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SI 02305: Redeterminations of Eligibility and/or Payment Amount

Effective Dates: 11/14/2013 - Present

TN 54 (11-06)

A. Introduction

This section provides procedures for developing recipient allegations about ownership of life insurance during a RZ interview.

B. Description of RZs Completed on MSSICS Screens

Opening a “REDETERMINATION with or without RECAPs” event creates a MSSICS “path” which guides the interviewer to the appropriate screens to document allegations and evidence relating to ownership of life insurance, as necessary.

C. Description of Form SSA-8202-BK

There is no question on the SSA-8202-BK specifically designed to obtain life insurance information.

D. Description of Form SSA-8202-OCR-SM

There is no question on the SSA-8202-OCR-SM specifically designed to obtain life insurance information.

E. Description of Form SSA-8203-BK - Question 18

Question 18 on the SSA-8203-BK — Do you (or your spouse living with you) own or are you buying any life insurance policies?

F. Description of Forms SSA-3988-OCR-SM and SSA-2989-OCR-SM

There is no question on either the SSA-3988-OCR-SM or the SSA-2989-OCR-SM specifically designed to obtain life insurance information.

G. Procedure

Develop allegations about ownership of life insurance, as follows:

1. If recipients allege no life insurance and other information in SSA records agrees

If recipients allege no life insurance and other information in SSA records agrees, do not develop life insurance any further.

2. If recipients allege no life insurance and other information in SSA records conflicts

If recipients allege no life insurance and other information in SSA records conflicts, determine whether the recipient still owns or is buying a life insurance policy.

  • If so, develop per SI 02305.102G.3.

  • If not and the policy was a countable resource, determine what happened to the policy.

  • If the recipient alleges cashing it in or letting it lapse, ask him/her for evidence which documents the value of the policy.

  • If the recipient does not have any documentation, then contact the insurance company.

  • Verify the cash surrender value (CSV) for the period of review up to the time the policy was cashed in or lapsed; and

  • Document the information on the SSA-8203-BK and appropriate MSSICS screens.

  • If the recipient transferred ownership for less than the fair market value, see SI 01150.110.

3. If recipients allege life insurance

If recipients allege life insurance, develop per SI 01130.300.

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SI 023: Posteligibility Events
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SI 02306: Miscellaneous Posteligibility Issues
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