317:35-5-41.2. Miscellaneous Personal property
(a) Cash savings and bank accounts.Pursuant to Section 416.1208 of Title 20 of the Code of Federal Regulations (C.F.R.), funds held in a financial institution account (including savings, checking, and time deposits, also known as certificates of deposit) are an individual's resource if the individual has an ownership interest in the account and can use the funds for his or her support and maintenance. Verification of the member's countable income or resources held in bank accounts or at other financial institutions can be established through an Asset Verification System (AVS). Section 1671 of Title 56 of the Oklahoma Statutes provides that financial records obtained for the purpose of establishing eligibility for assistance or services must be furnished without cost to the member or the Agency. • 2 If an individual is designated as sole owner by the account title, and can withdraw funds and use them for his or her support and maintenance, all of the funds, regardless of their source, are that individual's resource.For as long as these conditions are met, it is presumed that the individual owns one-hundred percent (100%) of the funds in the account.This presumption is non-rebuttable.
(1) If there is only one applicant or recipient account holder on a jointly held account, it is presumed that all of the funds in the account belong to that individual.If there is more than one (1) applicant or recipient account holder, it is presumed that all the funds in the account belong to those individuals in equal shares.
(2) If none of the account holders is an applicant or recipient, it is presumed that all of the funds in a jointly-held account belong to the deemor(s), in equal shares if there is more than one (1) deemor.A deemor is a person whose income and resources are required to be considered when determining eligibility and computing the SoonerCare benefit for an eligible individual.
(3) The presumption of ownership, as is established in Oklahoma Administrative Code (OAC) 317:35-5-41.2(a)(1) and (a)(2), above, may be rebutted, as follows, in accordance with 20 C.F.R. ' 416.1208.Successful rebuttal may be retroactive as well as prospective.
(A) The individual must submit his/her statement, along with corroborating statements from other account holders, regarding who owns the funds in the joint account, why there is a joint account, who has made deposits to and withdrawals from the account, and how withdrawals have been spent;
(B) The individual must submit account records showing deposits, withdrawals, and interest (if any) in the months for which ownership of funds is at issue; and
(C) The individual must correct the account title to show that the individual is no longer a co-owner if the individual owns none of the funds; or, if the individual owns only a portion of the funds, separate the funds owned by the other account holder(s) from his/her own funds and correct the account title on the individual's own funds to show they are solely-owned by the individual. • 3
(b) Life insurance policies. Life insurance owned by an individual (and spouse, if any) will be considered a resource to the extent of its cash surrender value.The cash surrender value is the amount which the insurer will pay upon cancellation of the policy before death of the insured or before maturity of the policy.
(1) If the total face value of all life insurance policies on any person does not exceed $1,500, no part of the cash surrender value of such life insurance will be taken into account in determining the resources of the individual (and spouse, if any).
(2) In determining the face value of life insurance on the individual (and spouse, if any), term insurance and burial insurance, as defined in 20 C.F.R. ' 416.1230, will not be taken into account.
(c) Burial spaces.The value of burial spaces for an individual, the individual's spouse or any member of the individual's immediate family will be excluded from resources.
(1) "Burial spaces" means burial plots, gravesites, crypts, mausoleums, urns, niches and other repositories which are customarily and traditionally used for the remains of deceased persons.Additionally, the term includes necessary and reasonable improvements or additions to or upon such burial spaces, including, but not limited to, vaults, headstones, markers, plaques, or burial containers and arrangements for opening and closing the gravesite for burial of the deceased.
(2) "Immediate family" means the individual's minor and adult children, including adopted children and step-children; and the individual's brothers, sisters, parents, adoptive parents, and the spouse of these individuals.Neither dependency nor living in the same household will be a factor in determining whether a person is an immediate family member.
(d) Burial funds.In accordance with 20 C.F.R. ' 416.1231, up to $1,500 each of funds specifically set aside for the burial expenses of the individual or the individual's spouse is excluded from resources. • 4 This exclusion applies only if the funds set aside for burial expenses are kept separate from all other resources not intended for burial of the individual (or spouse) and are clearly designated as set aside for the individual's (or spouses) burial expenses. This exclusion is in addition to the burial space exclusion. Each person's $1,500 exclusion shall be reduced by:
(1) The face value of insurance policies on the life of an individual owned by the individual or spouse (if any), if the cash surrender value of those policies has been excluded from resources; and • 5
(2) Amounts in an irrevocable trust (or other irrevocable arrangement) available to meet the burial expenses. • 5
(e) Irrevocable burial contract. Oklahoma law provides that a purchaser (buyer) of a prepaid funeral contract may elect to make the contract irrevocable.
(1) The irrevocability cannot become effective until thirty (30) days after purchase.
(2) For an irrevocable contract to be valid, the election to make it irrevocable must be made by the purchaser (owner) or the purchaser's guardian or an individual with power of attorney for the purchaser (owner). • 6 In instances where the DHS Form 08MA084E, Management of Recipient's Funds, is on file in the nursing facility, the form serves as a power of attorney for the administrator to purchase and/or elect to make irrevocable the burial funds for the member.
(3) The assignment of an insurance policy used to fund an irrevocable contract must also be made irrevocable.
(4) The irrevocable contract shall not be considered a countable resource. • 7
(f) Medical insurance.If a member is covered by insurance other than SoonerCare, then SoonerCare is the payer of last resort and should not be billed until all other payers have paid.If payment is made directly to the member, the member must reimburse OHCA up to the amount paid by SoonerCare.Any amount remaining after payment to OHCA is considered as an available resource.
