Page 1

1

MAGI-BASED ELIGIBILITY VERIFICATION PLAN (Insert Medicaid, CHIP, or Both) Medicaid & CHIP State: VT Last updated: 2/28/2024

Section A. Verification Procedures for Factors of Eligibility 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 1. Income* Yes No Yes Both are at or below applicable income standard See Comments Yes Yes Vermont will accept self-attestation without additional verification if the self-attestation is above the Medicaid threshold. The individual will then be screened for QHP with credits. If the attestation is at or below the Medicaid threshold, Vermont uses IRS FTI to verify income. If IRS FTI fails, Vermont checks DOL quarterly wage data. In cases where DOL quarterly wage data is reasonably compatible with a beneficiary's total attested income, earned wages are verified with that data and attestation of any self- employment or other non-wage income types is accepted. If unable to verify using the DOL quarterly wage data, Vermont sends a verification notice to the beneficiary. Vermont allows the beneficiary to verify via a reasonable explanation, if one applies, and, if not, otherwise resolve the inconsistency, including via satisfactory documentation. 2. Residency Yes No No See Comments N/A Yes Yes Vermont accepts self-attestation. Vermont will not verify this eligibility element unless information from the individual is not reasonably compatible with other information provided or otherwise available to the State. In the event an inconsistency is exposed, Vermont may ask for a reasonable explanation and/or paper documentation. Vermont allows the beneficiary to verify via a reasonable explanation, if one applies, and, if not, to otherwise resolve the inconsistency, including via satisfactory documentation. 3. Age (DOB) Yes No No See Comments N/A Yes Yes Vermont accepts self-attestation. Vermont will not verify this eligibility element unless information from the individual is not reasonably compatible with other information provided or otherwise available to the State. In the event an inconsistency is exposed, Vermont may ask for a reasonable explanation and/or paper documentation. Vermont allows the beneficiary to verify via a reasonable explanation, if one applies, and, if not, to otherwise resolve the inconsistency, including via satisfactory documentation. 4. Social Security Number ** No No Yes N/A N/A N/A No Vermont uses its connection to the Social Security Administration (SSA) through the Federal Data Services Hub (the Hub) to verify social security numbers (SSN). If the SSN is not verified through the Hub, Vermont attempts to verify SSNs through its legacy system - ACCESS. If the enrollee cannot be verified electronically, a notice is sent requesting additional documentation.