TN 19 (01-04)

A. Policy - general

Prior to October 1, 1990, an eligible couple remained an eligible couple for 6 months following the month of separation and became eligible individuals effective with the seventh month.

B. Examples — separation -- prior to October 1, 1990

1. Both in Own Household — OSS Involved

Andy and Maxine Johnson receive SSI as an eligible couple. He receives a company pension of $110 per month. She receives an annuity payment of $60 per month. On February 20, 1989, he leaves their household and begins living alone in his own apartment.

a. The Federal Eligibility Test

They are an eligible couple for 6 full months after separation. Effective with the seventh month (September 1989), each is an eligible individual. For the first 6 months of separation they are eligible because the CI of $150 ($110 pension +$60 annuity - $20 general exclusion) does not exceed the couple FBR ($553). After 6 months, he is eligible because his CI of $90 ($110 pension - $20 general exclusion) does not exceed the FBR ($368) and she is eligible because her CI of $40 ($60 annuity - $20 general exclusion) does not exceed the FBR.

b. The Federal Payment Computation

• February 1989: BM: December 1988.

They are an eligible couple.

• March through August 1989

They remain an eligible couple. The BM for each month's computation is 2 months before the month being computed.

• September 1989

They are now two eligible individuals. The BM is July.

He:

She:

c. The OSS Eligibility Test

They receive State supplement benefits in category A as an aged couple living independently. The OSS payment level for an individual is $175.00 and for a member of a couple is $155.00.

Because both are eligible for a Federal benefit in all months, they are both eligible for OSS in all months.

d. The OSS Payment Computation

They are due a Federal payment in all months, so they are due the full OSS payment level for all months.

• February 1989

They are due the full OSS payment level for aged couples living independently. Half the couple's level is due to each member.

• March 1989 through August 1989

(Although separated, they remain an eligible couple and are each due half the OSS payment level for aged couples living independently.)

• September 1989

They are due the full OSS payment level for aged individuals living independently.

He:

She:

2. Different OSS Payment Variations Involved (Both in Same Federal Living Arrangement)

Barbara and Larry Anderson are an aged eligible couple living alone in California. Because of his Title II benefit of $225 and her Title II benefit of $370, the couple has received only State supplement payments. Their OSS variation is code C, independent living without cooking facilities ($600 couple OSS payment level, $300 each member). On September 4, 1989, she moves alone into an apartment, which has cooking facilities. Her FLA remains A, but her OSS variation changes from State code C to code A ($500 couple OSS payment level, $250 each member). His OSS code remains C.

a. The Federal Eligibility Test

They retain eligible couple status for up to 6 months of separation. They are ineligible for a Federal payment in all months because their CI of $575 ($225 Title II + $370 Title II - $20 general exclusion) exceeds the FBR.

b. The OSS Eligibility Test

Since the couple is ineligible for SSI in all months of this example based on CM income, compare the amount of each CM's excess income to the OSS payment level.

For September 1989, the month of separation, the OSS payment variation for both couple members is living independently without cooking facilities. The couple is eligible because the excess income of $22 (225 +$370 - $20 CM FCI - $553 FBR) is less than the OSS payment level.

Beginning in October, the first full month of separation, her OSS payment variation changes to category A, independent living with cooking facilities. Her OSS level is $250, half the State's OSS payment level for couples in category A.

His OSS payment level is $300, half the State's level for couples in category C. Do not average the OSS payment levels when eligible couples are not living together. Do average the excess income as long as eligible couple's status is retained. Half the total couple's excess income of $11.00 is allocated to each member. Since $11.00 is less than either OSS payment level, both are eligible beginning with October.

c. The OSS Payment Computation

Since the couple is ineligible for SSI in all months based on excess income, subtract the BM's excess income from the OSS payment level.

• September 1989

Status: Eligible Couple Living Together

• October 1989 and After
  Status: Eligible Couple Living Separately

-She:

-He:

C. Policy — an eligible couple separates — one in own household -- one in household of another

1. Special Presumed Maximum Value

The special PMV applies to the member in the household of another. It is one sixth of the couple FBR. This PMV is treated differently for purposes of the eligibility determination and the payment computation.

2. Eligibility Computation

Do not consider the special PMV to compute the couple's eligibility. The couple is eligible based on income if their CI, not including the special PMV, does not exceed the couple FBR.

3. Federal Payment Computations

When the special PMV is part of the BM income, first compute the couple's CI without using the special PMV and derive the Federal benefit due the couple. Two-thirds of the Federal benefit amount is paid to the member of the couple who was in his own household in the BM. One-third of the SSI benefit amount reduced by the amount of the special PMV is paid to the member of the couple in the household of another (receiving food and shelter from within the household) in the BM.

NOTE: The two-thirds/one-third division is based on the presence of the special PMV in the BM. If the special PMV is in the BM, make the two-thirds/one-third division even if there is no special PMV in the CM.

