18.2 Increase in Earnings/Decrease in Group Size Extensions

18.2.1 Earned Income Extensions Under Non-MAGI Rules

18.2.2 Earned Income Extensions under MAGI Rules

18.2.1 Earned Income Extensions under Non-MAGI Rules

To receive a BC+ Extension due to an increase in earnings a person whose eligibility is determined under non-MAGIApply to households whose eligibility is determined using BadgerCare Plus relationship rules (prior to March 31, 2014) to budget income for a household prior to transitioning to MAGI BadgerCare Plus budgeting rules. rules must meet the following requirements:

The income increase which caused the countable income to exceed 100% FPL must be due solely to:

1. Increased earnings or,
2. Increased earnings along with other income (changed or unchanged).

S/he must be a BC+ member with income at or below 100% FPL, at the time the income increased to over 100% FPL.

The parent, caretaker or pregnant woman must have been enrolled in BC+ with income that was at or below 100% FPL for at least 3 of the 6 months immediately preceding the month in which the income went above 100% FPL.

S/he must otherwise meet the BC+ eligibility criteria for persons with income below 100% FPL, and

S/he verified his or her income, unless s/he is exempt from paying a premium.

Example 1: Mary and her two children had been enrolled in BC+ with income below 100% FPL, since January. Her husband Denny moved back into the house in June. When Denny was added to the case with his additional earned income the group’s countable income went over 100% FPL. Because Mary and the two children were enrolled in BC+ with income below 100% FPL for three of the prior six months, at the time the income went above 100%, they are eligible for a 12-month BC+ Extension. Denny is not included in the Extension, because he was not enrolled in BC+ at the time the income increased.

18.2.2 Earned Income Extensions under MAGI Rules

To receive a BC+ Extension due to an increase in earnings, a parent, caretaker or pregnant woman under MAGIModified Adjusted Gross Income. MAGI rules are used to determine BadgerCare Plus eligibility for new applicants beginning in 2014 and for existing members as of March 31, 2014, or their next regularly scheduled renewal, whichever is later. MAGI rules are based on tax relationships and family relationships, and they consider taxable income and whether children and tax dependents are required to file. rules must meet the following requirements:

The income increase which caused the countable income for his or her BC+ assistance group to exceed 100% FPL must be due solely to:

1. Increased earnings (of anyone in the same AG) or,
2. Increased earnings along with other income (changed or unchanged).

S/he must be a BC+ member with income at or below 100% FPL, at the time the income increased to over 100% FPL.

The parent, caretaker or pregnant woman must have been enrolled in BC+ with income that was at or below 100% FPL for at least 3 of the 6 months immediately preceding the month in which the income went above 100% FPL.

S/he must otherwise meet the BC+ eligibility criteria for persons with income below 100% FPL, and

S/he verified his or her income, unless s/he is exempt from paying a premium because s/he and any co-parent/spouse in the assistance group are disabled, a tribal member or pregnant. (This policy applies to all adults in the assistance group; unless they are all exempt from paying a premium, income must be verified.)

Note: These requirements do not apply to children eligible under MAGI Rules. See 18.1.3.

Example 2: Jane lives with her two teenage children and Dave, the non-marital co-parent of the two children. Jane is claiming both children on her taxes and her income for her MAGA assistance group of 3 is 90% FPL. Dave’s MAGA AG consists only of himself, and he is eligible for BC+ with income of 95% FPL. The children-in-common are eligible in a MAGC AG group of 4, with both parents as counted adults in their AG and their group’s income is 121% FPL. Jane was enrolled in BC+ with income below 100% FPL for three of the prior six months. In June, her earned income increased to 120% FPL. She is eligible for a 12-month BC+ Extension. Dave is not included in the Extension, because he was not a counted member of Jane’s AG. The children are eligible for a 12-month Extension because they were eligible in June when Jane’s income rose above 100% and their own AG’s income was below 156% FPL at the time.

18.2.3 SSI Exception

A person who was eligible for SSI benefits may be eligible for a BC+ Extension if s/he loses SSI and would have been eligible for BC+ with countable income at or below 100% if she had not been an SSI recipient.

Example 3: Mary is receiving SSI. Her two children are enrolled in BC+ with countable income at or below 100% FPL. Mary started a job and her earnings put her above the SSI income limit. Her earned income also caused the BC+ countable income to exceed 100%FPL. Both Mary and her two children are eligible for a 12 month BC+ Extension

This page last updated in Release Number: 14-02

Release Date: 05/14/14

Effective Date: 04/01/14