15. MAGI MC Income...The deposit or check may not reflect gross income if Medicare premiums are being deducted or an overpayment is being collected from the client’s check. page

Medi-CalMedi-Cal 15. MAGI MC Income

15. MAGI MC Income

15.1 Reported Income

Both the Single Streamline Application (SSApp/CCFRM604) and the California Healthcare Eligibility, Enrollment, and Retention System (CalHEERS) allow clients to provide their Current Monthly Income (CMI) and Projected Annual Income (PAI).

Single Streamline Application

In Step 2 of the SSApp, the application has the following questions which relate to CMI:

The SSApp also has the following question which relates to PAI:

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page 15-2Medi-Cal 15. MAGI MC Income

Floating View and Summary View

In Floating View and Summary View, PAI income is displayed separately from CMI (Earned/Self-Employed Income and Unearned Income). If the PAI fields are blank (as in the example below), the client has not attested to PAI in CalHEERS.

15.2 .Income Verification

15.2.1 Earned Income

Earned income can be verified using:

• E-Verification from the federal hub

• One pay stub (most current pay stub available to the client; not required to have been issued within the last 30 days but must accurately reflect the amount reported on the application).

• Copy of federal tax return that accurately reflects current income. For self employment, last years tax documents are sufficient. For all other income, the tax documents must have been filed within 90 days to be used as verification

• Signed letter from employer showing the gross amount and date of paycheck

• Receipts showing gross earnings and expenses

• Business records (Profit and Loss Statements)



Earned income must be verified prior to approval and at redetermination, restoration or reapplication. If there is a discrepancy between the pay stub submitted and the amount reported on the application, the EW may request additional pay stubs to determine the correct monthly income.

If the client receives income and items listed above are not available, EW must obtain a “Sworn Statement” as a last resort. Any statement signed and dated under penalty of perjury is acceptable (e.g. SCD 101, Attestation of Income form from Covered CA, etc.).

Individuals Paid in Cash

Individuals who are paid in cash often cannot provide proof of income. If all other options are exhausted (i.e. attempt to get employer statement, verification through the Federal Hub, etc.), the signature on an application is sufficient verification of income for clients paid in cash. Additionally, clients can complete a Sworn Statement as verification.

The Work Number

The Work Number is not to be utilized to obtain verification of income for MC only cases. It may however be used for combo MC cases. Additionally, if an individual is on CalFresh in one case, and Medi-Cal in another, the Work Number may be used to verify income for the Medi-Cal only case.

Example:

Daisy is on a CalFresh only case, because her and her roommate purchase and prepare food together, however, they file taxes separately, so Daisy is on her own Medi-Cal case. Because Daisy is active on both CalFresh and Medi-Cal (despite the fact that it is on two different cases) the Work Number can be used as verification on the Medi-Cal only case. Document the circumstances thoroughly in the Maintain Case Comment window.

15.2.2 Unearned Income

Unearned income can be verified using:

• Award letter or most recent cost-of-living increase notice

• IEVS/PVS abstract or printout

• Current bank statement if the applicant has direct deposit or copy of the applicants current benefit check

Note:Note:The deposit or check may not reflect gross income if Medicare premiums are being deducted or an overpayment is being collected from the client’s check.



• Signed statement from the person or organization providing the income.

If the client receives income and items listed above are not available, EW must obtain a “Sworn Statement” (SCD 101) from the individual (as a last resort).

Unearned income must be verified prior to approval, and at each reapplication, restoration, or redetermination.

15.2.3 Using the Federal Hub to Verify Income

When EDBC is run for a MAGI case, information from CalWIN is sent to CalHEERS and matched against the Federal Data Services Hub (Federal Hub). Reported income that matches the federal hub within the allowable threshold will be “e-verified”. E-verification is only valid for MAGI MC and APTC and must not be used as verification for Non-MAGI or other programs. In a combo case (i.e. CalFresh/MC) other verification must be requested.

There are two E-Verification categories on the Manual Verification page in CalHEERS: Household Current Monthly Income (CMI) and Household Income Subsidy. For MAGI individuals, the Household CMI must be e-verified or paper verification is required. For APTC individuals, the Household Income Subsidy must be e-verified or paper verification is required.

E-Verification is at an individual level. The same amount of income may be E-Verified for one person, and not E-Verified for another.

Example:

A mom is applying for her child and not requesting aid. The EW enters her income information into CalWIN and marks it Not Received. After running EDBC, mom’s manual verification page shows the income of $1000 is not E-Verified, however on the child’s manual verification page, the income of $1,000 is E-Verified. This is sufficient verification of income for the child. If the mom were requesting aid, paper verification would be required to establish eligibility.

DIVS Verification

CalHEERS has added a new DIVS verification for APTC, CSR, and QHP. Anything that is only DIVS verified is not sufficient verification for Medi-Cal household members. Other verification must be received.

15.3 Current Monthly Income

Current Monthly Income (CMI) should be entered for every individual who reports income, regardless of whether or not they report Projected Annual Income (PAI).



15.4 Projected Annual Income

For income that fluctuates month to month, the SSApp specifically asks for the PAI. CalHEERS also asks for PAI information and e-verifies PAI and CMI separately.

PAI is not required for a MC eligibility determination and benefits should never be denied or discontinued for failure to provide PAI verification.

Note:

PAI will not be counted in the CalWIN budget for Non-MAGI MC or any other program.

15.4.1 How CalHEERS E-Verifies PAI and CMI

CalHEERS calculates a monthly income amount from the PAI for comparison purposes. CalHEERS will always use the lower of the two monthly amounts to determine eligibility when both have been e-verified. If the lower amount is e-verified, it will e-verify the higher amount as well.

Table 15-1: CalHEERS eVerification of PAI and CMI

If... Then...

Both amounts are e-verified, CalHEERS will use the lower amount for eligibility.

The lower amount is e-verified, CalHEERS will use the lower amount for eligibility and automatically e-verify the higher amount so eligibility does not pend.

The higher amount is e-verified, CalHEERS may not e-verify the lower amount and verification may need to be requested. [Refer to Chapter 15, Section 15.4.3 "When to Request Verification,” page-6]

15.4.2 When to Enter PAI in CalWIN

PAI is only entered in the Display Projected Annual Income Detail window for individuals who attest to PAI that is more beneficial than their CMI. [Refer to Chapter 15, Section 15.5 "Income Flowchart,” page-10]

Examples of when PAI is used:

• When PAI is below the MAGI limit and CMI is above the MAGI limit.

• When both PAI and CMI are under the MAGI limit, but the CMI makes a child eligible to a premium aid code and the PAI makes the child eligible to a non-premium aid code.

• When PAI and CMI are both above the MAGI limit, and PAI is lower than CMI.



CMI must continue to be entered in the appropriate income-related windows, even when PAI is entered in CalWIN. Because PAI is used as a last resort, it should not be entered until it has been verified.

15.4.3 When to Request Verification

When a client reports PAI and CMI, verification is not necessarily required for both. Follow the table below for requesting verification.

Table 15-2: Requesting Verification

If... And... Then... Exception

Both amounts are within the MAGI limit,

One or both are e-verified, No further verification is required. If the unverified amount would qualify a child for a non-premium aid code and the e-verified amount qualifies a child for a premium aid code, request verification of the lower amount.

Neither is e-verified, Request verification of CMI.

One amount is over MAGI, one amount is below,

Only the amount above MAGI is e-verified,

Request verification of the amount below MAGI to see if the client is MAGI eligible.

Only the amount below MAGI is e-verified,

No further verification is required.

Both amounts are over MAGI (mixed households),

One or both are e-verified, No further verification is required.

Neither is e-verified, Request verification of the lower amount.

15.4.4 Display Projected Annual Income Detail window

The table below lists the CalWIN field in the Display Projected Annual Income Detail window, the CalHEERS field where the information can be found, and what to enter in CalWIN.

Table 15-3: Display Projected Annual Income Detail Window

CalWIN Field CalHEERS Field What to Enter in CalWIN

Effective Begin Date N/A The date PAI was reported

Calendar Year For Year Year the PAI record was created

PAI Begin Date Record Created Date the PAI record was created.

