MEMORANDA
Issued by the Connecticut Department of Social Services (last updated 3/16/14)


Subject: re: Lump Sum Income Question Redux
From:    "Gangi, Tiffany N." <Tiffany.Gangi@ct.gov>
Date:    6/20/2013 11:40 AM
To:      "'davis@sharinglaw.net'" <davis@sharinglaw.net>
CC:      "Love, Debra R." <Debbie.Love@ct.gov>

Hi Lisa,

Your email was forwarded to me for response.  I'm not sure if you are only asking about HUSKY D
or not, so I'll address that and then if you are looking for more info, please let me know.  As
far as lump sum income in HUSKY D, it is treated as income in the month of receipt, and as an
asset (to the extent retained) thereafter (still using UPM 8080.50).  For HUSKY D, assets are
excluded.  If this were a HUSKY D client in a nursing home, the lump sum income would be
counted in the month of receipt and due to the nursing home as applied income for that month.

Tiffany Gangi
Public Assistance Consultant
Eligibility Policy and Program Support
Connecticut Department of Social Services
25 Sigourney Street, 10th Floor
Hartford, CT 06106
Tel.:  860-424-4894
Fax:  860-424-4957                                                                                                              



From: Randall, Noeline K. [mailto:Noeline.Randall@ct.gov]
Sent: Monday, April 08, 2013 1:55 PM
To: Debbie Chianese; Butler, Daniel T.
Cc: Shok, Marc C.; Barbara W. Reynolds
Subject: RE: life only annuity

Hi Debbie,

In answer to your follow up question, we do consider the life only annuity to be actuarially sound based, in part, on the fact that there is no death benefit and is therefore not an estate planning tool. 

Let me know if you need any further information.

Kay 

Noeline  Kay Randall
Public Assistance Consultant
Dept. of Social Services/Adult Division
25 Sigourney Street
Hartford, CT 06106
Tele: 860-424-5298
Fax:  860-424-4939

From: Debbie Chianese [mailto:debbie@barbarareynoldslaw.com]
Sent: Thursday, April 04, 2013 3:30 PM
To: Butler, Daniel T.
Cc: Randall, Noeline K.; Shok, Marc C.; Barbara W. Reynolds
Subject: RE: life only annuity

Dan,

Thank you for your response. I hope you don't mind answering another annuity question.

Is a life only annuity (pays for annuitant's total lifetime but stops at death of the annuitant) considered "actuarially sound"?

Debbie

From: Butler, Daniel T. [mailto:Daniel.Butler@ct.gov]
Sent: Thursday, April 04, 2013 11:24 AM
To: Debbie Chianese
Cc: Randall, Noeline K.; Shok, Marc C.
Subject: life only annuity

Debbie:  I am responding to your question concerning whether the State of Ct. must be named as a beneficiary of a life-only annuity.  If an annuity contact is a life-only annuity, meaning that all payments stop upon the death of the annuitant and no death benefit is payable, then the State of Ct need not be named as a beneficiary of the policy in order to avoid a transfer of assets penalty.

If, however, there are any circumstances under which a benefit may be paid upon the death of the annuitant, such as an annuity contract that provides for a refund of the balance of the single premium if the annuitant dies before the amount of annuity payments made equals the amount of the single premium paid, then the State of CT must be named as a beneficiary in order to avoid a penalty.

Feel free to contact me if you have any questions.

Dan

Daniel T. Butler
Principal Attorney
Department of Social Services
Office of Legal Counsel
25 Sigourney Street
Hartford, CT  06106
Tel. 860-424-5488
Fax 860-424-5403


From: Shires, Catherine L. [mailto:Catherine.Shires@ct.gov]
Sent: Tuesday, November 08, 2011 2:16 PM
To: Torres, Eneida; Espejo, Jose O.; LaChapelle, Jaimie; Raven, Barbara;
Scricca, Janice; Starr, Shelley A.; Bonett, Carlos J.; Bruno, Carissa
A.; Graves, Veda F.; Martinez, Elizabeth A.; Newton, Robley D.; Shires,
Catherine L.
Cc: Elena Goggin
Subject: Pooled Trusts & Determining Disability [not-secure]

Hello,

As you know we have been recently experiencing some confusion regarding
how to determine a disability when a client is over age 65 and has
established a pooled trust.

Marc Shok has secured an answer for us from Colonial Cooperative Care.

We do not have to secure the "300 Series" Medical Packet that you
normally would for an under age-65 disability determination.

