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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 Application (Y/N)

Data Source

Used at

Renewal (Y/N)

Data Source Used Post-Enrollment (Y/N) If Used for Post-

Enrollment Frequency Used (i.e. monthly, quarterly) Comments

1. Social Security

Other (specify in

Administration comments)

Used post enrollment to identify changes in (SSA)

Medicare or App for Other Benefits. Also

can be used if an inconsistancy is identified YES YES YES NO NO NO NO NO NO YES YES NO YES YES YES

with Age/DOB in the course of verifying other information. State utilizes SSA SOLQi data feed for verification. State does not utilize the Hub.

2. Department of

Other (specify in

Used post enrollment and renewal for Homeland Security comments)

changes in status and 5 yr bar. (DHS) - SAVE YES NO NO YES NO NO NO NO NO NO NO NO YES YES YES

State utilizes current DHS SAVE data feed

for verification. State does not utilize the Hub at this time. 3. Vital Statistics NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO

No interface available. Vital Stats does not

have electronic data available.

4. Department of

Motor Vehicles YES NO NO NO YES NO NO NO NO NO NO NO YES NO NO

Can also be used for Age/DOB is necessary. On Demand (DMV)

5. Temporary Assistance for

Needy Families (TANF) YES NO NO NO YES NO NO NO NO NO NO NO YES YES NO

Can be utilized for verification of Age/DOB, Caretaker Relative, and Household Comp if necessary. MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: North Carolina Last updated 05/26/2016 Section B2. Use of Electronic Data Sources Non-Financial: MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 6