page 17-2 - Welcome to the County of Santa Clara verified by the Federal Data Services Hub (Federal Hub), or “e-verified”. E-verification is not a valid form of verification for

page 17-2 Medi-Cal HandbookMAGI MC Income

17. MAGI MC Income

17.1 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:

Revised: 10/26/16 Update # 16-35

Medi-Cal Handbook page 17-3MAGI MC Income

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

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.

17.2 Income Verification

When EDBC is run for a MAGI case, information from CalWIN is sent to CalHEERS and verified by the Federal Data Services Hub (Federal Hub), or “e-verified”. E-verification is not a valid form of verification for all types of Medi-Cal or other programs.

MAGI MC Cases

The eHIT results from the Federal Hub are sufficient for MAGI income verification.

Mixed MC Cases (MAGI and Non-MAGI)

The eHIT results from the Federal Hub are sufficient for MAGI income verification, however, paper verification is required for Non-MAGI individuals. [Refer to eHIT Chapter 18]

Update # 16-35 Revised: 10/26/16


Mixed Cases (APTC/CSR/QHP and MAGI MC)

The eHIT results from the Federal Hub are sufficient for MAGI, APTC/CSR, QHP income verification.

Combo Case

The other program (i.e. CalWORKs or CalFresh) methodology takes priority when calculating and verifying income.

17.3 Current Monthly Income

Current Monthly Income (CMI) is entered as actually received (i.e weekly, biweekly, semi-weekly, etc.) in the appropriate income-related windows. CalWIN calculates the CMI based on actual income.

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

17.4 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.



17.4.1 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.

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 “When to Request Verification,” page 17-6]

17.4.2 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 “Income Flowchart,” page 17-8.]

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 as actually received (i.e weekly, biweekly, semi-weekly, etc.) 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.



17.4.3 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.

17.4.4 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.

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,


Both amounts are over MAGI (mixed households),

One or both are e-verified,


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

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.



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:

Projected Annual Income

You Expect PAI amount.

PAI End Date Record Superceded Date the PAI ended.

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.

CalWIN Field CalHEERS Field What to Enter in CalWIN



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

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

17.4.5 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 Ch. 21, “CEW Through Portal Change DERs,” page 21-38.

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.

17.5 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.


17.6 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.

17.7 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 individual reports on their application and, may result in zero countable income for MAGI MC.



The amount that is entered on the SSApp is the amount that should be transmitted to CalHEERS which the Federal Hub uses to 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 are broader than those allowed for Non-MAGI net income from self-employment and rental property calculations.

17.8 CalWIN Income and Deduction Types

Income and deductions may be counted differently between Modified Adjusted Gross Income (MAGI) Medi-Cal (MC) and Advanced Premium Tax Credit (APTC). CalWIN has a feature that indicates if the income is counted or not counted when the income type is selected from the CalWIN drop-down menu. (CalWIN displays the CalHEERS income type which shows whether the income is counted or not counted). The tables in this chapter provide information of how various income and deduction types are (or are not) counted for both MAGI MC and APTC and which are the corresponding CalWIN types.

The income and deduction tables in this chapter do not apply to Non-MAGI MC. For Non-MAGI MC income information, refer to Non-MAGI Income Ch. 25.


Revised: 10/2

page 17- Medi-Cal HandbookMAGI MC

17.9 I

The rresponding line on the IRS Form 1040. It al EERS and/or Internal Revenue Service (IRS g between the various types in CalWIN and be available in this chapter. Once Cal ordingly.

