Benefits 101

1. Benefits 101 Jill Walter Nick Isham 2012 Legislative Days Training

2. Purpose of presentation • Understand SSI and SSDI basics • Be able to explain that there are work incentives to debunk the MYTH!

3. MYTH You will lose your benefits and health insurance if you work.

4. Title II SSDI Retirement DAC Based on work history, FICA paid. Comes with Medicare. Title XVI SSI Needs based, have little or no income and resources. Comes with Medicaid. SSDI vs. SSI

5. SSDI: Social Security Disability Insurance • Must have a permanent condition that prevents working. • Must have paid FICA taxes during employment • Entitled to benefits in one of 3 ways • Disability Insurance Benefits (DIB) • Disabled Widow Benefits (DWB) • Childhood Disability Benefits – also called DAC 24 month wait for Medicare

6. SSI: Supplemental Security Income • A financial and medical benefit available for people who meet income and asset limits. Asset Limits Individual: $2,000 Couple: $3,000 • Who have a disability or have a child with a disability • Or are at least 65 years old or are blind

7. SSI • Federal Benefit Rate (FBR) for 2012 is $698 • Eligible for WI State Supplement of $83.78 if receiving any amount of SSI • In WI, automatically enrolled in Medicaid.

8. Concurrent Beneficiaries • Receiving Title II and Title XVI • Two separate checks a month • Title II must be under $698 • Convenient for a PASS plan

9. Work Incentives • MYTH: Start working, you lose your benefits. • SSA program that allows people receiving Title II or XVI to work and still receive payments and health benefits. • Series of safety nets. • Some apply just to Title II, some to Title XVI, some to both.

10. Work Incentives for Title II • Trial Work Period (TWP): 9 months of unlimited earnings. • TWP = $720 in 2012 • Continue full SSDI payments • Does not have to be used consecutively – 5 year rolling period.

11. Work Incentives for Title II • Substantial Gainful Activity (SGA): the way SSA measures work that is significant, productive and will sustain you. • In 2012 SGA=$1,010/month of countable income • Cessation – the first month of earnings considered SGA after the TWP, followed by 2 Grace Period months.

12. Work Incentives for Title II • Extended Period of Eligibility (EPE): 36-month period in which a person can receive their SSDI payment any month their earnings are below SGA. • The number of times a person’s SSDI payments stop and start is not limited during the EPE. • Starts the month after TWP ends. • The first time a person earns over SGA after the EPE, their benefits would be terminated.

13. BOND National Demonstration Project • An additional SSDI work incentive meant to increase work activity for beneficiary's. • BOND randomly assign individuals who are entitled to SSDI. • SSA is piloting this project that runs until September of 2017. • BOND gives a gradual reduction with a 2/1 offset on earnings.

14. BOND Offset Example • If working 30 hours at $10.50/hour making $1,354.50 a month. • SSA would subtract the current SGA amount $1,010.00(1354.50-1010 = 344.50) • Then take half of this amount (344.50/2=172.25) from your current SSDI cash payment. • So your SSDI payment is reduced by $172.25, but your earnings are $1,354.50.

15. Work Incentives for Title II Options after termination • Expedited Reinstatement (EXR) • Reapply for Title II benefits

16. Work Incentives to reduce your earned income under SGA Subsidy and Special Conditions: Job coach, extra support, accommodations Impairment Related Work Expenses (IRWEs): Out of pocket expenses related to your disability and needed for employment.

17. Extended Period of Medicare Coverage (EPMC) Remain eligible for Medicare coverage after no longer eligible for SSDI payments • Eligibility for at least 93 months starting the month after TWP. • Ineligibility for SSDI must be due to earning at SGA level, not due to medical improvement.

18. Medicare • Part A – Hospital Insurance. • Part B – Supplemental Medical Insurance. • Part D – Prescription Drug Coverage.

19. Basic SSI Calculation Unearned income - $20 (General Income Exclusion)= Countable Unearned Income Gross Earned Income - $65 (Earned Income Exclusion) = Countable Earned 2 Income Countable Unearned + Countable Earned = Total Countable Income 698 (FBR) – Total Countable Income = SSI PAYMENT

20. Without unearned income (FBR x 2) +65 + 20 = BEP The BEP for someone receiving just SSI is $1,481 With unearned income Unearned -20 Counted Unearned FBR - Counted Unearned remainder (remainder x 2) +65 = BEP Break Even Point SSI calculation in reverse

21. SSI Calculation 2012

22. Work Incentives for SSI Student Earned Income Exclusion (SEIE): Allows students to exclude earnings from income in calculating SSI payment. • Earn up to $1,700/month before their SSI check is reduced. • Only $6,840/year can be excluded. • IRWEs: SSA will deduct $1 of countable income for every $2 spent out-of-pocket on an IRWE. This results in the SSI payment increasing.

23. Work Incentives for SSI • Plan to Achieve Self-Support (PASS): Allows people to set aside money into a PASS account to achieve a vocational goal. • Need to be receiving SSI or became ineligible for SSI due to other income. • The other monthly income (Title II or earned income) is put into the PASS account, not counted in SSI calculation and thus increasing your SSI payment.

24. 1619(b) Continuing Medicaid coverage after SSI ineligibility due to earnings • Have been eligible for an SSI cash payment for at least 1 month; • Still meet the disability requirement; and • Still meet all other non-disability SSI requirements; and • Need Medicaid benefits to continue to work; and • Have gross earnings that are insufficient to replace SSI, Medicaid and publicly funded attendant care services.