Page 39

39 | P a g e October 25 members of the Seminole Nation of Oklahoma, Seminole Tribe of Florida, Miccosukee Tribe of Florida and independent Seminole Indians of Florida. In that case, the first $2,000 of every payment would be excluded. • All monies awarded to Indian Tribes by the Indian claims commission or court of claims shall be excluded (if less than $2000) as authorized by P.L. 93-134, 92-254, 94-540 94-114 and 97-408, or other applicable awards as provided for in Public Law. If monies awarded are over $2000, see the Income Inclusion Section of the Manual. • Income from Indian Lease Lands is excluded up to $2,000 per individual (not household) in the twelve-month period preceding the month of application (not per payment). Any amount over $2,000 per individual per year is included. INCOME EXCLUSIONS: • Complementary assistance from other sub-grantees and organizations which consists of goods and services not included in or duplicated by LIHEAP. • Out-of-pocket Insurance Premiums. Insurance premiums paid directly by the client or insurance premiums paid by the employee but automatically deducted from an employee paycheck do not count as income. If an applicant has had automatic insurance premiums deducted from their paychecks, MUSE cannot be used to verify income. Similarly, Medicare premiums paid out of a Social Security benefit will not be counted as income. • State of Montana Pay Stubs: The “State Share Credit” is not income; it is part of the insurance package offered to all state employees. Allowable Insurance Deductions • Medical • Dental • Hardware • Vision

Unallowable Insurance Deductions • Basic Life • Public Employees Retirement • Optional Life Plan C • New PERS Retirement • AD&D (Accidental Death and Dismemberment • Deferred Comp • Medical FSA (Flexible Spending Account) • State FSA Administration Fee • State FSA Admin Fee Debit Card • Short Term Disability Premiums • Long Term Disability Premiums • Health Savings Accounts