0

Other Inc e CalWIN Window

$25 weekcompensAmerican

Acceleratsettlemenfor costs the insurelimit

Acceleratsettlemenfinancial

enter ext Box

Activity n

6/16 Update # 16-35

15 Income

ncome Types

following table provides various income types for MAGI MC and APTC, including its coso shows if the income is counted in the MC eligibility determination. Income from CalH) Form 1040 can be entered into several CalWIN windows. Due to the current mappin

CalHEERS only partial information, related to income, deductions and expenses, mayWIN and/or CalHEERS provide additional information, this chapter will be updated acc

Table 17-1: Income Types (or Losses) from IRS Form 104

ome Types or Losses

1040 Line #

MAGI MC APTC

CalHEERS Income Type CalWIN Income Typ

ly supplement to unemployment ation payment authorized by the Recovery

N/A Not Counted

Not Counted

ed death benefits/viatical ts if the insured is chronically ill of qualified long term care or if d is terminally ill not in excess of

N/A Not Counted

Not Counted

ed death benefits/viatical ts paid to persons with a

interest in the insured’s business

21 Counted Counted Choose “Other” and Income Type in the T

ot for profit, Pub.535 21 Counted Counted

Revised: 10/2


Adoption Collect Unearned Income Detail

Alaska Pe

Alimony r pport • Collect Child/Spousal Detail

• Collect Unearned Income Detail

AmeriCorEducation

AmeriCorCorps Sti

AmeriCorEducation

yments Collect Unearned Income Detail

Austrian gpayments

Ball v. Sw Collect Unearned Income Detail

Bartering

Black Lun Collect Unearned Income Detail

Bribes

Blood, placompensparts


6/16 Update # 16-35

16 Income

assistance payments N/A Not Counted

Not Counted

rmanent Fund dividends 21 Counted Counted

eceived 11 Counted Counted AR - Alimony Received

Alimony - Spousal Su

ps State/National Stipend and Award

21 Counted Counted

ps National Civilian Community pend and Education Award

21 Counted Counted

ps Vista Stipend and al Award

21 Counted Counted MS - Miscellaneous

AmeriCorps Vista Pa

eneral social insurance N/A Not Counted

Not Counted

oap payment N/A Not Counted

Not Counted

, 1099-B, Pub. 525 21 Counted Counted

g benefit payments

21 Counted Counted

sma, sperm, egg, embryo, or ation received for other body

21 Counted Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Business

on

on

has r reports

no rly rents ber

no gularly ber

ncome

nt to eed item

• Collect Rental Income Detail

• Collect Room & Board Detail

• Collect Unearned income Detail

CalFresh


6/16 Update # 16-35

17 Income

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

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

• Lump sum not fromtrade/business of self-employed persnon-recurring

• R & B/Room rent: business license oincome for taxes

• R & B/Room rent: business lic regulato non-family mem

• R & B/Room rent: business license rerents to family mem

• Self Employment i

• Third Party paymevendor for a non-n

benefits N/A Not Counted

Not Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Cancellat

• intende• amoun• amoun• with re

not in eresiden

Cancellatintended amounts dischargemortgagecost of yoimprovem

Collect Unearned Income Detail

Capital g Collect Unearned Income Detail

Carpool p

Child Sup Collect Child/Spousal Detail

Clergy hoexcess orespectiv

Clergy hoexcess orespectiv


6/16 Update # 16-35

18 Income

ion of non-business debt

d as a giftts not in excess of insolvencyts discharged in bankruptcygard to mortgage cancellation, xcess of the cost of the principal ce plus improvements, 1099-C

N/A Not Counted

Not Counted

ion of non-business debt, unless as a gift, that is in excess of • of insolvency • amounts d in bankruptcy • with regard to cancellation, in excess of the ur principal residence plus ents, 1099-C

21 Counted Counted CD - Cancelled Debts

Cancelled Debts

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

Capital Gains

ayments N/A Not Counted

Not Counted

port N/A Not Counted

Not Counted

using and utility allowance not in f market rate and actual cost ely

N/A Not Counted

Not Counted

using and utility allowance in f market rate and actual cost ely

21 Counted Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Clinical trexpenses

Clinical trand amou$2,000, 11396a(e)

