Page 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 Residency YES NO NO N/A N/A NO NO Additional verification is requested if there is a discrepancy with information received from electronic sources obtained for other purposed (as an integrated system) or returned mail is received. We do not use a specific data source for residency. Age (Date of Bi th) YES NO NO N/A N/A NO NO Social Security Number ** NO NO YES N/A N/A N/A YES For the legacy system we use batch interfaces with SSA and real time interfaces with state vital record. Georgia Gateway will be implemented 11/2016 and we will begin using the HUB to verify this information. Additional verification is requested if there is a discrepancy and we follow up post eligibility if there is a discrepancy. The state has an approved Hub waiver to use its current process for the legacy population. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 2