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MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: Oklahoma Last updated: 07/13/2016 Section C . Additional Factors of Eligibility for Separate CHIP Eligibility Factor Self-Attestation Accepted without Additional Verification Self-Attestation Accepted with Post- Enrollment Verification (Y/N) Electronic Data Source Used (Y/N) If Yes, please describe in comments Paper Documentation Required from the Individual (Y/N) Non- Applicable (N/A) Comments 1. Applicant does not have other coverage NO YES YES NO Must be Applied The OHCA screens for other third part liability (TPL) coverage through a systematic data match with a state contracted vendor. Member identifying information is shared with the vendor, the vendor searches its databases of past and effective dates for other sources of creditable coverage, and returns results to the state. Also, we ask for the information the during the application. 2. Applicant does not have access to affordable ESI NO YES YES YES The state internally verifies that the applicant is not enrolled in one of the state sponsored programs. One of those internal checks is to determine if the applicant has ever been in the OHCA's system. The state currently and will continue to only ask for paper documentation as a last resort. 3. When child has had coverage (as applicable to states' waiting period) N/A The state screens for other third part liability (TPL) coverage through a systematic data match with a state contracted vendor. Member identifying information is shared with the vendor; the vendor searches its databases of past and present effective dates for other sources of creditable coverage, and returns results to the state. Oklahoma does not have a waiting period. 4. Access to public employee coverage NO YES YES NO The state internally verifies that the applicant is not enrolled in one of the state sponsored programs. One of those internal checks is to determine if the applicant has ever been in the OHCA's system. Oklahoma does not cover children of state employees. 5a. Waiting period exception #1 (describe): N/A MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION C - Additional Factors of Eligibility for Separate CHIP 8