Projected Annual Income

You Expect PAI amount.

PAI End Date Record Superceded Date the PAI ended.



Guidelines for Entering PAI in CalWIN

• Never enter $0 PAI when the client has not attested to any PAI.

• Never enter PAI for dependents or other household members when they do not have their own annual income. PAI is individual-based; adding incorrect PAI will cause the household income to increase.

• When a PAI record is open and a client reports new CMI, but does not report PAI, the PAI should be end dated. A new record should only be opened when the client reports new PAI that is more beneficial to the client than CMI.

End Dating PAI

PAI should be end dated when an income change is reported.

• If no PAI is reported, end date the entry in the Display Projected Annual Income Detail window and update the CMI.

• If a new PAI amount is reported, determine whether the new PAI is more beneficial to the client. If it is, end date the existing PAI entry and create a new entry. If the PAI is not more beneficial, end date the existing PAI entry and update the CMI.

The Effective Begin Date in the Display Projected Annual Income Detail window should not be updated on an existing row unless it was entered in error at initial entry. To update or end PAI, enter an end date in PAI End Date and create a new row when applicable.

There can only be one PAI amount that covers the same PAI Begin and End Date range. An error message will display in the following scenarios:

• When an existing PAI record is not end dated and an EW tries to add a new PAI entry with the same calendar year.

Effective End Date N/A Not a fillable field. PAI is ended by PAI End Date, not Effective End Date.

Admin Verification N/A How it was verified in CalWIN.

State Verification N/A Verification from CalHEERS.

Table 15-3: Display Projected Annual Income Detail Window

CalWIN Field CalHEERS Field What to Enter in CalWIN



• When the new PAI Begin Date overlaps with the PAI Date Range (PAI Begin Date to PAI End Date) on an existing PAI entry.

15.4.5 Individuals With No PAI Who Are Pending Eligibility for PAI Verification

Individuals who have no PAI, but have household members that do, may pend for not having PAI verification. To grant those individuals eligibility, complete the following steps:

1. Log in to CalHEERS.

2. Enter the CalHEERS Case ID.

3. Select any individual from the appropriate case and click [Manual Verification].

4. Select the individual who is pending in CalWIN to open the Personal Verification page.



5. On the Personal Verification page, scroll down to “MAGI Medi-Cal Projected Annual Income”. The drop-down in the Verification Status column should say Pending.

6. Select Pass from the drop-down in the Verification Status column.

7. Click [Save].

8. Repeat Step 1 through 7 for any other household members who are pending for PAI but have no attested PAI.

9. On the Household Verifications page, click [Redetermine Eligibility]. This will send a CEW Through Portal Change DER to CalWIN. Process the Change DER. [Refer to “CEW Through Portal Change DERs,” page 18-38]

10. Once EDBC is run, the individual(s) should no longer be pending.

Note:

THIS SHOULD NOT BE USED FOR ANY OTHER SCENARIO. If individuals do have PAI and are pending for PAI, the verification must be requested and processed as usual.



15.5 Income Flowchart

Follow the flowchart below to determine which income type should be used:



Example 1

Maria files taxes as Head of Household and claims one child as a dependent. She reports PAI of $24,240 and CMI of $1,900 for a HH of 2. The PAI works out to $2,020 monthly which is e-verified and qualifies the child for T1. The CMI is not e-verified, but would qualify the child for T2. Both are under MAGI limits, but CMI qualifies the child for a non-premium aid code. A request is sent for CMI verification and Maria provides verification. Only CMI will be entered in CalWIN and used to determine eligibility.



Flowchart for Example 1

Example 2

Michael files taxes as Single. He reports PAI of $12,000 and CMI of $1,800. The PAI works out to $1,000 monthly. PAI and CMI are both e-verified. PAI and CMI will be entered in CalWIN and PAI will be used to determine eligibility.






Example 3

Darius files taxes as Single. He reports PAI of $12,000 and CMI of $1,900. The PAI works out to $1,000 monthly. CMI is e-verified and above MAGI. PAI is not e-verified and is below MAGI. PAI verification is requested and Darius does not provide any verification. CMI should be entered in CalWIN and will be used to determine eligibility.






15.6 Income of a Tax Dependent

The income of a tax dependent (qualifying child or qualifying relative) or child who is not expected to be required to file taxes is excluded from the tax household’s MAGI income calculation. Income of children and tax dependent is counted in determining MAGI household income when a child or tax dependent is expected to be required to file a tax return.

The EW can accept the tax filing requirement as reported by the client for the benefit year that they are applying for.

Note:

Supplemental Security Income (SSI) and Social Security benefits (i.e. Retirement, Survivor’s, Disability Insurance) are not counted for the purposes of determining whether a tax dependent will be required to file a tax return. However, if the tax dependent does have a tax filing requirement then the dependent’s Social Security benefits will be counted toward the household’s MAGI income.

If the Expected to be Required to File Taxes this Year [Y/N] field in Display Tax Filer Detail is marked No the income will not count in the MAGI MC budget.



15.7 Self-Employment Income

The amount the client enters or provides on the application should be the net taxable income from self-employment activities, which is the amount after applying expenses and deductions permitted by the IRS. IRS rules for determining taxable net profit income from self-employment may result in a negative number (a net income loss). The negative number may be used to offset other income the household reports on their application and, may result in zero countable income for MAGI MC. If the self-employed expenses exceed the self-employment income, CalWIN will send a negative number to CalHEERS.

The amount that is entered on the SSApp is the amount that should be transmitted to CalHEERS the Federal Hub will determine whether that amount is reasonably compatible. If it is not determined to be reasonably compatible, paper verifications of income must be provided (i.e. IRS Form 1040, Schedules C, E, K-1, etc.)

The IRS rules are different from the rules for determining net income from self-employment for Non-MAGI eligibility. The IRS deductions for MAGI MC are broader than those allowed for Non-MAGI MC net income from self-employment and rental property calculations.

Self-employment income is typically verified using the prior year’s tax documents, however, if the client is unable to provide the tax documents or states that the tax documents from last year do not accurately reflect the current year’s income, they must provide verification of their income and expenses from the last three months. The Eligibility Worker must average the three months of income and expenses and use the resulting amount as the monthly income/expenses in CalWIN.

15.7.1 Combo Cases

When an individual on a combo case is self-employed, the rules of the other programs must be used, rather than the information outlined above.

Note:

For instructions on how to enter self employment income on a MC/CF case please see SA 331.

15.8 Individuals Paid in Cash

Individuals who are paid in cash often cannot provide proof of income. If all other options are exhausted (i.e. attempt to get employer statement, verification through the Federal Hub, etc.), the signature on an application is sufficient verification of income for clients paid in cash. Additionally, clients can complete an SCD 101 as verification.


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Medi-

15.9

When a e sworn statement on the Applicat

ExEx

idual, the EW must request

15.10

Uncond pt it. This includes but is not limited to:

• Di• Ve• Re• Un

Individu they are not required to provide verificat criteria are met.

15.11

The Pub dentifies discrepancies in unrepor irectly from the U.S. Department of

Page 15-18

Cal 15. MAGI MC Income

Verification of Zero Income

client reports zero income at Application or Redetermination and the income is not E-Verified, thion/Redetermination forms is sufficient verification of income.

ception:ception:

If the client reports zero income, but there is an open employment record in CalWIN for that indivverification that the job has ended.

Unconditionally Available Income

itionally available income is income that is potentially available to the client if they claim and acce

sability Insurance Benefitsterans benefitstirement, Survivors, Disability Insurance (RSDI)employment Insurance Benefits

als applying for MAGI MC are required to apply for all unconditionally available income, however,ion that they applied, and eligibility can be granted in the meantime as long as all other eligibility

PARIS Federal Match

lic Assistance Reporting Information System (PARIS) Federal Match is a quarterly report which ited income. Information from the report is to be treated as verified federal income as it is taken d

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Defense rted by income amount, eligibility status, a d and record the findings on the spreads evaluated and appropriate NOA(s) should b

15.12

Income di-Cal (MC) and Advanced Premium when the income type is selected from the the income is counted or not counted or are not) counted for both MAGI MC and

The inco Income,” page 20-1] for Non-MAGI MC inco

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(DOD) and the U.S. Office of Personnel Management (OPM). DHCS will send a quarterly list sond aid code. The EW will compare the federal income on the list to the income the client reporteheet provided with the listing. If the income information does not match then eligibility must be ree sent. [Refer to MC HB 7.2.4 for PARIS Interstate Match].