County G

Coverdal

Court awcompensbreach ofon awardinfringem


Court awpersonal distress adamagescompensbreach ofon awardinfringem

Credit CaPayment

urance

e



6/16 Update # 16-35

19 Income

ails participation to the extent of incurred plus $2,000

N/A Not Counted

Not Counted

ial participation remuneration nts in excess of expenses minus 099-Misc and 42 U.S.C. Section (14)

21 Counted Counted

eneral Assistance cash grant N/A Not Counted

Not Counted

e education savings account 21 Counted Counted

ards/judgments/settlements for ation for lost wages/profits, contract, pension rights, interest s, patent or copyright ent and punitive damages

21 Counted Counted CA- Court Awards

Court Awards

ards/judgments/settlements for injury or sickness/emotional nd other compensatory property . This does not include ation for lost wages/profits, contract, pension rights, interest s, patent or copyright ent and punitive damages

N/A Not Counted

Not Counted

rd Insurance or Disability 21 Counted Counted MS - Misc. • Credit disability inspayments

• Credit life insurancpayments

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Disabilitydisability employer1099-A

enefits y


Disabilityprivate diinsuranceemployer

Disabilityresulting action, no


Disaster payments

Diversion

Down pa

Earned in

Economic

Employerbenefits fsalary redflexible sp


6/16 Update # 16-35

20 Income

Income -taxed (taxed private insurance premiums paid for by ) Pubs 525 and 907, 1099 and

21 Counted Counted MS - Misc. Disability Insurance Bfrom private compan

Income- untaxed (untaxed sability income -premiums not paid by ) Pubs 525 and 907

N/A Not Counted

Not Counted

payments received for injuries directly from a terrorist or military t including training exercises

N/A Not Counted

Not Counted

relief payments (qualified )

N/A Not Counted

Not Counted

cash assistance N/A Not Counted

Not Counted

yment assistance N/A Not Counted

Not Counted

come tax credit N/A Not Counted

Not Counted

stimulus payments (federal) N/A Not Counted

Not Counted

contributions to certain pretax unded by an employee’s elective uction, such as amounts for ending account

N/A Not Counted

Not Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Employmdifferentiacost-of-livdeferred services;vacation,strike andfor stock and reimbtransportexpensescommissfringe benbasis (incand transunder a pemployerduring peemployeremployerunemployfinanced services

alaries, ions,

spouse

gs, nuses &

r ceed

Collect Earned Income Detail

Energy C

Endowmebefore depaid upon


6/16 Update # 16-35

21 Income

ent (Wages; salary; back pay; l wage payments; Government ing allowances; Non-qualified

compensation; notes received for severance pay; sick pay; annual leave, and paid holidays; lockout benefits, cash payments appreciation rights; allowances ursements for travel,

ation, or other business ; commissions; advance

ions; tips; bonuses; awards; and efits not provided on a pre-tax

luding non-clergy housing, meals portation), disability pension lan that is paid for by your , guaranteed annual wages paid riod of unemployment by under a union agreement, paid supplemental ment benefits from an employer fund, fees received by clergy for performed, and other, W-2

7 Counted Counted • Census Income

• Earnings, wages, sbonuses, commissmilitary pay

• Excess income of

• Pre-strike - Earninwages, salaries, bocommissions

• Reimbursements oadvances which exexpenses

• Sick Pay

• Striker Picket Pay

• Therapeutic wages

• Tips

onservation Subsidy

nt Contracts paid as a lump sum ath, not in excess of costs or death to a beneficiary

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Endowmebefore deapplicablcontract)

Farm inco and Collect Unearned Income Detail

Federal I

Foreign Enon-taxab

e able),


Foster cahome

Foster caand trans

Gamblingraffles, Fo

ry, Collect Unearned Income Detail

Gifts/Cas Collect Unearned Income Detail

Health sa


6/16 Update # 16-35

22 Income

nt Contracts paid as a lump sum ath in excess of costs (not

e a veteran’s endowment

21 Counted Counted

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

Income from Fishing Farming

ncome Tax Return N/A Not Counted

Not Counted

arned Income (taxable and le), Form 2555

21 Count Gross

Count Gross

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

Foreign Earned Incom(taxable and non-taxForm 2555

re, maintaining a space in your 21 Counted Counted

re or other Title IV-E payments itional housing

N/A Not Counted

Not Counted

winnings: gambling, lottery, rm W2-G

21 Counted Counted MS - Misc. Winnings (bingo, lottegambling, etc)

h Contributions N/A Not Counted

Not Counted

vings account 21 Counted Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Hobby innot expec

