Current through all regulations passed and filed through December 16, 2024
(A)
This rule
describes how retirement funds are treated for purposes of determining medical
assistance eligibility.
(B)
Definition. "Retirement funds" are plans designed to
provide unearned income to supplant or supplement earned income. Retirement
funds may include, but are not limited to such plans as: public and private
pension, disability, or retirement plans; defined benefit employer pension
plans, profit sharing pension plans, 403(b) pension plans, money purchase
pension plans, employee stock ownership plans, individual retirement accounts
(IRA); KEOGH pension plans, Roth IRAs, simplified employee pension plans
(SEP-IRA), and 401k pension plans; or any other pension or retirement plans
authorized under 401, 403, 408 of the Internal Revenue Code (IRC) as outlined
in 26 U.S.C. (as in effect on February 1, 2016), or any other enacted IRC
provisions providing for a pension or retirement plan or any other similar
financial vehicles administered by an individual, employer, or union. A
retirement fund converted into an annuity shall be considered in accordance
with rule
5160:1-3-05.3 of the
Administrative Code.
(C)
Retirement funds treated as income.
(1)
A retirement fund
in which an individual has the legal ability to receive regular guaranteed
lifetime payments will be treated as a source of unearned income rather than as
a resource. A defined benefit employer pension plan is an example of this type
of retirement.
(2)
The individual is required to obtain the maximum
available amount of payment from the plan. If the maximum available amount of
payment requires the individual's spouse to consent to a waiver of the spouse's
survivor benefits, the individual must document a good faith attempt to obtain
that consent, and whether consent was obtained or refused. If consent is not
obtained, the individual must elect the minimum spousal survivor benefit
required by the plan.
(3)
If allowed in the plan, the individual may elect a
lesser payment in favor of retaining a minimum survivor benefit for a child who
can be documented to be blind or disabled, as defined in rule
5160:1-3-02 of the
Administrative Code.
(4)
If the retirement fund is determined to not be income,
then the retirement fund shall be evaluated as a potential
resource.
(D)
Retirement funds treated as a resource.
(1)
The retirement
fund shall be evaluated as a potential resource only after it is determined to
not be income.
(2)
A retirement fund is a countable resource if the
individual or the individual's spouse has an ownership interest in the
retirement fund and the legal ability to convert it to cash.
(a)
The value of a
retirement fund is the amount an individual can currently withdraw from the
fund.
(b)
This determination shall be made by reference to
documentation describing the retirement fund and/or a letter from the plan
administrator.
(c)
Self-defined retirement plans such as an IRA or KEOGH
plan are examples of this type of retirement fund.
(3)
If there is a
financial penalty imposed by the plan administrator in order to convert the
account to cash, the amount of the countable resource is the net amount payable
to the individual after deducting the penalty. The amount payable may not be
further reduced by the amount of any tax incurred by the individual as a result
of the conversion of the account to cash.
(4)
A retirement fund
is not a resource if an individual must terminate employment in order to obtain
any lump sum or payment.
(5)
A retirement fund determined to be a resource in
accordance with paragraph (D) of this rule, which is owned by an ineligible
spouse or parent or spouse of an ineligible parent, shall not be considered for
deeming purposes described in rule 5160:1-3-03.20 of the Administrative
Code.
(E)
Administrative agency responsibilities.
(1)
The
administrative agency must evaluate any retirement fund of which the individual
is a beneficiary.
(2)
The administrative agency shall obtain the summary plan
description or other document describing the rights and benefits under the
retirement fund. A letter from the plan administrator may also be obtained to
make the determinations required under this rule.
(F)
Individual
responsibilities. An individual is required to provide all available
documentation to aid the administrative agency in evaluating any retirement
fund of which the individual is a beneficiary.
Replaces: 5160:1-3- 03.10
