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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 Household Composition YES NO YES N/A N/A YES YES Current: Accept self-attestation unless information within the integrated system (SNAP and TANF) conflicts with application. Reasonable explanation is then requested. (80% of individuals are SNAP), and paper documentation if necessary. Georgia Gateway will be implement 11/2016 and self attestation will be accepted for Medicaid/CHIP unless the information within Georgia Gateway conflicts with the application. Reasonable explanation will be requested and paper documentation if necessary. Pregnancy *** YES NO NO N/A N/A NO NO If claiming multiple births, medical verification of multiple fetuses is required. Caretaker Relative YES NO YES N/A N/A NO YES Accept self-attestation unless information within the integrated system (SNAP and TANF) conflicts with application. Reasonable explanation is then requested, and paper documentation if necessary. Medicare NO YES YES N/A N/A NO YES We obtain data from Bendex for the legacy population and with the implementation of Georgia Gateway 11/16, we will use data from SOLQ. Paper documentation will be required if the data is not available through the electronic data sources or the information is inconsistent with the attestation. Application for Other Benefits NO YES YES N/A N/A NO YES Post-eligibility verification accepted for Medicaid only. Paper documentation requested after three months if electronic data source is unavailable or shows an inconsistency. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 4