assignment 10
what is the insurance status needed to be eligible for OASDI survivor benefits
...To be eligible for OASDI survivor benefits, individuals must have either fully insured status or currently insured status. The latter status requires a limited number of QCs or credits to have been earned in the period ending with the quarter in which the death occurs.
what are the beneficiary categories for OASDI
1 insured workers. 2) spouses of retired worker 3) spouses with dependent children under age 16 or a child over 16 with a disability occurring before age 22. 4) divorced spouses when the marriage lasted at least 10 years. 5) kids under age 18 6) grandkids and greatgrandkids can qualify as children if they are dependent on the grandparent (retired worker) if both parents of the kid are disabled or deceased.
What additional benefits does the federal government provide during periods of high unemployment?
A permanent federal-state extended benefits (EB) program is in existence that pays additional weekly benefits to unemployed workers in states with high unemployment. It provides an additional 13 weeks of benefits for those who have exhausted their 26 weeks of regular benefit eligibility on a state-by-state basis. The federal government pays one-half of the cost of the program.
what is the appeal process of UI
All state programs also allow employers to challenge decisions. Once a determination is made, however, the claimant continues to receive benefits until the determination is overturned. All states have a two-step review process. The first step is typically a semiformal hearing with a referee, hearing office or administrative law judge. The second step is before a more formal board or commission. Given the usually short duration of benefits, all states impose rather short time limits for filing appeals
what are the federal mandates around being denied unemployment benefits
Also, federal law mandates that benefits may not be denied solely on the basis of pregnancy or the termination of pregnancy, and may not be paid to professional athletes between seasons or to educators between terms if they have a reasonable expectation of being reemployed. UI benefits must be reduced by Social Security benefits and pension benefits funded by a "base period" employer. The qualifier base period refers to the employer whose account is charged for the UI benefits received by the individual.
What factors have contributed to a high percentage of UI recipients exhausting their regular unemployment benefits?
Generous benefits and easing of program requirements, such as applying for benefits and providing information on job search activities by phone or e-mail, have reduced the inconvenience of collecting benefits. In two-income families, if one spouse, especially if the secondary earner, is collecting unemployment benefits, there is often less urgency in finding another job soon. Also, the age structure of the U.S. labor force has changed.
who is eligible for HI benefits
HI eligibles include not only insured workers, but also spouses, disabled children (in the rare cases where they are at least aged 65) and survivors, such as widowed spouses and dependent parents. In addition, HI eligibility is available for disabled beneficiaries who have been on the benefit roll for at least two years. Further, persons under the age of 65 with endstage renal disease (ESRD) who require dialysis or renal transplant are eligible for HI benefits if they meet one of a number of requirements.
Who is covered by FUTA outside of the private sector?
In addition, under federal law, employees of state and local government must be covered regardless of employer size.
What are the monthly survivor benefits based on for calculations?
In all cases monthly survivor benefits are based on the PIA and then are adjusted to reflect the maximum family benefit
when are private sector employers covered by FUTA
In the private sector, employers are covered by FUTA if they have one or more employees on one day in each of 20 weeks in the current or preceding year, or if they pay $1,500 or more in any calendar quarter in the current or preceding year. Given that the $1,500 payroll threshold is not indexed and that nominal wages have increased substantially over the years, the extent of coverage has increased greatly. Moreover, many states have adopted more encompassing standards.
who can select smi
Individuals aged 65 or over can elect SMI on an individual basis regardless of whether they have OASDI insured status. In addition, disabled OASDI beneficiaries eligible for HI and persons with ESRD eligibility under HI can select SMI coverage
How are OASDI survivor benefits terminated and what is the exception?
Marriage (or remarriage) of the survivor beneficiary generally terminates benefit rights. The only exceptions are remarriage of a widow after the age of 60 (or after the age of 50 for disabled widows (or widowers)) and marriage to another OASDI beneficiary.
To whom does the Social Security program's Old Age, Survivors, and Disability Insurance (OASDI) coverage apply?
OASDI applies to somewhat more than 90% of the total workforce in the United States. The vast majority of persons covered under OASDI are so affected on a mandatory or compulsory basis although there are several categories that have optional or semioptional coverage. OASDI coverage applies not only to employees, both salaried and wage earner, but also to self-employed persons. Members of the armed forces are covered compulsorily, as are federal civilian employees hired after 1983.
describe the coordination of benefits with oasdi and other gov programs
OASDI disability benefits are coordinated with disability benefits payable under other governmental programs, except for needs-tested ones, benefits payable by the Department of Veterans Affairs and government employee plans coordinated with OASDI. The most important of such coordination is with workers' compensation programs, whose benefits are taken into account in determining the amount of the OASDI disability benefit. The total OASDI disability benefit (including any auxiliary benefit payable) and the other disability benefit recognized cannot exceed 80% of average current earnings
UI applies to what types of employers
Originally, the UI program applied only to private sector employers with eight or more workers in industry and commerce. Over the years, coverage has been expanded. UI now covers almost all private and public sector employment, most significant not-for-profit organizations (NPOs) and many agricultural and domestic service workers.
what does the social security act do>?
