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West Virginia Income Maintenance Manual Chapter 4

West Virginia Income Maintenance Manual Page 10 Chapter 4 Income

Under the ACA, an insurance plan that is certified by the Marketplace, provides essential health benefits, follows established limits on cost-sharing (like deductibles, copayments, and out-of- pocket maximum amounts) and meets other requirements. A QHP will have a certification by each Marketplace in which it is sold. REASONABLE COMPATIBILITY This term is applicable for Medicaid Groups and WVCHIP. There is considered to be reasonable compatibility when discrepancies between an individual’s self-attestation about his non-financial and financial information and the information reported by the FDH, AVS, or other electronic data sources available to the DOHS are within a designated threshold. REASONABLE COMPATIBILITY STANDARD FOR INCOME ONLY The Reasonable Compatibility Standard is an acceptable level of variance between self-attested income and income information obtained through electronic data sources. When the difference between the self-attestation and data source income affects eligibility, the reasonable compatibility test is applied by the eligibility system. Refer to 7.2.5.D.

West Virginia’s Reasonable Compatibility Standard for MAGI Medicaid coverage groups only is 10%. REASONABLE COMPATIBILITY STANDARD FOR ASSETS ONLY The reasonable compatibility standard for assets applies only during the automatic renewal process. Assets are considered verified at automatic redetermination when the value of liquid assets returned by the Asset Verification System plus the value of non-liquid assets previously verified in the case record are below the asset limit. Further verification is not required. When the total of these assets exceeds the asset limit, assets are not considered verified, i.e., discrepant. The client must be mailed a pre-populated redetermination form and be given the opportunity to verify the value of their assets at renewal. See Section 6.3.6. REIMBURSEMENT Compensation for past or future expenses. RELOCATION PAYMENTS Money received from federal, state or local agencies to cover moving costs, cost of purchasing a home in a new location, or as a rent supplement, when a person or family is displaced by such an agency. Examples of these payments include, but are not limited to, Highway Relocation, Urban Renewal and the Army Corps of Engineers. ROYALTIES