INSTRUCTIONS TO STAFF 317:35-5-41.2
1.(a) Effective October 1, 2015, Oklahoma became a Supplemental Security Income (SSI) criteria state.As such, when the individual receives SSI and applies only for Medicaid benefits, the worker is not responsible for verifying the individual's resource eligibility unless he or she provides questionable information.This may occur when the individual reports owning property or liquid resources in excess of the applicable resource standard, per Appendix C-1, Maximum Income, Resource, and Payment Standards.
(b) The worker must verify resource eligibility when the individual applies for a State Supplemental Payment.
2.(a) The individual's statement that he or she does not have money on hand or in a financial institution is sufficient unless there are contrary indications.When there is contrary information or the individual does not have records to verify the amount in a financial institution, the worker obtains verification from the financial institution, when not verified through the Oklahoma Health Authority (OHCA) Asset Verification System (AVS) per (b) of this Instruction.
(b) Staff may verify account information at financial institutions electronically through OHCA AVS.When the account is verified through OHCA AVS additional verification is not needed, unless different from normal deposits and withdrawals are seen.When the account is not verified through OHCA AVS, the worker may verify account information by requesting the individual:
(1) provide his or her account statement; or
(2) sign Form 08AD060E, Request for Release of Information, addressed to the designated financial institution, to authorize release of account information.
(c) Per Section 4001.1 of Title 56 of the Oklahoma Statutes (56 O.S. § 4001.1) money and assets in an individual savings or trust account owned by the designated beneficiary of the account and established to pay qualified disability expenses are excluded, per the Oklahoma Achieving a Better Life Experience (ABLE) Program or an ABLE program in any other state for the purpose of determining eligibility to receive, or the amount of any assistance or benefits, from local or state means-tested programs.An individual may only have one ABLE account.The individual must provide documents to verify the account meets exemption criteria before the funds are exempted from resource and income consideration.
(1) The Oklahoma State Treasurer is responsible for certifying an ABLE account.The program name is Oklahoma STABLE.The program is administered through a partnership with Ohio's STABLE Accounts, backed by Intuition ABLE Solutions, LLC.ABLE account rules state:
(A) only individuals whose disability was established before 26 years of age can set up ABLE Act accounts, and one account is allowed per individual;
(B) there is no limit to the number of persons who can contribute to the ABLE account; and
(C)upon the death of an ABLE Act participant, every dollar remaining in the account must be paid to the state Medicaid agency to repay costs of care received by the individual during life up to the amount Medicaid paid.
(2) At application and renewal, the individual must provide proof from the financial institution of the dates and amounts of money deposited into and withdrawn from the ABLE account in the last 12 months.
(A) The exemption from income and resource consideration applies to money deposited in the account up to the annual federal gift tax exclusion, per Section 2503(b) of Title 26 of the United States Code.The current gift tax exclusion amount is $15,000 per calendar year.Any money deposited in the account in a calendar year that is in excess of the annual federal gift tax exclusion is considered as countable income in the month deposited and as a resource for the following month.The maximum balance in the ABLE account is $300,000.
(B) When money is withdrawn to pay qualified disability expenses, the amount withdrawn is excluded from income or resource consideration.
(i) The individual must verify, preferably from the financial institution, that the withdrawn funds were used for qualified disability expenses.
(ii) Funds withdrawn and not used for qualified disability expenses are considered as income for the month of withdrawal.
(3) Qualified disability expenses means, expenses related to the eligible individual's blindness or disability and approved, per Section 529A of the Internal Revenue Code that are made for the benefit of an eligible individual, who is the designated beneficiary including, but not limited to, expenses for:
(D) employment, training, and support;
(E) assistive technology and personal support services;
(F) health, prevention and wellness, financial management, and administrative expenses;
(G) legal fees;
(H) oversight and monitoring; and
(I) funeral and burial expenses.
3.(a) This is also applicable when both account owners receive SoonerCare.The money in the account is a countable resource.
(b) When the individual dissolves the account as soon as notified, eligibility is not affected.
(c) When both account holders receive SSI, they may share a joint account.The worker only considers each individual’s share of the account in determining his or her eligibility.
4.Examples of funds set aside for burial may include savings or checking accounts, a certificate of deposit, or cash, when the money is clearly designated as being set aside for the individual’s burial.
5.The individual cannot receive the $1,500 revocable burial fund exclusion and an irrevocable prepaid burial fund exclusion.For example, when an individual has revocable burial funds of $4,500 and does not have other funds set aside for burial, the worker considers $3,000 of the cash value as a countable resource.
6.Per the Oklahoma State Insurance Commission, a funeral home cannot be the beneficiary of a life insurance policy used to fund a burial contract.When the individual uses life insurance to fund a burial contract, there must be an irrevocable agreement between the individual and the insurance company.This is in addition to the prepaid burial contract that must also be irrevocable.
7.There is no maximum face value to receive the irrevocable prepaid burial policy or contract exclusion.While it is irrevocable, it is excluded.
8.All life insurance policies must be considered in determining the amount that must be counted toward the resource limit.A life insurance policy that has a face value less than $1,500 cannot have a separate exemption per (c) of this Section.For example, when the individual has life insurance with a cash value of:
(1) $1,500 and has an irrevocable prepaid burial policy with a face value of $10,000, the worker considers the $1,500 cash value life insurance policy as a countable resource;
(2) $5,500 and an irrevocable prepaid burial policy with a face value of $10,000, the worker considers the $5,500 life insurance as a countable resource.In this example, the individual is not resource eligible for SSP, but meets resource standards for Qualified Medicare Beneficiary Plus benefits, when this is the only resource; or
(3) $750, a second life insurance policy with a cash value of $500, and an irrevocable prepaid burial policy with a face value of $15,000, the $1,250 in cash value life insurance is a countable resource and the irrevocable prepaid burial is excluded.