CalWIN Income and Deduction Types

and deductions may be counted differently between Modified Adjusted Gross Income (MAGI) Me Tax Credit (APTC). CalWIN has a feature that indicates if the income is counted or not counted

CalWIN drop-down menu. (CalWIN displays the CalHEERS income type which shows whether ). The tables in this chapter provide information of how various income and deduction types are ( APTC and which are the corresponding CalWIN types.

me and deduction tables in this chapter do not apply to Non-MAGI MC. [Refer to “Non-MAGI MCme information.

https://ssaconnect.sccgov.org/ssa_departments/debs_program/Documents/handbooks/medical/mcchap07.pdf#page=5

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15.13

The follo ne on the IRS Form 1040. It also shows i Revenue Service (IRS) Form 1040 can be e alWIN and CalHEERS only partial informa and/or CalHEERS provide addition

Other Inco CalWIN Window

$25 weeklycompensatAmerican R

Acceleratedthe insuredlong term cin excess o

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Income Types

wing table provides various income types for MAGI MC and APTC, including its corresponding lif the income is counted in the MC eligibility determination. Income from CalHEERS and/or Internalntered into several CalWIN windows. Due to the current mapping between the various types in C

tion, related to income, deductions and expenses, may be available in this chapter. Once CalWINal information, this chapter will be updated accordingly.

Table 15-4: Income Types (or Losses) from IRS Form 1040

me Types or Losses 1040 Line #

MAGI MC APTC

CalHEERS Income Type

CalWIN Income Type

supplement to unemployment ion payment authorized by the ecovery

N/A Not Counted

Not Counted

death benefits/viatical settlements if is chronically ill for costs of qualified are or if the insured is terminally ill not f limit

N/A Not Counted

Not Counted

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Acceleratedpaid to persinsured’s b

ox

Activity not

Adoption as Collect Unearned Income Detail

Alaska Natdistribution

Alaska Per

Alimony recseparation 12/31/18. Not countaseparation 01/01/2019

t • Collect Child/Spousal Detail

• Collect Unearned Income Detail

AmeriCorpsAward

AmeriCorpsStipend and

AmeriCorps ts Collect Unearned Income Detail

Austrian ge


Page 15-21


death benefits/viatical settlements ons with a financial interest in the

usiness

21 Counted Counted Choose “Other” and enterIncome Type in the Text B

for profit, Pub.535 21 Counted Counted

sistance payments N/A Not Counted

Not Counted

ive corporations and settlement trust s

N/A Not Counted

Count taxable portion only

manent Fund dividends 21 Counted Counted

eived: Income only if the divorce or instrument is executed on or before

ble income for any divorce or instrument modified on or after

11 Counted on or before 12/31/18

Counted on or before 12/31/18

AR - Alimony Received

Alimony - Spousal Suppor

State/National Stipend and Education 21 Not Counted

Counted

National Civilian Community Corps Education Award

21 Not Counted

Counted

Vista Stipend and Educational Award 21 Not Counted

Counted MS - Miscellaneous

AmeriCorps Vista Paymen

neral social insurance payments N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

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Ball v. Swo Collect Unearned Income Detail

Bartering, 1

Black Lung Collect Unearned Income Detail

Bribes

Blood, plascompensat

Business (o

rts

nts

rly

e

tem

• Collect Rental Income Detail

• Collect Room & Board Detail

• Collect Unearned income Detail


Page 15-22


ap payment N/A Not Counted

Not Counted

099-B, Pub. 525 21 Counted Counted

benefit payments

21 Counted Counted

ma, sperm, egg, embryo, or ion received for other body parts

21 Counted Counted

r loss), Schedule C or C-EZ 12 Counted Counted SE - Self-Employment

• Lump sum from trade/business of self-employed person

• Lump sum not from trade/business of self-employed person non-recurring

• R & B/Room rent: has business license or repoincome for taxes

• R & B/Room rent: no business lic regularly reto non-family member

• R & B/Room rent: no business license regularents to family member

• Self Employment incom

• Third Party payment to vendor for a non-need i



MAGI MC APTC


CalWIN Income Type

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CalFresh b

Cancellatio• intended• amounts• amounts• with rega

excess oplus imp

Cancellatiointended asinsolvency with regardthe cost of improveme

Collect Unearned Income Detail

Capital gain Collect Unearned Income Detail

Carpool pa

Child Supp Collect Child/Spousal Detail

Clergy houof market ra

Clergy houmarket rate

Clinical traiexpenses in


Page 15-23


enefits N/A Not Counted

Not Counted

n of non-business debt as a gift not in excess of insolvency discharged in bankruptcyrd to mortgage cancellation, not in f the cost of the principal residence rovements, 1099-C

N/A Not Counted

Not Counted

n of non-business debt, unless a gift, that is in excess of • amounts of • amounts discharged in bankruptcy • to mortgage cancellation, in excess of your principal residence plus nts, 1099-C

21 Counted Counted CD - Cancelled Debts

Cancelled Debts

(or loss), Schedule E 13 Counted Counted CG - Capital gains

Capital Gains

yments N/A Not Counted

Not Counted

ort N/A Not Counted

Not Counted

sing and utility allowance not in excess te and actual cost respectively

N/A Not Counted

Not Counted

sing and utility allowance in excess of and actual cost respectively

21 Counted Counted

ls participation to the extent of curred plus $2,000

N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

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Clinical triaamounts in1099-Misc

County Gen

Coverdale

Court awarcompensatcontract, pepatent or codamages


Court awarinjury or siccompensatinclude combreach of cawards, papunitive da

Credit Card ce Collect Unearned Income Detail

Disability Ininsurance p525 and 90

its Collect Unearned Income Detail

Disability Indisability inemployer) P


Page 15-24


l participation remuneration and excess of expenses minus $2,000, and 42 U.S.C. Section 1396a(e)(14)

21 Counted Counted

eral Assistance cash grant N/A Not Counted

Not Counted

education savings account 21 Counted Counted

ds/judgments/settlements for ion for lost wages/profits, breach of nsion rights, interest on awards, pyright infringement and punitive

21 Counted Counted CA- Court Awards

Court Awards

ds/judgments/settlements for personal kness/emotional distress and other ory property damages. This does not pensation for lost wages/profits,

ontract, pension rights, interest on tent or copyright infringement and mages

N/A Not Counted

Not Counted

Insurance or Disability Payment 21 Counted Counted MS - Misc. • Credit disability insuranpayments

• Credit life insurance payments

come -taxed (taxed private disability remiums paid for by employer) Pubs 7, 1099 and 1099-A

21 Counted Counted MS - Misc. Disability Insurance Beneffrom private company

come- untaxed (untaxed private come insurance-premiums not paid by ubs 525 and 907

N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

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Disability pdirectly fromincluding tr



Page 15-25


ayments received for injuries resulting a terrorist or military action, not

aining exercises

N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

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Disaster re

• From chasponsoreemergen

• From insareas. Note: Insnon-fedecount unon wheth

• From fedbased on

• For qualilocal govdefined b• Result• Result

comm• Is a Pr• Is an e

determ• From qu

source fo• Reaso

living, result

• Reasoincurrepersondisastea rente

• Reasoincurrecontenqualifie


Page 15-26


lief payments (qualified payments)

ritable organizations (not employer d) as a result of a disaster or cy hardships are considered gifts.urance in federally declared disaster

urance payments for losses in rally declared disaster areas may der certain circumstances, depending er they are taxable.eral or state government that are need,fied disasters from federal, state or ernment. A qualified disaster is y federal tax law as a disaster that:s from terrorist or military actions,s from an accident involving a on carrier,esidentially declared disaster, orvent that the Secretary of the Treasury ines is catastrophic.

alified disasters regardless of the r the following expense:nable and necessary personal, family, or funeral expenses incurred as a of a qualified disaster.nable and necessary expenses d for the repair or rehabilitation of a al residence due to a qualified r (a personal residence can be either d residence or owned).nable and necessary expenses d for the repair or replacement of the ts of a personal residence due to a d disaster.