We can accept the doctor's statement that accompanies the Pooled Trust
packet, however:

Be sure that the doctor's statement includes the diagnosis, and signs
and symptoms. If you find that these components are not present on your
inspection, you should require the client's representative to provide a
physician's statement that includes a diagnosis, signs and symptoms.

While you are awaiting our Legal Counsel's advice on the body of the
Pooled Trust (Resources), the Eligibility Worker should submit the
physician's statement to Colonial with the usual cover letter. You
should stipulate on the cover letter that this is for an approval of a
Pooled Trust. I hope this helps to eliminate some of our confusion on
this subject,

Thank you,

Cathy



Subject: Income Tax Refunds
Date: Tue, 1 Feb 2011 10:18:58 -0400
From: Shok, Marc C. <Marc.Shok@ct.gov>
To: DSS-DL-EligibilityStaff <DSS-DL-EligibilityStaff@ct.gov>
CC: Starkowski, Michael P. <michael.starkowski@ct.gov>, Beaulieu, Claudette J. <claudette.j.beaulieu@ct.gov>, Palermino, Peter J. <Peter.Palermino@ct.gov>

Good morning -

Under a new federal law, income tax refunds received after December 31, 2009
are excluded as income in the month of receipt and as assets (if retained)
for 12 months for all federally-funded programs.

HUSKY, Medicaid LIA & Medicare Savings Programs and SNAP Households under
185% FPL - do not count any income tax refunds by households, including any
Earned Income Tax Credit portion, as income. There are no asset
considerations for these programs.

Other Medicaid for the Aged, Blind & Disabled groups, TFA, State Supplement
and SNAP elderly/disabled households over 185% FPL - do not count any income
tax refunds by households, including any Earned Income Tax Credit portion,
as income in the month of receipt. Additionally, exclude any income tax
returns, including any EITC, as assets to the extent retained for the
following 12 months.

SAGA Cash - since SAGA cash is not federally-funded, continue to count any
income tax refunds, including any EITC portions, as income in the month of
receipt and as an asset to the extent retained.

Thanks for your attention. Please contact the Family Services Unit for any
TFA or HUSKY-related questions and the Adult Services Unit for any Medicaid
LIA, MAABD, State Supplement and SAGA related questions.

Marc Shok
Adult Services Program Manager
Connecticut Department of Social Services
25 Sigourney Street
Hartford, CT 06106

(860) 424-5246
(860) 424-4939 FAX







Subject:      RE: Interrupted 24 month+ caregiving scenario [not-secure]
From:         "Shok, Marc C." <Marc.Shok@ct.gov>
Date:          Mon, 30 Aug 2010 16:29:35 -0400
To:              "'Lisa Nachmias Davis'" <davis@sharinglaw.net>, "Butler, Daniel T." <Daniel.Butler@ct.gov>

Hi Lisa -

As I'm sure you know, there are two regs that could apply to transfers of the home.  UPM 3029.10A requires that the caregiver live with the person and provided care for the two year period immediately preceding his or her institutionalization.  The value of the home is not a factor.  This reg does not support the aggregation of multiple periods when care was provided.

UPM 3029.20 (Other Valuable Consideration) supports the aggregation of multiple periods of care, provided that they total to at lease 24 months.  Since the reg does not prohibit aggregation, the value of the other valuable consideration should be based on the aggregate number of months.

I hope this helps.

Marc

-----Original Message-----
From: Lisa Nachmias Davis [mailto:davis@sharinglaw.net]
Sent: Thursday, August 26, 2010 4:56 PM
To: Shok, Marc C.; Butler, Daniel T.
Subject: Interrupted 24 month+ caregiving scenario

Marc and Dan, I know you are busy, but hope you will consider this issue:

Can various periods of caregiving be aggregated as "other valuable
consideration"?

Caregiving family member lived with / cared for applicant from
2004-2006, keeping person out of institution.

2006-2009 applicant lived in a residential care home (private pay).

Subsequently, applicant has been living at home with caregiving family
member, except for 100 days in nursing home (Medicare, insurance).

There has been no Title 19 or CHCPE state, thus far.

Applicant wishes to transfer home to caregiving family member, who has
lived in the home for years.

Home may be worth more than $240,000.  Hypothetically, let's say it is
worth $360,000.

In the aggregate the caregiving time was probably 36 months.  However,
it was interrupted by institutionalization in an RCH.

In this type of scenario, is the Department willing to aggregate the
time spent caregiving?  Obviously, your answer would not be taken as
binding on the Department in a particular case.  I'm just trying to nail
down whether in appropriate cases (a) the value for other valuable
consideration might exceed 24 x average monthly cost of care (the UPM
suggests it would) and whether (b) aggregate caregiving "counts" towards
the 24 months prior to institutionalization even if interrupted by a
different institutionalization. It seems to me within the SPIRIT of
other valuable consideration, but I am trying to get a sense of the
Department's views on this.