SSA authorizes federal grants to the states for the administration of their unemployment programs, and it established the Unemployment Trust Fund (UTF). The act also provides for loans and advances to insolvent state programs. The program has been amended many times; however, with the exception of extended benefit durations during recessions, its basics have remained intact.
How are regular state unemployment compensation programs financed?
The FUTA tax together with state unemployment tax systems provides the funds for paying unemployment compensation to workers who have lost their jobs. Only employers pay FUTA taxes, and with the exception of three states, that is true also for state unemployment taxes; that is, UI is financed almost exclusively by employer payroll taxes based on the covered wages of the employees. Workers in Alaska, New Jersey and Pennsylvania pay state unemployment taxes. All unemployment tax contributions are deposited in a Federal Unemployment Trust Fund. Each state has a separate account, and the state's unemployment benefits are paid out of that account. Covered employers typically are experience rated and pay unemployment taxes based on the amount of unemployment in the firm.
how is oasdi financed?
The Federal Old Age and Survivors Insurance (OASI) Trust Fund, the Federal Disability Insurance (DI) Trust Fund, the Federal Hospital Insurance (HI) Trust Fund of Medicare, and the Federal Supplementary Medical Insurance (SMI) Trust Fund of Medicare.
how was the unemployment insurance program started>
The U.S. UI program was created by the Social Security Act of 1935 (SSA) and the Federal Unemployment Tax Act of 1939 (FUTA).
what oasdi benefits do divorced spouses receive if they have been married at least 10 years?
The benefits amount is the same as that of undivorced spouses.
what is the oasdi definintion of disability?
The disability must be so severe that the individual is unable to engage in any substantial gainful activity, and the impairment must be a medically determinable physical or mental condition that is expected to continue for at least 12 months or to result in prior death. For persons with alcoholism or drug abuse problems, disability benefits are not payable unless they have another disabling condition, which by itself, would be qualifying.
how much does a disabled worker receive?
The disabled worker receives a benefit equal to 100% of the PIA and the dependents each receive 50% of the PIA, subject to the maximum family benefit.
How is the earnings test applied to OASDI disability benefits?
The earnings or retirement test applies to the auxiliary beneficiaries of disabled workers, but not to the disabled worker beneficiary. However, the earnings of one beneficiary (e.g., the spouse of the disabled worker) do not affect the benefits of the other beneficiaries in the family (e.g., the disabled worker or the children). The test does not apply to disabled worker beneficiaries, because any earnings are considered in connection with whether recovery has occurred, except those during trial work periods (which earnings may possibly lead to removal from the benefit roll later).
HI Benefits
The principal benefit is for hospital services. Other basic benefits it provides include skilled nursing facility care, home health care and hospice care. All individuals aged 65 and over who are eligible for monthly benefits under OASDI are eligible for HI benefits.
Under "normal" economic conditions, how many weeks of UI is provided and how are weekly benefits determined?
The regular UI program provides up to 26 weeks of unemployment compensation in the majority of states. Many recipients are entitled to less because of insufficient covered employment or earnings in the base period. (During economic downturns, extended UI benefits are provided by the federal government.)
what oasdi benefits do spouses with dependent children under age 16/disbled before age 22 receive?
The spouse receives benefits regardless of age, in an unreduced amount (50% of the PIA).
what oasdi benefits do kids under 18 receive?
They are eligible for a supplementary payment at a rate of 50% of the PIA.
what oasdi benefits do spouses of retired workers receive?
They can receive benefits at the rate of 50% of the PIA if the claim is first made at the NRA or over, and at a reduced rate if claimed at ages down to the age of 62.
what oasdi benefits do insured workers receive?
They can receive unreduced retirement benefits in the amount of the primary insurance amount (PIA),2 beginning at the NRA, or actuarially reduced benefits beginning at earlier ages, down to the age of 62.
What insurance status is needed to the eligible for OASDI?
To be eligible for OASDI disability benefits, individuals must be fully insured and disability insured. The latter status requires a certain number of QCs or credits to have been earned in the period ending with the quarter in which the disability occurs. Special rules apply to younger workers and blind workers to make it easier for them to qualify for the OASDI disability benefits.
how is the UI program administered
UI was created by federal statute; however, most of the program operates under the 53 state unemployment laws. There is considerable variation from state to state. The federal government establishes parameters in regard to coverage, funding and fairness; and it administers the trust funds, pays state administrative expenses and funds extended benefits during periods of high unemployment. Federal administration of UI is done largely by the Office of Unemployment Insurance, Employment and Training Administration, U.S. Department of Labor. The Unemployment Trust Fund (UTF) is managed and invested by the Treasury Department
describe the taxation of unemployment benefits
Unemployment benefits are subject to federal, and often state, income taxation, but not payroll taxes.
what category of employees are excluded from FUTA
With the program covering more than 96% of wage-and-salary workers, one notable excluded category of employees are those that work in the railroad industry. They are covered under a separate program created by the Railroad Unemployment Insurance Act of 1938 and administered by the Railroad Retirement Board.
What are the eligibility requirements to qualify for unemployment benefits?