4. OSS

a. Compute OSS Eligibility Jointly-OSS Payment Amounts Separately

Compute OSS eligibility jointly, but OSS payment amounts separately. To determine OSS eligibility, combine half the OSS payment level for a couple in their own household with half the OSS payment level for a couple subject to the VTR. To determine OSS payment amount, use the same levels but do not combine them. Perform separate payment computations for each member.

b. OSS Eligibility Determination-Do Not Consider Special PMV

In the OSS eligibility determination, as with the Federal eligibility test, do not consider the special PMV. If there is no Federal eligibility, compare the couple's CM excess income (excluding the special PMV) to the combined OSS payment level described.

• In the OSS payment computation, if a Federal payment is due to both members of the couple, there is no excess income and each member is due the full OSS payment level described above.

• When a Federal payment is made to the member who resides in his own household, but not to the member in another's household (due to special PMV), the member who is paid SSI has no excess income and is due the full OSS payment level. To compute the OSS payment to the member in another's household, subtract his BM's excess income from half the State's payment level for couples subject to the VTR. This excess income resulted when the special PMV was applied against one-third of the couple's Federal payment amount in the Federal payment computation.

• When neither member of the couple is due a Federal payment based on either CM income (Federal ineligibility) or BM income, first determine BM excess income without considering the special PMV.

• If there is no BM excess income without considering the special PMV, the couple member who is in his own household is due his full OSS payment level. For the member in another's household, compare the special PMV to his one-third share of the couple's fictitious Federal benefit which would result in this situation. (Although the special PMV can be reduced by the $20 general exclusion, it will never be necessary in these cases because the entire exclusion will already have been used.)

• If the special PMV is less than or equal to the fictitious Federal benefit, there is no excess income and the full OSS level is payable. If the special PMV is greater than the fictitious Federal benefit, reduce the OSS payment level by the difference. The result, if any, is the OSS payment to the member in another's household.

• If there is excess BM income without considering the special PMV, divide it two-thirds/one-third. The payment for the member living in his own household is computed by subtracting two-thirds of the BM excess income from half the OSS payment level for couples in their own household. The payment for the member living in the household of another is computed by subtracting one-third of the BM excess income plus the special PMV from half the OSS payment level for couples subject to the VTR.

  NOTE: For Federal purposes, the two-thirds/one-third split applies to the couple payment amount. For OSS purposes, the two-thirds/one-third split applies to BM excess income.

D. Example -- eligible couple in own household, one member becomes subject to the special PMV, OSS

1. Status and Income

2. Rates

1. Individual FBR $368.

2. Couple FBR $553.

3. Federal Eligibility

1. They are always eligible; CI never exceeds FBR.

2. NOTE: Special PMV is not in the eligibility test.

4. Federal Payment

a. March 1989: BM: January

Status: Eligible Couple

These are the amounts due through May 1989.

June is the first month for which payment is affected by the special PMV. June is also the first month for which the couple's SSI payment is not divided evenly. Paul Smith in his own household in the BM receives two-thirds of the couple's monthly payment. Amy Smith, in the household of another (subject to the special PMV) in the BM, receives one-third of the couple's monthly payment less the special PMV.

July through September 1989: These are the final months of eligible couple status. The BM is 2 months prior to the month being computed. The amounts paid to each member for each of these months are the same as for June.

b. October 1989: BM: August

Status: Eligible Individuals

• He:

• She:

c. November 1989: BM: September

Status: Eligible Individuals

• He:

• She:

d. December 1989: BM: October

• He:

• She:

5. The OSS Eligibility Test

The couple OSS payment level for code A, living independently is $150. The couple OSS payment level for code B, in the household of another is $140; the individual OSS payment level for code B is $120 and the individual OSS payment level for code A is $125.

For March 1989 through September 1989: Both members of couple are eligible for OSS because they are eligible for Federal benefits.

6. The OSS Payment Computation

a. March 1989

Both members are due Federal payments based on BM income, so there is no excess income and the full OSS payment level is due.

b. April 1989

They are separated effective April. Payments must be computed separately. There is no BM excess income.

• He:

• She:

c. May 1989

Compute the payment as for April. Since both members receive Federal SSI payments, they are due their full OSS payment levels.

• He:

• She:

d. June 1989

This is the first month that the special PMV and the two-third split affects the Federal payment computation. Paul, who continues to live in his own household, receives a Federal payment, has no excess income, and is due the full OSS payment level. Amy, in the household of another, receives no Federal payment because of the special PMV.

• He:

• She:

e. July through September 1989

The amount due them for each month is the same as for June.

October 1989: Paul and Amy Smith are eligible individuals now. They are due a Federal payment. They have no excess income and are due the full OSS payment levels.

• He:

• She:

E. Policy -- an eligible couple separates — one in own household or subject to vtr, one subject to FLA-D

They remain an eligible couple for the first 6 months, but the income eligibility computation and the payment computation are performed as if they were two eligible individuals. For the payment computations, the BM's are still 2 months prior to the month for which payment is being computed.

For the OSS computation, treat the member of the couple not in FLA-D as an individual rather than a member of a couple. Use this member's own income to compute any excess income to affect the OSS payment and use the OSS level for individuals in the same living arrangement variation. For the other member, use the OSS level for FLA-D.