DEPARTMENT OF
PUBLIC WELFARECo-Payments for the Subsidized Child Care Program [41 Pa.B. 5232]
[Saturday, October 1, 2011]The purpose of this notice is to revise the co-payment schedule codified in 55 Pa. Code Chapter 3041, Appendix B (relating to co-payment chart family co-payment scale (based on the 2011 Federal Poverty Income Guidelines). The revised copayment schedule is effective October 3, 2011.
The act of June 30, 2011 (P. L. 89, No. 22) (Act 22) amended section 408.3 of the Public Welfare Code (code) (62 P. S. § 408.3), regarding co-payments for subsidized child care. Among other things, Act 22 directs the Department of Public Welfare (Department) to publish a notice in the Pennsylvania Bulletin setting forth the co-payment schedule for subsidized child care (section 408.3(b) of the code). Act 22 requires the Department to impose co-payments for the subsidized child care program based on a sliding income scale taking into account the Federal Poverty Income Guidelines (FPIG) (section 408.3(c)(1) of the code). Co-payment amounts must be a minimum of $5 per week and may increase at incremental amounts as determined by the Department, taking into account annual family income (section 408.3(c)(3) of the code). A family's co-payment shall not exceed 8% of the family's annual income if the family's annual income is 100% or less of the FPIG; or 11% of the family's annual income if the family's annual income exceeds 100% of the FPIG (section 408.3(c)(4) of the code).
The Department is revising the co-payment schedule for the subsidized child care program in accordance with the requirements set forth in Act 22. Chapter 3041, Appendix B of 55 Pa. Code establishes the family co-payment levels according to the family's computed annual income and lists the weekly family co-payment based on the annual family income.
GARY D. ALEXANDER,
SecretaryFiscal Note: 14-NOT-719. (1) General Fund; (2) Implementing Year 2011-12 is $17,796,000; (3) 1st Succeeding Year 2012-13 is $19,728,000; 2nd Succeeding Year 2013-14 is $19,728,000; 3rd Succeeding Year 2014-15 is $19,728,000; 4th Succeeding Year 2015-16 is $19,728,000; 5th Succeeding Year 2016-17 is $19,728,000; (4) Child Care Services: 2010-11 Program—$171,720,000; 2009-10 Program—$171,720,000; 2008-09 Program—$166,763,000; Child Care Assistance: 2010-11 Program—$189,582,000; 2009-10 Program—$198,147,000; 2008-09 Program—$201,956,000; (7) Child Care Services and Child Care Assistance; (8) recommends adoption. Funds have been included in the budget to cover this increase.
CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE 10/01/2011
(BASED ON THE 2011 FEDERAL POVERTY INCOME GUIDELINES)Weekly Family Size: 1 Weekly Family Size: 2 Co-pay Annual Income Co-Pay Annual Income $5.00 Less than: $8,890 $5.00 Less than: $8,660 $10.00 $8,890.01 $10,890 $10.00 $8,660.01 $12,710 $15.00 $10,890.01 $12,890 $19.00 $12,710.01 $14,710 $20.00 $12,890.01 $14,890 $23.00 $14,710.01 $16,710 $25.00 $14,890.01 $16,890 $27.00 $16,710.01 $18,710 $30.00 $16,890.01 $18,890 $31.00 $18,710.01 $20,710 $35.00 $18,890.01 $20,890 $36.00 $20,710.01 $22,710 $40.00 $20,890.01 $22,890 $41.00 $22,710.01 $24,710 $45.00 $22,890.01 $24,890 $46.00 $24,710.01 $26,710 $50.00 $24,890.01 $25,592 $51.00 $26,710.01 $28,710 $57.00 $28,710.01 $30,710 $63.00 $30,710.01 $32,710 $69.00 $32,710.01 $34,569 200% FPIG $21,780 200% FPIG $29,420 CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE 10/01/2011
