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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 Age (Date of Birth) NO YES YES N/A N/A YES YES Paper documentation required only when reasonable explanation does not clarify discrepancy that would impact eligibility. Social Security Number ** NO NO YES N/A N/A N/A YES Paper documentation is requested if data source is not compatible with what the individual documents on the application. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 2