N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

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Diversion c

Down paym

Earned inco

Economic s

Employer cfunded by areduction, saccount


Page 15-27


ash assistance N/A Not Counted

Not Counted

ent assistance N/A Not Counted

Not Counted

me tax credit N/A Not Counted

Not Counted

timulus payments (federal) N/A Not Counted

Not Counted

ontributions to certain pretax benefits n employee’s elective salary uch as amounts for flexible spending

N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

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Medi-

Employmendifferential cost-of-livincompensatseverance and paid hocash paymallowancestransportaticommissionbonuses; aon a pre-tameals and under a plaguaranteedunemploymagreement,unemploymfinanced fuperformed,

es,

se

s &

Collect Earned Income Detail

Energy Con

Endowmendeath, not ito a benefic

Endowmendeath in exveteran’s e

Farm incom Collect Unearned Income Detail


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t (Wages; salary; back pay; wage payments; Government g allowances; Non-qualified deferred ion; notes received for services; pay; sick pay; vacation, annual leave, lidays; strike and lockout benefits,

ents for stock appreciation rights; and reimbursements for travel, on, or other business expenses; s; advance commissions; tips;

wards; and fringe benefits not provided x basis (including non-clergy housing, transportation), disability pension n that is paid for by your employer, annual wages paid during period of ent by employer under a union employer paid supplemental ent benefits from an employer

nd, fees received by clergy for services and other, W-2

7 Counted Counted • Census Income

• Earnings, wages, salaribonuses, commissions,military pay

• Excess income of spou

• Pre-strike - Earnings, wages, salaries, bonusecommissions

• Reimbursements or advances which exceedexpenses

• Sick Pay

• Striker Picket Pay

• Therapeutic wages

• Tips

servation Subsidy

t Contracts paid as a lump sum before n excess of costs or paid upon death iary

t Contracts paid as a lump sum before cess of costs (not applicable a ndowment contract)

21 Counted Counted

e (or loss), Schedule F 18 Counted Counted FF - farming or fishing income

Income from Fishing and Farming



MAGI MC APTC


CalWIN Income Type

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Federal Inc

Foreign Eanon-taxable ,

Collect Earned Income Detail

Foster care

Foster caretransitional

Gambling wForm W2-G

, Collect Unearned Income Detail

Gifts/Cash Collect Unearned Income Detail

Health savi

Hobby incoexpect to s

Holocaust vPersecution


Host or hos


Page 15-29


ome Tax Return N/A Not Counted

Not Counted

rned Income (taxable and ), Form 2555

21 Count Gross

Count Gross

FI - Foreign Earned Income (taxable and non-taxable) Form 2555

Foreign Earned Income (taxable and non-taxable)Form 2555

, maintaining a space in your home 21 Counted Counted

or other Title IV-E payments and housing

N/A Not Counted

Not Counted

innings: gambling, lottery, raffles, 21 Counted Counted MS - Misc. • Winnings (bingo, lotterygambling, etc)

Contributions N/A Not Counted

Not Counted

ngs account 21 Counted Counted

me, or from an activity you did not ee a profit

21 Counted Counted

ictims restitution/Victims of Nazi /German Reparation Payment

N/A Not Counted

Not Counted

tess gift or gratuity 21 Counted Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Income fromSources• Indian fin

Indian Fiprofit-maenterpris

• Student fof Indian

ian Collect Unearned Income Detail

Income fromSchedule-C

Income frombusiness in

l • Collect Rental Income Detail


Income In-K525

Collect inkind Income Detail

Income Taxdeducted o

Indian finanFinancing AIndian-ownreservation

Individual R1099-R

Inheritanceinherited pe


Page 15-30


American Indian or Alaska Native

ancing grants under title IV of the nancing Act of 1974 to expand king Indian-owned economic es on or near reservationsinancial aid provided under the Bureau Affairs education programs

Not Counted

Not Counted

AA - American Indian or Alaskan Native

Income from American Indor Alaska Native Sources

illegal activities (Schedule C or -EZ)

21 Counted Counted

the rental of personal property (not come)

21 Counted Counted Rent from real or personaproperty not a business

ind (non-taxable fringe benefits) Pub N/A Not Counted

Not Counted

Refund (Federal and State, if not n Federal Income Tax)

N/A Not Counted

Not Counted

cing grants under title IV of the Indian ct of 1974 to expand profit-making

ed economic enterprises on or near s

N/A Not Counted

Not Counted

etirement Account (IRA) distributions, 15b Counted Counted RP - Retirement/ pension

IRA Distributions

or taxable portion of inherited IRA or nsion

N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Interest inc1099-INT

r

Interest inccharged wa

In-Home Suwages paidregardless beneficiary• In-Home• Nursing • Persona• IHSS Plu• Commun• IHSS- Re

In-Home Su• Restaura• Advance


Page 15-31


ome (taxable and non-taxable), 8a & 8b

Counted Counted IN - Interest income (taxable and non-taxable) 1099-INT

• Interest Income

• Contract of sale of OtheProperty/Interest

• Interest on payment to replace an excluded resource

• Interest portion of Retirement refund

• Loan interest paymentsreceived by client

• Interest on CalWORKs Restricted Account

• Trust Fund Interest Distributed

ome not received because the interest s below the applicable federal rate

21 Counted Counted

pportive Services (IHSS) caregiver to an enrolled provider who, of relationship, resides with the MC who receives those services from the: Operations WaiverFacility/Acute Hospital Waiverl care Services Programs Optionity first Choice Optionsidual Program

N/A Not Counted

Not Counted

N/A

pportive Servicesnt Meals Allowance Payments for Caregiver

N/A Not Counted

Not Counted

N/A



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Japanese ofrom the Un


Job Corps

Jury duty p Collect Earned Income Detail

Kickbacks

KinGAP pa

Life insuransurrender in

Life insurannon-taxable

Loan proce Collect Unearned Income Detail

Long-term 1099 LTC

Long-term LTC

Lost, stolen

Manufactur

Medical Sa969

Military allo


Page 15-32


r Aleutian reparation payment whether ited States or Canada

N/A Not Counted

Not Counted

N/A

earnings/stipend 21 Counted Counted

ay in excess of costs 21 Counted Counted JD - Jury Duty Pay

Jury Duty/Court

21 Counted Counted

yments N/A Not Counted

Not Counted

N/A

ce proceeds turned over for price, e.g. excess of the cost of the insurance

21 Counted Counted

ce proceeds upon death, including annuity payments/proceeds

N/A Not Counted

Not Counted

N/A

eds N/A Not Counted

Not Counted

care benefits – non-taxable amount – N/A Not Counted

Not Counted

care benefits – taxable amount – 1099 21 Counted Counted

, or damaged property payments N/A Not Counted

Not Counted

er incentive payments 21 Counted Counted

vings Account (Archer-Medicare), Pub. 21 Counted Counted

wances N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Mortgage aof the Natio

Needs-bas

Netherland

Net Operatother line 2

Nutrition beAssistanceElderly or D

Ordinary/qu Collect Unearned Income Detail

Other gains m Collect Unearned Income Detail

Paid Family


Page 15-33


ssistance payments under section 235 nal Housing Act

N/A Not Counted

Not Counted

ed assistance N/A Not Counted

Not Counted

s WUV victims of persecution N/A Not Counted

Not Counted

ing Loss Carryover, Subtract from 1 income, Pub. 536

21 Subtract Losses

Subtract Losses

nefits (Supplemental Nutrition Program, Nutrition Programs for the isabled.

