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1224 (07/2026) Chapter 8: Examples • Chapter 8: Examples Example 2: Harold applies for OSIPM and services in August 2018. During the interview Harold reports receiving $1,800 SSB and quarterly, third-party trust distributions of $600. Harold receives these payments in Jan, April, July, and Oct. The countable income is calculated as follows: • For eligibility purposes:

Š August and ongoing: $1,800 SSB + $180 trust income ($600 ÷ 3 - $20 monthly exclusion) = $1,980 • Countable income used in liability calculation:

Š August - September: $1,800 SSB

Š October and ongoing: $1,800 SSB + $200 ($600 ÷ 3) = $2,000 (SSA COLA not included) Example 3: Burt applies for OSIPM and services in July 2018. Burt reports $1,500 SSB and ongoing quarterly trust income of $600, received each Jan, April, July, and Oct. The countable income is calculated as follows: • For eligibility purposes:

Š July and ongoing: $1,500 SSB + $180 trust income ($600 ÷ 3 - $20 monthly exclusion) = $1,680 • Countable income used in liability calculation:

Š July - Sept: $1,500 SSB

Š October and ongoing: $1,500 SSB + $200 ($600 ÷ 3) = $1,700 If periodic income is received regularly but the amount varies, the individual will have to provide you verification of the last several payments so you can come up with an average amount, after which you will average over the period the payment covers.