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Electronic Data Source To Be Used (Y/N) Social curity Number S e Citizenship Immigration Status Residency Age/DOB Pregnancy eho Hous ld Composition Caretaker Relative Medicare Application for other Benefits Other Data Source Used at Application (Y/N) Data Sour ce Used at Rene wal (Y/N) Data Source Used Post- Enrollment (Y/N) If Used for Post- Enrollment Frequency Used (i.e., monthly, quarterly) Comments MMIS YES NO NO NO NO NO YES NO NO NO NO NO NO NO YES Monthly Staff check MMIS on a monthly basis. If there is information received in the MMIS claims system that is inconsistent with the participant's attestation of pregnancy such as a claim for a sterilization procedure, claims for family planning services for contraceptives, or no claims submitted for pregnancy related services within the nine-month eligibility period we will follow-up with the individual. * Under 42 CFR 435.945(d), all State Medicaid eligibility systems must conduct a match with PARIS for Interstate benefit information. If used for other purposes, please indicate in Section D. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 9