California LifeLine Related Forms and Notices For Carriers

California LifeLine Program (previously known as Universal LifeLine Telephone Service or ULTS)

California LifeLine Program - Rules and Regulations

Decision 20-10-006 - Establishing Specific Support Amounts and Minimum Service Standards for California LifeLine Program and Authorizing replacement of Federal Support for Wireline Participants
Connection/Activation Reimbursement 2016
Resolution T-17337 - Sets the Specific Support Amount Subsidy for the California LifeLine Program at $11.50 effective January 1, 2012.
General Order 153 - (REVISED per Resolution T-17321 and effective December 1, 2011).
Resolution T-17321 - Revises General Order 153 effective December 1, 2011.
General Order 153 - (REVISED per Resolution T-17202 and effective July 1, 2009 - November 30, 2011.)
Resolution T-17202 - Revises General Order 153 to reflect administrative revisions to the California LifeLine Program effective July 1, 2011.
General Order 153 - Public Utilities commission of the State of California - Procedures for administration of the Moore Universal Telephone Service Act effective May 3, 2007.
Decision D.10-11-033 - Adopting forward-looking modifications to California LifeLine Program in compliance with the Moore Universal Telephone Service Act effective November 19, 2010.
Decision D.08.08.029 - Adopting a Pre-Qualification Requirement for the California LifeLine Program and Resolving Remaining Phase 2 Issues effective July 1, 2009. Appendices
Rulemaking R20.02.008 - Docket listing all documents pertaining to California LifeLine rules, documents and decisions.

How to Become a California LifeLine Carrier

For carriers interested in offering California LifeLine service in California, please contact Robert Sansone (robert.sansone@cpuc.ca.gov) to answer any questions and to begin the process of database interface with the 3rd party administrator. Questions related to claims of reimbursement from the ULTS Fund can be addressed to lifelineclaim@cpuc.ca.gov.

California LifeLine Administrator

Administrative Letters

SSA Administrative Letter - 2021
Interim Implementation Cost for September to December 2019 (February 3, 2020)
SSA Administrative Letter - 2020
Amended Claim Instructions for July to August 2019 (August 5, 2019)
Interim Implementation Cost for July to August 2019 (August 5, 2019)
Amended Claim Instructions for April to June 2019 (June 24, 2019)
Interim Implementation Cost for April to June 2019 (June 24, 2019)
Interim Claim Instructions for April to May 2019 (May 20,2019)
Implementation Costs to transition to the new Third-Party Administrator, Maximus (February 11, 2019)
SSA Administrative Letter - 2019
Implementation of the California LifeLine Eligibility Criteria Provisions (August 27, 2018)
Replacement for Form 497 in California LifeLine Claim Filings
CPUC's Executive Director Notice regarding Emergency Consumer Protections for Counties Impacted by the December 2017 Wildfires
SSA Administrative Letter - 2018
SSA Administrative Letter - 2017
California LifeLine Expedited Payment Option (August 4, 2016)
CPUC’s Response to FCC Commissioner Pai’s Request for Information regarding the California LifeLine Program (July 27, 2016)
SSA Administrative Letter - 2016
Claim Payment Schedule Notification (June 8, 2015)
Effective Date on Denials Global Issue (February 12, 2015)
Guidance for Acceptable Identification Documents
SSA Administrative Letter - 2014
Guidance for Advice Letter Components regarding California Lifeline Wireless Services (February 14, 2014)
Revised Administrative Letter - 2013 SSA - Sets the Specific Support Amount Subsidy for the California LifeLine Program at $11.50 effective January 1, 2013.
Specific Support Amount (SSA) - 2013
Notice to All California LifeLine Service Providers (December 3, 2012) - Offering California LifeLine Program Discounts
Notice to All California LifeLine Service Providers (November 30, 2012) - California LifeLine Rates Beginning January 1, 2013
Notice to All Carriers (September 13, 2012) - Implementation Costs to transition to a new third-party administrator, Xerox
Notice to All Carriers (October 14, 2011) - Captioned telephone technology in the California LifeLine program
Notice to All Carriers (September 9, 2011): Implementation of Weighted Average Subscriber Report in compliance with Decision D.10-11-033.
Administrative Letter - Solix Form Name Changes (June 25, 2009)
Notice to All Carriers Providing Residential Telephone Service dated February 27, 2009
September 29, 2008 Workshop Staff Report
Carrier instructions regarding toll-limitation
California LifeLine Program Rates - Effective January 1, 2009

California LifeLine Program Income Limits

Information - Only Filings

California LifeLine Program Flat Rate Cost Factor (CF) pursuant to Decision D.03.01.035

California WIRELESS LifeLine Program - Claim Reimbursement Process

For Claim Periods on or after December 1, 2020

For wireless claims for reimbursement beginning with the December 2020 claim period, please use the California LifeLine Wireless Claim Form Effective 12.1.2020. Instructions and Sample Wireless Claim Form are available.

For Claim Periods on or after December 1, 2019

For wireless claims for reimbursement beginning with the December 2019 claim period, please use the California LifeLine Wireless Claim Form Effective 12.1.2019. Instructions and Sample Wireless Claim Form are available.

For Claim Periods on or after May 1, 2018

For wireless claims for reimbursement beginning with the May 2018 claim period, please use the California LifeLine Wireless Claim Form Effective 05.01.2018. Instructions and Sample Wireless Claim Form are available.

For Claim Period on or after March 1, 2014:

For claim reimbursement after March 1, 2014, please use this version of Wireless California Lifeline Claim Form (G.O. 153, D.14-01-036, D.10-11-033/Res. T-17321), and Instructions.

California LifeLine Program - Claim Reimbursement Process

For Claim Periods on or after December 1, 2020

For wireline claims for reimbursement beginning with the December 2020 claim period, please use the California LifeLine Wireline Claim Form Effective 12.01.2020. Instructions and Sample Wireline Claim Form are available.

For Claim Periods on or after December 1, 2019

For wireline claims for reimbursement beginning with the December 2019 claim period, please use the California LifeLine Wireline Claim Form Effective 12.01.2019. Instructions and Sample Wireline Claim Form are available.

For Claim Periods on or after May 1, 2018

For wireline claims for reimbursement beginning with the May 2018 claim period, please use the California LifeLine Wireline Claim Form Effective 05.01.2018. Instructions and Sample Wireline Claim Form are available.

For Claim Period on or after December 1, 2011:

For claim reimbursement after December 1, 2011, please use this version of California Lifeline Claim Form (G.O. 153, D.10-11-033/Res. T-17321), Instructions, and claim form example with formulae

For Claim Period on or after July 1, 2009:

For claim reimbursement after July 1, 2009, please use this version of California LifeLine Claim Form (G.O. 153 - D.08-08-029 / Res. T-17202) and Instructions

For Claim Period on or before June 30, 2009:

For claim instruction and sample form, please go to G.O.153 Section 9 and Appendix D
For bad debt calculations and information please go to G.O. 153 Section 9.3.9. Sample bad debt spreadsheet should be included with monthly claim.

Claim form and supporting documents can be submitted via e-mail to lifelineclaim@cpuc.ca.gov

California LifeLine Working Group Conference Calls

Agendas
Meeting Minutes
Consumer Affairs Branch Customer Statistics
Top 5 LifeLine Application Denials
Third Party Administrator LifeLine Customer Counts
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