(BASED ON THE 2011 FEDERAL POVERTY INCOME GUIDELINES)Weekly Family Size: 3 Weekly Family Size: 4 Co-pay Annual Income Co-Pay Annual Income $5.00 Less than: $8,660 $5.00 Less than: $8,660 $10.00 $8,660.01 $14,530 $10.00 $8,660.01 $16,350 $19.00 $14,530.01 $16,530 $21.00 $16,350.01 $18,350 $25.00 $16,530.01 $18,530 $26.00 $18,350.01 $20,350 $29.00 $18,530.01 $20,530 $31.00 $20,350.01 $22,350 $33.00 $20,530.01 $22,530 $35.00 $22,350.01 $24,350 $37.00 $22,530.01 $24,530 $39.00 $24,350.01 $26,350 $41.00 $24,530.01 $26,530 $43.00 $26,350.01 $28,350 $46.00 $26,530.01 $28,530 $47.00 $28,350.01 $30,350 $51.00 $28,530.01 $30,530 $51.00 $30,350.01 $32,350 $56.00 $30,530.01 $32,530 $56.00 $32,350.01 $34,350 $61.00 $32,530.01 $34,530 $61.00 $34,350.01 $36,350 $66.00 $34,530.01 $36,530 $66.00 $36,350.01 $38,350 $71.00 $36,530.01 $38,530 $71.00 $38,350.01 $40,350 $77.00 $38,530.01 $40,530 $76.00 $40,350.01 $42,350 $83.00 $40,530.01 $42,530 $81.00 $42,350.01 $44,350 $89.00 $42,530.01 $43,546 $86.00 $44,350.01 $46,350 $92.00 $46,350.01 $48,350 $98.00 $48,350.01 $50,350 $104.00 $50,350.01 $52,350 $110.00 $52,350.01 $52,523 200% FPIG $37,060 200% FPIG $44,700 CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE 10/01/2011
(BASED ON THE 2011 FEDERAL POVERTY INCOME GUIDELINES)Weekly Family Size: 5 Weekly Family Size: 6 Co-pay Annual Income Co-Pay Annual Income $5.00 Less than: $8,660 $5.00 Less than: $8,660 $10.00 $8,660.01 $18,170 $10.00 $8,660.01 $19,990 $23.00 $18,170.01 $20,170 $25.00 $19,990.01 $21,990 $27.00 $20,170.01 $22,170 $29.00 $21,990.01 $23,990 $32.00 $22,170.01 $24,170 $33.00 $23,990.01 $25,990 $37.00 $24,170.01 $26,170 $38.00 $25,990.01 $27,990 $41.00 $26,170.01 $28,170 $43.00 $27,990.01 $29,990 $45.00 $28,170.01 $30,170 $47.00 $29,990.01 $31,990 $49.00 $30,170.01 $32,170 $51.00 $31,990.01 $33,990 $53.00 $32,170.01 $34,170 $55.00 $33,990.01 $35,990 $57.00 $34,170.01 $36,170 $59.00 $35,990.01 $37,990 $62.00 $36,170.01 $38,170 $63.00 $37,990.01 $39,990 $67.00 $38,170.01 $40,170 $67.00 $39,990.01 $41,990 $72.00 $40,170.01 $42,170 $72.00 $41,990.01 $43,990 $77.00 $42,170.01 $44,170 $77.00 $43,990.01 $45,990 $82.00 $44,170.01 $46,170 $82.00 $45,990.01 $47,990 $87.00 $46,170.01 $48,170 $87.00 $47,990.01 $49,990 $92.00 $48,170.01 $50,170 $92.00 $49,990.01 $51,990 $97.00 $50,170.01 $52,170 $97.00 $51,990.01 $53,990 $103.00 $52,170.01 $54,170 $102.00 $53,990.01 $55,990 $109.00 $54,170.01 $56,170 $107.00 $55,990.01 $57,990 $115.00 $56,170.01 $58,170 $112.00 $57,990.01 $59,990 $121.00 $58,170.01 $60,170 $118.00 $59,990.01 $61,990 $126.00 $60,170.01 $61,500 $124.00 $61,990.01 $63,990 $130.00 $63,990.01 $65,990 $136.00 $65,990.01 $67,990 $142.00 $67,990.01 $69,990 $147.00 $69,990.01 $70,477 200% FPIG $52,340 200% FPIG $59,980 CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE 10/01/2011
(BASED ON THE 2011 FEDERAL POVERTY INCOME GUIDELINES)Weekly Family Size: 7 Weekly Family Size: 8 Co-pay Annual Income Co-Pay Annual Income $5.00 Less than: $8,660 $5.00 Less than: $8,660 $10.00 $8,660.01 $21,810 $10.00 $8,660.01 $23,630 $26.00 $21,810.01 $23,810 $28.00 $23,630.01 $25,630 $30.00 $23,810.01 $25,810 $32.00 $25,630.01 $27,630 $34.00 $25,810.01 $27,810 $36.00 $27,630.01 $29,630 $38.00 $27,810.01 $29,810 $40.00 $29,630.01 $31,630 $43.00 $29,810.01 $31,810 $44.00 $31,630.01 $33,630 $48.00 $31,810.01 $33,810 $49.00 $33,630.01 $35,630 $52.00 $33,810.01 $35,810 $54.00 $35,630.01 $37,630 $56.00 $35,810.01 $37,810 $58.00 $37,630.01 $39,630 $60.00 $37,810.01 $39,810 $62.00 $39,630.01 $41,630 $64.00 $39,810.01 $41,810 $66.00 $41,630.01 $43,630 $68.00 $41,810.01 $43,810 $70.00 $43,630.01 $45,630 $72.00 $43,810.01 $45,810 $74.00 $45,630.01 $47,630 $76.00 $45,810.01 $47,810 $78.00 $47,630.01 $49,630 $81.00 $47,810.01 $49,810 $82.00 $49,630.01 $51,630 $86.00 $49,810.01 $51,810 $86.00 $51,630.01 $53,630 $91.00 $51,810.01 $53,810 $91.00 $53,630.01 $55,630 $96.00 $53,810.01 $55,810 $96.00 $55,630.01 $57,630 $101.00 $55,810.01 $57,810 $101.00 $57,630.01 $59,630 $106.00 $57,810.01 $59,810 $106.00 $59,630.01 $61,630 $111.00 $59,810.01 $61,810 $111.00 $61,630.01 $63,630 $116.00 $61,810.01 $63,810 $116.00 $63,630.01 $65,630 $121.00 $63,810.01 $65,810 $121.00 $65,630.01 $67,630 $126.00 $65,810.01 $67,810 $126.00 $67,630.01 $69,630 $132.00 $67,810.01 $69,810 $131.00 $69,630.01 $71,630 $138.00 $69,810.01 $71,810 $136.00 $71,630.01 $73,630 $144.00 $71,810.01 $73,810 $141.00 $73,630.01 $75,630 $150.00 $73,810.01 $75,810 $147.00 $75,630.01 $77,630 $156.00 $75,810.01 $77,810 $153.00 $77,630.01 $79,630 $163.00 $77,810.01 $79,454 $159.00 $79,630.01 $81,630 $165.00 $81,630.01 $83,630 $171.00 $83,630.01 $85,630 $177.00 $85,630.01 $87,630 $184.00 $87,630.01 $88,431 200% FPIG $67,620 200% FPIG $75,260 CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE 10/01/2011