HolocausNazi PersPayment


Host or h

Income fror Sched

Income frproperty

sonal ss



Income Inbenefits)

Collect inkind Income Detail

Income Tnot deduc

Indian finIndian Finprofit-maenterprise

Individuadistributio

InheritancIRA or inh


6/16 Update # 16-35

23 Income

come, or from an activity you did t to see a profit

21 Counted Counted

t victims restitution/Victims of ecution/German Reparation

N/A Not Counted

Not Counted

ostess gift or gratuity 21 Counted Counted

om illegal activities (Schedule C ule-C-EZ)

21 Counted Counted

om the rental of personal (not business income)

21 Counted Counted Rent from real or perproperty not a busine

-Kind (non-taxable fringe Pub 525

N/A Not Counted

Not Counted

ax Refund (Federal and State, if ted on Federal Income Tax)

N/A Not Counted

Not Counted

ancing grants under title IV of the ancing Act of 1974 to expand

king Indian-owned economic s on or near reservations

N/A Not Counted

Not Counted

l Retirement Account (IRA) ns, 1099-R

15b Counted Counted RP - Retirement/ pension

IRA Distributions

e or taxable portion of inherited erited pension

N/A Not Counted

Not Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Interest in1099-INT

Other

nt to d

ents

RKs t

t

Interest ininterest cfederal ra


6/16 Update # 16-35

24 Income

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

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

• Interest Income

• Contract of sale ofProperty/Interest

• Interest on paymereplace an excluderesource

• Interest portion of Retirement refund

• Loan interest paymreceived by client

• Interest on CalWORestricted Accoun

• Trust Fund InteresDistributed

come not received because the harged was below the applicable te

21 Counted Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


In-Home caregiverprovider wresides wreceives

• In-Hom• Nursin• Person• IHSS P• Comm• IHSS-

In-Home

• Restau• Advanc

Japanesewhether f


Job Corp

Jury duty Collect Earned Income Detail

Kickback

KinGAP p

Life insurprice, e.gof the ins


6/16 Update # 16-35

25 Income

Supportive Services (IHSS) wages paid to an enrolled ho, regardless of relationship,

ith the MC beneficiary who those services from the:

e Operations Waiverg Facility/Acute Hospital Waiveral care Services Programlus Option

unity first Choice OptionResidual Program

N/A Not Counted

Not Counted

N/A

Supportive Services

rant Meals Allowancee Payments for Caregiver

N/A Not Counted

Not Counted

N/A

or Aleutian reparation payment rom the United States or Canada

N/A Not Counted

Not Counted

N/A

s earnings/stipend 21 Counted Counted

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

Jury Duty/Court

s 21 Counted Counted

ayments N/A Not Counted

Not Counted

N/A

ance proceeds turned over for . surrender in excess of the cost urance

21 Counted Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Life insurincludingpayments

Loan pro Collect Unearned Income Detail

Long-termamount –

Long-term– 1099 LT

Lost, stolpayments

Manufact

Medical S(Archer-M

Military a

Mortgagesection 2

Needs-ba

Netherlan

Net Operfrom othe


6/16 Update # 16-35

26 Income

ance proceeds upon death, non-taxable annuity /proceeds

N/A Not Counted

Not Counted

N/A

ceeds N/A Not Counted

Not Counted

care benefits – non-taxable 1099 LTC

N/A Not Counted

Not Counted

care benefits – taxable amount C

21 Counted Counted

en, or damaged property N/A Not Counted

Not Counted

urer incentive payments 21 Counted Counted

avings Account edicare), Pub. 969

21 Counted Counted

llowances N/A Not Counted

Not Counted

assistance payments under 35 of the National Housing Act

N/A Not Counted

Not Counted

sed assistance N/A Not Counted

Not Counted

ds WUV victims of persecution N/A Not Counted

Not Counted

ating Loss Carryover, Subtract r line 21 income, Pub. 536

21 Subtract Losses

Subtract Losses

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Nutrition Assistancfor the El

