1. It’s A Wrap-Up MAGI

2. Introduction to Wrap-up  Wrap-up will display the household’s  Eligibility results  Coverage begin dates  Eligibility status for each High-Level Program Group  Participation Status  Verification Checklist  Income  Monthly Billing Unit (MBU) for each member  Reasonable Opportunity Period (ROP)  Certification Periods 8.100.4.E What is Wrap-up?

3. Eligibility Results FIRST: Select the month you want to see SECOND: Highlight each member THIRD: Look at the Eligibility Result, Begin Date, and Category

4. Eligible, Counted and Excluded Individuals  In CBMS codes are used to determine who is “eligible”, “counted” or “excluded” for each individual’s MBU  Eligible Adult  Eligible Child  Excluded Adult  Excluded Child  Counted Adult  Counted Child Note: “Eligible” does not pertain to program eligibility. It really means: “the person the MBU is being determined for”

5. Introduction to Household Composition  Household composition is the number and configuration of individuals living together based on their relationships to each other.  MAGI household composition is determined primarily by relationships of tax dependency, but also considers legal and biological relationships. 8.100.4.E What is household composition?

6. Medical Financial Eligibility Program List (MBU) FIRST: Select the month you want to see SECOND: Highlight each member one at a time THIRD: Monthly Budget Unit (MBU) will be displayed

7. Remember FIRST: Select the month you want to see SECOND: Highlight the NEXT member THIRD: Monthly Budget Unit (MBU) will be displayed

8. Three Questions

9. Scenario 1 Jenna is pregnant. She lives alone and files her own taxes. What is her MBU? Jenna’s MBU: 2

11. Scenario 2 Jenna’s boyfriend, Rick, moves in. They each file taxes separately. What is Jenna’s MBU? What is Rick’s MBU? Jenna’s MBU: 2 Rick’s MBU: 1

13. Scenario 3 Jenna has had her baby. Rick is the father. Jenna claims her baby when she files taxes and Rick files separately. What are the MBUs of Jenna, Rick, and the baby Clara? Jenna’s MBU: 2 Rick’s MBU: 1 Clara’s MBU: 3

15. Scenario 4 Jenna and Rick get married, but they still file taxes separately. Jenna claims Clara on her taxes. What are the MBUs of Jenna, Rick and Clara? Jenna’s MBU: 3 Rick’s MBU: 2 Clara’s MBU: 3

17. Scenario 5 Jenna and Rick decide to file taxes together. They claim Clara. Jenna is the primary tax-filer. What are the MBUs of Jenna, Rick and Clara? Jenna’s MBU: 3 Rick’s MBU: 3 Clara’s MBU: 3

19. Scenario 6 Rick’s son from another relationship, Ken, moves in. He is 14. Ken is claimed by his mother (whom he does not live with) on her taxes. What are the MBUs for Jenna, Rick, Clara and Ken? Jenna’s MBU: 3Rick’s MBU: 3 Clara’s MBU: 3Ken’s MBU: 4

21. Tax-Filer An individual, head of household or married couple who expects to file a tax return Non-Filer An individual who neither files a tax return nor is claimed as a tax dependent Tax- Dependent Anyone expected to be claimed as a dependent by a Tax Filer

22. Tax Filer Rules Member Member’s spouse, if living with them All of the Member's tax dependents

23. Non-Filer Rules Member Member’s spouse, if living with them Member’s children under 19, if living with them If Member is under 19 and if living with: Member’s parents Member’s siblings under 19

24. Tax Dependent Rules Member The person claiming the Member All other tax dependents and their spouse, if living with them, of that tax filer The Member’s spouse, if living with them

25. Three Exceptions Expects to be claimed as a tax dependent of somebody other than a spouse or parent Is a child under 19 who lives with both parents, but the parents do not expect to file a joint tax return Is a child under 19 who and expects to be claimed by a non- custodial parent

26. Income MAGI Income

27. MAGI: Income  MAGI (Monthly Adjusted Gross Income) is a methodology used to determine countable income.  MAGI is not a number on a tax return.

28. Self-Attestation  Self-Attestation (Member declares information) of income is acceptable for MAGI Medical Assistance.  Individuals who provide self- attestation of income must also provide a Social Security Number for wage verification purposes.

29. Self-Attestation  Self-Attestation of income can be accepted from:  The applicant  An adult in the applicant’s household or family  An Authorized Representative  Someone acting responsibly for the individual (if the applicant is a minor or incapacitated)

30. Income Verification  If an applicant is unable to provide verification using self- attestation, income can be verified by the following:  Wage Stubs  Written documentation from the employer  Telephone call to an employer

31. Countable Income Earned Income Salaries, Wages and Tips Self-Employment Foreign earned income Unearned Income Social Security Benefits Retirement Benefits Social Security Disability Insurance (SSDI) Survivor’s Benefits – Title II Unemployment Benefits Alimony Retirement Benefits Veterans Benefits

32. Exempt Income Child Support Supplemental Security Income (SSI) Title XVI Certain American Indian or Alaskan Native payments Education scholarships/grants Unless used for living expenses Foster Care payments Earned Income Tax Credit (EIC)

33. Exempt Income  Annual Income less than $5800  If an individual’s total countable income is less than $5800, that individual’s income is considered exempt for MAGI income calculation All income should be entered into CBMS. CBMS will determine if the income should be counted or excluded.

35. MAGI Income Calculations MAGI Weekly four checks provided in May. $200 $200 MAGI Weekly two checks in May : $200 $200=$400 2=$200 4.33 $800 Actual $860 Converted

36. CHP+ Income Calculations CHP+ Every two weeks two checks in May: $200 CHP+ Every two weeks one check in May: $200 2.16 $400 Actual $432 Conversion

37. Scenario 7 Rick works for Big Box Company. He earns $200.00 every two weeks. What is his total monthly income? Rick’s income $430.00 $200 X 2.15 = $430.00

38. Continuing Scenario 7 Jenna works for Noisy Machinery. She earns $400.00 twice a month. What is Jenna's income? Jenna’s income $800.00 $400 X 2 = $800.00

39. Income Results Highlight the member’s name and click on the Medical Financial Detail

40. Countable Income for Rick

43. Questions 43

44. Scavenger Hunt

45.  If you have any questions please:  Email Staff Development Center Eligibility Inbox  soc_staffdevelopment@state.co.us 45

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