As the baby boomer population ages

March 9, 2012 in General

As the baby boomer population ages, we find ourselves with an increase percentage of clients who have smaller awards and or are over the age of sixty-five so a traditional Individual Special Needs Trust cannot be used.  Especially those who are seriously injured and require continued eligibility for Medi-Cal and Supplemental Security Income (SSI).  As experts in protecting the injured you already use the following primary indicators to determine then your client will need a Special Needs Trust:

  • Client qualifies or receives Medi-Cal and/or Supplemental Security Income (SSI)
  • Client has a dependent that has or is qualified for Medi-Cal and/or SSI
  • Client is permanently unable to work and meets Social Security Administration definition of disabled

So what do you do when settling a case for an individual over the age of sixty-four. As you know Federal law permits Special Needs Trust to hold assets of a person while preserving your clients needs-based public benefits as identified in 42 USC §1396p (d)(4)(A) & (d)(4)(C).   There are two First-Party Special Needs Trusts options available to your client. An Individual Special Needs Trust or  a Pooled Special Needs Trust. The diagram below will help you differentiate the two First-Party trusts available.  This article will focus on how you can utilize the First-Party Pooled Special Needs Trusts to serve the baby boomer generation.

First Party Special Needs Trust Comparison

Pooled Trusts use a state approved master Special Needs Trust administered by a non-profit rather than an individual or a bank.  Fortunately in California Medi-Cal allows the transfer of settlement funds into a Pooled Trust or (d)(4)(C) trust for individuals of any age.

Charities Pooled Trust (CPT) of California offers comprehensive prompt support to consumer attorneys. They use a one-page trust application that can be submitted online. Trust documents are provided within three business days.  They do not have minimum funding requirement.  CPT also has a probate compliant master trust so they can accept cases that are court supervised.  In addition, CPT will hold Medicare Set-asides funds so they will remain uncountable to Medi-Cal & SSI.  The MSA funds are still professionally administered by your MSA vendor

Now you have a way to process cases of any size for clients of any age while still protecting Medi-Cal & SSI eligibility.

CA resident eligible for Medi-Cal/Medicare while getting SS payments?

March 2, 2012 in Frequently Asked Questions, General

Can an injured California resident still be eligible for Medi-Cal and Medicare benefits while receiving structured settlement payments?

Yes.

Federal law permits a first party Special Needs Trusts (SNTs) to hold assets (such as structured settlements) of injured parties under age 64 while preserving their needs-based public benefits such as California’s Medi-Cal, Medicare and SSI. However, under federal law, individual Special Needs Trusts cannot be used by individuals age 64 and over without disqualifying the injured parties from receiving public benefits. A plaintiff who, for example, is eligible for Medi-Cal and receives a litigation recovery will lose Medi-Cal benefits until the litigation recovery is spent below $2,000 for an individual or $3,000 for a couple (the resource limits for Medi-Cal). Fortunately, a first party Pooled SNTs can overcome these disqualifying hurdles.

However, within days an injured party of any age or settlement amount can combine a Pooled SNT with structured settlement assets to preserve government benefits while receiving income for nonmedical needs. Pooled SNTs are a state approved master trust that is established and managed by a charity. Because they are created through a nonprofit entity, support a “pool” of individuals, not a single individual, and the settlement money remains in the trust and is not owned by the plaintiff until distributed, the income from these trusts is not counted against needs-based public benefits.

When the trust is terminated and the state lien has been paid, the remainder passes to heirs just as it would with an individual SNT. Because the Pooled SNT is a state approved master trust the trust documents are created and provided within three business days.

Pooled SNTs can be used for an individual of any age, but this is the only type of special needs trust available to people age 65 or older.

Much like the SNT used to preserve a plaintiff’s eligibility for Medi-Cal, a Medicare Set Aside Arrangement (MSA) is used to preserve a plaintiff’s future eligibility for Medicare. When the plaintiff is receiving (or soon will receive) both Medi-Cal and Medicare, an MSA is placed inside a Pooled SNT but must be professionally administered.