Ordinary/

rest: t

rest:


Other gai s), from Collect Unearned Income Detail

Paid Fam

PensionsRetiremeendowmeand taxab

e Collect Unearned Income Detail

ities

t

tirement


6/16 Update # 16-35

27 Income

benefits (Supplemental Nutrition e Program, Nutrition Programs derly or Disabled.

N/A Not Counted

Not Counted

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

• Dividends

• Dividends and inteIrregular/infrequen

• Dividends and inteRegular

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

Other gains (or losse4797

ily Leave, 1099-G 21 Counted Counted

, Department of Defense nt Board military retirement, nt contracts paid as annuities le annuities, 1099-R

16b Counted Counted RP - Retirement/ pension

• Annuities/InsurancCompany

• Civil Service Annu

• Foreign Pension

• Pension/Retiremenpayments

• Public Employees Retirement

• State Teachers Re

• Military benefits

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Pension pemployeecontributito tax

Physical distress p

Principal

Prizes an awards Collect Unearned Income Detail

Public asassistancgeneral a

Pulitzer, N

Qualified

Qualifiedflexible sp

Radiationpayment


6/16 Update # 16-35

28 Income

ayments that were paid by the (such as premiums of ons that were previously subject

N/A Not Counted

Not Counted

injury, illness, or emotional ayments

N/A Not Counted

Not Counted

payments on loans N/A Not Counted

Not Counted

d awards 21 Counted Counted Winnings, prizes and

sistance payments, general e, Bureau of Indian Affairs ssistance

N/A Not Counted

Not Counted

oble or similar prize 21 Counted Counted

Tuition Program, Pub. 970 21 Counted Counted

reservist distribution from health ending account, W-2, Pub 525

21 Counted Counted

exposure compensation N/A Not Counted

Not Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Railroad non-taxab

nt

nt bility

nt Total bility


Recoveriwhich a cRefunds/itemized

ReemploAssistancagency, 1

Refugee

Refugee program DepartmeJustice su(VOLAG)

Reimbursincurred

ReimbursFee


6/16 Update # 16-35

29 Income

retirement benefits (taxable and le), RRB1099

20a & 20b

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

• Railroad Retireme

• Railroad RetiremeOccupational DisaBenefit

• Railroad Retireme& Permanent DisaBenefit

es of amounts deducted or for redit was taken an earlier year. reimbursements/rebates of deductions

21 Counted Counted

yment Trade Adjustment e payments made by a state 099-G

21 Counted Counted

cash assistance N/A Not Counted

Not Counted

reception and replacement one-time payments by the nt of State or Department of ch as Voluntary Agency

payments

N/A Not Counted

Not Counted

ements not in excess of costs N/A Not Counted

Not Counted

ement for Employment Agency 21 Counted Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Relocatio Collect Unearned Income Detail

