TN 24 (09-02)

RS 00615.756 Adjusting Benefits for the Family Maximum (FMAX)

A. Policy

A beneficiary's benefit rate is established by law to be a set percentage of the insured individual's PIA, subject to the family maximum. The Original Benefit (OB) for an Aged Wife, Husband, Young Wife/Husband (with child in care) is 50% of the PIA. The OB for a Young Mother/Father (with child in care) is 75% of the Number Holder's Death PIA. And the OB for a widow(er) is 100% of the Number Holder's Death PIA.

B. Procedure

1. Life Case

  • Determine family maximum.

  • Deduct PIA from maximum.

  • Divide b. by number of auxiliaries. (Result not to exceed OB)

2. Death Case - All Original Benefits the Same

  • Determine family maximum.

  • Divide by number of survivors. (Result not to exceed OB)

3. Death Case - Different Original Benefits - WIB DRCs Not Involved

The following formula will be used to determine each survivor rate:

Original Benefit (OB) x Family Maximum (FMAX) = Survivor Rate (Not to exceed OB)

Total of all OBs (TOTOB)

EXAMPLE: D (age 65) and seven C's are entitled to benefits beginning 1/01

Based on a PIA of $492.90 and a FMAX of $862.60 the rates are calculated as follows:

  • TOTOB = $369.60 (C's OB) x 7 + $492.90 (D's OB) = $3080.10

  • D rate = $492.90 x $862.60 = $138.00

                               $3080.10

  • C rate = $369.60 x $862.60 = $103.50 each

                              $3080.10

NOTE: If the W/E received reduced benefits, calculate the widow(er)'s benefit amount using this formula and apply the widow(er)'s own reduction factor if applicable. If after applying the reduction factor, the widow(er)'s benefit is still higher than both the 82.5 of the Death PIA or the amount the W/E would have received if alive, apply the RIB/LIM as per RS 00615.320.

4. Widow(er) and Other Survivor Rates Based on Different PIAs - Windexing

The family maximum that applies on claims involving widow(er)s is always the maximum based on the deceased NH's PIA. There is no separate maximum that corresponds with the widow(er)'s OB if the OB is calculated under the alternate method as described in RS 00615.302. (Windexing)

Use the following formula to determine each survivor rate:

OB x FMAX = Survivor's Rate (Not to exceed OB)

TOTOB

  • The OB for the widow(er) is based on the Windexing PIA

  • The other survivors' OB are based on the PIA of the DNH

  • The FMAX is based on the PIA of the DNH

EXAMPLE: Two claimants are entitled on the ER of a deceased NH.

  • Nora is entitled as a widow with an OB calculated under the alternate computation as prescribed by the 1983 amendments of $310.00

  • Michael, a disabled child on the same ER, has an OB of $225.00 based on a PIA of $300.00 and a FMAX of $450.00. The rates are calculated as follows:

  • TOTOB = $310.00 (D's OB) + $225.00 (C's OB) x 1 = $535.00

  • Nora:      $310.00 x $450.00 = $260.70    (to be reduced for age if necessary)
                     $535.00
    Michael: $225.00 x $450.00 = $189.20
                       $535.00


To Link to this section - Use this URL:
http://policy.ssa.gov/poms.nsf/lnx/0300615756
RS 00615.756 - Adjusting Benefits for the Family Maximum (FMAX) - 07/16/2014
Batch run: 07/16/2014