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Title 5: Centrally Administered Programs Page 43 Iowa Department of Human Services Employees’ Manual Chapter E: Healthy and Well Kids in Iowa (hawk-i) Income Revised August 20, 2010 Verification of Income
While the 30-day period will 30 days from when the signed application is received, not from May 27, it seems clear from the pay stubs and Ms. H’s statements on the application that Ms. H’s pay stubs do not vary. The application is sent back to Ms. H for her signature. No further pay stubs are requested. The counselor documents in the case file the reason pay stubs from a period other than the 30 days before the application date were used. 4. Mr. and Mrs. J receive coverage under hawk-i for their children. The Js’ annual renewal was received January 11. They sent in one pay stub for Mr. J’s job. At their last annual renewal, the Js submitted four weekly pay stubs for Mr. J’s job showing he was paid $750 gross per week.
The pay stub submitted with this annual renewal shows $750 weekly gross pay. Since this pay stub is consistent with those submitted last year, no addition pay stubs are requested. Countable family income will be determined using $750 weekly gross income from Mr. J’s job. Income Limits Legal reference: 441 IAC 86.2(2) For a child to have initial and ongoing eligibility for the program, countable income shall not exceed 300 percent of the federal poverty level for a family of the same size. When determining initial and ongoing eligibility, all earned and unearned income shall be countable unless specifically exempted. Countable income is always annualized.
Annual Income Family Size 133% of Poverty 150% of Poverty 300% of Poverty 1 $14,404 $16,244 $32,490 2 $19,379 $21,854 $43,710 3 $24,353 $27,464 $54,930 4 $29,327 $33,074 $66,150 5 $34,301 $38,684 $77,370 6 $39,275 $44,294 $88,590 7 $44,250 $49,904 $99,810 8 $49,224 $55,514 $111,030 For each person over 8, add: $4,974 $5,610 $11,220