SECTION 370.803. Definitions

In this subchapter, words and terms have the following meanings, unless the context clearly indicates otherwise:

(1) Applicant--An individual who applies for health and dental care coverage on behalf of the child. An applicant can only be:

(A) a child's parent, whether biological or adoptive;

(B) a child's grandparent, relative, or other adult who provides care for the child;

(C) a minor not living with an adult applying for himself/herself;

(D) a child's step-parent; or

(E) a taxpayer who expects to claim the child on a federal income tax return for the taxable year in which CHIP eligibility is requested.

(2) Child--An adoptive, step, or natural child who is under age 19.

(3) Federal Poverty Income Level (FPL)--The income guidelines issued annually and published in the Federal Register by the U.S. Department of Health and Human Services.

(4) HHSC--The Texas Health and Human Services Commission.

(5) Household composition--The group of individuals who are considered in determining eligibility for an applicant or recipient for certain medical programs based on tax status, tax relationships, living arrangements, and family relationships, referenced in 42 CFR §435.603(f) as "household."

(6) Household income--The sum of the individual income of every individual within an applicant's or recipient's household composition, from which is subtracted the standard income disregard.

(7) Household size--The number of individuals in an applicant's or recipient's household composition, plus the number of unborn children if applicable, referenced in 42 CFR §435.603(b) as "family size."

(8) Individual income--The sum of certain income received by individuals in a household composition, from which is subtracted certain expenses, referenced in 42 CFR §435.603(e) as "MAGI-based income."

(9) MAGI--Modified adjusted gross income.

(10) Non-custodial parent--A parent who does not have custody of a child pursuant to a court order, or binding agreement of separation or divorce.

(11) Parent--An individual who is the adoptive, step, or natural parent of a child.

(12) Recipient--An individual receiving CHIP services, including a person who is renewing eligibility for CHIP.

(13) Sibling--An individual under age 19 who is an adoptive, step, or natural sibling of a child.

(14) Standard income disregard--An income disregard equal to five percentage points of FPL for the applicable household size.

(15) Tax dependent--An individual who expects to be claimed as a dependent on a federal income tax return for the taxable year in which CHIP eligibility is requested.

(16) Taxpayer--An individual, or a married couple, who expects:

(A) to file a federal income tax return for the taxable year in which CHIP eligibility is requested;

(B) if married, to file a joint federal income tax return for the taxable year in which CHIP eligibility is requested;

(C) that no other taxpayer will be able to claim him, her, or them as a tax dependent on a federal income tax return for the taxable year in which CHIP eligibility is requested; or

(D) to claim a personal exemption deduction on his or her federal income tax return for one or more applicants, who may or may not include himself or herself and his or her spouse.

(17) Taxable year--The 12-month period between January and December that an individual uses to report income for federal income tax purposes.

Source Note: The provisions of this §370.803 adopted to be effective January 1, 2014, 38 TexReg 9477; amended to be effective June 1, 2014, 39 TexReg 3983