R382-10-11. Household Composition and Income Provisions

  (1) The Department adopts and incorporates by reference, 42 CFR 457.315 (October 1, 2015), regarding the household composition and income methodology to determine eligibility for CHIP.

  (a) The eligibility agency shall count in the household size, the number of unborn children that a pregnant household member expects to deliver.

  (b) The Department elects the option in 42 CFR 435.603(f)(3)(iv)(B).

  (c) The eligibility agency will treat separated spouses, who are not living together, as separate households.

  (2) Any individual described in Subsection R382-10-11(1) who is temporarily absent solely by reason of employment, school, training, military service, or medical treatment, or who will return home to live within 30 days from the date of application, is part of the household.

  (3) The eligibility agency may not count as income any payments from sources that federal law specifically prohibits from being counted as income to determine eligibility for federally-funded programs.

  (4) The eligibility agency may not count as income any payments that an individual receives pursuant to the Individual Indian Money Account Litigation Settlement under the Claims Resettlement Act of 2010, Pub. L. No. 111 291, 124 Stat. 3064.

  (5) The eligibility agency shall count as income cash support received by an individual when:

  (a) it is received from the tax filer who claims a tax exemption for the individual;

  (b) the individual is not a spouse or child of the tax filer; and

  (c) the cash support exceeds a nominal amount set by the Department.

  (6) The eligibility agency determines eligibility by deducting an amount equal to 5% of the federal poverty guideline, as defined in 42 CFR 435.603(d)(4).