03/08/13
Effective immediately, applications submitted to the Stroger Family Community Resource Center (FCRC) for CountyCare may contain proof of income that is older than 30 days if the proof meets the following conditions:
- The proof of income is for a 30 day period;
- The 30 day period falls within the three months prior to the month of application;
- There is no reason to believe the amount of income is incorrect; and
- The proof of income is reasonably compatible with income expected to be received for the first regular roll month of coverage.
This policy applies only to eligibility determinations for CountyCare.
Reasonable Compatibility
Consider the income to be reasonably compatible when the following conditions are met:
- The reported income is at or below 133% of the federal poverty level (FPL);
- The total amount of the proof of income after income averaging is at or below 133% FPL;
- The proof of income is from the same employer/source as reported on the application; and
- There is no known change to the income that would affect the applicant's eligibility for CountyCare.
The determination of reasonable compatibility also includes reviewing electronic sources of income.
Note: AWVS is not yet showing monthly wage history for all wage earners. For those with only quarterly wage information, do not consider AWVS to be a reliable electronic source for current employment. If AWVS shows receipt of unreported unemployment benefits however, this is a change that requires follow up.
Example 1: The Stroger FCRC receives a CountyCare application on 3/29/13. Mr. A, the applicant, provided 30 days' worth of paystubs from January 2013 dated 1/7, 1/14, 1/21 and 1/28. Mr. A reported that he is working 20 hours per week at $8.50 per hour, however, his paystubs reflect an average of 24 hours per week.
The determination of reasonable compatibility-
- The reported income ($8.50 x 20= $170 x 4.3= $731) is below the standard $1,273 (133% FPL);
- The paystub total (income averaged total=$867) is below 133%;
- The paystubs are from the same employer as reported on the application; and
- There is no information in the Work Number. Although AWVS shows a different employer from last quarter, there is no other reason to assume that Mr. A didn't change jobs. There is no known change in income.
Because the income is reasonably compatible, accept the proof of income and proceed with processing the application.
Example 2: Stroger FCRC receives a CountyCare application for Ms. B on 3/1/13. Ms. B reports a part time job and provides 30 days' worth of paystubs from the last two weeks in December 2012 and the first two weeks in January 2013. She reports no other type of income.
In reviewing the clearances for Ms. B, the caseworker discovers unemployment benefits in AWVS that started a few weeks ago. Although there are 30 days' worth of paystubs and they are within three months of the month of application, contact Ms. B to follow up with the change in income.
Example 3: Stroger FCRC receives a CountyCare application for Ms. C on 3/6/13. Ms. C reports a part time job and provides only 3 out of 4 pay stubs from the month of February.
In reviewing the clearances, the caseworker discovers in the Work Number that Ms. C has employment with a different employer. However, the reported employment does not appear in the Work Number. Contact Ms. C regarding the missing paystub and the second unreported job that appeared in the Work Number. Ask Ms. C to explain the status of each job and provide proof of current income.
[signed copy on file]
Michelle R.B. Saddler
Secretary, Illinois Department of Human Services
Julie Hamos
Director, Illinois Department of Healthcare and Family Services
