Page 3
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 Pregnancy *** YES NO NO N/A N/A NO NO If State has information that is not reasonably compatible with what the individual attested to, then State may reach out for further information. Paper documentation is only required from the client if they are unable to provide a satisfactory reasonable explanation for the compatibility issue. Caretaker Relative YES NO YES N/A N/A YES YES For individuals not known to the system, State will accept self- attestation without additional verification. For individuals already known to the integrated system, (i.e. through SNAP or TANF), State will perform verification using an electronic data source. Paper documentation is only required from the client if they are unable to provide a satisfactory reasonable explanation for the compatibility issue and eligibility is affected. MAGI-BASED ELIGIBILITY VERIFICATION PLAN SECTION A - Verification Procedures for Factors of Eligibility 3