Currently, only one California Pooled SNT has the ability to provide plaintiffs’ protection of their settlement recovery from both Medi-Cal and Medicare: the California Charities Pooled Trust (CPT).

Structured settlement payments in California while injured?

December 30, 2011 in Frequently Asked Questions, General

Can an injured party living in California still be eligible for Medi-Cal and Supplemental Security Income (SSI) benefits while receiving structured settlement payments?

Yes.

Federal law permits a first party Special Needs Trusts (SNTs) to hold assets (such as structured settlements) of injured parties under age 65 while preserving their needs-based public benefits such as California’s Medi-Cal, Medicare and SSI. However, under federal law, individual Special Needs Trusts cannot be used by individuals over age 64 and over without disqualifying the injured parties from receiving public benefits. A plaintiff who, for example, is eligible for Medi-Cal and receives a litigation recovery will lose Medi-Cal benefits until the litigation recovery is spent below $2,000 for an individual or $3,000 for a couple (the resource limits for Medi-Cal). Fortunately, a first party Pooled SNTs can overcome these disqualifying hurdles.

However within days an injured party of any age or settlement amount can combine a Pooled SNT with structured settlement assets to preserve government benefits while receiving income for nonmedical needs. Pooled SNTs are a state approved master trust that is established and managed by a charity. Because they are created through a nonprofit entity, support a “pool” of individuals, not a single individual, and the settlement money remains in the trust and is not owned by the plaintiff until distributed, the income from these trusts is not counted against needs-based public benefits.

When the trust is terminated and the state lien has been paid, the remainder passes to heirs just as it would with an individual SNT. There is no minimum funding requirement and the trust documents are provided to Plaintiff firm within three business days.

Pooled SNTs can be used for an individual of any age, but this is the only type of special needs trust available to people age 65 or older.

Much like the SNT used to preserve a plaintiff’s eligibility for Medi-Cal, a Medicare Set Aside Arrangement (MSA) is used to preserve a plaintiff’s future eligibility for Medicare. When the plaintiff is receiving (or soon will receive) both Medi-Cal and Medicare, an MSA is placed inside a Pooled SNT but must be professionally administered.

Currently, only one California Pooled SNT has the ability to provide plaintiffs’ protection of their settlement recovery from both Medi-Cal and Medicare: the California Charities Pooled Trust (CPT).

Obama approves California Medi-Cal cuts

October 28, 2011 in General

October 27, 2011

Obama administration approves California Medi-Cal cuts
Gov. Jerry Brown scored a budget win Thursday as the Obama administration approved a major share of Medi-Cal cuts that health care providers and patient advocates said would cut off medical access to the state’s most vulnerable residents.

The federal Centers for Medicare & Medicaid Services (CMS) will allow the state to cut reimbursement rates by 10 percent this fiscal year for a variety of Medi-Cal providers, including physicians, pharmacists and optometrists. The state Department of Health Care Services says it will not cut rates paid to pediatricians or home health providers.

California Medical Association CEO Dustin Corcoran said Thursday his group will file suit asking the court to immediately block this latest round of Medi-Cal cuts.

The state expects to save a significant part of the projected $623 million associated with the rate cut, though it may fall short due to excluding some services.

Doctors, pharmacists and patient advocates lobbied CMS this summer to block the Medi-Cal cuts, suggesting that many providers would abandon the system.

“We are providing California with flexibility to address their difficult budget circumstances while protecting the health care needs of Californians served by the Medicaid program,” said Cindy Mann, Deputy Administrator and Director of the Center for Medicaid and CHIP Services, in a statement. “Many of the state’s rate cut proposals are now off the table, and we and the state will monitor implementation of the remaining reductions on an ongoing basis to ensure that they do not jeopardize Californians’ access to care.”

