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5. Citizenship ** No No Yes N/A N/A N/A Yes Vermont uses its connection to SSA through the Hub to verify citizenship. If citizenship is not verified through the Hub, Vermont attempts to verify citizenship through ACCESS. If the enrollee cannot be verified electronically, a notice is sent requesting additional documentation. The applicant is granted benefits and is given a 90-day reasonable opportunity period post-enrollment, if otherwise eligible, to respond to the request for additional documentation concerning citizenship. 6. Immigration Status ** No No Yes N/A N/A N/A Yes Vermont uses SAVE through the Hub's VLP service for step 1. Steps 2 and 3 are done through Vermont's web-based SAVE connection. As of 10/29/2020, Vermont has a permanent extension of the state's Hub waiver to forego using SAVE through the HUB's VLP service for steps 2 and 3. If additional documentation is needed for step 3, Vermont will request paper documentation at that time. If otherwise eligible, the enrollee is given a 90-day reasonable opportunity period to respond to the request for additional documentation to verify immigration status. 7. Household Composition 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. 8. Pregnancy *** 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. 9. Caretaker Relative 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. 10. Medicare Yes No No

N/A No No

11. Application for Other Benefits No Yes Yes See Comments N/A Yes Yes Vermont uses its data connection with PARIS post-enrollment to verify that a beneficiary does not have services in other states. 12. Other: (Please describe any eligibility factors in the space below)

*State must check electronic data sources determined useful to verify income in accordance with 42 CFR 435.948 but can be done post-enrollment. If the information obtained from electronic data sources and information provided by or on behalf of the individual are both above, or at below the applicable income standard, the State must determine the applicant eligible for Medicaid/CHIP. (NOTE: this option is prepopulated for the state and is not an option that can be changed). **States must follow statute, regulations, and guidance for verification of SSN, citizenship and immigration status including obtaining such information through the federal data services hub if available. ***States must accept self-attestation of pregnancy unless they have information that is not reasonably.