0855.005.00 Eligibility Requirements for Ticket to Work Health Assurance (TWHA) Program

0855.005.40.01 Social Security Cost of Living Adjustment (COLA) Disregard

IM-76 December 23, 2014; IM-114 December 13, 2013; IM-100 December 7, 2012; IM-03 January 7, 2008

Senate Bill 577 (2007) amended Section 208.153 RSMo to specify that programs in which income eligibility is determined by Federal Poverty Level (FPL) will not be adjusted for annual Cost of Living Adjustment (COLA) changes in OASDI or SSI benefits until the next FPL adjustment.

FAMIS disregards the COLA amount entered for January’s income for the MO HealthNet Ticket to Work Health Assurance (TWHA) program until the next FPL adjustment for April.  SSA and SSI incomes for individuals in any FAMIS EU entered after the adjustment must include the pre-COLA adjusted amount for December and the COLA-adjusted amount for January with a verification code of CO (COLA).

NOTE: The disregard of COLA increases for January through March applies to both the gross income test and net income test completed for TWHA.

Example 1: Applications Made After COLA Mass Adjustment (December)

On February 8, Ms. Foster applies for Food Stamps and TWHA benefits.  Ms. Foster has been receiving Social Security Disability Income (SSDI/SSA) for five years. Enter Ms. Foster’s pre-COLA adjusted SSA income for the month of December with a verification code of HC or TC.  Enter her COLA-adjusted SSA income for the budget month of January and ongoing with verification code of CO.  The Food Stamp EU eligibility determination budgets the current (COLA-adjusted) SSA amounts; the TWHA eligibility determination budgets the pre-COLA adjusted SSA amount.

Example 2: Active EUs with Participants that Begin Receiving SSA/SSI Between COLA and FPL Mass Adjustments

The Jackson family is active in FAMIS, receiving TWHA and Food Stamp benefits. Mrs. Jackson reports that daughter, Jessie, begins receiving SSI February 1. Enter Jessie’s new SSI income for the month of February with a verification code of HC or TC.  Continue to budget Mrs. Jackson’s pre-COLA SSA income that she was receiving based on disability using a verification code of CO; do not change the verification code from CO to HC or TC.

Example 3: Exploring Prior Quarter for TWHA Applications Taken After the FPL Adjustments

On March 15, Ms. Ola applies for TWHA.  She requests prior quarter coverage for her emergency room visit.  Ms. Ola has been receiving SSDI for several years. Enter her pre-COLA SSDI received for December with the appropriate verification code of HC or TC and the COLA-adjusted income for the months of January-March with a verification code of CO.

NOTE:  FAMIS does not disregard the COLA amount entered for January’s income for Blind Pension (BP), Vendor (VEND), Missouri Children with Developmental Disabilities (MOCDD), Home and Community Based (HCB) Waiver Services, Supplemental Aid to the Blind (SAB), and Supplemental Nursing Care (SNC) programs.