Section 17-1724.2-20 - Budget periods(a) The determination of monthly income and household size is dependent on the period for which assistance is being requested and the circumstances involved. (1) The following methods shall be used when determining current income: (A) For a month prior to the current month, the actual income received within that month shall be considered income for that month.(B) For the current month, income already received and any income anticipated to be received within the current month, shall be considered income for that month.(2) The following methods shall be used when determining future income: (A) To account for future changes in income that can be reasonably anticipated, projected income shall be calculated by one of the following methods: (i) Current weekly income multiplied by 4.3333 to convert to monthly income;(ii) Current bi-weekly income multiplied by 2.1667 to convert to monthly income;(iii) When no significant fluctuation is anticipated, the income received in the month immediately prior to the current month can be used for the projection; or(iv) If there has been fluctuation, an average of the three months income immediately preceding the current month may be utilized.(B) Actual changes in income and circumstances, as required to be reported by the household, including deviations from reasonably anticipated fluctuations in income, shall be acted upon by the department.(b) The department shall determine the current and future household monthly income or the projected annual household income and household size for an applicant or beneficiary. The department shall adopt a reasonable percentage for an increase or decrease in income, and take into account verifying financial information with the Income Eligibility Verification System (IEVS) data and whether the IEVS income causes the total combined countable household income (IEVS income plus all previously reported income) to be above or below the medical assistance standard for the appropriate household size as described in chapter 17-1714.1: (1) The department shall continue to use the self-attested income amount when: (A) The IEVS income amount is below or at ten per cent of the self-attested income amount, even if the total combined countable household's income exceeds the medical assistance income standard for the applicable household size; or(B) The IEVS income is above ten percent of the self-attested amount but the total combined countable household's income remains at or below the medical assistance standard; or(2) The department shall request for additional information from the household when the IEVS income differs more than ten per cent of the self-attested income amount. A change in the total combined countable household income requires the household to be redetermined under the appropriate category and medical assistance standard for the applicable household size. The department shall redetermine household's eligibility based on the verified income amount; unless a reasonable explanation, and if necessary, appropriate documentation, are provided.(c) If a household's MAGI-based income is above the applicable medical assistance income standard for a household of applicable size, but the household's income does not exceed one hundred per cent of the federal poverty level for advance payments of the premium tax credits (APTC) eligibility, MAGI as defined in chapter 17-1700.1, which the Exchange employs, shall apply. Differences in methodologies between medical assistance and APTC include, but are not limited to, treatment of certain types of income, annualizing income, and household composition.Haw. Code R. § 17-1724.2-20
[Eff 09/30/13] (Auth: HRS § 346-14; 26 C.F.R §1.36B; 42 C.F.R. §§435.4, 435.601, 435.602, 435.603 ) (Imp: HRS § 346-14; 26 C.F.R §1.36B; 42 C.F.R. §§435.4, 435.601, 435.602, 435.603 )[Am and Comp 11/10/2016] (Auth: HRS § 435.945, 435.952)