Premium Information
(SRS Form ES-3165)
Click here to download the 3165 Working Healthy premiums form (in English).
There is a monthly premium charge for Working Healthy medical
coverage when net income is between 100% and 300% of the federal
poverty level; however, some income is disregarded in calculating
the premium (see
below). The following chart lists the income breakdowns for
the monthly premium charges.(updated May 2008)
PREMIUM CHART FOR WORKING HEALTHY PROGRAM
| Monthly Net Income | Monthly Premium |
|---|---|
| 0.00-867 | 0.00 |
| 867.01-1084 | 55.00 |
| 1084.01-1300 | 69.00 |
| 1300.01-1517 | 83.00 |
| 1517.01-1734 | 97.00 |
| 1734.01-1950 | 110.00 |
| 1950.01-2167 | 124.00 |
| 2167.01-2384 | 138.00 |
| 2384.01-2600 | 152.00 |
| greater than 2600 | NOT ELIGIBLE |
| Monthly Net Income | Monthly Premium |
|---|---|
| 0.00-1167 | 0.00 |
| 1167.01-1458 | 74.00 |
| 1458.01-1750 | 93.00 |
| 1750.01-2042 | 112.00 |
| 2042.01-2334 | 130.00 |
| 2334.01-2625 | 149.00 |
| 2625.01-2917 | 168.00 |
| 2917.01-3209 | 186.00 |
| 3209.01-3500 | 205.00 |
| 2 person greater than 3500 | NOT ELIGIBLE |
| 3500.01-4400 (3 person) | 205.00 |
| 3 person greater than 4400 | NOT ELIGIBLE |
How to Calculate Your Net Income
You can figure your net income using the following steps:
- Add all of your gross earnings (amount before taxes) and divide by two.
- Add all of your monthly unearned income, such as Social Security or Veterans benefits and subtract $20.00.
- Add the amounts from steps 1 and 2.
- Take that total amount and look at the chart to see if your family's income would have a Working Healthy premium charge.
Single persons without a spouse should use the single coverage column. If you are living with a spouse, his or her income must also count toward the total net income. Follow the same steps to determine his of her income, add it to your net income, but now use the two/three person column to determine the monthly premium amount. The two/three person column also applies when an application is filed for a 16 or 17 year old child living with his or her parent(s).
Once you know your monthly net income and this income amount shows you probably will have monthly premium, you can now decide whether or not to continue the application process for Working Healthy.
It is also important to note that there are additional disregards called Impairment Related Work Expenses (IRWEs)and Blind Work Expenses (BWEs). IRWEs are those expenses incurred as a result of working with a physical or mental impairment. The following are examples of expenses that are considered IRWEs:
- Specialized transportation;
- Drugs or other medical expenses not covered by Medicaid or other insurance;
- Service animal expenses such as obtaining animal food, licenses and vet bills.
For IRWEs the first $100.00 of reported earned income is exempt. If expenses exceed $100.00, additional expenses are allowed with proper documentation and receipts. If the expenses do not exceed $100.00 receipts are not required. IRWEs must never exceed the amount of a persons' total earned income.
Blind Work Expenses (BWEs) are reasonable, allowable expenses that are related to earning income for individuals who are blind. Examples of BWE's include but are not limited to the following:
- Service animal expenses;
- Transportation to and from work;
- Visual aides and translation services;
- Costs of training to use specialized equipment related to the disability.
For BWEs the first $300.00 of reported earned income is exempt. If expenses exceed $300.00, additional expenses are allowed with proper documents and receipts.
If you have questions about your possible work related expenses and exemptions please contact your local Benefits Specialist.
Click here to download a "Working Healthy Premium Calculator" worksheet to figure out what your premium might be!
Questions about Working Healthy premium payments:
As of July 1, 2007 KATCO is the entity that handles Working Healthy premiums.
Any questions about premiums should be directed to:
Mary Ann Newton
625 Merchant, Suite 205
Emporia, KS 66801
TOLL FREE PHONE - 1-866-465-2826 (V/TTY)
FAX -(620) 342-6400
Email - maryann@katco.net
Working Healhty premium payment checks can be made out to the State of Kansas - Working Healthy, and can be sent to the following address:
Columbian Bank
PO Box 902
Topeka, Kansas 66601-0902
Example
Joe is a single person who receives gross monthly Social Security Disability benefits of $854.00 and has gross monthly earnings from work of $665.00. Joe now determines what his premium would be if he applied for Working Healthy:
- Social Security Disability (unearned income) = $854.00
- Earned income = $665.00
Steps:
- Earned income disregard (first $65.00 of earned income) = $ 65.00 ($665.00 - $65.00 = $600.00)
Earned income disregard (half of remaining earned income) = $ 300.00 ($600 ÷ 2 = $300.00)
After subtracting these disregards from his earned income, Joe's earned income = $300.00 - Joe then subtracts a standard disregard of $20.00 (for all persons except those in nursing facilities) from his unearned income ($854.00-20.00) and his earned income = $834.00
- Joe now adds his adjusted earned income to his adjusted unearned income to arrive at his countable income for Working Healthy - $834.00 + $300.00 = $1134.00
- When Joe's income is compared to the table for a single person assistance plan above, his countable income of $1134.00 falls into the range, $1064.01 - $1277, giving Joe a monthly premium of $69.00.
This example is provided as a guideline for how to figure a premium. However, we encourage you to please contact the Benefits Specialist in your area to discuss what your Working Healthy premium would be.