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Effective: December 1, 2006 |
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20.30.05ar1 - MinnesotaCare Income Changes (Archive) |
Archived: March 1, 2008 |
Changes must be reported 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. Increases in income or assets reported at time of or after re-enrollment are disregarded until the household’s annual renewal.
l Provide 10-day notice of any negative actions.
l Verification of an income change is not required.
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, but 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, or who did not file taxes from clients who 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. His income for the coming year is expected 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:
m 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. Based on her current business records, projected income is now below 150% FPG.
Action:
This is a substantial change. Her children’s group status will change to Group 1 and they will now be eligible for a fixed premium.