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MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: Rhode Island Section B2. Use of Electronic Data Sources Non-Financial: 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 Administration (SSA) YES YES YES NO NO YES NO NO NO YES NO NO YES NO NO verification of citizenship, DOB, and SSN are one-time only activities 2. Department of Homeland Security (DHS) - SAVE YES NO NO YES NO YES NO NO NO NO NO NO YES YES YES Other (specify in comments) For post-enrollment and renewals, this check will only be performed for individuals whose 5-yr bar is to be met, and/or immigration statuses subject to change or expiration. 3. Vital Statistics YES NO YES NO NO YES NO NO NO NO NO NO YES NO NO 4. Department of Motor Vehicles (DMV) NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 5