TMA Premium Example 2

Example 2: Household consists of a married couple with two children, ages 16 and 14. Both parents work and the QRF shows their combined gross earned income to be $2,200 per month. TMA is entering Month 7. The countable income exceeds 100% FPL for a four-person household, yet it is less than 185% FPL. The children are covered by creditable health insurance.

Factors to Consider:

• The parents are subject to the 100 Hour Rule, so if we want to cover them we would need to keep the TMA case open or have an incapacity determination from SRT.
• Regardless of the 100 Hour Rule, the family's countable income exceeds the MNIL for four (the parent's income standard) and also exceeds 100% FPL for four (the children's income standard).
• Although the countable income is less than 185% FPL, we cannot merely close the parents and run the children in Kids Connection because the children are insured.

Result: In this case, all four family members are subject to the TMA premium. The premium amount is based on the chart at 468-000-215.

(Rev. 3/1/03)