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MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: New Jersey Section B2. Use of Electronic Data Sources Non-Financial: ber s tion e er If Used for Electronic Data Source To Be Used (Y/N) Social Security Num Citizenship Immigration Statu Residency Age/DOB Pregnancy sehold Composi Caretaker Relativ Medicare Application for oth Benefits Other Data Source Used at Application (Y/N) Data Source Used at Renewal (Y/N) Data Source Used Post- Enrollment (Y/N) Post- Enrollment Frequency Used (i.e. monthly, Comments Hou quarterly) 1. Social Security Administration (SSA) YES YES YES NO NO YES NO NO NO YES NO NO YES YES NO 2. Department of Homeland Security (DHS) - SAVE YES NO NO YES NO NO NO NO NO NO NO NO YES YES NO 3. Vital Statistics YES NO YES NO NO YES NO NO NO NO NO NO YES NO NO Used as a back-up if citizenship cannot be verified through SSA. 4. Department of Motor Vehicles (DMV) NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO 5. Temporary Assistance for Needy Families NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO (TANF) MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 8