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MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 2 Eligibility Factor Self- Attestation Accepted without Additional Verification (Y/N) Self- Attestation Accepted with Post- Eligibility Verification (Y/N) Electronic Data Source Used (Y/N) Reasonable Compatibility Standard Used Specify Reasonable Compatibility Standard for Income Ask for a Reasonable Explanation from the Individual (Y/N) Paper Documentation Required from the Individual (Y/N) Comments Immigration Status ** NO NO YES N/A N/A N/A YES The Hub's VLP service will be used for electronic verification of immigration status. If documentation is needed, the state gives that individual a 90-day reasonable opportunity period to provide documentation. Household Composition YES NO NO N/A N/A NO NO Pregnancy *** YES NO NO N/A N/A NO NO Caretaker Relative YES NO NO N/A N/A NO NO Medicare YES NO NO N/A N/A NO NO System modifications are being done to obtain electronic verification. We match to the SSA composite through the Hub. Application for Other Benefits NO YES YES N/A N/A NO YES Arkansas engages in post eligibility periodic checks to ascertain if the beneficiary is receiving other benefits. If it is discovered through electronic communication with other agencies that the beneficiary may be eligible for benefits, the beneficiary must apply. If data sources do not show receipt of or application for benefits, request paper documentation to show the individual has applied. Other: (Please describe any other eligibility factors in the space below) * States must check electronic data sources determined useful to verify income in accordance with 42 CFR 435.948 but can be done post-enrollment. If the information obtained from electronic data sources and the information provided by or on behalf of the individual are both above, at or below the applicable income standard, the State must determine the applicant eligible or ineligible for Medicaid/CHIP. (NOTE: this option is prepopulated for the state and is not an option that can be changed). ** States must follow statute, regulations, and guidance for verification of SSN, citizenship and immigration status including obtaining such information through the federal data services hub if available.