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Eligibility Factor Self-Attestation Accepted without Additional Verification (Y/N) Self- Attestation Accepted with Post- Eligibility Verification (Y/N) Electronic Data Source Used (Y/N) Reasonable Compatibility Standard Used Specify Reasonable Compatibility Standard for Income Ask for a Reasonable Explanation from the Individual (Y/N) Paper Documentation Required from the Individual (Y/N) Comments Residency YES NO NO N/A N/A NO NO State accepts self-attestation. If a post-enrollment check through PARIS shows that the indiviudal may live in another state, will verify in TANF, SNAP, or DMV and/or seek additional information from the individual. May also pursue additional information if lead information is received from other sources, such as fraud hotline. Age (Date of Birth) NO NO YES N/A N/A NO YES Paper Documentation only if cannot verify electronically. Will use secondary data sources after SSA before documenation. Social Security Number ** NO NO YES N/A N/A N/A YES Paper Documentation only if cannot verify electronically. Citizenship ** NO NO YES N/A N/A N/A YES Paper Documentation only if cannot verify electronically. Immigration Status ** NO NO YES N/A N/A N/A YES Paper Documentation only if cannot verify electronically. Household Composition YES NO NO N/A N/A NO NO May pursue additional information if lead information is received from other sources, such as fraud hotline. Pregnancy *** YES NO NO N/A N/A NO NO Accept self-attestation once per pregnancy. Caretaker Relative YES NO NO N/A N/A NO NO Medicare NO NO YES N/A N/A YES YES MMA Interface. Only request an explanation or paper documenation if the information from the electronic data source is inconsistent. Application for Other Benefits NO NO YES N/A N/A NO YES Worker/system will determine if applicant should have applied for Social Security, Unemployment Compensation, Railroad Retirement, or Veteran Benefits (exemption: Pregnancy). If determined they should have and there is no electronic verification of applicant having applied then proof of application will be required. Other: (Please describe any other eligibility factors in the space below) MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 2