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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 Income* YES NO YES Percent Threshold 10% YES YES standard of 10% is used. - If the difference is less than 10%, the information is considered reasonably compatible and self-attested income is used. - If the difference is greater than 10%, reasonable explanation is requested. If reasonable explanation is provided, the self-attested income is used. If not reasonable, further verification is required. If an individual's attestation cannot be confirmed, due to no available data source or paper documenation, self-attestation will be accepted if the reported income is less than $600/month. Paper documentation is requested for self-employment income, when reasonable explanation is not provided, when data sources do not exist, or it is needed to resolve discrepancies. Individuals determined ineligible for Medicaid are referred for APTC through the marketplace. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 2