Workers unemployed through no fault of their own, who are ready, willing and able to work and are actively seeking work are entitled to unemployment benefits. In addition, benefits are limited to "job losers" who lost their job involuntarily and through no fault of their own. Benefits are not available to "job leavers" who quit their job without good cause, nor are they available to those terminated for gross misconduct on the job. Benefits also are not available to new entrants and reentrants because they do not have a significant recent attachment to the labor force.
List the survivors of insured workers who can receive OASDI monthly benefits
a) Surviving spouse aged 60 or over (b) Dependent parents aged 62 or over (c) Children under the age of 18 (or at any age if disabled before the age of 22), children aged 18 who are full-time students in elementary or high school (i.e., defined just the same as in the case of retirement and disability beneficiaries) (d) Widowed parent of an eligible child under the age of 16 or disabled before the age of 22 (e) Disabled widow (or widower) or surviving divorced spouse who is aged 50 or older is eligible for benefits under certain conditions.
who administers UI?
administered by the 53 "states" with some federal oversight and assistance during periods of high unemployment. (53 "states" covers the 50 states plus the District of Columbia, Puerto Rico and the Virgin Islands.)
how is SMI financed?
financed by monthly premiums charged to beneficiaries (higher for those who fail to enroll as early as they possibly can) and by payments from general revenues. In the aggregate, persons aged 65 and over pay only about 25% of the cost, while for disabled persons such proportion is only about 20%.
describe the oasdi program
first developed in 1934-1935. originally only retirement benefits. was not until 1939 that auxiliary (or dependents) and survivor benefits were added, and not until 1956 that disability benefits were made available. The normal retirement age (NRA), also called the full retirement age, was originally established at the age of 65.1 The original program applied only to workers in commerce and industry. It was not until the 1950s that coverage extended to additional categories of workers. Now, almost all categories of workers are covered, including the self-employed. Beginning in the 1950s, pressure developed to provide early retirement benefits, first for spouses and then for insured workers. The minimum early retirement age was set at the age of 62 and the benefit amounts are reduced when claimed before the NRA is reached, and are increased when the claim for benefits is delayed beyond the NRA
describe the eligibility for OASDI
fully insured status—depends on having a certain number of quarters of coverage (QCs), sometimes referred to as "credits," varying with the year of birth or, expressed in another manner, depending on the year of an individual's attainment of the age of 62.
what is the SMI benefit
partial reimbursement for four basic benefits: doctors' services, outpatient hospital services, home health care and other medical and health services (for example, ambulance services and prosthetic devices).
what is the disability freeze?
periods of disability are blanked out for purposes of determining insured status and benefit amounts for subsequent retirement, disability and survivor benefits.
what are the two general financing mechanisms
the OASI and DI programs have been financed entirely by payroll taxes (and interest earned on the trust fund assets) with minor exceptions. The General Fund of the Treasury does pass on to the trust funds (OASI and DI) the proceeds of the federal income tax on part of the monthly OASDI benefits for upper-middle-income and high-income persons.
who has complusary coverage of OASDI?
the armed forces, lay employees of churches, nonprofit employees, EE of state and local gov without a retirement sys. americans who work abroad for American businesses. americans employed in the US by a foreign government or by an int'l org
what happened to UI during the 2008 recession?
the federal government's share of the FUTA tax, and loans from the FUTA to state programs, proved inadequate. Federal assistance had to be increased to 100% general fund financing for several extensions of unemployment benefits allowing the state programs to continue to pay needed benefits.
what is the taxation for OASI, DI, HI?
the payroll tax rate is a combined one for OASI, DI and HI, but it is allocated among the three trust funds. The employer and employee rates are equal. However, the Patient Protection and Affordable Care Act (PPACA) of 2010 imposes an additional tax on high-income individuals. The self-employed pay the combined employer-employee rate.
how is an earnings test applied to OASDI benefits?
the retirement earnings test applies only to people below the NRA, which ranges from 65 to 67 depending on the date of birth. The general underlying principle of the earnings test is that retirement benefits should be paid only to persons who are substantially retired. The basic feature of the earnings test is that an annual exempt amount applies ($14,160 in 2011), so full benefits are paid if earnings, including those from both covered and noncovered employment, are not in excess thereof. An alternative test applies for the initial year of retirement. Also, earnings of the "retired" worker affect, under the earnings test, the total family benefits payable. However, if an auxiliary beneficiary (spouse or child) has earnings and these are sizable enough to affect the earnings test, any reduction in benefits is applicable only to such individuals' benefits.
how are UI benefits determined?
the weekly benefit amount (WBA) is a function of the amount of the recipient's covered employment and earnings during the base period. Benefits are typically set at about 50% of the claimant's weekly earnings within certain minimums and maximums. The period of past wages used and the formulas for computing the benefits from these past wages vary greatly across the states since there are no federal standards for the benefits amounts. The variation is, in part, because of differences in cost of living, industry and occupational mix and what might be called state philosophy or tradition.
limits on SMI coverage
workers' compensation cases, medical care under liability policies, private group health insurance applicable to ESRD and employer-sponsored group health insurance for employees and their spouses
