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MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: North Dakota Section B1. Use of Electronic Data Sources Financial: Electronic Data Source Determined Useful (Y/N)1 Accuracy Considered (Y/N) Timeliness Considered (Y/N) Ability to Access Considered (Y/N) Age of Data Considered (Y/N) Comprehensive Considered (Y/N) Other Criteria Used (Y/N) (Please Describe in Comments section) Data Source Used at Applicati on (Y/N) Data Source Used at Renew al (Y/N) Data Source Used Post- Enrollme nt (Y/N) If Data Source Used for Post- Enrollment - Frequency Used (e.g. monthly, quarterly) Comments 1. Internal Revenue Service (IRS) YES YES YES YES YES YES NO YES YES NO 2. Social Security Administration (SSA) (SSI, Title II) YES YES YES YES YES YES NO YES YES NO Other (specify in comments) Used post-enrollment when system notifies of change post enrollment 3. State Wage Information Collection Agency (SWICA) YES YES YES YES YES YES NO YES YES NO Other (specify in comments) Used post-enrollment when system notifies of change post 4. State Unemployment Compensation YES YES YES YES YES YES NO YES YES NO Other (specify in comments) Used post-enrollment when system notifies of change post 5. State Administered Supplementary Payment Program NO NO NO NO NO NO NO NO NO NO ND does not have a State administered Supplimentary Payment program 6. State General Assistance Programs NO NO NO NO NO NO NO NO NO NO ND does not have a State General Assistance program 7. Supplemental Nutrition Assistance Program (SNAP) YES YES YES YES YES YES NO YES YES NO Using the raw income wage data from SNAP/TANF (not Medicaid MAGI calculated income). MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B1 - Use of Electronic Data Sources, Financial 4