(1) Benefits
paid on a life insurance policy are counted as unearned income in the month
received. Except in the QMB-BAS, QMB-SMB, and QMB-SMF programs, any amount
retained into the following month is counted as a resource.
(a) The Department counts benefits as
received when the insured individual dies or when the insured individual is
eligible for and receives accelerated payments before death, such as when the
insured individual has a terminal illness.
(b) When the payment is a lump sum due to the
death of the insured individual a deduction is allowed, not to exceed $1,500,
for the cost of the deceased individual's last illness and burial if these
costs were not otherwise insured.
(2) Burial insurance that generates a cash
surrender value is treated in the same manner that this rule treats life
insurance.
(3) Burial insurance
that does not generate a cash surrender value is treated as follows:
(a) For all programs except OSIP, OSIPM, and
QMB-DW, it is excluded.
(b) In the
OSIP, OSIPM, and QMB-DW programs, it is considered an irrevocable burial
arrangement and treated in accordance with OAR
461-145-0040.
(4) When the ownership or
beneficiary of a life insurance policy has been irrevocably assigned and
designated for burial, it is treated in accordance with OAR
461-145-0040 and is
not counted towards the $1500 life insurance limit.
(5) The value of a life insurance policy is
treated as follows:
(a) All term insurance
that has no cash surrender value is excluded.
(b) In the QMB-BAS, QMB-SMB, QMB-SMF, REF,
REFM, SFPSS, SNAP, TA-DVS, Pre-TANF, and TANF programs, the cash surrender
value of the life insurance policy is excluded.
(c) In the OSIP, OSIPM, and QMB-DW programs:
(A) For the purposes of this subsection, the
following definitions apply:
(i) "Cash
surrender value" means the equity that the policy acquires over time.
(ii) "Dividend" means a payment of surplus
company earnings from the insurer.
(iii) "Dividend accumulation" means a
dividend left with the insurer to accumulate interest that may
be withdrawn without affecting the policy's face value or
cash surrender value.
(iv) "Dividend addition" means the amount of
insurance purchased with a dividend that increases the
policy's death benefit and cash surrender value.
(v) "Face value" means the amount of the
death benefit contracted for at the time the policy was purchased and does not
include a dividend addition added after purchase of the
policy.
(vi) "Viatical settlement"
means an agreement allowing a third party to acquire a life insurance policy
from a terminally ill individual at an agreed-upon percentage of the life
insurance policy's face value.
(B) The
cash surrender value
of life insurance policies owned by the
financial group (see
OAR
461-110-0530) is excluded if the total
face value of all
policies for the insured individual is less than or equal to $1,500. If the
total
face value of all policies for the insured individual is
more than $1,500, the entire
cash surrender value are counted
as a resource to the owner of the policies. The total
face
value does not include any
dividend addition. A
dividend accumulation must count as a resource even if the
face value of the policy that generated the
dividend
accumulation is excluded.
(C) The face value of term
life insurance policies excluded under subsection (a) of this section are not
counted in determining if the $1,500.00 life insurance exclusion limit is
exceeded.
(D) The cash
surrender value of a policy acquired through a viatical
settlement is excluded.
Notes
Or. Admin. Code §
461-145-0320
AFS 80-1989, f. 12-21-89,
cert. ef. 2-1-90; AFS 12-1991(Temp), f. & cert. ef. 7-1-91; AFS 16-1991, f.
8-27-91, cert. ef. 9-1-91; AFS 8-1992, f. & cert. ef. 4-1-92; AFS 28-1992,
f. & cert. ef. 10-1-92; AFS 10-1995, f. 3-30-95, cert. ef. 4-1-95; AFS
21-1995, f. 9-20-95, cert. ef. 10-1-95; AFS 9-1997, f. & cert. ef. 7-1-97;
AFS 5-2002, f. & cert. ef. 4-1-02; SSP 29-2003(Temp), f. 10-31-03, cert.
ef. 11-1-03 thru 3-31-04; SSP 6-2004, f. & cert. ef. 4-1-04; SSP 24-2004,
f. 12-30-04, cert. ef. 1-1-05; SSP 14-2006, f. 9-29-06, cert. ef. 10-1-06; SSP
7-2007, f. 6-29-07, cert. ef. 7-1-07; SSP 5-2010, f. & cert. ef. 4-1-10;
SSP 18-2010, f. & cert. ef. 7-1-10;
SSP
35-2015, f. 12-23-15, cert. ef.
1/1/2016; SSP 25-2016(Temp), f. 6-30-16, cert. ef.
7-1-16 thru 12-27-16;
SSP
31-2016, f. & cert. ef.
9/1/2016;
SSP
14-2017, f. 6-5-17, cert. ef.
7/1/2017;
SSP
28-2018, amend filed 09/06/2018, effective
10/1/2018;
SSP
21-2020, amend filed 07/08/2020, effective
7/8/2020;
SSP
26-2021, amend filed 03/24/2021, effective
4/1/2021;
SSP
17-2023, amend filed 06/14/2023, effective
7/1/2023; SSP
5-2025, minor correction filed 04/08/2025, effective
4/8/2025
Statutory/Other Authority: ORS 411.706, 411.816, 412.049,
413.085, 414.619, 411.060, 411.070, 411.083, 411.404, 411.704 &
409.050
Statutes/Other Implemented: ORS 411.706, 411.816, 412.049,
413.085, 414.619, ORS 409.010, 411.060, 411.070, 411.083, 411.404, 411.704 & 414.117