report changes as they happen

What documents does Covered CA (& Medi Cal) accept as proof of expected
MAGI Income
   Line 11 + ?* income?
Proof Of Identity

What is it that Covered CA is doing by asking for Proof of Income?

What documents do they need?

 

#Documents accepted as Proof Of Income 

Documents for Proof Of who you are – Identity

  • Copy of pay stubs
  • Sworn affidavit from absent parent
  • Award letter or most recent cost-of-living increase notice
  • Copy of the current benefit check
  • Signed statement from the individual or organization providing the income
  • Other documents to support Proof of Unearned Income  – But is it MAGI Income?
  • Signed letter from employer that displays the gross income, payment frequency, and date of paycheck
  • Investment account statement
  • Payment records (notes and mortgages)
  • Lease or sales agreement

Most of the time Covered CA and Medi-Cal don’t need your proof, they get it from Big Brother and the Federal Hub.   They need your consent though. Check out this problem for January 2017 where Covered CA didn’t get consent.

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Calculate your  Covered CA MAGI Income

take #Line8b 11 Adjusted Gross income then add line 2a, 6a &   8 (Foreign Income)

 

MAGI Income from 1040

How does your Income and Household Size get #verified?
Page 5.206 Western Poverty Law 

  • Your  income and tax household size is  checked with data sources using the federal verification hub. wikipedia *
  • For Medi-Cal, if the income information submitted by the individual is “reasonably compatible” with the information obtained through the electronic data sources, e.g., IRS, state wage data, unemployment, Social Security, Medi-Cal accepts the amount listed on the application.  The two amounts are “reasonably compatible” for Medi Cal in any of the following circumstances:
    •   • Both show the individual’s income above the relevant income standard;
      • Both show the individual’s income is at or below the relevant income standard; or
      • The individual states their income is above the income standard and the information obtained by the state shows the individual’s income is at or below the relevant income standard.   In this case, the individual must be told that the income information they provided was higher than the information the state obtained through electronic verification and the individual may request to have their income determined at the lower, verified amount.
  • If the income information obtained through electronic verification is not reasonably compatible with the information provided by the individual, the individual must provide additional information that explains the discrepancy, such as pay stubs or other documentation regarding income.  WIC 14013.3  *
  • For Covered California, income information is checked against an applicant’s previous year’s tax return through the IRS database.
  • If the applicant says that the income and tax household size on their last year’s tax return represents an accurate projection of their income and household size for the benefit year for which they are applying for coverage, Covered California uses that tax information.
    • Covered California accepts self-attestation of income and household size if tax data is unavailable or the applicant attests that a change in income or household size has occurred or is reasonably expected to occur such that the tax data is not accurate for this benefit year.
    • If, however, Covered California finds that the application’s attested income and household size are not reasonably compatible with other information from the applicant or information Covered California has other than the tax data, then the attestation will be verified against state electronic data sources. If state sources are unavailable, the applicant must submit documentation to support their attested income.
    • There is an alternative verification process for individuals who attest to projected household income.  If their projected income is no more than 10% below the income on their most recent tax return, it must be accepted without further verification. If the projected annual income is more than 10% below the latest tax income or if the tax data is unavailable, the applicant’s attested income is verified with state data sources or by requesting documentation from the applicant.
    • When income cannot be verified electronically, Covered California notifies applicants of what information is needed and gives them 90 days to provide it.
      • If the applicant does not provide the information within 90 days, Covered California uses the information available through electronic databases to determine their eligibility.  For MCAP, if income cannot be electronically verified, paper documentation is requested. Page 5.206  *
  • Learn more about  Understanding Reasonable Opportunity Period (ROP) & Auto Discontinuance  Toolkit 

Federal IRS  #Form8962 Instructions Premium Tax Credit

Reconciliation Form for Covered CA Subsidies attaches to 1040
Subsidy is IMHO hocus pocus - smoke & mirrors
it all comes out when you file taxes!

 

8962 goes by MAGI

 

 

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