N.J. Admin. Code § 10:167D-4.2

Current through Register Vol. 56, No. 16, August 19, 2024

Section 10:167D-4.2 - Income standards

(a) Any single permanent resident of New Jersey who is 65 years of age or older or who is between 18 and 65 and is receiving Social Security Title II disability benefits must have an annual income of less than $ 28,769 to be eligible for the Lifeline Programs.

(b) Any married permanent resident of New Jersey who is 65 years of age or older or who is between 18 and 65 and is receiving Social Security Title II disability benefits, and his or her spouse, must have a combined annual income of less than $ 35,270 to be eligible for the Lifeline Programs.

1. An applicant and spouse shall be considered separated when each maintains a separate residence and the applicant does not have access to or receive support from the spouse's income.

i. Any support payment received by the applicant, for the sole benefit of the applicant, shall be considered as income for eligibility purposes.

2. An applicant and spouse shall be considered separated when the spouse has been institutionalized in a long-term care facility, either skilled or intermediate, or in a State or county psychiatric hospital at least 30 consecutive days prior to application.

(c) All income, from whatever source derived, is considered when determining eligibility for the Lifeline Programs.

1. All income, taxable and nontaxable, is to be included. Examples of possible sources of income, which shall be gross amounts unless otherwise noted, are as follows:

i. Social Security benefits paid to or on behalf of the applicant;

ii. Veterans benefits;

iii. Disability benefits, whether public or private;

iv. Salaries;

v. Wages;

vi. Bonuses;

vii. Commissions;

viii. Fees;

ix. Dividends;

x. Interest taxable and nontaxable;

xi. Capital gains;

xii. Royalties;

xiii. Bequests and Death benefits;

xiv. Support payments;

xv. Unemployment benefits;

xvi. Pensions and Black Lung Benefits;

xvii. Annuities, whether contributory, noncontributory, qualified or nonqualified;

xviii. Retirement benefits including distribution from Individual Retirement Arrangements (IRAs), such as Traditional, Simple, Roth, or Educational, and benefit payments from foreign countries;

xix. Net business income;

xx. Fair market value of prizes and awards;

xxi. Gambling and lottery winnings; and

xxii. Net rental income after expenses.

2. Sources of income which are excluded in considering eligibility for the Lifeline Programs are as follows:

i. Benefit amounts received under the Lifeline Programs;

ii. Benefits received under New Jersey Homestead Rebates;

iii. Proceeds from spouse's life insurance;

iv. Capital gains of up to $ 250,000 for a single person or up to $ 500,000 for a married couple on the sale of a main home which is also excluded from income taxation by IRS and the New Jersey Division of Taxation;

v. Stipends from the Volunteers in Service to America (VISTA), Foster Grandparents programs, Workforce 55+ program and programs under Title V of the Older Americans Act of 1965;

vi. Agent Orange payments;

vii. Rewards involving health care fraud or abuse which apply to 10:49-13.4;

viii. Holocaust reparations;

ix. Proceeds from viatical settlements;

x. Proceeds received by the beneficiary of a special needs trust as described in N.J.A.C. 10:167D-4.2(d);

xi. Rollovers from one tax deferred financial instrument, such as pension, annuity, IRA, insurance contract or other retirement benefits, to another tax deferred financial instrument;

xii. 1035 Tax Free Exchanges of a policy or contract handled between two insurance companies; and

xiii. An insurance policyholder's original contributions if demutualization of the policy occurs and, in that case, only the earnings on the policy would be counted.

(d) To be considered a special needs trust to be excluded as income for determining eligibility for the Lifeline Programs, the trust shall include the following provisions:

1. The trust shall specifically state that the trust is for the sole benefit of the trust beneficiary;

2. The trust shall specifically state that its purpose is to permit the use of trust assets to supplement, and not to supplant, impair or diminish, any benefits or assistance of any Federal, State or other governmental entity for which the beneficiary may otherwise be eligible or which the beneficiary may be receiving;

3. The trust shall specifically state the age of the trust beneficiary, that the trust beneficiary is disabled within the definition of 42 U.S.C. § 1382c(a)(3), and whether the trust beneficiary is competent at the time the trust is established;

4. The trust shall specifically identify, in an attached schedule, the source of the initial trust property and all assets of the trust;

