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Only those listed may be named a beneficiary above the Medicaid program; all other beneficiaries must be listed below the Medicaid program. A community spouse cannot name an institutionalized spouse as a residual beneficiary in a position above the Medicaid program. Count annuities owned by the Medicaid client or an eligible spouse unless all exemption criteria are met. NOTE: An eligible spouse is the ABD spouse of a Medicaid applicant/recipient where neither spouse is institutionalized or open on Waiver. Count annuities purchased or converted by a Medicaid client on or after February 8, 2006, unless determined to be an uncompensated asset transfer, or ALL of the following are met: 1. The client or eligible spouse are receiving scheduled payments; AND 2. Scheduled payments are made at least annually; AND 3. The contract requires equal payments (no balloon payments): AND 4. Payment schedule is actuarially sound (equal payments resulting in full payout based on the annuitant’s life expectancy); AND 5. The annuity is irrevocable; AND 6. The contract and payments are non-assignable. Annuities that are not amended to meet the above criteria are treated as uncompensated asset transfers. Annuities the institutionalized or community spouse purchases on or after February 8, 2006, are evaluated under uncompensated asset transfer rules if within the 60-month asset transfer look-back period. The following are not considered uncompensated asset transfers and do not require beneficiary assignment to the Medicaid program when payments are made to the account owner: 1. An individual retirement annuity (section 408, subsection (b) of the IRS Code of 1986); or 2. A qualified employer plan annuity (section 408, subsection (q) of the IRS Code of 1986); or 3. Purchasing an annuity with an IRA, employer, or employer association account; or 4. A qualified salary reduction arrangement (section 408(a), (c) or (p) of the IRS Code of 1986); or 5. A simplified employee pension (within the meaning of section 408(k) of the IRS code of 1986). Request assistance through the Service Desk if one of these situations is alleged. Evaluate individual retirement annuities both to determine an uncompensated asset transfer and whether or not a countable resource.