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COMAR 10.09.24.03
384 State of Maryland Medical Assistance Manual Revised July 2012 DHMH 1159G
Worksheet- COLA Deduction
(Pickle Amendment)
Method A
Locate appropriate line based on SSI termination date.
Enter the amount of Social Security Benefit at time of SSI termination in Column 1.
Multiply by COLA factor, Column II, enter Product in Column III.
Enter the amount from Column III on the next line, Column I.
Continue until current benefit is reached.
I
II
III
SSI Terminated
Before:
Previous Benefit COLA Factor
Increased Benefit
July, 1977
______________ x 1.059
= __________________
July, 1978
______________ x 1.065
= __________________
July, 1979
______________ x 1.099
= __________________
July, 1980
______________ x 1.143
= __________________
July, 1981
______________ x 1.112
= __________________
July, 1982
______________ x 1.074
= __________________
Jan., 1984
______________ x 1.035
= __________________
Jan., 1985
______________ x 1.035
= __________________
________
______________x ___________ = __________________
________
______________x ___________ = __________________
________
______________x ___________ = __________________
Current SSB
$ _____________
Benefit at SSI Termination
$___________
COLA Deduction
$______________