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MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION C - Additional Factors of Eligibility for Separate CHIP 11 MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: Arkansas Last updated 12/08/2017 Section C . Additional Factors of Eligibility for Separate CHIP Eligibility Factor Self- Attestation Accepted without Additional Verification Self- Attestation Accepted with Post- Enrollment Verification (Y/N) Electronic Data Source Used (Y/N) If Yes, please describe in comments Paper Documentation Required from the Individual (Y/N) Non- Applicable (N/A) Comments 1. Applicant does not have other coverage YES NO NO NO Must be Applied Our CHIP program has the same verification requirement process as our regular Medicaid program. The system checks against legacy system data to determine if the applicant is already receiving Medicaid benefits 2. Applicant does not have access to affordable ESI YES NO NO NO 3. When child has had coverage (as applicable to states' waiting period) YES NO NO NO 4. Access to public employee coverage NO NO NO NO N/A This process is no longer utilized. 5a. Waiting period exception #1 (describe): YES NO NO NO The health insurance is a non-group or non-employer sponsored plan. These exceptions went into production 6/30/2015. 5b. Waiting period exception #2 (describe): YES NO NO NO The health insurance was lost through termination of employment for any reason. These exceptions went into production 6/30/2015. 5c. Waiting period exception #3 (describe): YES NO NO NO The health insurance was lost through no fault of the applicant. These exceptions went into production 6/30/2015. 5d. Waiting period exception #4 (describe): YES NO NO NO The health insurance is/was not primary comprehensive. These exceptions went into production 6/30/2015. 5e. Waiting period exception #5 (describe): YES NO NO NO Health insurance coverage is available to a child through a person other than the child's custodial adult and is determined to be inaccessible. These exceptions went into production 6/30/2015. 6. Other eligibility factors or exceptions to eligibility factors: (Please describe in the space provided below) Arkansas is currently updating policy to include all the federally mandated exceptions. This development will not occur until after a System Integrator is in place.