Relocatiodue to floCommun

Rental ofself-empl

ersonal iness

ult unit lling on

ersonal s week

ersonal hours


• Collect Earned Income Detail

Rental reS-CorporSchedule

ersonal or

f trade

use of



Renter’s


6/16 Update # 16-35

30 Income

n assistance payments N/A Not Counted

Not Counted

n and Rehabilitation payments ods under the Housing and ity Development Act

N/A Not Counted

Not Counted

personal property – not oyment

21 Counted Counted MS-Misc. • Rent from real or pproperty not a bus

• Rent from unit of mdwelling/other dweprop exmt as PR

• Rental other real/pproperty < 20 hour

• Rental other real/pproperty > or = 20 week

al estate, royalties, partnerships, ations, Trusts, etc. (or loss), E

17 Counted Counted RR - Rental or royalty income

• Rent from real or pproperty business appreciable effort

• Royalties as part oor business or frompublication of work

• Royalties paid for property

tax credit (California) N/A Not Counted

Not Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Repaymeof origina

Reverse

Rewards

Ricky Ra

Roth IRAQualified

Salary oremployer

Scholarshnot used

Scholarshused for l

SDI, not tinsurance


6/16 Update # 16-35

31 Income

nt of bona fide loan not in excess l loan

N/A Not Counted

Not Counted

Annuity Mortgage N/A Not Counted

Not Counted

21 Counted Counted

y hemophilia relief fund N/A Not Counted

Not Counted

, 401K, 403(b), or 457(b) Distribution

N/A Not Counted

Not Counted

wages from a decedents’ (received by a surviving spouse)

N/A Not Counted

Not Counted

ips, awards, fellowship grants for living expenses, Pub. 970

21 Not Counted

Counted

ips, awards, fellowship grants iving expenses, Pub, 970

21 Counted Counted

reated as unemployment benefits

N/A Not Counted

Not Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Self-empSchedule

on

has r reports

ncome

on

no rly rents ber

no gularly ber

nt to eed item






6/16 Update # 16-35

32 Income

loyment (in excess of expenses), K-1, Schedule SE

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

• R & B/Room rent: business license oincome for taxes

• Self Employment i

• Lump sum not fromtrade/business of self-employed persnon-recurring

• R & B/Room rent: business lic regulato non-family mem

• R & B/Room rent: business license rerents to family mem

• Third Party paymevendor for a non-n

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Social senon-taxab

isabled

lity

ed Adult

based , or child


ent Collect Unearned Income Detail

ors

er's


Sponsor’immigran

State taxstate tax


6/16 Update # 16-35

33 Income

curity benefits (taxable and le), SSA-1099

20a & 20b

Counted Counted SD - Social Security Disability

• SSA/RSDI - Blind

• SSA/RSDI: Blind DAdult Child (DAC)

• SSA/RSDI: Disabibenefits

• SSA/RSDI: DisablChild (DAC)

• SSA/RSDI: incomeon parent, spousedisability

SR - Social Security Retirement

• SSA/RSDI: Retirembenefits

SO - Social Security Survivors

• SSA/RSDI: Survivbenefits

• SSA/RSDI: Widowbenefits

s income given to a sponsored t

N/A Not Counted

Not Counted

•

refund in excess of prior year deducted

21 Counted Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


State or FcompensInsuranceunemployRailroad Trade ReUnemploDisaster AssistancUnemploAirline De1099-G

ss

ent gross


Stolen pr

Strike an earned Collect Unearned Income Detail

SupplemSupplembenefits


Taxable rstate/loca

izens t

s


6/16 Update # 16-35

34 Income

ederal unemployment ation, 1099-G State Disability (SDI), when treated as ment compensation, 1099-G

Unemployment benefits, 1099-G adjustment allowances, 1099-G yment assistance under the Relief and Emergency e Act of 1974, 1099-G yment assistance under the regulation Act of 1974 Program,

19 Counted Counted UE - Unemployment

• UIB: Disaster

• UIB: lump sum gro

• UIB: regular paym

operty received 21 Counted Counted

d lockout benefits 21 Counted Counted UE - Unemployment

• Strike Benefits Un

ental Security Income/State entary Payment (SSI/SSP)

