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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 Applicatio n (Y/N) Data Source Used at Renewal (Y/N) Data Source Used Post- Enrollme nt (Y/N) If Used for Post- Enrollment Frequency Used (i.e. monthly, quarterly) Comments 5. Temporary Assistance for Needy Families (TANF) YES YES YES YES NO YES NO NO NO NO NO NO YES YES NO Only use for citizenship and immigration status if they have been verified in accordance with Medicaid/CHIP rules. This data source is used as part or ELE. Can be used for residency if needed post- eligibility due to a discrepancy. 6. Supplemental Nutrition Assistance Program (SNAP) YES YES YES YES NO YES NO NO NO NO NO NO YES YES NO Only use for citizenship and immigration status if they have been verified in accordance with Medicaid/CHIP rules. This data source is used as part or ELE. Can be used for residency if needed post- eligibility due to a discrepancy. 7. Office of Child Support Enforcement NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO not applicable 8. State General Assistance Programs NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO not applicable 9. Women, Infants and Children Program (WIC) NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO not applicable MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 9