The executive commissioner by rule shall require each applicant to provide at least the following information:
(1) the applicant's full name and address;
(2) the applicant's social security number, if available;
(3) the number of persons in the applicant's household, excluding persons receiving Temporary Assistance for Needy Families, Supplemental Security Income, or Medicaid benefits;
(4) the applicant's county of residence;
(5) the existence of insurance coverage or other hospital or health care benefits for which the applicant is eligible;
(6) any transfer of title to real property that the applicant has made in the preceding 24 months;
(7) the applicant's annual household income, excluding the income of any household member receiving Temporary Assistance for Needy Families, Supplemental Security Income, or Medicaid benefits; and
(8) the amount of the applicant's liquid assets and the equity value of the applicant's car and real property.
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