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Effective: March 1, 2008 | |
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20.30.05 - MinnesotaCare Income Changes |
Clients must report changes following policy found in Income Changes and the policy explained in this section for MinnesotaCare (MCRE).
Income Change - Between Renewals.
Act on all income changes reported at renewal.
Require verification of income at renewal whether reported prior to or at renewal.
Income Change - Between Renewals
Clients are required to report changes in income within 10 days of the change.
Act immediately on an income change when reported.
l Households that voluntarily cancel coverage due to active military duty may re-enroll following the tour of duty without regard to increases in income or assets. Disregard increases in income or assets reported at the time of or after re-enrollment until the household’s annual renewal. See Special Provisions - Active Military Duty.
l Provide 10-day notice of any negative actions.
l Do not require verification of an income change.
l Update MMIS information to decrease or increase the premium amount.
l Document changes in case notes.
Example:
Ellen contacts her worker and reports she has received a wage increase.
Action:
Act upon the change immediately. Provide 10-day notice for any negative
actions, including an increase in premium amount.
Example:
On May 21, Rita calls to report her husband, Karl, left the household.
Karl did not have coverage, but his income was counted to determine the
household's premium.
Action:
Act to remove Karl's income and decrease the household size immediately.
Example:
Anthony calls his worker to report that his Unemployment Insurance (UI)
stopped and he began a job. The wages he reports from the job are higher
than the UI and would result in an increased premium.
Action:
Act on the change to increase Anthony’s premium giving 10-day notice.
Example:
Jackson reports changes in his household's employment. He received a raise
and his wife started a new job at a lower hourly rate. The combined effect
of the two changes is decreased household income that would result in
a lower premium.
Action:
Act on the income changes immediately.
When self-employment income changes check to see if it is:
l A normal fluctuation. This is not considered substantial change.
l The nature or scope of the business has changed.
When the nature or scope of a business creates an income change:
n Request business records covering the time period since the last tax return was filed for clients who submit tax returns but report a substantial change in income.
Example:
Mr. Jones is a dairy farmer. He sold half his herd at the end of the last tax year. He expects his income for the coming year to be about one-half of the previous year’s income.
Action:
Consider this to be a substantial change. Use current business records to determine income. Also, determine whether Mr. Jones received countable capital gains from the sale of his herd.
n If the client asks for assistance determining whether or not there has been a substantial change, determine whether the change affects eligibility, including eligibility for children with a fixed premium.
Example:
Ms. Anderson and her children are enrolled in MCRE. She owns a beauty shop. Her income for the last tax year was over 150% FPG. At the time of her annual renewal, she reports that her earnings have significantly decreased. Her projected income is now below 150% FPG based on her current business records.
Action:
This is a substantial change. Her children will now be eligible for a fixed premium.