N/A Not Counted

Not Counted

alified dividends, 1099-DIV 9a Counted Counted OQ - Ordinary/qualified dividends, 1099-DIV

• Dividends

• Dividends and interest: Irregular/infrequent

• Dividends and interest: Regular

(or losses), Form 4797 14 Counted Counted OG - Other gains (or losses), Form 4797

Other gains (or losses), fro4797

Leave, 1099-G 21 Counted Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Pensions, DBoard militapaid as ann


ent

Pension paemployee (were previo

Per-Capita Indian or Al


Physical injpayments

Principal pa

Prizes and rds Collect Unearned Income Detail

Public assisBureau of I

Pulitzer, No

Qualified Tu


Page 15-34


epartment of Defense Retirement ry retirement, endowment contracts uities and taxable annuities, 1099-R

16b Counted Counted RP - Retirement/ pension

• Annuities/Insurance Company

• Civil Service Annuities

• Foreign Pension

• Pension/Retirement payments

• Public Employees Retirement

• State Teachers Retirem

• Military benefits

yments that were paid by the such as premiums of contributions that usly subject to tax

N/A Not Counted

Not Counted

Gaming Distributions to American askan Natives

21 Counted Counted PC - PCGD • Native American gaming/other proceeds

ury, illness, or emotional distress N/A Not Counted

Not Counted

yments on loans N/A Not Counted

Not Counted

awards 21 Counted Counted Winnings, prizes and awa

tance payments, general assistance, ndian Affairs general assistance

N/A Not Counted

Not Counted

ble or similar prize 21 Counted Counted

ition Program, Pub. 970 21 Counted Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Qualified respending a

Radiation e

Railroad renon-taxable

al


Recoveriescredit was tRefunds/redeductions

Reemploympayments m

Refugee ca

Refugee reone-time paDepartmen(VOLAG) p

Reimburse

Reimburse


Page 15-35


servist distribution from health flexible ccount, W-2, Pub 525

21 Counted Counted

xposure compensation payment N/A Not Counted

Not Counted

tirement benefits (taxable and ), RRB1099

20a & 20b

Counted Counted RB - Railroad retirement benefits (taxable and non- taxable), RRB-1099

• Railroad Retirement

• Railroad Retirement Occupational Disability Benefit

• Railroad Retirement Tot& Permanent Disability Benefit

of amounts deducted or for which a aken an earlier year. imbursements/rebates of itemized

21 Counted Counted

ent Trade Adjustment Assistance ade by a state agency, 1099-G

21 Counted Counted

sh assistance N/A Not Counted

Not Counted

ception and replacement program yments by the Department of State or

t of Justice such as Voluntary Agency ayments

N/A Not Counted

Not Counted

ments not in excess of costs incurred N/A Not Counted

Not Counted

ment for Employment Agency Fee 21 Counted Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Relocation Collect Unearned Income Detail

Relocation floods undeDevelopme

Rental of pe nal

nit on

al ek

al


• Collect Earned Income Detail

Rental realS-Corporat

nal

e

f



Renter’s ta

Repaymenoriginal loa


Page 15-36


assistance payments N/A Not Counted

Not Counted

and Rehabilitation payments due to r the Housing and Community nt Act

N/A Not Counted

Not Counted

rsonal property – not self-employment 21 Counted Counted MS-Misc. • Rent from real or persoproperty not a business

• Rent from unit of mult udwelling/other dwelling prop exmt as PR

• Rental other real/personproperty < 20 hours we

• Rental other real/personproperty > or = 20 hoursweek

estate, royalties, partnerships, ions, Trusts, etc. (or loss), Schedule E

17 Counted Counted RR - Rental or royalty income

• Rent from real or persoproperty business or appreciable effort

• Royalties as part of trador business or from publication of work

• Royalties paid for use oproperty

x credit (California) N/A Not Counted

Not Counted

t of bona fide loan not in excess of n

N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Reverse An

Rewards

Ricky Ray h

Roth IRA, 4Distribution

Salary or w(received b

Scholarshipfor living ex

Scholarshipliving expen

SDI, not trebenefits


Page 15-37


nuity Mortgage N/A Not Counted

Not Counted

21 Counted Counted

emophilia relief fund N/A Not Counted

Not Counted

01K, 403(b), or 457(b) Qualified N/A Not Counted

Not Counted

ages from a decedents’ employer y a surviving spouse)

N/A Not Counted

Not Counted

s, awards, fellowship grants not used penses, Pub. 970

21 Not Counted

Counted

s, awards, fellowship grants used for ses, Pub, 970

21 Counted Counted

ated as unemployment insurance N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Self-employSchedule K

rts

e

nts

rly

tem


• Collect Rental Income Detail




Page 15-38


ment (in excess of expenses), -1, Schedule SE

21 Counted Counted SE • Lump sum from trade/business of self-employed person

• R & B/Room rent: has business license or repoincome for taxes

• Self Employment incom

• Lump sum not from trade/business of self-employed person non-recurring

• R & B/Room rent: no business lic regularly reto non-family member

• R & B/Room rent: no business license regularents to family member

• Third Party payment to vendor for a non-need i



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Social secuSSA-1099

led

ult

ed ild




Sponsor’s i

State tax rededucted


Page 15-39


rity benefits (taxable and non-taxable), 20a & 20b

Counted Counted SD - Social Security Disability

• SSA/RSDI - Blind

• SSA/RSDI: Blind DisabAdult Child (DAC)

• SSA/RSDI: Disability benefits

• SSA/RSDI: Disabled AdChild (DAC)

• SSA/RSDI: income bason parent, spouse, or chdisability

SR - Social Security Retirement

• SSA/RSDI: Retirement benefits

SO - Social Security Survivors

• SSA/RSDI: Survivors benefits

• SSA/RSDI: Widower's benefits

ncome given to a sponsored immigrant N/A Not Counted

Not Counted

fund in excess of prior year state tax 21 Counted Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

State or Fe1099-G Statreated as uRailroad UnReadjustmeUnemploymRelief and E1099-G UnAirline Dere

oss


Stolen prop

Strike and l d Collect Unearned Income Detail

SupplemenSupplemen


Surrogacy Collect Unearned Income Detail

Taxable refincome tax

Unearned iby another,

Collect Inkind Income Detail

Unemploym

Utility rebat


Page 15-40


deral unemployment compensation, te Disability Insurance (SDI), when nemployment compensation, 1099-G employment benefits, 1099-G Trade nt allowances, 1099-G ent assistance under the Disaster mergency Assistance Act of 1974,

employment assistance under the gulation Act of 1974 Program, 1099-G

19 Counted Counted UE - Unemployment

• UIB: Disaster

• UIB: lump sum gross

• UIB: regular payment gr

erty received 21 Counted Counted

ockout benefits 21 Counted Counted UE - Unemployment

• Strike Benefits Unearne

tal Security Income/State tary Payment (SSI/SSP) benefits

N/A Not Counted

Not Counted

N/A Counted Counted ? Other unearned

unds, credits, or offsets of state/local es

10 Counted Counted TR - Taxable refunds, credits, or offsets of state/local income taxes

• CA FTB Senior CitizensTax Postponement

• Income tax Refund

• Property tax refunds

ncome in-kind/personal expenses paid including a corporation

21 Counted Counted

ent benefits paid by a union 21 Counted Counted

es 21 Counted Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Veteran’s Abenefits pa

VA agent o

VA children

VA compenpayments

VA death gof the Arme10, 2001

VA depend

VA disabilitveteran or t

VA educatio

VA grants fliving

VA grants fotheir sight o

VA insurancto veteransproceeds obefore deat

VA insuranc


Page 15-41


dministration (VA) aid and attendance id to the veteran or their families

N/A Not Counted

Not Counted

range benefits N/A Not Counted

Not Counted

with certain birth defects N/A Not Counted

Not Counted

sated work-therapy program N/A Not Counted

Not Counted

ratuity paid to a survivor of a member d Forces who died after September

N/A Not Counted

Not Counted

ent-care assistance program benefits N/A Not Counted

Not Counted

y compensation paid either to the heir families

N/A Not Counted

Not Counted

n, training or subsistence allowances N/A Not Counted

Not Counted

or homes designed for wheelchair N/A Not Counted

Not Counted

r motor vehicles for veterans who lost r the use of their limbs

N/A Not Counted

Not Counted

e proceeds and dividends paid either or their beneficiaries, including the f a veteran’s endowment policy paid h

