Contents

1. Family Household with tax dependent without direct relationship to the child

2. Non-Marital Co-Parent with both parents filing taxes

1. Family Household with tax dependent without direct relationship to the child

Jake is 30 years old. He is a tax payer. He is married to Lena, who is also 30 years old. She is a joint tax payer of Jake. Jake and Lena have a child in common, Kendra, who is 9 months old. Lena’s nephew, Will, who is 7 years old, lives with them.

Jake (30)
Tax payer / Lena (30)
Joint Tax Payer of Jake / Kendra (9 months)
Tax dependent of Jake / Will (7)
Tax dependent of Jake

Tax Rules:

Person / Rule
Jake(30) / Tax Filer Rules (Tax Payer)
Lena(30) / Tax Filer Rules (Tax Dependent)
Kendra (9mos.) / Tax Filer Rules (Tax Dependent)
Will (7) / Non-Filer Rules ( Tax Dependent without Direct Relationship#)

Household Composition:

Medical Eligibility For / Eligibility Category / Jake / Lena / Kendra / Will / Group Size
Jake / Parent/Caretaker / EA / CA / CC / CC / 4
Lena / Parent/Caretaker / CA / EA / CC / CC / 4
Kendra / Children / CA / CA / EC / CC / 4
Will / Children / XA / XA / XC / EC / 1

Income:

Jake, Lena, and Kendra:

Step 1 Determine potential sources of income

Person / Potential sources of income
Jake / Jake earns $2800/month with projected annual income of $33,600
Lena / Lena earns $1200/month with a projected annual income of $14,400
Kendra / Kendra earns $0.00
Will / Will earns $0.00

Step 2 Determine if anyone’s income is exempt

Person / Income Exempt?
Jake / No
Lena / No
Kendra / N/A
Will / N/A

Step 3 Determine household income

Person / MAGI based income / Medical/CHP+ Household income / Eligibility Result
Jake / $2,800 + 1200.00=$4000 / $4,000/FPL for HH size of 4=204% > 138% FPL / Ineligible for MAGI. Refer to the Marketplace
Lena / $2,800 + 1200.00=$4000 / $4,000/FPL for HH size of 4=204% > 138% FPL / Ineligible for MAGI. Refer to the Marketplace
Kendra / $2,800 + 1200.00=$4000 / $4,000/FPL for HH size of 4=204% > 138% FPL; < 255% FPL / Eligible for the Children’s Subcategory CHP+

Income:

Will:

Step 1 Determine potential sources of income

Person / Potential sources of income
Will / Will earns $0.00

Step 2 Determine if anyone’s income is exempt

Person / Income Exempt?
Will / N/A
Person / MAGI based income / Medical/CHP+ Household Income / Eligibility Result
Will / $0.00 / $0.00/FPL for HH size of 1=0% < 138% FPL / Eligible for the Children’s Category in Medical

2. Non-Marital Co-Parent with both parents filing taxes

Tony lives with his girlfriend, Jackie, who is pregnant. Tony has a son, Matt, from a past relationship. He also has a daughter in common with Jackie, Lillian. Tony and Jackie both file their own taxes. Lillian and Matt live with Tony and Jackie. They are both tax dependents of Jackie.

  • Tony (32), tax payer
  • Jackie (30), tax payer, pregnant (1 fetus)
  • Matt (8), tax dependent of Jackie, disabled
  • Lillian (9 mos.), tax dependent of Jackie

Tony (32)
Tax payer / Jackie (30)
Tax Payer, pregnant* / Lillian (9 months)
Tax dependent of Jackie / Matt (8)
Tax dependent of Jackie

Tax Rules:

Person / Rule
Tony / Tax Filer Rules (Tax Payer)
Jackie / Tax Filer Rules (Tax Payer)
Lillian / Non-Filer Rules (Child with Non-Marital Co-Parents)
Matt / Non-Filer Rules (Tax Dependent Without Direct Relationship to Tax Payer)#

Household Composition:

Medical Eligibility For / Eligibility Category / Tony / Jackie / Lillian / Matt / Group Size
Tony / Parents/Caretakers / EA / XA / XC / XC / 1
Jackie / Pregnant Women / XA / EA / CC / CC / 4*
Lillian / Children / CA / CA / EC / CC / 4
Matt / Children / CA / XA / CC / EC / 3

Income:

Tony:

Step 1: Determine potential sources of income

Person / Potential sources of income
Tony / Tony earns $2,550/month with projected annual income of $30,600

Step 2: Determine if Tony’s income is exempt

Person / Income Exempt?
Tony / No

Step 3 Determine household income for Tony

Person / MAGI based income / Medical/CHP+ Household income / Eligibility Result
Tony / $2,550 / $2,550/ FPL for HH size of 1= 266% > 138% FPL / Ineligible for MAGI. Refer to the Marketplace

Jackie:

Step 1: Determine potential sources of income

Person / Potential sources of income
Jackie / Jackie earns $1,200/month with projected annual income of $14,400
Lillian / Lillian earns $0.00
Matt / Matt earns $0.00

Step 2: Determine if anyone’s income is exempt

Person / Income Exempt?
Jackie / No
Lillian / N/A
Matt / N/A

Step 3: Determine household income for Jackie

Person / MAGI based income / Medical/CHP+ Household income / Eligibility Result
Jackie / $1,200 +$0 +$0 / $1,200/FPL for HH size of 4*= 61% < 138% FPL / Eligible for MAGI Pregnant Women Category

Lillian:

Step 1: Determine potential sources of income

Person / Potential sources of income
Tony / Tony earns $2,550/month with projected annual income of $30,600
Jackie / Jackie earns $1,200/month with projected annual income of $14,400
Lillian / Lillian earns $0.00
Matt / Matt earns $0.00

Step 2: Determine if anyone’s income is exempt

Person / Income Exempt?
Tony / No
Jackie / No
Lillian / N/A
Matt / N/A

Step 3: Determine household income for Lillian

Person / MAGI based income / Medical/CHP+ Household income / Eligibility Result
Lillian / $2,550 + $1,200 +$0 +$0 = $3,750 / $3,750/ FPL for HH size of 4 = 191% > 138% FPL, < 255% FPL / Eligible for CHP+

Matt:

Step 1: Determine potential sources of income

Person / Potential sources of income
Tony / Tony earns $2,550/month with projected annual income of $30,600
Lillian / Lillian earns $0.00
Matt / Matt earns $0.00

Step 2: Determine if anyone’s income is exempt

Person / Income Exempt?
Tony / No
Lillian / N/A
Matt / N/A

Step 3: Determine household income for Matt

Person / MAGI based income / Medical/CHP+ Household income / Eligibility Result
Matt / $2,550 +$0 +$0 = $2,550 / $2,550/ FPL for HH size of3 = 157% > 138% FPL; < 255% FPL / Eligible for CHP+. Potentially eligible for an HCBS Non-MAGI Waiver program depending on extent of disability

10/24/2013