for cancellations, expungements, repayments, and FS conversions are based on the date the transaction is processed on the current vendors AT. This field can be used by the EBT staff or the financial staff who complete the FNS-46 Issuance Reconciliation Report as required by 7 CFR 274.4.

Database Value Balance to ASAP

This field provides a means for HHSC to validate that the total outstanding liability for food benefits on the current vendors AT balances to the State’s Letter of Credit in the Federal Reserve’s ASAP System.

2.10 DELUXE BALANCING STATEMENT - EBTDS105-1

The Deluxe Balancing Statement EBTDS105-1 pulls together the debits and credits of the settlement process for the reporting day and shows that the settlement process is in balance when the net amount for the EBT Gateway and the ACH Account Balance equals zero. This information https://www.fns.usda.gov/snap/admin/state-option-guidance https://www.ecfr.gov/current/title-7/subtitle-B/chapter-II/subchapter-C/part-274/section-274.4 https://www.ecfr.gov/current/title-7/subtitle-B/chapter-II/subchapter-C/part-274/section-274.4

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Report Frequency Daily.

Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

b. Current vendor Management – Federal Reporting

c. Current vendor Management – Accounts Payable

d. Inspector General

Rundate The date the report was created.

EBT

Gateway

The amount of money debited from the current vendor settlement account and moved to TPP accounts for payment of EBT Gateway transactions. This amount corresponds with the EBT Gateway Total on the Clearing Statement EBTDS104-1 for the same report setdate.

ACH

Originating Account

Direct Deposits Direct deposits do not apply for Texas.

Merchant Deposits The amount of money debited from the current vendor settlement account and moved to EBT-only retailer accounts, both state-supported and non-exempt.

This amount corresponds with the Merchant ACH Total on the Clearing Statement EBTDS104-1 for the same report setdate.

Letter of Credit The Letter of Credit is the amount of money moved (credited) to a current vendor

Procurement Library Page 29 of 164 settlement bank account for SNAP transactions funded by the FNS and processed by either TPPs or EBT-only retailers (EBT Gateway or ACH transactions). This is the amount of money transferred via ASAP. This amount corresponds with the Letter of Credit – SNAP amount on the Clearing Statement EBTDS104-1 for the same report setdate.

Texas Health and Human Service The amount listed for the department is the total amount of money moved to a current vendor settlement bank account for transactions to be paid by HHSC.

This amount corresponds with the Texas HHSC amount on the Clearing Statement EBTDS104-1 for the same report setdate.

ACH Account Balance

The debit totals, credit totals, and net amount for the ACH originating activity.

The net amount of the debits and credits added together should equal zero when the system is in balance.

2.11 EBT ACCOUNT ACTIVITY DAILY REPORT - EBTDS119-1

The EBT Account Activity Daily Report EBTDS119-1 summarizes all the Business Day’s activities, both financial and non-financial, that affect the benefit account balances. The report is broken down by benefit type and then sorted by benefit year and Federal Fiscal Year (FFY). It includes all benefit years for which there is account activity to report for the Business Day. The summaries are listed in reverse order, with the daily activities that affect the oldest benefit year first and the daily activities that affect the current benefit year last on the report page.

Report Frequency Daily.

Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

b. Current vendor Management – Federal Reporting

c. Current vendor Management – Accounts Payable

d. Inspector General

e. QA

f. Lone Star Business Services

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Rundate The date the report was created.

Benefit Type

Benefit Type. The EBT Account Activity report is broken down by each of the four (4) benefit types. Refer to the Benefit Group/Type Codes table in Section 10, Code Tables of this document for a list of the state-identified benefit types.

Note: The EBT Account Activity Report EBTDS119-1 includes all benefit types for which there is activity to report.

State FY State Fiscal Year (SFY). The SFY runs from September through August.

Account activities are sorted on the report by SFY and FFY. The report includes all current vendor years for which there is current account activity to report.

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Federal FY

Federal Fiscal Year (FFY). The FFY runs from October through September of each year. Account activities are sorted on the report by SFY and FFY. The report includes all current vendor years for which there is current account activity to report.

Opening Balance

The balance of debits and credits at the start of the Business Day (or month, if viewing the monthly version of this report) for the specified SFY.

Transaction Types

The activity for the SFY and FFY is summarized by the following transaction types:

a. ADJUSTMENTS –The net amount of settled (debit and credit) transaction claim disputes.

b. AGED-INACTIVITY – (Aged Cancel)

c. AGED-LAPSE TANF– TANF benefits expunged after two (2) years, at the end of the benefit year (August 31).

d. AT EXPEDITED

e. AT TIMELY AUTH

f. BALANCE INQUIRY

g. CANCELATIONS

h. CASH PURCH CB

i. CASH PURCHASE

j. CASH WITHDRAWAL

k. FS PURCHASE

l. FS RETURN

m. REGULAR AUTH – Monthly Authorization

n. REPAYS-NONSETL – (Client Payback) Non-settling transactions.

o. REVERSALS – Net of both debits and credits.

p. SUPPLEMENTAL

q. VOIDS – Net of both debits and credits.

r. VOUCHER CLEAR – Vouchers that were settled (debited from the client and paid to the retailer). Includes vouchers cleared on the portal, cleared through a POS device, and paper vouchers received from a retailer and cleared by the help desk.

Note: The report lists only the transaction types for which there is current activity to report

Count The number of transactions processed during the current Business Day (or current month if viewing the monthly version of this report) for each transaction type.

Account The dollar value of the transactions processed during the current Business Day (or current month if viewing the monthly version of this report) for each

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Value transaction type.

