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Electronic Data Source To Be Used (Y/N) Social Security Number Citizenship Immigration Status Residency Age/DOB Pregnancy Household Composition Caretaker Relative Medicare Application for other Benefits Other Data Source Used at Applicatio n (Y/N) Data Source Used at Renewal (Y/N) Data Source Used Post- Enrollme nt (Y/N) If Used for Post- Enrollment Frequency Used (i.e. monthly, quarterly) Comments 8. State General Assistance Programs YES NO YES YES NO NO NO NO NO NO NO YES YES YES YES Other (specify in comments) Daily Only used for citizenship and immigration status if they have been verified in accordance with Medicaid and CHIP rules. Back up to use when hub sources fail. Citizenship is a one-time verification and not reviewed at renewal or post- enrollment. Immigration status may be reviewed once every 12 months or if there is a change in immigration status. The "other" column indicates data that we receive that the individual is receiving State General Assistance ( those referred eligibles from Massachusetts Department of Transitional Assistance, specifically Emergency Aid for Elderly, Disabled, and Children EAEDC) benefits and therefore automatically eligible for MassHealth. MA has received authority to establish eligiblity for these groups by referral, through our 1115 Demonstration amendment, approved on October 1, 2013. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 9