N.H. Admin. Code § He-W 628.03

Current through Register No. 50, December 12, 2024

Section He-W 628.03 - Unemployed Parent (UP) Medical Assistance Program

(a) A child in a 2-parent household shall be considered to be deprived of parental support or care due to unemployment for eligibility for UP medical assistance when the PWE:

(1) Currently works less than 100 hours per month on average, using a best estimate as described in (e) below;

(2) Expects to continue working less than 100 hours per month on average, using a best estimate;

(3) Has a work/education history or an unemployment compensation history that meets the requirements of (m) through (o) below;

(4) Has not refused an offer of employment within 30 days prior to receipt of assistance if such offer is at a wage that is customary for the specific position in the community according to the department of employment security;

(5) Has not refused a specific training opportunity at a specific location within 30 days prior to the receipt of assistance;

(6) Is currently eligible for unemployment compensation benefits in NH or unemployment compensation benefits from another state even if not actually receiving such benefits; and

(7) Is willing to apply for and receive unemployment compensation benefits.

(b) When determining which parent is the PWE, the following shall apply:

(1) The PWE shall be the parent who earned the higher income in the 24 months preceding the month of application;

(2) The earnings of both parents shall be counted for the full 24 months in determining the PWE regardless of when their relationship began;

(3) If parents had identical income for the 24 months, the household shall designate the PWE;

(4) When one of the parents has been designated as the PWE, that parent shall remain the PWE for purposes of determining deprivation due to unemployment; and

(5) If the family files a new application after a break in eligibility, the PWE status shall be redetermined pursuant to (b)(1) through (4).

(c) UP medical assistance shall end when the employment criterion in (a)(1) above is no longer met.

(d) The average of 100 hours in (a)(1) and (2), and (c), above, shall be determined by deriving a best estimate of hours.

(e) A best estimate of hours shall be determined as follows:

(1) If the hours worked in the current month are less than 100 hours and are representative of anticipated future hours based on documentation provided by the individual, then the best estimate shall be the number of hours worked in the current month;

(2) If the hours worked in the current month are less than 100 hours and are not representative of anticipated future hours based on documentation provided by the individual, then the best estimate shall equal the number of hours per month anticipated to be worked in the future; and

(3) If the hours worked in the current month are greater than 100 hours, then the hours worked in the previous 2 month period shall be considered in determining the best estimate as follows:

a. The hours worked in both of the previous 2 months shall be less than 100 hours;

b. Documentation provided by the individual regarding future anticipated hours shall be less than 100 hours;

c. The best estimate shall be equal to the number of hours anticipated to be worked in the future; and

d. If the number of hours worked in the current and previous 2 month period are greater than 100 hours per month, or if the anticipated future number of hours will be greater than 100 hours per month based on documentation supplied by the individual, then deprivation due to unemployment shall not exist and the application for UP medical assistance shall be denied.

(f) For purposes of this rule, a non-significant change means a temporary or short term variation in the number of hours worked caused by a situation which is not ongoing.

(g) Non-significant changes shall not be used to determine the best estimate.

(h) For purposes of this rule, a significant change means a variation in the number of hours worked that is expected to continue for more than one month.

(i) For continued eligibility for UP medical assistance, if the derived estimate in (e) above results in a current or anticipated average of 100 hours or more of employment per month, deprivation due to unemployment for purposes of the UP medical assistance program shall no longer exist when the advance notice period pursuant to He-W 604.03 expires.

(j) Fluctuating hours shall be converted to a monthly amount by averaging monthly hours for the previous 2 months.

(k) The 2-month average shall not be used when one of the following circumstances applies:

(1) If fluctuating hours have been worked for less than 2 months, the average shall be based on the actual number worked in the most recent month; and

(2) If the income in the previous 2 months is higher or lower than current or anticipated earnings and does not reflect a best estimate of current and future hours as determined in (e) above, a new best estimate shall be determined for the remainder of the current period of eligibility that is based on anticipated hours to be worked in the future.

(l) When a currently eligible individual is verified to have worked more than 100 hours in any one month, a best estimate shall be made to determine if the individual expects to continue working more than 100 hours per month for more than one month.

