Income

There are two types of income HSRI uses to assess a household’s eligibility.

  • Current Income: Gross Income you are earning “right now”. Can differ from month to month. Most common types are Employment or Self-Employment Wages
  • Annual Income: Net Income you expect to earn by the end of the policy year; i.e. what will be reported on your tax return?

Since income may vary throughout the year and the two types of income can be different, you have the option to provide a “Reasonable Explanation” if you do not have documented proof of your attested income information. The Reasonable Explanation can be input by going to your User Account on www.HealthSourceRI.com or, for assistance, you may contact HSRI. The list includes:

  • Lost job
  • Decrease in hours
  • Multiple employers
  • Self-employed
  • Do not file taxes
  • Have not filed taxes yet
  • Homeless
  • Victim of domestic violence
  • Victim of natural disaster
  • Fluctuating income
  • Work on commissions
  • Income from capital gains
  • Income from dividends
  • Income from royalties
  • Seasonal worker
  • Divorce or marriage
  • Death in family
  • Victim of identity theft

 

The other option would be to submit documents to verify your information. The following list summarizes acceptable income documentation when verifying eligibility:

 

  • Pay stubs representative of the last four (4) weeks of income
  • Earnings Statement
  • Employment Letter
  • Book Keeping Records
  • Property Unit Proof
  • Owner Occupied Proof
  • Monthly Rental Income Proof
  • Mortgage Breakdown Proof
  • Income Tax Returns
  • Reports from Social Security Veteran’s Administration and other agencies
  • When the applicant is unable to obtain the information requested Departmental forms (Wage Report, AP-50; Bank Clearance, AP-91; Clearance with VA, AP-150 and AP-151) are used.

Current Income Acceptable Documents

Income Source Preferred Documents to Submit for Verification
Current Income / Employment Income
  • Pay stubs representative of the last four (4) weeks of income
  • Earnings statement (Most recent from the first of the previous month)
  • Employer letter (Most recent from the first of the previous month)
Social Security Disability Income
  • Social Security Administration Statements
  • 1099-SSA
Unemployment Income
  • 1099-G
  • Unemployment benefits letter

Annual Income Acceptable Documents

Income Source Preferred Documents to Submit for Verification

Annual Income

  • Most recent Federal 1040 Tax Return or State Tax Return
  • W-2s and/or 1099s
  • Pay stubs representative of the last four (4) weeks of income
  • Earnings statement

Self-Employment Income

  • 1040 Schedule C/F or 1099-MISC (Self-employment)
  • Self-employment documentation

Social Security Income

  • Federal 1040 Tax Return or State Tax Return
  • Social Security Administration Statements
  • 1099-SSA

Unemployment Income

  • Federal 1040 Tax Return or State Tax Return
  • 1099-G
  • Unemployment benefits letter

HealthSource RI connects you with health and dental insurance from these companies:

Individuals & Families: 1-855-840-4774
Employers & Employees: 1-855-683-6757