Lisa Davis

--
====

Lisa Nachmias Davis
Davis O'Sullivan & Priest LLC
Attorneys at Law
129 Church Street, Suite 805
New Haven, CT 06510
203-776-4400
Fax 203-774-1060
www.sharinglaw.net
www.estate-elder.com
davis@sharinglaw.net



Subject:    [Fwd: Annuities] + new question [not-secure]
From:        "Shok, Marc C." <Marc.Shok@ct.gov>
Date:        Tue, 4 May 2010 14:25:10 -0400
To:        "'davis@sharinglaw.net'" <davis@sharinglaw.net>
CC:        "Butler, Daniel T." <Daniel.Butler@ct.gov>

Good afternoon Lisa –

*  *  * [portions omitted related to life only annuity]  *  *  *

With regard to your email of yesterday, I can confirm that (1) if the Community Spouse annuitizes her IRA, DSS will no longer count the IRA as a counted resource; and (2) if purchased by Community Spouse with assets always owned by Community Spouse, it need not be actuarially sound.

Regards,

Marc Shok
Adult Services Program Manager
Connecticut Department of Social Services
25 Sigourney Street
Hartford, CT  06106
(860) 424-5246
(860) 424-4939 FAX 

-----Original Message-----

From: Lisa Nachmias Davis [mailto:davis@sharinglaw.net]
Sent: Monday, May 03, 2010 6:27 PM
To: Shok, Marc C.
Subject: [Fwd: Annuities] + new question

Marc,

*  *  *

I wanted to know if you could CONFIRM that:  (1) if the Community Spouse annuitizes her IRA, DSS will no longer count the IRA as a counted resource, provided the State is named in 1st position after she dies; and (2) if purchased by Community Spouse with assets always owned by Community Spouse, it need not be actuarially sound.






(E-mail forwarded by Judith Hoberman, Hamden, CT)

Kevin Loveland
Director, Bureau of Assistance Programs
Connecticut Department of Social Services
860-424-5031

As you may know, the President recently signed the American Recovery and Reinvestment Act (the Economic Stimulus Package) into law.  The ARRA provides for an immediate increase of up to $25 per week in unemployment benefits, as well as a one-time $250 supplemental payment to recipients of Social Security, SSI, VA and Railroad Retirement benefits.  The following describes how these payments will impact eligibility for our programs:

$25 Per Week Increase in UCB

The Department of Labor began issuing the increased unemployment benefits on Monday, March 2, 2009.

It is important to note that under the provisions of the federal law these additional unemployment benefits are not counted as income for Medicaid or HUSKY B.  The additional benefits are, however, counted for our other programs such as State Supplement, TFA, SNAP and SAGA.

Workers should code the "base" unemployment benefits as unearned income type "UC" as usual.  If there is a companion SNAP AU, the additional unemployment benefits should be coded as unearned income type "OF".  Additional unemployment benefits on companion SAGA AUs should be coded as unearned income type "OG".  Additional unemployment benefits on companion TFA AUs should be coded as unearned income type "OA".

Please code the additional unemployment benefits as unearned income type "OA" for State Supplement clients.  Clients should not, however, under any circumstances lose Medicaid eligibility by including the additional unemployment benefits. If this occurs, please contact the Adult Support Team at (860) 424-5250 through your supervisor for instructions.


Workers have begun to receive a large number of additional UCB alerts due to these increased benefits.  For HUSKY or Medicaid only cases, these alerts may be immediately dispositioned without requiring further action.  For other programs, including SNAP (since this information is considered verified upon receipt) you must reflect the increased benefits as described above.

$250 One-Time Stimulus Payments

The Social Security Administration has informed us that they will soon begin to issue one-time additional of payments of $250 to recipients of Social Security, SSI, VA, and Railroad Retirement benefits.  They have indicated that they expect to complete their issuance process by the end May, but have not provided any more specific information regarding when the payments will be issued.


Under the federal economic stimulus law these payments must be disregarded when determining eligibility for any federal or federally-assisted programs.  We have determined that this means that we will not count these benefits for the Medicaid, HUSKY, State Supplement, TFA or SNAP programs.  However, they must be counted as lump sum payments under SAGA policy.  Given that they are one-time payments received in the current month and most SAGA clients will not qualify for these benefits we expect minimal if any impact on eligibility from these payments.

Contact the Adult Support Unit through your supervisor at (860) 424-5250 if you have any questions about these changes.

