CurrentConnecticut Department of Social ServicesPolicy N/A

2015 Federal Poverty Level Tables

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Updates Connecticut DSS Uniform Policy Manual procedures using revised Federal Poverty Level figures for CADAP, Medicare Savings Programs, QDWI, specified waiver programs, and the Jobs First gross earnings test.

Policy Summary

PayerConnecticut Department of Social Services

Policy2015 Federal Poverty Level Tables

Policy CodePolicy N/A

Change TypeRevised Federal Poverty Level income figures

Effective DateMarch 1, 2015

Next Review DateN/A

Key ActionUpdate the Uniform Policy Manual by removing superseded pages and inserting the revised procedure pages identified in the transmittal.

SourceLink

POLICY UPDATE CHANGES

UPM procedures were revised to reflect newly published Federal Poverty Level income figures for multiple DSS assistance and coverage groups.

211% FPLQMB income threshold

231% FPLSLMB income threshold

246% FPLALMB income threshold

200% FPLQDWI income threshold

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CurrentConnecticut Department of Social ServicesPolicy N/A

2015 Federal Poverty Level Tables

Customize your policy alerts

Sign up for all Connecticut Department of Social Services policy alerts

Know when Connecticut Department of Social Services releases new policies or updates existing guidance.

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Policy Summary

PayerConnecticut Department of Social Services

Policy2015 Federal Poverty Level Tables

Policy CodePolicy N/A

Change TypeRevised Federal Poverty Level income figures

Effective DateMarch 1, 2015

Next Review DateN/A

Key ActionUpdate the Uniform Policy Manual by removing superseded pages and inserting the revised procedure pages identified in the transmittal.

SourceLink

POLICY UPDATE CHANGES

UPM procedures were revised to reflect newly published Federal Poverty Level income figures for multiple DSS assistance and coverage groups.

211% FPLQMB income threshold

231% FPLSLMB income threshold

246% FPLALMB income threshold

200% FPLQDWI income threshold

Medicare Savings and Disability Coverage Eligibility

Qualified Medicare Beneficiary (QMB – Q01)

Determine eligibility for Qualified Medicare Beneficiaries (QMB – Q01) when ALL of the following requirements are met:

ALL of the following

Determine the size of the needs group.
For assistance units with earnings, subtract the AABD earned income disregard from the assistance unit's total gross earned income to determine applied earned income.
Allow appropriate earned income expenses when the spouse of the applicant or recipient is not eligible for assistance and is working.
Cross-reference: 5020.70.
The combined applied earned income and gross unearned income of the needs group is below the applicable monthly income level.211% of the Federal Poverty Level
Monthly income levels: $2,069.91 for a needs group of 1; $2,802.08 for a needs group of 2.

Specified Low Income Medicare Beneficiary (SLMB – Q03)

Determine eligibility for Specified Low Income Medicare Beneficiaries (SLMB – Q03) when ALL of the following requirements are met:

ALL of the following

Determine the size of the needs group.
For assistance units with earnings, subtract the AABD earned income disregard from the assistance unit's total gross earned income to determine applied earned income.
Cross-reference: 5030.10.
Allow appropriate earned income expenses when the spouse of the applicant or recipient is not eligible for assistance and is working.
Cross-reference: 5020.70.
The combined applied earned income and gross unearned income of the needs group is below the applicable monthly income level.231% of the Federal Poverty Level

Additional Low Income Medicare Beneficiary (ALMB – Q04)

Determine eligibility for Additional Low Income Medicare Beneficiaries (ALMB – Q04) when ALL of the following requirements are met:

ALL of the following

Determine the size of the needs group.
For assistance units with earnings, subtract the AABD earned income disregard from the assistance unit's total gross earned income to determine applied earned income.
Cross-reference: 5030.10.
Allow appropriate earned income expenses when the spouse of the applicant or recipient is not eligible for assistance and is working.
Cross-reference: 5020.70.
The combined applied earned income and gross unearned income of the needs group is below the applicable monthly income level.246% of the Federal Poverty Level

Qualified Disabled Working Individuals (QDWI)

Determine eligibility for Qualified Disabled Working Individuals (QDWI) when ALL of the following requirements are met:

ALL of the following

Determine the size of the needs group.
The applied income of the needs group is below the applicable monthly income level.200% of the Federal Poverty Level
Monthly income levels: $1,962.00 for a needs group of 1; $2,656.00 for a needs group of 2.

Income Standards

QMB Income Standard

Federal Poverty Level standard211% of the Federal Poverty Level

Needs group size 1$2,069.91 monthly income level

Needs group size 2$2,802.08 monthly income level

SLMB Income Standard

Federal Poverty Level standard231% of the Federal Poverty Level

Needs group size 1$2,266.11 monthly income level

Needs group size 2$3,067.68 monthly income level

Implementation and Case Processing Actions

Documentation Required

Update UPM procedure pages

Update the Uniform Policy Manual by removing and recycling the superseded pages and inserting the revised procedure pages identified in the transmittal. Once the UPM has been updated, the policy transmittal may be recycled.

Remove and recycle: P-4530.25, P-4530.26, P-4530.27, P-4530.29, and P-8035.05 page 1.
Insert the corresponding revised procedure pages identified in the transmittal.

Billing Rule

Close CADAP assistance unit for Medicaid noncooperation

If the regional office advises that a CADAP client failed to cooperate with the Medicaid eligibility process, close the CADAP assistance unit in EMS using reason code 540.