N/A Not Counted

Not Counted

e interest left on deposit with the VA N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Veteran’s FTrust

Veteran’s N

VA pensionfamilies

Veteran’s bpolitical subcombat zon

Victims of c

Vocational received, nand rehabil

Volunteer W• Peace C

utilities, h• National

services expenseProgramProgram

• Service Camountsout-of-po

• Volunteetransporthave in tcounselin


Page 15-42


ilipino Veterans Equity Compensation N/A Not Counted

Not Counted

orth Vietnam POW/MIA N/A Not Counted

Not Counted

benefits paid to the veteran or their N/A Not Counted

Not Counted

onus payment paid by any state or division because of service in a e

N/A Not Counted

Not Counted

rimes payments N/A Not Counted

Not Counted

rehabilitation goods, services and cash ot in return for services, but for training itation due to disability

N/A Not Counted

Not Counted

ork amounts:orps living allowances for housing, ousehold supplies, food, and clothingSenior Service Corps supportive or reimbursements for out-of-pocket s from the Retired Senior Volunteer (RSVP), Foster Grandparent , or Senior Companion Programorps of Retired Executives (SCORE)

for supportive services or cket expensesr tax counseling reimbursements for ation, meals, and other expenses you raining for, or actually providing tax g for the elderly

N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

Walker v. B

Weatherizaemergencyheating/coo

Whistleblow

Withholdingoverpayme

Work traininpaid by a swhat wouldbenefits

Worker’s cosurvivors

Workforce

Work traininwelfare agewould have


Page 15-43


ayer payment N/A Not Counted

Not Counted

tion, home energy assistance, repair, or replacement of ling devices

er’s award 21 Counted Counted

from a benefit to repay an nt from the same income source

N/A Not Counted

Not Counted

g program payments – entire amount tate welfare agency if greater than otherwise be paid for public welfare

21 Counted Counted

mpensation paid to the worker or their N/A Not Counted

Not Counted

Investment Act payments N/A Not Counted

Not Counted

g program payments made by a state ncy if the total does not exceed what been paid in public welfare benefits

N/A Not Counted

Not Counted



MAGI MC APTC


CalWIN Income Type

Update #20-02

Medi-

15.13.1

The follo g line on the IRS Form 1040.

Income De pe CalWIN Window

Alimony padivorce or sexecuted oNot a deduseparation or after 01

Collect Other Expense Detail

Business eperforming rtists


Child Care

Deductible tax


Educator e Collect Other Expense Detail

Health Sav t Collect Other Expense Detail

Hobby incoexpenses fnot expect

tivity Collect Other Expense Detail

IRA deduct Collect Other Expense Detail

Moving expduty militarpermanent


Page 15-44


Deductions and Expenses

wing table provides various deduction types for MAGI MC and APTC, including its correspondin

Table 15-5: Income Deduction Types from IRS Form 1040

duction Types 1040 Line #

MAGI MC APTC CalHEERS Deduction

Type CalWIN Deduction Ty

id: Deduction only if the eparation instrument is n or before 12/31/18. ction for any divorce or instrument modified on /01/2019

31a Deducted on or before 12/31/18

Deducted on or before 12/31/18

AL- Alimony Alimony Paid

xpenses of reservists, artists, etc.

24 Deducted Deducted BE -Business expenses of reservists, performing artists, etc.

Business expenses of reservists performing a

Not Deducted

Not Deducted

part of self-employment 27 Deducted Deducted DS- Deductible part of self-employment tax

Deductible part of self-employment tax

xpenses 23 Deducted Deducted EE- Educator expenses Educator expenses

ings Account 25 Deducted Deducted HS- Health Savings Account

Health Savings Accoun

me expenses, or rom an activity you did to see a profit

Deducted Deducted HE- Hobby income expenses, or expenses from an activity you did not expect to see a profit

Hobby or non-profit acexpenses

ion 32 Deducted Deducted ID- IRA deduction IRA Deduction

enses: Only if active y and moved due to change of station

26 Deducted Deducted ME- Moving Expenses Moving Expenses

Update #20-02

Medi-

Penalty on savings

rawal Collect Other Expense Detail

Rental of pexpenses

perty Collect Other Expense Detail

Self-employdeduction


Income De pe CalWIN Window

Page 15-45


early withdrawal of 30 Deducted Deducted EW- Penalty on early withdrawal of savings

Penalty on early withdof savings

ersonal property Deducted Deducted PP- Rental of personal property expenses

Rental of personal proexpenses

ed health insurance 29 Deducted Deducted SH- Self-employed health insurance deduction

Self-employed health insurance deduction


duction Types 1040 Line #




bor

ope

sine

om

rmin

her s

w

pe

Self-Employment Pension (SEP), Simple, and qualified deduction

28 Deducted Deducted QD - Self-employed SEP, Simple, and qualified deduction

• Self-Employment Depreciation

• Self-Employment Employee Salaries

• Self-Employment Entertainment

• Self-Employment LaCosts

• Self-Employment PrInsurance Premiums

• Self Employment BuLicense

• Self-Employment RoBoard Expenses

• Self-Employment Fa& Fishing Losses

• Self-Employment OtNecessary Expense

• Self-Employment RaMaterial & Goods

• Self Employment Transportation

Student loan interest 33 Deducted Deducted SL- Student loan interest Student loan interest


Income Deduction Types 1040 Line #





15.14 CalWIN Income and Expenses NOT Mapped to CalHEERS

The following tables contain CalWIN Income and Expense Types that are not mapped to any value in CalHEERS and therefore will not count for MAGI MC or APTC/CSR. Ensure countable income is included in the final eligibility determination. [Refer to “Budgeting,” page 9-1]

Example:

Income Type: Net Countable Income for Medi-Cal is entered in order to count the income for MC but not for another program. This Income Type will NOT count for MAGI MC or APTC/CSR.

15.14.1 Income

Table 15-6: CalWIN Income Types NOT Mapped to CalHEERS

CalWIN Income Type Window in CalWIN

Adoption Assistance Program Income Collect Unearned Income Detail

Ball v. Swoap payments Collect Unearned Income Detail

Basic Education Oppt Grant-BEOG • Collect Unearned Income Detail

• Display Student Financial Aid Detail

BIA • Collect Unearned Income Detail


BIA Educational Grants/Loans • Collect Unearned Income Detail


Black Lung Collect Unearned Income Detail

BOGG • Collect Unearned Income Detail


Bureau of Indian Affairs general assistance payments (BIAGA) Collect Unearned Income Detail

CA Franchise Tax Board Renter's Credit Collect Unearned Income Detail

Cal Grant A • Collect Unearned Income Detail


Cal Grant B • Collect Unearned Income Detail




Cal Grant C • Collect Unearned Income Detail


Cal-learn Bonus • Collect Unearned Income Detail


CalWORKs Collect Unearned Income Detail

CalWORKs Diversion (Diversion period is greater than 4 months) Collect Unearned Income Detail

CalWORKs Diversion (Diversion period is less than 4 months) Collect Unearned Income Detail

CalWORKs Homeless Assistance Collect Unearned Income Detail

CAPI Collect Unearned Income Detail

CAPI ISM Collect Unearned Income Detail

Carl D Perkins Loan • Collect Unearned Income Detail


Cash Contributions Private Non Profit Collect Unearned Income Detail

Cash Contributions Public Non Profit Collect Unearned Income Detail

CGSL: California Guaranteed Student Loan • Collect Unearned Income Detail


Child/Spousal Support DA-Current Disregard • Collect Child/Spousal Detail


Child/Spousal Support DA-Excess Collect Child/Spousal Detail

Child/Spousal Support DA-Pass-On Paid to Client Collect Child/Spousal Detail

Child/Spousal Support DA-Prior Disregard Collect Child/Spousal Detail

Child/Spousal Support DA-Prior Retained Collect Child/Spousal Detail

Child/Spousal Support Direct From A/P or DA Collect Child/Spousal Detail

College Assistant Migrant Program Display Student Financial Aid Detail

CW/FS Non-MFG Direct Child Support EXEMPT for Food Stamps Collect Child/Spousal Detail