5. If the trust makes provisions which are intended to limit invasion by creditors or to insulate the trust from liens or encumbrances, the trust shall state that such provisions are not intended to limit the State's right to reimbursement or to recoup incorrectly paid benefits;

6. The special needs trust shall state that it is established by a parent, grandparent, or legal guardian of the trust beneficiary or by a court;

7. The trust shall specifically state that it is irrevocable. Neither the grantor, the trustee(s), nor the beneficiary shall have any right or power, whether alone or in conjunction with others, in whatever capacity, to alter, amend, revoke, or terminate the trust or any of its terms or to designate the persons who shall possess or enjoy the trust estate during his or her lifetime;

8. The trustee shall be specifically identified by name and address. The trust shall state that the original trust beneficiary cannot be the trustee. The trust shall make provisions for naming a successor trustee in the event that any trustee is unable or unwilling to serve;

9. The trust shall specifically state that the trustee shall fully comply with all State laws, including the Prudent Investor Act, 3B:20-11.1 et seq. The trust shall provide that the trustee cannot take any actions not authorized by, or without regard to, State laws. If the trust gives the trustee authorization or power not provided for in the Prudent Investor Act, an accompanying letter shall provide an explanation for each such authorization or power;

10. The trust shall specifically state that the trustee shall be compensated only as provided by law in accordance with N.J.S.A. 3B:18-2 et seq. If the trust identifies a guardian, the trust shall specifically identify him or her by name. A guardian shall be compensated only as provided by law;

11. The trust shall specify that a formal or informal accounting of all expenditures made by the trust shall be submitted to the appropriate eligibility determination agency on an annual basis;

12. The State shall be given advance notice of any expenditure in excess of $ 5,000, and of any amount which would substantially deplete the principal of the trust. Notice shall be given to the Office of State Health Insurance for the Aged & Disabled, Division of Aging Services, PO Box 715, Trenton, NJ 08625-0715, or any successor agency, 45 days prior to the expenditures; and

13. New Jersey rules and laws do not permit a trust to create a will for an incompetent or a minor. The money creating the trust, any additions and interest accumulated, cannot be left to other parties, but shall pass by intestacy. The trust shall not create other trusts within it.

(e) Upon request by the Department, the applicant must be able to document the amounts reported on the eligibility application, and will be required to submit photocopies of his or her Federal, State and city income tax return and other acceptable evidence.

(f) Eligibility for the Lifeline Programs is conferred based upon annual income for the current calendar year, which is estimated at the time of application. Previous year income information is used as a gauge and supplements estimates of current income to determine current eligibility. However, if previous income exceeds the standard, but current year income is expected to fall within legal limits, an initial applicant may estimate current year income for the purpose of establishing eligibility.

(g) Since eligibility is based upon actual annual income, if the actual annual income for the current calendar year exceeds the income standard, the person will become ineligible for the entire calendar year.

(h) The Department shall take necessary action to recover the full amount of payments made on behalf of beneficiaries during an ineligible period, when appropriate.

(i) Beneficiaries are required to notify the Department immediately if their current year income exceeds the established income standard.

(j) The income eligibility limits shall increase annually on January 1 by the amount of the maximum Social Security benefit cost-of-living adjustment for that year for single and married persons, respectively, in accordance with 42 U.S.C. § 415(i)(2)(D), incorporated herein by reference. The Commissioner shall publish the new income limits annually in the New Jersey Register.

N.J. Admin. Code § 10:167D-4.2

Administrative correction.
See: 36 N.J.R. 5683(a).
Administrative change.
See: 37 N.J.R. 5001(a).
Administrative change.
See: 38 N.J.R. 5362(a).
Administrative change.
See: 40 N.J.R. 182(a), 6966(a).
Administrative change.
See: 43 N.J.R. 3365(a).
Administrative change.
See: 45 N.J.R. 33(a).
Administrative change.
See: 46 N.J.R. 78(a).

Administrative change, 47 N.J.R. 485(a).

Administrative Change, 49 N.J.R. 104(a).

Amended by, 49 N.J.R. 3220(a), effective 9/18/2017.

Administrative Change, 49 N.J.R. 4010(a).

Administrative Change, 51 N.J.R. 89(b).

Administrative Change, 52 N.J.R. 108(a).

Administrative Change, 53 N.J.R. 80(a).