N/A Not Counted

Not Counted

efunds, credits, or offsets of l income taxes

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

• CA FTB Senior CitTax Postponemen

• Income tax Refund

• Property tax refund

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Unearnedexpensescorporatio

Collect Inkind Income Detail

Unemplo

Utility reb

Veteran’sattendanctheir fami

VA agent

VA childre

VA comppayments

VA deathmember after Sep

VA depenbenefits

VA disabithe vetera

VA educaallowance


6/16 Update # 16-35

35 Income

income in-kind/personal paid by another, including a n

21 Counted Counted

yment benefits paid by a union 21 Counted Counted

ates 21 Counted Counted

Administration (VA) aid and e benefits paid to the veteran or

lies

N/A Not Counted

Not Counted

orange benefits N/A Not Counted

Not Counted

n with certain birth defects N/A Not Counted

Not Counted

ensated work-therapy program N/A Not Counted

Not Counted

gratuity paid to a survivor of a of the Armed Forces who died tember 10, 2001

N/A Not Counted

Not Counted

dent-care assistance program N/A Not Counted

Not Counted

lity compensation paid either to n or their families

N/A Not Counted

Not Counted

tion, training or subsistence s

N/A Not Counted

Not Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


VA grantswheelcha

VA grantswho lost t

VA insurapaid eithebeneficiaveteran’sdeath

VA insurathe VA

Veteran’sCompens

Veteran’s

VA pensiotheir fami

Veteran’sstate or pservice in

Victims o


6/16 Update # 16-35

36 Income

for homes designed for ir living

N/A Not Counted

Not Counted

for motor vehicles for veterans heir sight or the use of their limbs

N/A Not Counted

Not Counted

nce proceeds and dividends r to veterans or their

ries, including the proceeds of a endowment policy paid before

N/A Not Counted

Not Counted

nce interest left on deposit with N/A Not Counted

Not Counted

Filipino Veterans Equity ation Trust

N/A Not Counted

Not Counted

North Vietnam POW/MIA N/A Not Counted

Not Counted

n benefits paid to the veteran or lies

N/A Not Counted

Not Counted

bonus payment paid by any olitical subdivision because of a combat zone

N/A Not Counted

Not Counted

f crimes payments N/A Not Counted

Not Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Vocationaand cashservices,due to dis

Volunteer

• Peace housinfood, a

• Nationsupporfor out-Retired(RSVPor Sen

• Service(SCORservice

• Voluntereimbumeals,trainingcounse

Walker v.

Weatheriemergenheating/c

Whistlebl


6/16 Update # 16-35

37 Income

l rehabilitation goods, services received, not in return for but for training and rehabilitation ability

N/A Not Counted

Not Counted

Work amounts:

Corps living allowances for g, utilities, household supplies, nd clothingal Senior Service Corps tive services or reimbursements of-pocket expenses from the Senior Volunteer Program ), Foster Grandparent Program, ior Companion Program Corps of Retired Executives E) amounts for supportive s or out-of-pocket expenseser tax counseling

rsements for transportation, and other expenses you have in for, or actually providing tax ling for the elderly

N/A Not Counted

Not Counted

Bayer payment N/A Not Counted

Not Counted

zation, home energy assistance, cy repair, or replacement of ooling devices

ower’s award 21 Counted Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


Withholdioverpaymsource

Work traiamount pgreater thfor public

Worker’sor their su

Workforc

Work traia state wexceed wpublic we


6/16 Update # 16-35

38 Income

ng from a benefit to repay an ent from the same income

N/A Not Counted

Not Counted

ning program payments – entire aid by a state welfare agency if an what would otherwise be paid welfare benefits

21 Counted Counted

compensation paid to the worker rvivors

N/A Not Counted

Not Counted

e Investment Act payments N/A Not Counted

Not Counted

ning program payments made by elfare agency if the total does not hat would have been paid in lfare benefits

N/A Not Counted

Not Counted

ome Types or Losses

1040 Line #

MAGI MC APTC


Revised: 10/2


17.9.1

The corresponding line on the IRS Form 104

Income D on Type CalWIN Window

Alimony p Collect Other Expense Detail

Businessperformin

es of ing artists

Collect Other Expense Detail

Deductibltax

f tax


Domestic tion Collect Other Expense Detail

Educator es Collect Other Expense Detail

Health Sa ccount Collect Other Expense Detail

6/16 Update # 16-35

39 Income

Deductions and Expenses

following table provides various deduction types for MAGI MC and APTC, including its0.