(m) If the individual described in (l) above will work 100 hours or more for longer than one month and provides the department with documentation of hours of employment, deprivation as described in (a) and (c) above shall no longer exist when the advance notice period pursuant to He-W 604.03 expires.

(n) To determine if the work history requirement pursuant to He-W 628.03(a)(3) has been met, the following shall apply:

(1) The PWE shall have worked at least 6 calendar quarters in a period of 13 consecutive calendar quarters ending within one year prior to the application for assistance and earned at least $50 for each quarter;

(2) Calendar quarters shall be periods of 3 consecutive months dated as follows:

a. January 1 through March 31;

b. April 1 through June 30;

c. July 1 through September 30; and

d. October 1 through December 31;

(3) A self-employed PWE shall be credited with calendar quarters worked in a calendar year by:

a. Determining the PWE's countable earned income for a calendar year;

b. Dividing by $50; and

c. Taking the result, in whole numbers, to equal the number of calendar quarters that can be credited in a calendar year up to a maximum of 4; and

(4) If the self-employed PWE can be credited with less than 4 quarters, the quarters shall be credited within the year in a way that is most beneficial to the PWE when determining if the requirement in (1) above has been met.

(o) For eligibility for UP medical assistance based upon educational history, educational activities may be substituted for no more than 4 quarters of work when the activities consist of one of the following:

(1) Full time elementary or secondary school attendance;

(2) Full time participation in a vocational or technical training program that is preparatory to employment; or

(3) Participation in a post secondary education or vocational skills training activity as defined in He-W 637.01.

(p) A history of unemployment compensation may be substituted for a history of work or education if the PWE met one of the following conditions at any time during the calendar year immediately prior to applying for UP medical assistance:

(1) He or she received unemployment compensation benefits; or

(2) He or she was eligible for unemployment compensation benefits, even if the benefit check was not being received due to:

a. Recoupment due to an overpayment; or

b. A diversion of the benefit to the IRS, child support services, or another party.

(q) A PWE shall be considered eligible for unemployment compensation benefits, although not receiving them due to disqualification by the New Hampshire department of employment security, if the PWE is:

(1) Seeking or receiving unemployment compensation benefits in another state;

(2) Leaving self-employment, such as closing one's business or failing to return to self-employment; or

(3) Unavailable for employment outside the home for any reason for a period of 30 days or less.

(r) The PWE shall not be considered to be eligible for unemployment compensation benefits if the PWE:

(1) Was discharged for misconduct associated with work, including:

a. Neglect of duty due to recurring careless or negligent acts; or

b. Willful misconduct due a deliberate violation of a company rule designed to protect the legitimate interests of the employer;

(2) Failed to accept or apply for suitable employment without good cause determined in accordance with He-W 637.07;

(3) Was unavailable for work outside the home for more than 30 days;

(4) Was separated from his or her last employer due to a disciplinary layoff;

(5) Was separated from his or her last employer due to participation in a labor dispute as determined by the commissioner of the department of employment security, pursuant to RSA 282-A:36;

(6) Was discharged due to intoxication or use of controlled drugs on the job;

(7) Was discharged due to arson, sabotage, or dishonesty connected with the job; or

(8) Voluntarily quit a job through no fault of the employer.

(s) A PWE shall no longer be considered to have voluntarily quit a job when new employment is obtained, at comparable wages or hours, then lost through no fault of the PWE.

(t) A PWE shall be willing to apply for and accept unemployment compensation benefits in New Hampshire or another state, if potentially eligible for these benefits.

(u) The department shall advise the PWE of his or her right to appeal a department of employment security disqualification determination.

N.H. Admin. Code § He-W 628.03

(See Revision Note at Chapter Heading He-W 600) #5171, eff 6-26-91; ss by #6531, INTERIM, eff 6-27-97, EXPIRED: 10-25-97; ss by #6614, eff 10-24-97; amd by #6825, eff 8-3-98; ss by #7084, eff 8-26-99; ss by #8970, eff 8-25-07; ss by #10163, eff 7-26-12

The amended version of this section by New Hampshire Register Number 23, eff. 5/10/2023 is not yet available.