Revision 15-4; Effective October 1, 2015

CHIP, CHIP Perinatal

Income is any type of payment that is of gain or benefit to a household. Income is either counted or exempted from the budgeting process. Earned income is related to employment and entitles a household to deductions not allowed for unearned income. Unearned income is income received without performing work-related activities. It includes benefits from other programs. To determine the date income can reasonably be anticipated, the advisor should use factors specific to the source of income, distance it has to travel through the mail, weekends and holidays.

Advisors must use Modified Adjusted Gross Income (MAGI) rules to determine financial eligibility for the Children’s Health Insurance Program (CHIP) and CHIP perinatal following the Medical Programs policy, explained in A-1300, Income.

Revision 15-4; Effective October 1, 2015

CHIP, CHIP Perinatal

Income limits for CHIP and CHIP perinatal are defined in C-131.1, Federal Poverty Income Limits (FPIL).

Revision 15-4; Effective October 1, 2015

CHIP, CHIP Perinatal

Use the Medical Programs policy, explained in A-1320, Types of Income, to determine the countable and exempt income types for CHIP and CHIP perinatal.

Revision 15-4; Effective October 1, 2015

CHIP, CHIP Perinatal

For CHIP and CHIP perinatal, each individual’s MAGI household income is calculated following the Medical Programs policy explained in A-1341, Income Limits and Eligibility Tests.

 

D—1051 Income Frequency

Revision 15-4; Effective October 1, 2015

CHIP, CHIP Perinatal

Income received must be converted to a monthly amount, unless received monthly. Advisors must use the following conversion factors. (Monthly pay means that the employee is paid once a month.)

Income Frequency	Conversion Factor
Weekly (paid once every week)	Multiply by 4.33
Bi-weekly (paid every other week)	Multiply by 2.17
Semi-monthly (paid twice a month)	Multiply by 2.0
Annually (paid once a year)	Divide by 12

If the income frequency cannot be determined based on the information listed on the application or from the verification, the advisor must generate Form H1020, Request for Information or Action, to request the income frequency.

 

D—1052 Terminated Income

Revision 15-4; Effective October 1, 2015

CHIP, CHIP Perinatal

Count terminated income in the month received. Use actual income and do not use conversion factors if terminated income is less than a full month's income. If the income terminated in the application month, the advisor must request missing information to verify the termination. Self-declaration is not acceptable verification.

 

D—1053 Budget Months

Revision 15-4; Effective October 1, 2015

CHIP

The system will determine CHIP eligibility for the following months:

At Application

• Application month
• Process month

At Redetermination

The month following the last month of CHIP coverage.

D—1060 Verification Requirements

Revision 15-4; Effective October 1, 2015

CHIP, CHIP Perinatal

Income verification requirements for CHIP and CHIP perinatal align with the Medical Programs policy explained in A-1370, Verification Requirements.

 

D—1061 Verification Sources

Revision 15-4; Effective October 1, 2015

CHIP, CHIP Perinatal

Determining whether client-reported income is reasonably compatible with electronic data sources is the preferred method of wage verification for CHIP and CHIP perinatal. Reasonable compatibility is explained in A-1370, Verification Requirements, Medical Programs.

Other income verification sources for CHIP and CHIP perinatal align with the Children’s Medicaid (TP 33, TP 34, TP 35, TP 43, TP 44 and TP 48) policy explained in A-1371, Verification Sources.

Revision 15-4; Effective October 1, 2015

CHIP, CHIP Perinatal

Exempt Income

Document:

• why it is exempt, and
• the name and address or telephone number of the income source.

Terminated Income

Document:

• the name and address or telephone number of the income source, and
• vacation pay received before or after termination, including the dates received.

Income

Document the:

• date of each income statement or stub used;
• date income is actually received;
• date income is anticipated using factors such as time it has to travel via mail, weekends and holidays;
• name and address or telephone number of the income source;
• gross amount of income;
• frequency of receipt (such as weekly, every two weeks, semi-monthly, monthly); and
• calculations used.

Income Computations

Document verification and computation of household income at the initial application, when a change is reported and at each subsequent application/redetermination. Record all sources, amounts, dates and computations.

Other Income

Document the method used to verify income other than earned income. This documentation includes the type of income, the check or document seen, the date on the check or document, the amount recorded on the check or document, the date the income was verified and any computations performed to determine the total income.

Self-Employment

Document:

• the method for averaging income;
• deductions for the cost of doing business;
• the number of hours engaged in the enterprise;
• other factors used to determine the amount of income;
• that the individual was informed to keep self-employment records and receipts for verification purposes for future recertifications; and
• when using Form H1049, Client's Statement of Self-Employment Income, as the only source of verification, the reason Form H1049 is the only source of income.