Table 17-2: Income Deduction Types from IRS Form 1040

eduction Types1040 Line #

MAGI MC APTC

CalHEERS Deduction Type CalWIN Deducti

aid 31a Deducted Deducted AL- Alimony Alimony Paid

expenses of reservists, g artists, etc.

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

Business expensreservists perform

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

Deductible part oself-employment

production activities 35 Deducted Deducted DP- Domestic production activities

Domestic ProducActivities

expenses 23 Deducted Deducted EE- Educator expenses

Educator expens

vings Account 25 Deducted Deducted HS- Health Savings Account

Health Savings A

Revised: 10/2


Hobby incexpensesnot expec

fit activity Collect Other Expense Detail

IRA dedu Collect Other Expense Detail

Moving e Collect Other Expense Detail

Penalty osavings

withdrawal Collect Other Expense Detail

Rental of expenses

l property Collect Other Expense Detail

Self-empldeduction

alth ion



6/16 Update # 16-35

40 Income

ome expenses, or from an activity you did t 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-proexpenses

ction 32 Deducted Deducted ID- IRA deduction

IRA Deduction

xpenses 26 Deducted Deducted ME- Moving Expenses

Moving Expenses

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

Penalty on early of savings

personal property Deducted Deducted PP- Rental of personal property expenses

Rental of personaexpenses

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

Self-employed heinsurance deduct


MAGI MC APTC


Revised: 10/2


Self-EmpSimple, a

nt

nt ries

nt

nt Labor

nt Property iums

nt Business

nt Room & s

nt Farming es

nt Other enses

nt Raw ds

nt



6/16 Update # 16-35

41 Income

loyment Pension (SEP), nd qualified deduction

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

• Self-EmploymeDepreciation

• Self-EmploymeEmployee Sala

• Self-EmploymeEntertainment

• Self-EmploymeCosts

• Self-EmploymeInsurance Prem

• Self EmploymeLicense

• Self-EmploymeBoard Expense

• Self-Employme& Fishing Loss

• Self-EmploymeNecessary Exp

• Self-EmploymeMaterial & Goo

• Self EmploymeTransportation


MAGI MC APTC


Revised: 10/2


Student lo rest • Collect Income Expense Detail (student)

• Collect Other Expense Detail

Tuition an(not paid

ellaneous

datory Fees

ion

Collect Income Expense Detail (student)


6/16 Update # 16-35

42 Income

an interest 33 Deducted Deducted SL- Student loan interest

Student loan inte

d fees paid by individual by financial aid)

36 Deducted Deducted TF - Tuition and fees paid by individual (not paid by financial aid)

• Education MiscExpenses

• Education Man

• Education Tuit


MAGI MC APTC



17.10CalWIN 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. These Income Types may NOT count for MAGI MC or APTC/CSR due to CalHEERS functionality limitations. Ensure countable income is included in the final eligibility determination. [Refer to Budgeting Ch. 9]

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.

17.10.1 Income

Table 17-3: 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)


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)


CalWORKs Diversion (Diversion period is less than 4 months)


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


Education Awards/Scholarships for Teens Display Student Financial Aid Detail

Energy Crisis Assistance-Energy Conserv. Prog./Low Inc. Energy Assist.


Executive Volunteer Program Payment for supportive services



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


Life ins/death benefits: individual is beneficiary and owner of policy


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 Education loans, grants, scholarships, fellowships Non-exempt

Display Student Financial Aid Detail

Other Education loans, grants, scholarships, fellowships, Exempt

Display Student Financial Aid 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



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



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


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




17.10.2 Expenses

Table 17-4: 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


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




Table 17-5: Income Types NOT Counted

(Not found in IRS Form 1040 or in CALWIN income windows)

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 clothing

Nat’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 expenses

Volunteer 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



Documents

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