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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 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 6. Supplemental Nutrition Assistance Program (SNAP) YES YES YES YES YES YES NO YES NO NO NO NO YES YES NO Information from the SNAP and TANF programs is located in the same system as Medical. Information from this system will be used at time of application for individuals that are enrolled in these programs and post-eligibility for reported changes. 7. Office of Child Support Enforcement NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO N/A - The Medicaid agency does not currently have access to non-financial information from the Division of Child Support. 8. State General Assistance Programs NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO N/A - The State of South Dakota does not have State General Assistance Programs. 9. Women, Infants and Children Program (WIC) NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO N/A - The Medicaid agency does not have access to non-financial information from WIC 10. State Income Tax NO NO NO NO NO NO NO NO NO NO NO NO NO NO NO N/A - South Dakota does not have a state income tax. 11. Commercial database: (Please describe any commercial databases in the space below) 12. PARIS* YES NO NO NO YES NO NO NO NO NO NO YES NO NO YES Quarterly To identify dual state participation and eligibility for federal health insurance benefits. 13. Other: (Please describe additional electronic data sources in the space provided below) HMS (ORFI) YES NO NO NO NO NO NO NO NO NO NO YES NO NO YES Monthly HMS is used to identify enrollment in private health insurance for Targeted Low Income Children. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION B2 - Use of Electronic Data Sources, Non-Financial 11