Financial Value

Benefits authorizations have an account value, but do not have a financial value until they are redeemed.

New Account Balance

The new account value and cumulative financial value of the transactions processed during the current Business Day (or current month if viewing the monthly version of this report) for the specified SYF and FFY combination.

2.12 EBT ACCOUNT ACTIVITY MONTHLY REPORT - EBTMS119-1

The EBT Account Activity Monthly Report EBTMS119-1 summarizes all the month’s activities, both financial and non-financial, that affect the benefit account balances. The report is broken down by benefit type, and then sorted by SFY and FFY. It includes all benefit years for which there is account activity to report for the current month. The summaries are listed in reverse order, with the month’s activities that affect the oldest benefit year on the first page and the month’s activities that affect the current benefit year on the last report page.

Report Frequency Daily.

Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

b. Current vendor Management – Federal Reporting

c. Current vendor Management – Accounts Payable

d. Inspector General

e. QA

f. Lone Star Business Services

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For a detailed description of each of the fields in the EBT Account Activity Monthly Report, see the Field Descriptions for the EBT Account Activity Daily Report – EBTDS119-1 in this Exhibit.

2.13 FEE BILLING DETAIL REPORT - EBTMS550-1

The monthly Fee Billing Detail Report EBTMS550-1 lists by processor and retailer all transactions in the month for which the retailer will be paid the cash withdrawal fee of $0.50 per transaction.

Cash fees are only paid to the retailer for a client’s first two (2) cash withdrawal transactions in the month of $50 or more. No fee is paid if the transaction includes a client purchase. Fees are paid to the retailers on the 7th calendar day of the month for the previous month’s activity.

Report Output Format CSV, PDF, TXT

Procurement Library Page 34 of 164

User Groups a. Finance and Contract Operations*

b. Current vendor Management – Federal Reporting

c. Current vendor Management – Accounts Payable

d. Inspector General

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Field Name Description

Setdate The last calendar date of the month for which the report was generated. This report includes all activity for the calendar month.

Rundate The date the report was created.

Processor

ID

A unique number assigned by the current vendor identifying the processor.

Merchant

ID

A unique number assigned by the processor to identify the retailer.

PAN The primary account number issued and printed on the front of the card.

Transaction Date

The date of the transaction.

Transaction Time

The time of the transaction.

Terminal Time

The identification number of the terminal.

Transaction Amount

The dollar amount of the transaction.

Transaction Type

The Transaction Type is always CW for cash withdrawal.

Transaction Fee Amount

The dollar amount of the transaction fee.

Merchant Totals

Merchant ID A unique number assigned by the processor to identify the retailer.

Total Transactions The number of cash withdrawal fee transactions paid to the retailer.

Total Fees The total dollar amount of cash withdrawal fees paid to the retailer.

Processor Tables

Processor ID A unique number assigned by the current vendor identifying the processor.

Total Transactions The number of cash withdrawal fee transactions handled by the processor.

Total Fees The total dollar amount of cash withdrawal fees handled by the processor.

2.14 FEE BILL PROCESSOR SUMMARY - EBTMS550-3

The Fee Bill Processor Summary EBTMS550-3 is a monthly report that summarizes the total number of cash withdrawal transactions and fees to be reimbursed to each TPP/retailer for the month. Cash fees are only paid to the retailer for a client’s first two (2) cash withdrawal

Procurement Library Page 36 of 164 transactions of $50.00 or more in the calendar month. No fee is paid if the transaction includes a purchase. Fees are paid to the TPPs on the 7th calendar day of the month for the previous calendar month’s activity.

Report Frequency Monthly.

Report Output Format CSV, PDF, TXT.

User Groups a. Finance and Contract Operations*

b. Current vendor Management – Federal Reporting

c. Current vendor Management – Accounts Payable

d. Inspector General

EBTMS550-3 TEXAS HEALTH AND HUMAN SERVICE – TXHHSC

SETDATE: 12/31/XX

PAGE:

FEE BILL PROCESSOR SUMMARY RUNDATE: 12/31/XX

PROCESSOR ID MER HANT TOTAL TRANSACTIONS TOTAL FEES

1888001001 000000000001234 1 .50 1888001001 000000000001235 1 .50

1888001001 000000000001236 4 2.00

1888001001 000000000001237 4 2.00

1888001001 000000000001238 1 .50

1888001001 000000000001239 1 .50

1888001001 000000000001240 1 .50

1888001001 000000000001241 1 .50

1888001001 000000000001242 1 .50

1888001001 000000000001243 1 .50

1888001001 000000000001244 1 .50

1888001001 000000000001245 1 .50

1888001001 000000000011246 3 1.50

1888001001 000000000011247 4 2.00

1888001001 000000000011248 2 1.00

TEXAS HEALTH AND HUMAN SERVICE – TXHHSC SETDATE: 12/31/XX PAGE: 3

FEE BILL PROCESSOR SUMMARY RUNDATE: 12/31/XX

000000000591249 1 .50 000000000621250 1 .50 000000000631251 2 1.00 000000000631253 1 .50 000000000631254 7 3.50 000000000811255 1 .50 000000000851256 2 1.00 000000000941257 41 320.50 000000000961258 2 1.00

KRKW8018071259 1 .50

KRKW8018071260 1 .50

747 373.50

EBTMS550-3

1888089007 1888089007 1888089007 1888089007 1888089007 1888089007 1888089007 1888089007 1888089007 1888113009 1888113009

Fee Bill Processor Summary

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Field Name Description

Setdat…