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10. “Modified Adjusted Gross Income” or “MAGI” means income, adjusted by any amount excluded from gross income under Section 911 of the IRS Code, and any interest accrued. Social Security benefits are not included in gross income. The MAGI methodology is the standard for determining income eligibility for all Medicaid affordable care coverage groups, which are described in further detail in Part 1 of this Chapter. 11. “Policy holder” means the employee with access to ESI. 12. “Rhode Island Works” or “RI Works” means the State’s Temporary Assistance for Needy Families (TANF) program that provides assistance to low income needy families on the path to full employment and financial independence. The Program is administered by the Rhode Island Department of Human Services, one of the four State agencies under the Executive Office of Health and Human Services (EOHHS) umbrella. 13. “RIte Share-approved employer-sponsored insurance” means an ESI plan that meets the coverage and cost-effectiveness criteria for RIte Share. 14. “RIte Share Buy-In” means, the requirement that applies to a household with MAGI-based income above 150% of the FPL where only the child(ren) is Medicaid eligible and the parent/caretaker has access to ESI that is RIte Share-approved. These families are required to enroll in RIte Share, the State will pay the premium for a family plan, and the parent/caretaker will be responsible for a small monthly cost share to the State. 15. “RIte Share Premium Assistance Program” means the Rhode Island Medicaid premium assistance program in which the State pays the eligible Medicaid member’s share of the cost of enrolling in a RIte Share-approved ESI plan. This allows the State to share the cost of the health insurance coverage with the employer. 16. “RIte Share Unit” means the entity within EOHHS responsible for assessing the cost-effectiveness of ESI, contacting employers about ESI as appropriate, initiating the RIte Share enrollment and disenrollment processes, handling member communications, and managing the overall operations of the RIte Share Program. 17. “Third-party liability” or “TPL” means other health insurance coverage. This insurance is in addition to Medicaid and is usually provided through an employer. Since Medicaid is always the payer of last resort, the TPL is always the primary coverage. 18. “Wrap-around services or coverage” means any health care services not included in the ESI plan that would have been covered had the Medicaid member been enrolled in a Medicaid managed care plan (see Part 2 of this Subchapter for details). Coverage of deductibles, co-insurance and