California, which already ranks among the nation’s worst in Medicaid reimbursements, approved 10 percent rate cuts as part of the 2011-12 budget deal. The state initially faced a $26 billion deficit, which lawmakers and Brown resolved by a mix of cuts and an assumption that tax revenues would grow throughout the fiscal year.

State leaders also approved mandatory co-payments for Medi-Cal patients, as well as a conditional cap on health care visits. Federal officials have yet to weigh in on those cuts. All told, Medi-Cal cuts add up to $1.7 billion, though not all require federal approval.

Providers and patients filed suit against similar rate cuts in previous budgets. Federal courts blocked or reduced those reductions, but the U.S. Supreme Court this month heard arguments on whether outside groups had the legal right to challenge Medicaid cuts.

Corrected to note that nursing homes were not exempted from the cut.

Read more: http://blogs.sacbee.com/capitolalertlatest/2011/10/obama-administration-approves-california-medi-cal-cuts.html#ixzz1c6TNgbui

Special Needs Planning In Your Fiduciary Practice

October 21, 2011 in General

Special Needs Planning In Your Fiduciary Practice

The attached presentation was presented by Will Lindahl,MBA, CLPF at PFAC meeting at Paradise Village in National City on October 19, 2011.  Outline below is covered in attached presentation.  Click here to download Will’s presentation in PDF format:   Special Needs Planning in your Fiduciary practice

Objectives

  • Determine who needs Special Planning
  • Learn which government benefits can be protected & when to consider a Special Needs Trust
  • Learn differences between an Individual & Pooled SNT
  • Learn how to evaluate Special Needs providers

Who needs Special Planning

  • Minors
  • Adults who lack capacity
  • Wards receiving public benefits

Defining Disability

  • Someone could be substantially disabled in the commonly understood sense (e.g., if the person must use a wheelchair for mobility). However, that individual would not be considered disabled under the SSI or Medi-Cal rules if he or she holds a full-time job and earns a living wage

Defining disability for SSI

  • “Disability” for an adult is defined as the inability to engage in any “substantial gainful activity” (SGA) due to any medically determinable physical or mental impairment, or combination of impairments, that has lasted or can be expected to last for a continuous period of at least 12 months, or result in death.
  • “Disability” for a minor is defined as a medically determinable physical or mental impairment or combination of impairments that causes marked and severe functional limitations, and that can be expected to cause death or that has lasted or can be expected to last for a continuous period of not less than 12 months

Public Benefit Programs

  • Needs Based – Medi-Cal (Medicaid) & Supplemental Security Income (SSI)
  • Entitlement – SSDI, SS, Medicare
  • Other – Section 8 & VA

SSI Eligibility Requirements

Medi-Cal Eligibility

What Supplemental Security Income providers

What Medi-Cal can provide

Special Needs Trusts

Trust Types that can preserve government benefits eligibility for SSI & Medi-Cal 42 U.S.C ‘ 1396p

Individual vs Pooled Special Needs Trusts

What can’t a SNT pay for?

What can a SNT Pay for?

Just about anything. For example:

Which SNT type do I use?

Interview questions for a Pooled Trust provider

Pooled Trust Programs to avoid

What to look for in Pooled Trust Provider

How does it work

Summary

Why Us

May 20, 2011 in

Investments

  • Held by two nationally recognized investment firms. – We will not risk your funds with a small organization.
  • Multiple Asset Allocation Models are utilize. - A risk assessment allows your funds to be safely invested, one size does not fit all, your funds should be invested based on your needs and goals.
  • No proprietary investment products are used.
  • No front load or back load investment products are used.
  • Full corpus transferable if necessary

Trustee

  • The charity is your trustee, not an individual
  • When your trust is court supervision we add an additional layer of protection by having a state chartered bank as trustee to be sure we meet all the state probate codes.

Qualities

  • No minimum funding
  • Online enrollment system
  • Documents in days
  • Accept Medicare Set-Asides
  • Accept Structured Settlements
  • Any age may enroll