Where Eligibility Starts: Modified Adjusted Gross Income (MAGI)
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1 Where Eligibility Starts: Modified Adjusted Gross Income (MAGI) 1
2 Where Eligibility Starts: Modified Adjusted Gross Income (MAGI) Monday, Sept. 26, :30 to 3:30 p.m.
3 Before we get started Recording will be sent next week Send questions via chat Do not use the Raise Hand function Technical difficulties? Call ReadyTalk:
4 Presenters Becky McKinney, Colorado Department of Health Care Policy and Financing Ian McMahon, Connect for Health Colorado 4
5 Session Goal Participants will understand the basics of Modified Adjusted Gross Income (MAGI) methodology used to determine eligibility for Health First Colorado (Colorado s Medicaid Program, Child Health Plan Plus (CHP+) and Connect for Health Colorado
6 What is MAGI? MAGI stands for Modified Adjusted Gross Income MAGI is a methodology is used to determine eligibility based on household composition and income It is used to determine eligibility for: Health First Colorado CHP+ Advanced Premium Tax Credits (APTCs) Cost Sharing Reductions (CSRs)
7 Household Composition
8 Household Composition The number and configuration of individuals living together based on their relationships to each other MAGI Household Composition: Tax relationships Legal relationships Biological relationships
9 Relationships Tax Relationship: Individuals who are, or intend to be, on a tax return together The individual may or may not have a biological or legal relationship Biological/Legal Relationship: Biological (e.g. full or half siblings) Legal (e.g. spouse, step-parent, adoptive child)
10 Monthly Budget Unit (MBU) Determined at an individual level Each person in a household may have a different household size Based on relationships to the individuals in the household To determine eligibility, each person s MBU will include everyone whose income counts towards them
11 Individuals who will Always be in Your Household Self Spouse Mandatory for Health First Colorado/CHP+, APTCs and CSRs Unborn Children Any MBU that includes the pregnant woman will also include her unborn child(ren) Mandatory for Health First Colorado/CHP+ Excluded until born for APTCs/CSRs
12 MAGI MBU Flowcharts
13 Definitions Tax-Filer Tax- Dependent Non-Filer An individual, head of household or married couple who expects to file a tax return Anyone expected to be claimed as a dependent by a tax filer An individual who neither files a tax return nor is claimed as a tax dependent
14 Tax Filer Rules Tax Filer MBU Individual Individual s spouse, if living with them All of the individual's tax dependents
15 Tax Dependent Rules Tax Dependent MBU Individual The person claiming the individual (tax filer) All other tax dependents of that tax filer The individual s spouse, if living with them
16 Non-Filer Rules Non-Filer MBU Individual Individual s spouse, if living with them Individual s children* under 19 If individual is under 19: *Biological, step or adopted Individual s parents* Individual s siblings* under 19
17 Tax Dependent Exceptions for Health First Colorado/CHP+ Expects to be claimed as a tax dependent of somebody other than a spouse or parent Is a child under 19 who lives with both parents and expects to be claimed as a tax dependent by one of the parents, but the parents do not expect to file a joint tax return Is a child under 19 who expects to be claimed by a non-custodial parent
18 Household Income
19 MAGI: Income MAGI is a methodology used to determine eligibility for MAGI-based programs (including tax credits and cost sharing reductions for purchasing Qualified Health Plans) MAGI is a reference to a particular number but it is also used in reference to income methodologies used for determining eligibility MAGI is not a number on a tax return
20 MBU and Income Limits Both MAGI Medical Assistance and CHP+ have Monthly Maximum Income Guidelines The income guidelines are based on the Federal Poverty Level (FPL) for each category of assistance
21 Countable Income Earned Income Unearned Income Salaries, Wages and Tips Self-employment Foreign Earned Income Social Security Benefits Retirement Benefits Social Security Disability Insurance (SSDI) Survivor s Benefits Title II Unemployment Benefits Alimony Retirement Benefits Veterans Benefits
22 Exempt Income Child Support Supplemental Security Income (SSI) Title XVI Certain American Indian or Alaskan Native Payments Education Scholarships/Grants Unless used for living expenses Foster Care Payments Earned Income Tax Credit (EIC)
23 Exempt Income Annual income less than the minimum required for tax-filing If an individual s total countable income is less than the minimum, that individual s income is considered exempt for MAGI income calculation
24 Exempt Income Annual Income less than the All income should be minimum required for tax-filing entered into CBMS. If an individual s CBMS will total determine countable if income is less than the income minimum, should that be individual s counted income or is excluded. considered exempt for MAGI income calculation
25 Connect for Health Colorado Connect for Health Colorado calculates the MAGI differently, which may result in different income calculations
