M E M O R A N D U M

IM-102  08/11/99  MC+/ MAF INCOME VERIFICATION REQUIREMENTS


SUBJECT:
MC+/ MAF INCOME VERIFICATION REQUIREMENTS FORMS MANUAL REVISION #30 :  IM-1UA, MC+ APPLICATION; IM-31A(MC+), MC+ REQUEST FOR INFORMATION
 
DISCUSSION:
Effective immediately, for all new applications, income verification is required for MC+ (children, custodial parents, non-custodial parent, and pregnant women) and Medical Assistance for Family (MAF) cases.  The verification requirement is not as strict for  MC+ and MAF as it is for Temporary Assistance and Food Stamps because there is a larger income range in which families remain eligible.

The IM-1UA and IM-31A(MC+) forms have been created or revised for use with the MC+ (children, custodial parent, non-custodial parent and pregnant women) and MAF programs.  The asset question now requests the client to declare what assets they own.  The net worth limit still only applies to MC+ CHIP children and remains $250,000.  The other changes to the forms are discussed later in this memorandum.

VERIFICATION REQUIREMENTS:

Use the following income verification guidelines for MC+ and MAF;

  • Earned Income - It is appropriate to accept a single pay stub along with the applicant's statement of earnings if it is not questionable.  IMES information may be used as verification if the applicant's  employer and earnings in the past quarter are consistent with what is claimed on the Eligibility Statement.  If income is questionable it may be necessary to obtain additional pay stubs or contact the  employer for more accurate information.

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  • Unearned Income - Verification of unearned income shall be obtained through the system whenever possible.  Accept the applicant's statement for interest income claimed as long as it will not adversely affect the eligibility determination.  For other unearned income not in the system, verification will need to be obtained. 
FORMS REVISIONS:

The IM-1UA, MC+ Application revisions are as follows:

  • In Section B, the instructions, the sentence "Please submit income verification with application, if possible," has been added.

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  • On the 2nd page of the instructions under INFORMATION  NEEDED: "federal income tax return" has been added to the example of Income verification.

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  • On the first page of the application, Section A, Question #5, has been replaced. It now asks that the applicant mark the appropriate box showing the amount of their net worth and asks them to list their assets.

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  • On the first page of the application , Section B, INCOME, "Please attach Income verification (i.e. paycheck stub, letter from employer, award letter, federal income tax return, etc.)" has been added.  
The IM-31A(MC+), MC+ Request for Information, has been created to request information that may be needed in determining eligibility for MC+.  It should be used in place of the IM-31A when the request is only for MC+ or MAF.
 
NECESSARY ACTION:
  • Share memorandum with appropriate staff.

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  • Start using the revised IM-1UA and begin using the IM-31A(MC+) to request information for the MC+ programs.

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  • An initial supply of the revised IM-1UA and IM-31A(MC+) will be sent to the offices.

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  • Destroy existing IM-1UAs as soon as revised issues are available.

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  • File the revised IM-1UA and IM-31A(MC+) and instructions in the Forms Manual.
MJS
DISTRIBUTION #2

[ 1999 Memorandums ]