Page 1

MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: Hawaii HAWAII Year 2 DRAFT Section A. Verification Procedures for Factors of Eligibility 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 Income* NO YES YES Both are above, at or below the applicable income standard. Percent Threshold 10% YES YES Hawaii decided to not use IRS data at the time of application because the data is old and the security requirements are too onerous. Instead, it will accept self attestation at the time of application and verify income from SWICA , SSA, and UI within 90 days of the application. At the time of verification, the State will apply the reasonable compatibility standard. If there are discepancies (verification above the income threshold and applicant reporting below the threshold) that exceed the 10%, the State will ask for a reasonable explanation or paper documentation. Refer to the Inconsistency Process powerpoint file. If the individual attests to income below the applicable income standard and data sources indicate income above the applicable standard, but the difference between the two is 10% or less, the information is considered reasonably compatible. If attested income is above the applicable income standard, applicant would be ineligible for Medicaid and sent in a file to the Hawaii Health Connector (Hawaii's HIX) to be screened for APTC. If there is no data source available for any types of income, then state will accept the self-attetstation. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 1 Last updated: April 5, 2016