26 Differences in MAGI Health First Colorado/CHP+ Do not have to file taxes Can be married and file separately Unborn child counted in household Three tax dependent exceptions Income period is current monthly Lump sum payments counted in month received Does not count: Scholarships, awards or fellowship grants, and certain distributions to American Indians/Alaska Natives APTCs/CSRs Must file taxes Must file jointly if married Children only counted in household after born No tax dependent exceptions Income period is projected annual Lump sum payments factored into annual income Does count: Taxable amounts for scholarships, awards or fellowship grants, and certain distributions to American Indians/Alaska Natives
27 Seasonal Workers/Fluctuating Income New application will ask for monthly and annual income Connect for Health Colorado tax credit determination will be based off of annual income Medical Assistance is still based off of monthly income until further notice
28 Annualized Income for Health First Colorado and CHP+ For more information on the implementation of Annualized Income and how it may affect individuals with Fluctuating income, view the Annualized Income webinar p37yqmujibj/?launcher=false&fcs Content=true&pbMode=normal
29 Self-Attestation Self-attestation of income is acceptable for MAGI-based programs (including tax credits and cost sharing reductions for purchasing Qualified Health Plans) Individuals who provide self-attestation of income must also provide a Social Security number for electronic wage verification purposes
30 Earned Income Earned income is verified through the following interfaces: Colorado Department of Labor and Employment (CDLE) Income and Eligibility Verification System (IEVS)
31 Income Verification If an applicant is unable to provide verification using selfattestation, income can be verified by the following: Wage stubs Written documentation from the employer Telephone call to an employer
32 Creating an MBU
33 Scenario 1 Tanya Greg Tanya, Greg and their daughter, Nina, live together. Tanya and Greg are married. They file taxes jointly and claim Nina. Nina
34 Scenario 1 Tanya Greg Tanya, Greg and their daughter, Nina, live together. Tanya and Greg are married. They file taxes jointly and claim Nina. Nina 3
35 Scenario 1 Tanya Greg Tanya, Greg and their daughter, Nina, live together. Tanya and Greg are married. They file taxes jointly and claim Nina. Nina 3 3
36 Scenario 1 Tanya Greg Tanya, Greg and their daughter, Nina, live together. Tanya and Greg are married. They file taxes jointly and claim Nina. Nina 3 3 3
37 Scenario 1 Tanya Greg Tanya, Greg and their daughter, Nina, live together. Tanya and Greg are married. They file taxes jointly and claim Nina. Nina APTC/CSR 3
38 Scenario 2 Kendra James Kendra, James and their daughter, Kiki, live together. Kendra and James are not married. They file their taxes separately, and James claims Kiki as a tax dependent. Kiki
39 Scenario 2 Kendra James Kendra, James and their daughter, Kiki, live together. Kendra and James are not married. They file their taxes separately, and James claims Kiki as a tax dependent. Kiki 1
40 Scenario 2 Kendra James Kendra, James and their daughter, Kiki, live together. Kendra and James are not married. They file their taxes separately, and James claims Kiki as a tax dependent. Kiki 1 2
41 Scenario 2 Kendra James Kendra, James and their daughter, Kiki, live together. Kendra and James are not married. They file their taxes separately, and James claims Kiki as a tax dependent. Kiki 1 3 2
42 Scenario 2 Kendra James Kendra, James and their daughter, Kiki, live together. Kendra and James are not married. They file their taxes separately, and James claims Kiki as a tax dependent. Kiki APTC/CSR 1 2
43 Scenario 3 Mary John Max Mary, John and their son, George, live together. Mary and John are not married. John s 20- year-old brother, Max, lives with them. Nobody files taxes. George
44 Scenario 3 Mary John Max Mary, John and their son, George, live together. Mary and John are not married. John s 20- year-old brother, Max, lives with them. Nobody files taxes. George 2
45 Scenario 3 Mary John Max Mary, John and their son, George, live together. Mary and John are not married. John s 20- year-old brother, Max, lives with them. Nobody files taxes. George 2 2
46 Scenario 3 Mary John Max Mary, John and their son, George, live together. Mary and John are not married. John s year-old brother, Max, lives with them. Nobody files taxes. George 2 3 2
47 Scenario 3 Mary John Max Mary, John and their son, George, live together. Mary and John are not married. John s 20- year-old brother, Max, lives with them. Nobody files taxes. George
48 More Information In-depth sessions at Building Better Health conference: Household Composition Related to Financial Assistance Programs Income Deep Dive Reasonable Compatibility Tip Sheet es/what%20is%20reasonable%20compatibilit y.pdf
49 Questions? 50
50 Next Pre-Webinar Communications 101: Building Communications into Your Outreach Monday, Oct. 3; 2:30 3:30 pm 51
51 Thank you 52
52 Attributions Photograph of an original color mural painted in oils by artist Charles R. Knight depicting a Neanderthal family during the Ice Age. Don Glut s Dinosaurs. Knight Neanderthals Paintbrush icon: Created by john melven from the Noun Project Scenarios girl icon: Created by Andrew McKinley from the Noun Project Scenario baby icon created by Saeed Farrahi from the Noun Project Scenario boy icon created by Ferran Brown from the Noun Project Let s Practice document icon: Created by Creative Stall from the Noun Project MBU & Income money icon: Created by Creative Stall from the Noun Project Presentation template by SlidesCarnival
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