Disaster Relief and Disaster Emergency Assistance payments Collect Unearned Income Detail

Education Awards/Scholarships for Teens Display Student Financial Aid Detail

Energy Crisis Assistance-Energy Conserv. Prog./Low Inc. Energy Assist. Collect Unearned Income Detail

Executive Volunteer Program Payment for supportive services • Collect Earned Income Detail






FFEL: Federal Family Education Loan • Collect Unearned Income Detail


FISL: Federally Insured Student Loans Display Student Financial Aid Detail

Foster Care Collect Unearned Income Detail

GA/GR Collect Unearned Income Detail

GA/GR Grant Amount Prior to CW eligibility Collect Unearned Income Detail

GA/GR Other Exempt Collect Unearned Income Detail

GA/GR Other Non-exempt Collect Unearned Income Detail

Gifts: Cash Collect Unearned Income Detail

Holocaust Restitution Payment Collect Unearned Income Detail

Holocaust Restitution Payment: interest on retained funds Collect Unearned Income Detail

In kind for CAAP - Other Collect Inkind Income Detail

In kind for CAAP - Stabilization Collect Inkind Income Detail

In kind for CAAP GA Collect Inkind Income Detail

In kind for CAAP SSIP, CALM, PAES Collect Inkind Income Detail

In Kind Housing-shared w/1 GA Collect Inkind Income Detail



In-Kind Clothing Collect Inkind Income Detail

In-Kind Food Collect Inkind Income Detail

In-Kind Housing Collect Inkind Income Detail

In-Kind Utilities Collect Inkind Income Detail

Japanese-American/Aleutians Restitution Payment Collect Unearned Income Detail

KinGAP Collect Unearned Income Detail

Life ins/death benefits: individual beneficiary not owner of policy Collect Unearned Income Detail

Life ins/death benefits: individual is beneficiary and owner of policy Collect Unearned Income Detail

Loan principal payments received by client Collect Unearned Income Detail

Manual Cash Grant Collect Unearned Income Detail

MFG - Child Support • Collect Unearned Income Detail

• Collect Child/Spousal Detail





MFG - SSA Disability from Absent Parent • Collect Unearned Income Detail

• Collect Child/Spousal Detail

National Science Scholars Program • Collect Unearned Income Detail


NDSL: National Direct Student Loan • Collect Unearned Income Detail


Net Countable Income for CalWORKs Collect Unearned Income Detail

Net Countable Income for CAPI Collect Unearned Income Detail

Net Countable Income for Food Stamps Collect Unearned Income Detail

Net Countable Income for Foster Care Collect Unearned Income Detail

Net Countable Income for General Assistance Collect Unearned Income Detail

Net Countable Income for IHSS Collect Unearned Income Detail

Net Countable Income for KinGAP Collect Unearned Income Detail

Net Countable Income for Medi-Cal Collect Unearned Income Detail

Net Countable Income for Medi-Cal-CMSP Collect Unearned Income Detail

Net Countable Income for RCA Collect Unearned Income Detail

Other Government disability Collect Unearned Income Detail

Paul Douglas Teacher Scholarship Program • Collect Unearned Income Detail


Pell Grant • Collect Unearned Income Detail


PLUS: Parent Loan Student Program • Collect Unearned Income Detail


Radiation Exposure Compensation Collect Unearned Income Detail

RCA: Refugee Cash Assistance Collect Unearned Income Detail

Reimbursements or Advances that do not exceed Expenses • Collect Earned Income Detail


Relocation Assistance Payments Collect Unearned Income Detail

Retroactive SSI/SSP, including lump sums Collect Unearned Income Detail

Ricky Ray Hemophilia Relief Fund Act Payments Collect Unearned Income Detail

SDI/DIB/FMLA Gross Collect Unearned Income Detail





SEOG: Supplemental Educational Opportunity Grant Pgm • Collect Unearned Income Detail


SLS: Supplemental Loans For Students • Collect Unearned Income Detail


SSI Only - Aged Collect Unearned Income Detail

SSI Only - Blind Collect Unearned Income Detail

SSI Only - Disabled Collect Unearned Income Detail

SSI/SSP or SSP only - Aged Collect Unearned Income Detail

SSI/SSP or SSP only - Blind Collect Unearned Income Detail

SSI/SSP or SSP only - Disabled Collect Unearned Income Detail

SSIG: State Student Incentive Grants • Collect Unearned Income Detail


Stafford Loan Subsidized/Unsubsidized • Collect Unearned Income Detail


Susan Walker v Bayer Corp payments Collect Unearned Income Detail

TANF Out Of State Collect Unearned Income Detail

Title IV Educational Grant/Loan • Collect Unearned Income Detail


Training Allowance from Ancillary Payment Collect Unearned Income Detail

Training incentive payments/work allowances under Manpower programs Collect Earned Income Detail

Tribal TANF funds - CE Collect Unearned Income Detail

Tribal TANF funds - not CE Collect Unearned Income Detail

Victims of Crime Program Collect Unearned Income Detail

Work Incentive Collect Earned Income Detail

Work Study CalWORKs • Collect Earned Income Detail


Work Study State/Federal • Collect Earned Income Detail


Worker's Compensation - Permanent Collect Unearned Income Detail

Worker's Compensation - Temporary Collect Unearned Income Detail

Worker's Compensation - Vocational Rehab Collect Unearned Income Detail





15.14.2 Expenses

Table 15-7: CalWIN Expenses NOT Mapped to CalHEERS

CalWIN Expense Type Window in CalWIN

Apartment/House/Condo/Trailer,etc. Rent

Blind Work Expenses • Collect Income Expense Detail

• Collect Other Expense Detail

Board and Care • Collect Medical Expense Detail

Car Pool • Collect Income Expense Detail

• Collect Income Expense Detail (student)

Child/Dependent Care Collect Income Expense Detail

Child/Spousal Support paid • Collect Income Expense Detail


Coal Display Shelter/Food Expense Detail

Coal Oil Display Shelter/Food Expense Detail

Condominium Fees

Conservator/Guardian fees • Collect Income Expense Detail


Education Books and Supplies Collect Income Expense Detail (student)

Education Dependent/Child Care Collect Income Expense Detail (student)

Education Equipment and Supplies Collect Income Expense Detail (student)

Education Food & Housing Collect Income Expense Detail (student)

Education Loan Origination Fees Collect Income Expense Detail (student)

Education Special Clothing Collect Income Expense Detail (student)

Education Transportation Collect Income Expense Detail (student)

Electricity Display Shelter/Food Expense Detail

Energy Assistance Display Shelter/Food Expense Detail

Equipment and Property Rental • Collect Income Expense Detail


Federal/State Tax • Collect Income Expense Detail


Fees necessary to obtain income • Collect Income Expense Detail




FICA • Collect Income Expense Detail


Firewood Display Shelter/Food Expense Detail

Food

Food and Shelter

Funeral/Cremation/Burial Collect Other Expense Detail

Garbage Display Shelter/Food Expense Detail

Gas Display Shelter/Food Expense Detail

IHSS SOC pd to provider: family member in the home • Collect Income Expense Detail

• Collect Medical Expense Detail

IHSS SOC pd to provider: not family member in home • Collect Income Expense Detail