Kevin Loveland
Director, Bureau of Assistance Programs
Connecticut Department of Social Services
860-424-5031







(E-mail provided by Attorney Donna Levine of New Haven, Connecticut, now of North Haven, CT)

From: Shok, Marc C.
Sent: Monday, January 03, 2005 2:39 PM
To:  DSS-DL-EMS; Ragaglia, Kristine D.; Hart, Lorraine M.; Allen, Juanita L.;  Gray, Mary Ann; EMSALL@po.state.ct.us
Subject: CHC Program & Pooled  Trusts


This e-mail is to inform those of you who process applications  for the Connecticut Home Care (CHC) program about "pooled" trusts.  You  will likely see more CHC applicants with these trusts as they can be used to  reduce their incomes to below the program limit of 300% of the SSI payment  standard. Here's how it works:

The Medicaid waiver portion of the CHC  program has a gross income limit equal to 300% of the SSI payment  standard.  This limit will be $1,737 in 2005. Individuals with incomes  above this limit cannot qualify for the Medicaid waiver portion of the CHC  program.  Often these individuals receive assistance under the  state-funded component of the CHC program (M03 cases) which has no income  limit.

This is disadvantageous for both clients and the state.   Clients do not receive Medicaid benefits under the state-funded component of  the CHC program to cover ancillary expenses such as prescription drugs.   The state does not receive any federal reimbursement for expenditures made  under the state-fundedcomponent of the CHC program.

Federal law and  UPM regulations at 4030.80(D)(6) allow individuals to establish certain types  of trusts without affecting their eligibility for Medicaid benefits.   You have likely seen one type of these trusts, a special needs trust (SNT),  used to shelter assets of disabled individuals without affecting their  Medicaid eligibility.

What you may not be aware of is that these types of  trusts can also be used  to shelter individuals' incomes.  A client may  assign his or her income to the trust with the trust document providing only  for the release of a monthly amount below the 300% of SSI limit to the  client.  We only count what comes out of the trust as the client's  income for Medicaid eligibility purposes.

Although SNT's are only  available to disabled individuals under age 65, "pooled" trusts are available  to disabled individuals of any age.  This is why you will likely see  more CHC applicants with these trusts as the program is limited to  individuals aged 65 or older.  These trusts are more fully described in  UPM 4030.80(D)(6)(b).

Any pooled trust documents should be forwarded to  Attorney Daniel Butler, Office of Legal Counsel, Regulations and  Administrative Hearings, in Central Office for a review of legal  sufficiency.  Additionally, you will need to  have Colonial Cooperative  Care perform a disability determination for the client. Please notate "Pooled  trust disability determination" on the W-302 routing slip. Given the frail  nature of CHC clients, disability determinations should not be  problematic.

Some final notes - Disabled individuals under age 65 can  also use SNT's to shelter income to qualify for the Katie Beckett, DMR,  Acquired Brain Injury and Personal Care Attendant waivers, which also have a  300% of SSI gross income limit.  SNT's are more fully described in  4030.80(D)(6)(a).  SNT documents should be forwarded to Attorney Butler  for review.  However both SNT's and pooled trusts CANNOT be used to circumvent the State Supplement gross income limit of 300% of SSI.

As always, thanks for your attention.  Please feel free to contract the Adult Support Unit at (860) 424-5250 if you have any questions







(E-mail provided by Kevin Brophy of Connecticut Legal Services (Waterbury))
From:       MARC.SHOK@CTTAO
                Department of Social Services
Subject:    Anthem BC/BS Demutualization
Date:        9-5-01

Recently Anthem Blue Cross/Blue Shield announced that they were changing their organizational structure from a mutual company to a stock company. As a mutual company, owners of certain Anthem Blue Cross/Blue Shield policies (typically non-group policies) were entitled to certain "membership rights".  In the conversion from a mutual company to a stock company, (a process known as demutualization), these member rights will be exchanged for shares of Anthem stock or cash.  According to Anthem, demutualization will not affect the medical benefits of the policies.

Clients who own qualifying Anthem policies are scheduled to receive these demutualization payments in late November or early December. These payments should be treated as counted assets in determining eligibility. Please remember that MAABD eligibility is not affected in the month that recipients acquire assets that cause them to exceed the asset limit.  (MAABD recipients who don't reduce their excess assets by the end of the first month become ineligible as of the following month.)  However MAABD clients reestablish their eligibility without interruption if they subsequently reduce their assets by the end of the month following the month they acquire the excess asset.  (Please see UPM 4005.l5.)

Please contact the Adult Support Unit at (860) 424-5250 if you have any questions.

Thank you.
 



          


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