(BASED ON THE 2011 FEDERAL POVERTY INCOME GUIDELINES)Weekly Family Size: 9 Weekly Family Size: 10 Co-pay Annual Income Co-Pay Annual Income $5.00 Less than: $8,660 $5.00 Less than: $8,660 $10.00 $8,660.01 $25,450 $10.00 $8,660.01 $27,270 $30.00 $25,450.01 $27,450 $32.00 $27,270.01 $29,270 $34.00 $27,450.01 $29,450 $36.00 $29,270.01 $31,270 $38.00 $29,450.01 $31,450 $40.00 $31,270.01 $33,270 $42.00 $31,450.01 $33,450 $44.00 $33,270.01 $35,270 $46.00 $33,450.01 $35,450 $48.00 $35,270.01 $37,270 $50.00 $35,450.01 $37,450 $52.00 $37,270.01 $39,270 $55.00 $37,450.01 $39,450 $56.00 $39,270.01 $41,270 $60.00 $39,450.01 $41,450 $61.00 $41,270.01 $43,270 $64.00 $41,450.01 $43,450 $66.00 $43,270.01 $45,270 $68.00 $43,450.01 $45,450 $70.00 $45,270.01 $47,270 $72.00 $45,450.01 $47,450 $74.00 $47,270.01 $49,270 $76.00 $47,450.01 $49,450 $78.00 $49,270.01 $51,270 $80.00 $49,450.01 $51,450 $82.00 $51,270.01 $53,270 $84.00 $51,450.01 $53,450 $86.00 $53,270.01 $55,270 $88.00 $53,450.01 $55,450 $90.00 $55,270.01 $57,270 $92.00 $55,450.01 $57,450 $94.00 $57,270.01 $59,270 $97.00 $57,450.01 $59,450 $98.00 $59,270.01 $61,270 $102.00 $59,450.01 $61,450 $102.00 $61,270.01 $63,270 $107.00 $61,450.01 $63,450 $107.00 $63,270.01 $65,270 $112.00 $63,450.01 $65,450 $112.00 $65,270.01 $67,270 $117.00 $65,450.01 $67,450 $117.00 $67,270.01 $69,270 $122.00 $67,450.01 $69,450 $122.00 $69,270.01 $71,270 $127.00 $69,450.01 $71,450 $127.00 $71,270.01 $73,270 $132.00 $71,450.01 $73,450 $132.00 $73,270.01 $75,270 $137.00 $73,450.01 $75,450 $137.00 $75,270.01 $77,270 $142.00 $75,450.01 $77,450 $142.00 $77,270.01 $79,270 $147.00 $77,450.01 $79,450 $147.00 $79,270.01 $81,270 $152.00 $79,450.01 $81,450 $152.00 $81,270.01 $83,270 $158.00 $81,450.01 $83,450 $157.00 $83,270.01 $85,270 $164.00 $83,450.01 $85,450 $162.00 $85,270.01 $87,270 $170.00 $85,450.01 $87,450 $167.00 $87,270.01 $89,270 $176.00 $87,450.01 $89,450 $173.00 $89,270.01 $91,270 $182.00 $89,450.01 $91,450 $179.00 $91,270.01 $93,270 $188.00 $91,450.01 $93,450 $185.00 $93,270.01 $95,270 $194.00 $93,450.01 $95,450 $191.00 $95,270.01 $97,270 $200.00 $95,450.01 $97,408 $197.00 $97,270.01 $99,270 $203.00 $99,270.01 $101,270 $209.00 $101,270.01 $103,270 $215.00 $103,270.01 $105,270 $221.00 $105,270.01 $106,385 200% FPIG $82,900 200% FPIG $90,540 CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE 10/01/2011
(BASED ON THE 2011 FEDERAL POVERTY INCOME GUIDELINES)Weekly Family Size: 11 Weekly Family Size: 12 Co-pay Annual Income Co-Pay Annual Income $5.00 Less than: $8,660 $5.00 Less than: $8,660 $10.00 $8,660.01 $29,090 $10.00 $8,660.01 $30,910 $34.00 $29,090.01 $31,090 $36.00 $30,910.01 $32,910 $38.00 $31,090.01 $33,090 $39.00 $32,910.01 $34,910 $42.00 $33,090.01 $35,090 $43.00 $34,910.01 $36,910 $46.00 $35,090.01 $37,090 $47.00 $36,910.01 $38,910 $50.00 $37,090.01 $39,090 $51.00 $38,910.01 $40,910 $54.00 $39,090.01 $41,090 $55.00 $40,910.01 $42,910 $58.00 $41,090.01 $43,090 $59.00 $42,910.01 $44,910 $62.00 $43,090.01 $45,090 $63.00 $44,910.01 $46,910 $67.00 $45,090.01 $47,090 $67.00 $46,910.01 $48,910 $72.00 $47,090.01 $49,090 $72.00 $48,910.01 $50,910 $76.00 $49,090.01 $51,090 $77.00 $50,910.01 $52,910 $80.00 $51,090.01 $53,090 $81.00 $52,910.01 $54,910 $84.00 $53,090.01 $55,090 $85.00 $54,910.01 $56,910 $88.00 $55,090.01 $57,090 $89.00 $56,910.01 $58,910 $92.00 $57,090.01 $59,090 $93.00 $58,910.01 $60,910 $96.00 $59,090.01 $61,090 $97.00 $60,910.01 $62,910 $100.00 $61,090.01 $63,090 $101.00 $62,910.01 $64,910 $104.00 $63,090.01 $65,090 $105.00 $64,910.01 $66,910 $108.00 $65,090.01 $67,090 $109.00 $66,910.01 $68,910 $112.00 $67,090.01 $69,090 $113.00 $68,910.01 $70,910 $117.00 $69,090.01 $71,090 $117.00 $70,910.01 $72,910 $122.00 $71,090.01 $73,090 $122.00 $72,910.01 $74,910 $127.00 $73,090.01 $75,090 $127.00 $74,910.01 $76,910 $132.00 $75,090.01 $77,090 $132.00 $76,910.01 $78,910 $137.00 $77,090.01 $79,090 $137.00 $78,910.01 $80,910 $142.00 $79,090.01 $81,090 $142.00 $80,910.01 $82,910 $147.00 $81,090.01 $83,090 $147.00 $82,910.01 $84,910 $152.00 $83,090.01 $85,090 $152.00 $84,910.01 $86,910 $157.00 $85,090.01 $87,090 $157.00 $86,910.01 $88,910 $162.00 $87,090.01 $89,090 $162.00 $88,910.01 $90,910 $167.00 $89,090.01 $91,090 $167.00 $90,910.01 $92,910 $172.00 $91,090.01 $93,090 $172.00 $92,910.01 $94,910 $177.00 $93,090.01 $95,090 $177.00 $94,910.01 $96,910 $182.00 $95,090.01 $97,090 $182.00 $96,910.01 $98,910 $188.00 $97,090.01 $99,090 $187.00 $98,910.01 $100,910 $194.00 $99,090.01 $101,090 $192.00 $100,910.01 $102,910 $200.00 $101,090.01 $103,090 $198.00 $102,910.01 $104,910 $206.00 $103,090.01 $105,090 $204.00 $104,910.01 $106,910 $212.00 $105,090.01 $107,090 $210.00 $106,910.01 $108,910 $218.00 $107,090.01 $109,090 $216.00 $108,910.01 $110,910 $224.00 $109,090.01 $111,090 $222.00 $110,910.01 $112,910 $230.00 $111,090.01 $113,090 $228.00 $112,910.01 $114,910 $236.00 $113,090.01 $115,090 $234.00 $114,910.01 $116,910 $241.00 $115,090.01 $115,362 $240.00 $116,910.01 $118,910 $246.00 $118,910.01 $120,910 $252.00 $120,910.01 $122,910 $258.00 $122,910.01 $124,339 200% FPIG $98,180 200% FPIG $105,820 CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE 10/01/2011
(BASED ON THE 2011 FEDERAL POVERTY INCOME GUIDELINES)Weekly Family Size: 13 Weekly Family Size: 14 Co-pay Annual Income Co-Pay Annual Income $5.00 Less than: $8,660 $5.00 Less than: $8,660 $10.00 $8,660.01 $32,730 $10.00 $8,660.01 $34,550 $38.00 $32,730.01 $34,730 $41.00 $34,550.01 $36,550 $41.00 $34,730.01 $36,730 $44.00 $36,550.01 $38,550 $45.00 $36,730.01 $38,730 $47.00 $38,550.01 $40,550 $49.00 $38,730.01 $40,730 $51.00 $40,550.01 $42,550 $53.00 $40,730.01 $42,730 $55.00 $42,550.01 $44,550 $57.00 $42,730.01 $44,730 $59.00 $44,550.01 $46,550 $61.00 $44,730.01 $46,730 $63.00 $46,550.01 $48,550 $65.00 $46,730.01 $48,730 $67.00 $48,550.01 $50,550 $69.00 $48,730.01 $50,730 $71.00 $50,550.01 $52,550 $73.00 $50,730.01 $52,730 $75.00 $52,550.01 $54,550 $78.00 $52,730.01 $54,730 $79.00 $54,550.01 $56,550 $83.00 $54,730.01 $56,730 $84.00 $56,550.01 $58,550 $87.00 $56,730.01 $58,730 $89.00 $58,550.01 $60,550 $91.00 $58,730.01 $60,730 $93.00 $60,550.01 $62,550 $95.00 $60,730.01 $62,730 $97.00 $62,550.01 $64,550 $99.00 $62,730.01 $64,730 $101.00 $64,550.01 $66,550 $103.00 $64,730.01 $66,730 $105.00 $66,550.01 $68,550 $107.00 $66,730.01 $68,730 $109.00 $68,550.01 $70,550 $111.00 $68,730.01 $70,730 $113.00 $70,550.01 $72,550 $115.00 $70,730.01 $72,730 $117.00 $72,550.01 $74,550 $119.00 $72,730.01 $74,730 $121.00 $74,550.01 $76,550 $123.00 $74,730.01 $76,730 $125.00 $76,550.01 $78,550 $127.00 $76,730.01 $78,730 $129.00 $78,550.01 $80,550 $132.00 $78,730.01 $80,730 $133.00 $80,550.01 $82,550 $137.00 $80,730.01 $82,730 $138.00 $82,550.01 $84,550 $142.00 $82,730.01 $84,730 $143.00 $84,550.01 $86,550 $147.00 $84,730.01 $86,730 $148.00 $86,550.01 $88,550 $152.00 $86,730.01 $88,730 $153.00 $88,550.01 $90,550 $157.00 $88,730.01 $90,730 $158.00 $90,550.01 $92,550 $162.00 $90,730.01 $92,730 $163.00 $92,550.01 $94,550 $167.00 $92,730.01 $94,730 $168.00 $94,550.01 $96,550 $172.00 $94,730.01 $96,730 $173.00 $96,550.01 $98,550 $177.00 $96,730.01 $98,730 $178.00 $98,550.01 $100,550 $182.00 $98,730.01 $100,730 $183.00 $100,550.01 $102,550 $187.00 $100,730.01 $102,730 $188.00 $102,550.01 $104,550 $192.00 $102,730.01 $104,730 $193.00 $104,550.01 $106,550 $197.00 $104,730.01 $106,730 $198.00 $106,550.01 $108,550 $202.00 $106,730.01 $108,730 $203.00 $108,550.01 $110,550 $207.00 $108,730.01 $110,730 $208.00 $110,550.01 $112,550 $213.00 $110,730.01 $112,730 $213.00 $112,550.01 $114,550 $219.00 $112,730.01 $114,730 $218.00 $114,550.01 $116,550 $225.00 $114,730.01 $116,730 $224.00 $116,550.01 $118,550 $231.00 $116,730.01 $118,730 $230.00 $118,550.01 $120,550 $237.00 $118,730.01 $120,730 $236.00 $120,550.01 $122,550 $243.00 $120,730.01 $122,730 $242.00 $122,550.01 $124,550 $249.00 $122,730.01 $124,730 $248.00 $124,550.01 $126,550 $255.00 $124,730.01 $126,730 $254.00 $126,550.01 $128,550 $261.00 $126,730.01 $128,730 $260.00 $128,550.01 $130,550 $267.00 $128,730.01 $130,730 $266.00 $130,550.01 $132,550 $273.00 $130,730.01 $132,730 $272.00 $132,550.01 $134,550 $278.00 $132,730.01 $133,316 $278.00 $134,550.01 $136,550 $284.00 $136,550.01 $138,550 $290.00 $138,550.01 $140,550 $295.00 $140,550.01 $142,293 200% FPIG $113,460 200% FPIG $121,100 CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE 10/01/2011
(BASED ON THE 2011 FEDERAL POVERTY INCOME GUIDELINES)Weekly Family Size: 15 Weekly Family Size: 16 Co-pay Annual Income Co-Pay Annual Income $5.00 Less than: $8,660 $5.00 Less than: $8,660 $10.00 $8,660.01 $36,370 $10.00 $8,660.01 $40,190 $43.00 $36,370.01 $38,370 $48.00 $40,190.01 $42,190 $46.00 $38,370.01 $40,370 $51.00 $42,190.01 $44,190 $49.00 $40,370.01 $42,370 $55.00 $44,190.01 $46,190 $53.00 $42,370.01 $44,370 $59.00 $46,190.01 $48,190 $57.00 $44,370.01 $46,370 $63.00 $48,190.01 $50,190 $61.00 $46,370.01 $48,370 $67.00 $50,190.01 $52,190 $65.00 $48,370.01 $50,370 $71.00 $52,190.01 $54,190 $69.00 $50,370.01 $52,370 $75.00 $54,190.01 $56,190 $73.00 $52,370.01 $54,370 $79.00 $56,190.01 $58,190 $77.00 $54,370.01 $56,370 $83.00 $58,190.01 $60,190 $81.00 $56,370.01 $58,370 $87.00 $60,190.01 $62,190 $85.00 $58,370.01 $60,370 $91.00 $62,190.01 $64,190 $90.00 $60,370.01 $62,370 $96.00 $64,190.01 $66,190 $95.00 $62,370.01 $64,370 $101.00 $66,190.01 $68,190 $99.00 $64,370.01 $66,370 $105.00 $68,190.01 $70,190 $103.00 $66,370.01 $68,370 $109.00 $70,190.01 $72,190 $107.00 $68,370.01 $70,370 $113.00 $72,190.01 $74,190 $111.00 $70,370.01 $72,370 $117.00 $74,190.01 $76,190 $115.00 $72,370.01 $74,370 $121.00 $76,190.01 $78,190 $119.00 $74,370.01 $76,370 $125.00 $78,190.01 $80,190 $123.00 $76,370.01 $78,370 $129.00 $80,190.01 $82,190 $127.00 $78,370.01 $80,370 $133.00 $82,190.01 $84,190 $131.00 $80,370.01 $82,370 $137.00 $84,190.01 $86,190 $135.00 $82,370.01 $84,370 $141.00 $86,190.01 $88,190 $139.00 $84,370.01 $86,370 $145.00 $88,190.01 $90,190 $143.00 $86,370.01 $88,370 $149.00 $90,190.01 $92,190 $148.00 $88,370.01 $90,370 $153.00 $92,190.01 $94,190 $153.00 $90,370.01 $92,370 $158.00 $94,190.01 $96,190 $158.00 $92,370.01 $94,370 $163.00 $96,190.01 $98,190 $163.00 $94,370.01 $96,370 $168.00 $98,190.01 $100,190 $168.00 $96,370.01 $98,370 $173.00 $100,190.01 $102,190 $173.00 $98,370.01 $100,370 $178.00 $102,190.01 $104,190 $178.00 $100,370.01 $102,370 $183.00 $104,190.01 $106,190 $183.00 $102,370.01 $104,370 $188.00 $106,190.01 $108,190 $188.00 $104,370.01 $106,370 $193.00 $108,190.01 $110,190 $193.00 $106,370.01 $108,370 $198.00 $110,190.01 $112,190 $198.00 $108,370.01 $110,370 $203.00 $112,190.01 $114,190 $203.00 $110,370.01 $112,370 $208.00 $114,190.01 $116,190 $208.00 $112,370.01 $114,370 $213.00 $116,190.01 $118,190 $213.00 $114,370.01 $116,370 $218.00 $118,190.01 $120,190 $218.00 $116,370.01 $118,370 $223.00 $120,190.01 $122,190 $223.00 $118,370.01 $120,370 $228.00 $122,190.01 $124,190 $228.00 $120,370.01 $122,370 $233.00 $124,190.01 $126,190 $233.00 $122,370.01 $124,370 $238.00 $126,190.01 $128,190 $238.00 $124,370.01 $126,370 $243.00 $128,190.01 $130,190 $244.00 $126,370.01 $128,370 $248.00 $130,190.01 $132,190 $250.00 $128,370.01 $130,370 $253.00 $132,190.01 $134,190 $256.00 $130,370.01 $132,370 $259.00 $134,190.01 $136,190 $262.00 $132,370.01 $134,370 $265.00 $136,190.01 $138,190 $268.00 $134,370.01 $136,370 $271.00 $138,190.01 $140,190 $274.00 $136,370.01 $138,370 $277.00 $140,190.01 $142,190 $280.00 $138,370.01 $140,370 $283.00 $142,190.01 $144,190 $286.00 $140,370.01 $142,370 $289.00 $144,190.01 $146,190 $292.00 $142,370.01 $144,370 $295.00 $146,190.01 $148,190 $298.00 $144,370.01 $146,370 $301.00 $148,190.01 $150,190 $304.00 $146,370.01 $148,370 $307.00 $150,190.01 $152,190 $310.00 $148,370.01 $150,370 $313.00 $152,190.01 $154,190 $315.00 $150,370.01 $151,270 $319.00 $154,190.01 $156,190 $325.00 $156,190.01 $158,190 $331.00 $158,190.01 $160,190 $336.00 $160,190.01 $160,247 200% FPIG $128,740 200% FPIG $136,380 CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE 10/01/2011
(BASED ON THE 2011 FEDERAL POVERTY INCOME GUIDELINES)Weekly Family Size: 17 Weekly Family Size: 18 Co-pay Annual Income Co-Pay Annual Income $5.00 Less than: $8,660 $5.00 Less than: $8,660 $10.00 $8,660.01 $42,010 $10.00 $8,660.01 $43,830 $49.00 $42,010.01 $44,010 $52.00 $43,830.01 $45,830 $52.00 $44,010.01 $46,010 $55.00 $45,830.01 $47,830 $56.00 $46,010.01 $48,010 $58.00 $47,830.01 $49,830 $60.00 $48,010.01 $50,010 $62.00 $49,830.01 $51,830 $64.00 $50,010.01 $52,010 $66.00 $51,830.01 $53,830 $68.00 $52,010.01 $54,010 $70.00 $53,830.01 $55,830 $72.00 $54,010.01 $56,010 $74.00 $55,830.01 $57,830 $76.00 $56,010.01 $58,010 $78.00 $57,830.01 $59,830 $80.00 $58,010.01 $60,010 $82.00 $59,830.01 $61,830 $84.00 $60,010.01 $62,010 $86.00 $61,830.01 $63,830 $88.00 $62,010.01 $64,010 $90.00 $63,830.01 $65,830 $92.00 $64,010.01 $66,010 $94.00 $65,830.01 $67,830 $96.00 $66,010.01 $68,010 $98.00 $67,830.01 $69,830 $101.00 $68,010.01 $70,010 $102.00 $69,830.01 $71,830 $106.00 $70,010.01 $72,010 $107.00 $71,830.01 $73,830 $110.00 $72,010.01 $74,010 $112.00 $73,830.01 $75,830 $114.00 $74,010.01 $76,010 $116.00 $75,830.01 $77,830 $118.00 $76,010.01 $78,010 $120.00 $77,830.01 $79,830 $122.00 $78,010.01 $80,010 $124.00 $79,830.01 $81,830 $126.00 $80,010.01 $82,010 $128.00 $81,830.01 $83,830 $130.00 $82,010.01 $84,010 $132.00 $83,830.01 $85,830 $134.00 $84,010.01 $86,010 $136.00 $85,830.01 $87,830 $138.00 $86,010.01 $88,010 $140.00 $87,830.01 $89,830 $142.00 $88,010.01 $90,010 $144.00 $89,830.01 $91,830 $146.00 $90,010.01 $92,010 $148.00 $91,830.01 $93,830 $150.00 $92,010.01 $94,010 $152.00 $93,830.01 $95,830 $154.00 $94,010.01 $96,010 $156.00 $95,830.01 $97,830 $158.00 $96,010.01 $98,010 $160.00 $97,830.01 $99,830 $162.00 $98,010.01 $100,010 $164.00 $99,830.01 $101,830 $167.00 $100,010.01 $102,010 $168.00 $101,830.01 $103,830 $172.00 $102,010.01 $104,010 $172.00 $103,830.01 $105,830 $177.00 $104,010.01 $106,010 $177.00 $105,830.01 $107,830 $182.00 $106,010.01 $108,010 $182.00 $107,830.01 $109,830 $187.00 $108,010.01 $110,010 $187.00 $109,830.01 $111,830 $192.00 $110,010.01 $112,010 $192.00 $111,830.01 $113,830 $197.00 $112,010.01 $114,010 $197.00 $113,830.01 $115,830 $202.00 $114,010.01 $116,010 $202.00 $115,830.01 $117,830 $207.00 $116,010.01 $118,010 $207.00 $117,830.01 $119,830 $212.00 $118,010.01 $120,010 $212.00 $119,830.01 $121,830 $217.00 $120,010.01 $122,010 $217.00 $121,830.01 $123,830 $222.00 $122,010.01 $124,010 $222.00 $123,830.01 $125,830 $227.00 $124,010.01 $126,010 $227.00 $125,830.01 $127,830 $232.00 $126,010.01 $128,010 $232.00 $127,830.01 $129,830 $237.00 $128,010.01 $130,010 $237.00 $129,830.01 $131,830 $242.00 $130,010.01 $132,010 $242.00 $131,830.01 $133,830 $247.00 $132,010.01 $134,010 $247.00 $133,830.01 $135,830 $252.00 $134,010.01 $136,010 $252.00 $135,830.01 $137,830 $257.00 $136,010.01 $138,010 $257.00 $137,830.01 $139,830 $262.00 $138,010.01 $140,010 $262.00 $139,830.01 $141,830 $268.00 $140,010.01 $142,010 $267.00 $141,830.01 $143,830 $274.00 $142,010.01 $144,010 $272.00 $143,830.01 $145,830 $280.00 $144,010.01 $146,010 $277.00 $145,830.01 $147,830 $286.00 $146,010.01 $148,010 $282.00 $147,830.01 $149,830 $292.00 $148,010.01 $150,010 $288.00 $149,830.01 $151,830 $298.00 $150,010.01 $152,010 $294.00 $151,830.01 $153,830 $304.00 $152,010.01 $154,010 $300.00 $153,830.01 $155,830 $310.00 $154,010.01 $156,010 $306.00 $155,830.01 $157,830 $316.00 $156,010.01 $158,010 $312.00 $157,830.01 $159,830 $322.00 $158,010.01 $160,010 $318.00 $159,830.01 $161,830 $328.00 $160,010.01 $162,010 $324.00 $161,830.01 $163,830 $334.00 $162,010.01 $164,010 $330.00 $163,830.01 $165,830 $340.00 $164,010.01 $166,010 $336.00 $165,830.01 $167,830 $346.00 $166,010.01 $168,010 $342.00 $167,830.01 $169,830 $352.00 $168,010.01 $169,224 $348.00 $169,830.01 $171,830 $354.00 $171,830.01 $173,830 $360.00 $173,830.01 $175,830 $366.00 $175,830.01 $177,830 $373.00 $177,830.01 $178,201 200% FPIG $144,020 200% FPIG $151,660 CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE 10/01/2011
(BASED ON THE 2011 FEDERAL POVERTY INCOME GUIDELINES)Weekly Family Size: 19 Weekly Family Size: 20 Co-pay Annual Income Co-Pay Annual Income $5.00 Less than: $8,660 $5.00 Less than: $8,660 $10.00 $8,660.01 $45,650 $10.00 $8,660.01 $47,470 $54.00 $45,650.01 $47,650 $56.00 $47,470.01 $49,470 $57.00 $47,650.01 $49,650 $59.00 $49,470.01 $51,470 $60.00 $49,650.01 $51,650 $62.00 $51,470.01 $53,470 $64.00 $51,650.01 $53,650 $66.00 $53,470.01 $55,470 $68.00 $53,650.01 $55,650 $70.00 $55,470.01 $57,470 $72.00 $55,650.01 $57,650 $74.00 $57,470.01 $59,470 $76.00 $57,650.01 $59,650 $78.00 $59,470.01 $61,470 $80.00 $59,650.01 $61,650 $82.00 $61,470.01 $63,470 $84.00 $61,650.01 $63,650 $86.00 $63,470.01 $65,470 $88.00 $63,650.01 $65,650 $90.00 $65,470.01 $67,470 $92.00 $65,650.01 $67,650 $94.00 $67,470.01 $69,470 $96.00 $67,650.01 $69,650 $98.00 $69,470.01 $71,470 $100.00 $69,650.01 $71,650 $102.00 $71,470.01 $73,470 $104.00 $71,650.01 $73,650 $106.00 $73,470.01 $75,470 $108.00 $73,650.01 $75,650 $110.00 $75,470.01 $77,470 $113.00 $75,650.01 $77,650 $114.00 $77,470.01 $79,470 $118.00 $77,650.01 $79,650 $119.00 $79,470.01 $81,470 $122.00 $79,650.01 $81,650 $124.00 $81,470.01 $83,470 $126.00 $81,650.01 $83,650 $128.00 $83,470.01 $85,470 $130.00 $83,650.01 $85,650 $132.00 $85,470.01 $87,470 $134.00 $85,650.01 $87,650 $136.00 $87,470.01 $89,470 $138.00 $87,650.01 $89,650 $140.00 $89,470.01 $91,470 $142.00 $89,650.01 $91,650 $144.00 $91,470.01 $93,470 $146.00 $91,650.01 $93,650 $148.00 $93,470.01 $95,470 $150.00 $93,650.01 $95,650 $152.00 $95,470.01 $97,470 $154.00 $95,650.01 $97,650 $156.00 $97,470.01 $99,470 $158.00 $97,650.01 $99,650 $160.00 $99,470.01 $101,470 $162.00 $99,650.01 $101,650 $164.00 $101,470.01 $103,470 $166.00 $101,650.01 $103,650 $168.00 $103,470.01 $105,470 $170.00 $103,650.01 $105,650 $172.00 $105,470.01 $107,470 $174.00 $105,650.01 $107,650 $176.00 $107,470.01 $109,470 $178.00 $107,650.01 $109,650 $180.00 $109,470.01 $111,470 $183.00 $109,650.01 $111,650 $184.00 $111,470.01 $113,470 $188.00 $111,650.01 $113,650 $188.00 $113,470.01 $115,470 $193.00 $113,650.01 $115,650 $193.00 $115,470.01 $117,470 $198.00 $115,650.01 $117,650 $198.00 $117,470.01 $119,470 $203.00 $117,650.01 $119,650 $203.00 $119,470.01 $121,470 $208.00 $119,650.01 $121,650 $208.00 $121,470.01 $123,470 $213.00 $121,650.01 $123,650 $213.00 $123,470.01 $125,470 $218.00 $123,650.01 $125,650 $218.00 $125,470.01 $127,470 $223.00 $125,650.01 $127,650 $223.00 $127,470.01 $129,470 $228.00 $127,650.01 $129,650 $228.00 $129,470.01 $131,470 $233.00 $129,650.01 $131,650 $233.00 $131,470.01 $133,470 $238.00 $131,650.01 $133,650 $238.00 $133,470.01 $135,470 $243.00 $133,650.01 $135,650 $243.00 $135,470.01 $137,470 $248.00 $135,650.01 $137,650 $248.00 $137,470.01 $139,470 $253.00 $137,650.01 $139,650 $253.00 $139,470.01 $141,470 $258.00 $139,650.01 $141,650 $258.00 $141,470.01 $143,470 $263.00 $141,650.01 $143,650 $263.00 $143,470.01 $145,470 $268.00 $143,650.01 $145,650 $268.00 $145,470.01 $147,470 $273.00 $145,650.01 $147,650 $273.00 $147,470.01 $149,470 $278.00 $147,650.01 $149,650 $278.00 $149,470.01 $151,470 $283.00 $149,650.01 $151,650 $283.00 $151,470.01 $153,470 $288.00 $151,650.01 $153,650 $288.00 $153,470.01 $155,470 $293.00 $153,650.01 $155,650 $293.00 $155,470.01 $157,470 $299.00 $155,650.01 $157,650 $298.00 $157,470.01 $159,470 $305.00 $157,650.01 $159,650 $303.00 $159,470.01 $161,470 $311.00 $159,650.01 $161,650 $308.00 $161,470.01 $163,470 $317.00 $161,650.01 $163,650 $314.00 $163,470.01 $165,470 $323.00 $163,650.01 $165,650 $320.00 $165,470.01 $167,470 $329.00 $165,650.01 $167,650 $326.00 $167,470.01 $169,470 $335.00 $167,650.01 $169,650 $332.00 $169,470.01 $171,470 $341.00 $169,650.01 $171,650 $338.00 $171,470.01 $173,470 $347.00 $171,650.01 $173,650 $344.00 $173,470.01 $175,470 $353.00 $173,650.01 $175,650 $350.00 $175,470.01 $177,470 $359.00 $175,650.01 $177,650 $356.00 $177,470.01 $179,470 $365.00 $177,650.01 $179,650 $362.00 $179,470.01 $181,470 $371.00 $179,650.01 $181,650 $368.00 $181,470.01 $183,470 $377.00 $181,650.01 $183,650 $374.00 $183,470.01 $185,470 $383.00 $183,650.01 $185,650 $380.00 $185,470.01 $187,470 $389.00 $185,650.01 $187,178 $386.00 $187,470.01 $189,470 $392.00 $189,470.01 $191,470 $398.00 $191,470.01 $193,470 $404.00 $193,470.01 $195,470 $410.00 $195,470.01 $196,155 200% FPIG $159,300 200% FPIG $166,940 CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE 10/01/2011
(BASED ON THE 2011 FEDERAL POVERTY INCOME GUIDELINES)Weekly Family Size: 21 Weekly Family Size: 21 Co-pay Annual Income Co-Pay Annual Income $5.00 Less than: $8,660 $214.00 $125,290.01 $127,290 $10.00 $8,660.01 $49,290 $219.00 $127,290.01 $129,290 $59.00 $49,290.01 $51,290 $224.00 $129,290.01 $131,290 $62.00 $51,290.01 $53,290 $229.00 $131,290.01 $133,290 $65.00 $53,290.01 $55,290 $234.00 $133,290.01 $135,290 $68.00 $55,290.01 $57,290 $239.00 $135,290.01 $137,290 $72.00 $57,290.01 $59,290 $244.00 $137,290.01 $139,290 $76.00 $59,290.01 $61,290 $249.00 $139,290.01 $141,290 $80.00 $61,290.01 $63,290 $254.00 $141,290.01 $143,290 $84.00 $63,290.01 $65,290 $259.00 $143,290.01 $145,290 $88.00 $65,290.01 $67,290 $264.00 $145,290.01 $147,290 $92.00 $67,290.01 $69,290 $269.00 $147,290.01 $149,290 $96.00 $69,290.01 $71,290 $274.00 $149,290.01 $151,290 $100.00 $71,290.01 $73,290 $279.00 $151,290.01 $153,290 $104.00 $73,290.01 $75,290 $284.00 $153,290.01 $155,290 $108.00 $75,290.01 $77,290 $289.00 $155,290.01 $157,290 $112.00 $77,290.01 $79,290 $294.00 $157,290.01 $159,290 $116.00 $79,290.01 $81,290 $299.00 $159,290.01 $161,290 $120.00 $81,290.01 $83,290 $304.00 $161,290.01 $163,290 $125.00 $83,290.01 $85,290 $309.00 $163,290.01 $165,290 $130.00 $85,290.01 $87,290 $314.00 $165,290.01 $167,290 $134.00 $87,290.01 $89,290 $319.00 $167,290.01 $169,290 $138.00 $89,290.01 $91,290 $325.00 $169,290.01 $171,290 $142.00 $91,290.01 $93,290 $331.00 $171,290.01 $173,290 $146.00 $93,290.01 $95,290 $337.00 $173,290.01 $175,290 $150.00 $95,290.01 $97,290 $343.00 $175,290.01 $177,290 $154.00 $97,290.01 $99,290 $349.00 $177,290.01 $179,290 $158.00 $99,290.01 $101,290 $355.00 $179,290.01 $181,290 $162.00 $101,290.01 $103,290 $361.00 $181,290.01 $183,290 $166.00 $103,290.01 $105,290 $367.00 $183,290.01 $185,290 $170.00 $105,290.01 $107,290 $373.00 $185,290.01 $187,290 $174.00 $107,290.01 $109,290 $379.00 $187,290.01 $189,290 $178.00 $109,290.01 $111,290 $385.00 $189,290.01 $191,290 $182.00 $111,290.01 $113,290 $391.00 $191,290.01 $193,290 $186.00 $113,290.01 $115,290 $397.00 $193,290.01 $195,290 $190.00 $115,290.01 $117,290 $403.00 $195,290.01 $197,290 $194.00 $117,290.01 $119,290 $409.00 $197,290.01 $199,290 $199.00 $119,290.01 $121,290 $415.00 $199,290.01 $201,290 $204.00 $121,290.01 $123,290 $421.00 $201,290.01 $203,290 $209.00 $123,290.01 $125,290 $426.00 $203,290.01 $205,132 200% FPIG $174,580 [Pa.B. Doc. No. 11-1702. Filed for public inspection September 30, 2011, 9:00 a.m.]