Impairment Related Work Expenses • Collect Income Expense Detail


Interest on Loans for Capital Assets or Goods • Collect Income Expense Detail


Interest on real property loan • Collect Income Expense Detail


Legal Fees • Collect Income Expense Detail


Mandatory Homeowners Assoc. Fees

Mandatory Payroll Deductions • Collect Income Expense Detail


Meals • Collect Income Expense Detail


Medical Expenses not Covered by Insurance • Collect Income Expense Detail


Medical Insurance - Involuntary • Collect Income Expense Detail


Medical Premiums • Collect Income Expense Detail






Medicare Premiums - Part A

Medicare Premiums - Part B

Mortgage

Natural Gas Display Shelter/Food Expense Detail

Other Benefit Overpayment Adjustment

Other Tax deductions Collect Other Expense Detail

Other Utilities Display Shelter/Food Expense Detail

Phone/Internet/Other Communication-Standard • Collect Income Expense Detail

• Display Shelter/Food Expense Detail

Propane/Butane Display Shelter/Food Expense Detail

Property Taxes and Assessments • Collect Income Expense Detail


Public Transportation - Bus • Collect Income Expense Detail


Public Transportation - Train • Collect Income Expense Detail


Real Property Insurance Premiums • Collect Income Expense Detail


Real/Rental Property Upkeep & Repairs • Collect Income Expense Detail


SDI/DIB Overpayment Adjustment Client Caused • Collect Income Expense Detail


SDI/DIB Overpayment Adjustment not Client Caused • Collect Income Expense Detail


Septic Tank Display Shelter/Food Expense Detail

Sewer Display Shelter/Food Expense Detail

Space Rent

Sponsor's Rental Expenses Collect Other Expense Detail

SSA/RSDI Insurance Overpayment Adjustment Collect Other Expense Detail

Support for a Disabled Relative • Collect Income Expense Detail






Tips Allocated but Not Received • Collect Income Expense Detail


UIB Overpayment Adjustment Client Caused Collect Other Expense Detail

UIB Overpayment Adjustment not Client Caused Collect Other Expense Detail

Unreimbursed Cost of Home Repair Due to Disaster Collect Other Expense Detail

Utility

Water Display Shelter/Food Expense Detail

Wood Pellets Display Shelter/Food Expense Detail





Not found in IRS Form 1040 or in CALWIN income windows

Table 15-8: Income Types NOT Counted

Non-Income Types Also Known As

$25 weekly supplement to unemployment compensation payment authorized by the American Recovery and reinvestment Act of 2009

Accelerated death benefits/viatical settlements if the insured is chronically ill for costs of qualified long-term care or if the insured is terminally ill not in excess of limit

Austrian general social insurance payments

CalFresh benefits

Cancellation of non-business debt: intended as a gift, amounts not in excess of insolvency, or amounts discharged in bankruptcy or,with regard to mortgage cancellation, not in excess of the cost of your principal residence plus improvements, 1099-C

Carpool payments

Clergy housing and utility allowance not in excess of market rate and actual cost respectively

Clinical trials participation to the extent of expenses incurred plus $2,000

Court awards/judgments/settlements for personal injury or sickness/emotional distress and other compensatory property damages. This does not include compensation for lost wages/profits, breach of contract, pension rights, interest on awards, patent or copyright infringement, or punitive damages.

Disability Income -untaxed (untaxed private disability income insurance -premiums not paid by employer) Pubs 525 and 907

Disability payments received for injuries resulting directly from a terrorist or military action, not including training exercises

Diversion cash assistance

Down payment assistance

Earned income tax credit • Earned Income Tax Credit: actual...

• Earned Income Tax Credit: received...

Economic stimulus payments (federal)

Employer contributions to certain pretax benefits funded by an employee’s elective salary reduction,

Contributions earmarked

Endowment Contracts paid as a lump sum before death not in excess of costs, or paid upon death to a beneficiary

Federal Income Tax Return Income Tax refund



Fringe benefits provided on a pre-tax basis by an employer, such as transportation benefits, parking, or moving expenses

Home and Community Based Waiver Caregiver Wages

Housing and Urban Development Section 8 Rental Vouchers or Benefits Federal Housing Assistance

In-Home Supportive Services • Restaurant Meals Allowance • Advance Payments for Caregiver

• IHSS Advance pay to IPW recipient-New Affid

• IHSS Advance pay to IPW recipient-Old/No Affid

• IHSS Advance pay to Residual recipient-New Affid

• IHSS Advance pay to Residual recipient-Old/No Affid

Income Tax Refund – Federal Income Tax Refund – State – if not deducted on Federal Income Tax in which case it would be income

Income Tax refund

Indian financing grants under title IV of the Indian Financing Act of 1974 to expand profit-making Indian-owned economic enterprises on or near reservations

Inheritance or taxable portion of inherited IRA or inherited pension Inheritance in form of cash, securities or other liquid assets

Loan proceeds

Long-Term Care benefits (LTC) – non-taxable amount 1099-LTC

Lost, stolen or damaged property payments

Military allowances (BAH, BAS) Military Benefits

Military hostile fire/imminent danger pay

Mortgage assistance payments under section 235 of the National Housing Act

Needs-based assistance

Netherlands WUV victims of persecution

Nutrition benefits (Supplemental Nutrition Assistance Program, Nutrition Programs for the Elderly or Disabled)

Pension payments that were paid by the employee (such as premiums or contributions) that were previously subject to tax

Physical injury, illness or emotional distress payments

Refugee reception and replacement program one-time payments by the Dept. of State or Dept. of Justice, such as Voluntary Agency (VOLAG) payments

VOLAG Resettlement Income

Renter’s tax credit (California)

Repayment of bona fide loan not in excess of original loan





Reverse Annuity Mortgage

Roth IRA, 401K, 403(b), or 457(b) Qualified Distribution • IRA Distribution

• 401K Interest Income

• 401k Principal Income

Sponsor’s income given to a sponsored immigrant

Veteran’s Administration (VA) aid and attendance benefits paid to the veteran or their families

• Vet A&A Paymt recvd by non Pickle person for care of Pickle fam mem

• Vet A&A Paymt recvd for care of one who is not a Pickle-elig fam mem

• Veteran's A&A Payments received by the surviving spouse of a veteran

• Veteran's A&A Payments received by the veteran

Veteran’s Administration agent orange benefits Agent Orange Settlements

Veteran’s Administration children with certain birth defects

Veteran’s Administration compensated work-therapy program payments

Veteran’s Administration death gratuity paid to a survivor of a member of the Armed Forces who died after September 10, 2001.

Veteran’s Administration dependent-care assistance program benefits

Veteran’s Administration disability compensation paid either to the veteran or their families

Veteran's Benefits-Disability

Veteran’s Administration education, training or subsistence allowances and allowances

• Veterans Education Assistance Program (VEAP)

• Veterans Education GI Bill

• Veterans Student Service Program

Veteran’s Administration grants for homes designed for wheelchair living

Veteran’s Administration grants for motor vehicles for veterans who lost their sight or the use of their limbs.

Veteran’s Administration insurance interest left on deposit with the VA

Veteran’s Administration insurance proceeds and dividends paid either to veterans or their beneficiaries, including the proceeds of a veteran’s endowment policy paid before death

Veteran’s Administration pension benefits paid to the veteran or their families Veterans Benefits/Pensions

Veteran’s bonus payment paid by any state or political subdivision because of service in a combat zone

Increase due to deployment to combat zone





Veteran’s Filipino Veterans Equity Compensation Trust

Veteran’s North Vietnam POW/MIA Compensation (FED) to persons captured/interned by North Vietnam

Vocational rehabilitation goods, services and cash received, not in return for services, but for training and rehabilitation due to disability

Volunteer Work Amounts: Peace Corps living allowances for housing, utilities, household supplies, food and clothingNat’l Senior Service Corps supportive services or reimbursements for out-of-pocket expenses from the Retired Senior Volunteer Program (RSVP); Foster Grandparent Program; or Senior Companion Program.Service Corps of Retired Executives (SCORE) amounts for supportive services or out-of-pockets expensesVolunteer tax counseling reimbursements for transportation, meals, and other expenses you have in training for, or actually providing tax counseling for the elderly.

Weatherization, home energy assistance, emergency repair or replacement of heating/cooling devices

Withholding from a benefit to repay an overpayment from the same income source

Workforce Investment Act payments




