N.J. Admin. Code § 10:69-10.13

Current through Register Vol. 56, No. 21, November 4, 2024

Section 10:69-10.13 - Earned income disregards for AFDC-related Medicaid

(a) The CWA shall disregard from the earned income of each employed individual in the eligible family, the first $ 90.00 of such earnings to cover work-related expenses including, but not limited to, transportation and mandatory payroll deductions.

(b) The CWA shall disregard from the total earned income not already disregarded, an amount equal to the difference between 133 percent of the Federal poverty level (see 42 CFR 9902(2)) and the Income Standard established for the size of the family unit, in accordance with the chart at N.J.A.C. 10:69-10.3(b) as follows:

1. For beneficiaries eligible on and after June 15, 2002, regardless of date of application; and

2. For applicants who apply on and before June 14, 2002 with a disposition pending.

(c) For applications received on and after June 15, 2002, the CWA shall disregard from the total earned income not already disregarded, the first $ 30.00 and one-third of the remainder for each employed individual.

1. This disregard shall apply to the earned income of a person for a period of four consecutive months. Once this disregard has applied for a four consecutive month period, it shall not again be applied on behalf of that individual as long as he or she continues to receive AFDC-related Medicaid expansion as described in (b) above. If, after receiving this disregard for a four-month period, the individual becomes ineligible for AFDC-related Medicaid or Medicaid expansion, this disregard shall not be applied to this or her income unless the individual has remained ineligible for AFDC-related Medicaid or Medicaid expansion for a period of 12 consecutive months.

2. For any month in which any part of the $ 30.00 and one-third disregard is applied, that month shall be counted as one of the four consecutive months of disregard.

3. Any month for which the individual loses the $ 30.00 and one-third disregard because of a provision in (e) below shall be considered as one of the four consecutive months.

4. For a period not exceeding eight months from the end of the four consecutive months of the $ 30.00 plus one-third of the remainder disregard, a deduction of the first $ 30.00 of the remaining income shall be applied.

i. Upon expiration of the eight-month period this deduction shall not be applied again so long as the wage earner is a beneficiary of AFDC-related Medicaid or Medicaid expansion. This deduction shall again be applied after the eight-month period only after the wage earner has not been a beneficiary of AFDC Medicaid or Medicaid expansion for a period of 12 consecutive months.

5. When an AFDC-related family loses eligibility for AFDC-related Medicaid, due to the following reasons, the disregard in (b) above shall apply:

i. Earnings or increased earnings from employment, including earnings from new employment;

ii. Expiration of the $ 30.00 or one-third disregards of earned income because of the time-limited application of those disregards; or

iii. Increased hours of employment.

(d) The CWA shall disregard from the remaining earned income, the actual costs paid for child care or for care of an incapacitated individual in the same home as the AFDC-C or-F eligible family when the circumstances described at (d)1 through 4 below exist. The amount of the disregard shall not exceed the limits as follows.

1. $ 175.00 per month, per child age two or older, or incapacitated adult, for full-time employment;

2. $ 200.00 per month, per child under age two, for full-time employment;

3. $ 135.00 per month, per child age two or older, or incapacitated adult, for part-time employment; and

4. $ 150.00 per month, per child under age two, for part-time employment.

(e) None of the disregards above shall apply to the earned income of the individual for any month which one of the following conditions apply to him or her:

1. His or her employment is terminated or his or her earned income is reduced without good cause within 30 days prior to that month.

i. Good cause includes the following circumstances:

(1) The termination or reduction is not voluntary;

(2) The wages of employment are below the applicable minimum wage;

(3) The individual is not physically able to engage in the employment;

(4) The employment constitutes a risk to health or safety; or

(5) The applicant voluntarily requested AFDC-related Medicaid be terminated for the primary purpose of avoiding the receipt of the $ 30.00 and one-third disregard for four consecutive months.

(f) The earned income disregard of a full-time or part-time student is described in 10:69-10.15.

(g) None of the disregards above in this section shall apply to the earned income of the individual for any month in which one of the following conditions apply to him or her:

1. The individual terminated his or her employment or reduced his or her earned income without good cause within 30 days prior to that month.

i. Good cause includes the following circumstances:

(1) The termination or reduction is not voluntary;

(2) The wages of employment are below the applicable minimum wage;

(3) The individual is not physically able to engage in the employment; and

(4) The employment constitutes a risk to health or safety.

2. The individual refused without good cause, within 30 days prior to that month, to accept employment in which he or she is able to engage which is offered through the State Division of Employment Security or any other bona fide offer of employment. The good cause provisions of (f)1i above apply.

3. The individual voluntarily requested AFDC-related Medicaid program coverage to be terminated for the primary purpose of avoiding the receipt of the $ 30.00 and one-third disregard for four consecutive months.

N.J. Admin. Code § 10:69-10.13

Amended by 49 N.J.R. 3729(a), effective 12/4/2017