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MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: Minnesota Section A. Verification Procedures for Factors of Eligibility Eligibility Factor Self- Attestation Accepted without Additional Verification (Y/N) Self- Attestatio n Accepted with Post- Eligibility Verificatio n (Y/N) Electron ic Data Source Used (Y/N) Reasonable Compatibility Standard Used Specify Reasonable Compatibility Standard for Income Ask for a Reasonabl e Explanatio n from the Individual (Y/N) Paper Documentati on Required from the Individual (Y/N) Comments Income* NO NO YES Both are above, at or below the applicable income standard. Percent Threshold 10 percentage points YES YES Minnesota accepts income provided by or on behalf of an individual with one exception: If income is reported by an electronic data source but not reported by or for an individual, the income reports are considered not reasonably compatible. A reasonable explanation for income not provided by or on behalf of the individual will be accepted. In the absence of a reasonable explanation, the application and household income determination will be pended until the inconsistency can be resolved, a process that may include paper documentation. Individual income sources are combined into household income. Total income obtained through electronic data matches is converted to a percentage of FPL; total income provided by self- attestation is converted to a percentage of FPL; and the following determines reasonable compatibility: (i) When the FPL for household income from electronic sources and household income provided by self-attestation are both above, at or below the applicable income standard they are considered reasonably compatible. Self-attested income is used to determine eligibility. (ii) If the FPL for self-attested household income is above the income standard, but the FPL for household income from electronic data sources is below the applicable standard, they are considered reasonably compatible. Household income provided by self-attestation is used to determine eligibility. (iii) If the FPL for self-attested household income is at or below the income standard, but the FPL for household income from electronic data sources is above the income eligibility level, and the two FPL values are no more than 10 points apart, they will be considered reasonably compatible. Household income provided by self-attestation will be used to determine eligibility. If the difference between the two FPLs values is greater than 10 points, the State will ask for paper documentation of all unverified sources of income. Residency YES NO NO N/A N/A NO NO Age (Date of Birth) YES NO NO N/A N/A NO NO Social Security Number ** NO NO YES N/A N/A N/A NO MN does not accept paper documentation of SSN. If we are unable to verify SSN electronically, we will assist the individual in resolving discrepancies with the Social Security Administration (SSA). Once the inconsistency has been resolved, we will initiate an attempt to re-verify the SSN through the Federal Data Hub (SSA). We will allow eligibility to continue, if otherwise eligible, as long as the individual is cooperating with SSA to resolve the discrepancy. We require documentation from an individual claiming SSN exception (religious objection, not eligible to receive SSN, or only eligible to receive SSN for valid non-work reason only). MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 1