943 Income limits and co-payments for the Subsidized Child Care Program

DEPARTMENT OF PUBLIC WELFARE

Income Limits and Co-payments for the Subsidized Child Care Program

[44 Pa.B. 2715]
[Saturday, May 3, 2014]

 This notice increases the income limits codified at 55 Pa. Code Chapter 3041, Appendix B (relating to co-payment chart family co-payment scale effective May 5, 2014 (based on the 2014 Federal Poverty Income Guidelines)) under 55 Pa. Code § 3041.107(b) (relating to availability and use of the Federal Poverty Income Guidelines). This increase is effective May 5, 2014.

 Section 3041.107(b) of 55 Pa. Code requires the Department of Public Welfare to update the co-payment schedule in 55 Pa. Code Chapter 3041, Appendix B to reflect changes in the Federal Poverty Income Guidelines (FPIG). Effective May 5, 2014, the income guidelines for the subsidized child care program are increased due to increases in the FPIG. Under section 408.3 of the Public Welfare Code (62 P. S. § 408.3), the co-payment schedule is adjusted to reflect the increases. Chapter 3041, Appendix B of 55 Pa. Code also 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.

BEVERLY D. MACKERETH, 
Secretary

 Fiscal Note: 14-NOT-863. No fiscal impact; (8) recommends adoption.

CO-PAYMENT CHART

FAMILY CO-PAYMENT SCALE EFFECTIVE MAY 5, 2014
(BASED ON THE 2014 FEDERAL POVERTY INCOME GUIDELINES)

Weekly	Family Size:	1	Weekly	Family Size:	2	Weekly	Family Size:	3
Co-pay	Annual Income		Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$9,670	$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$9,670.01	$11,670	$10.00	$8,660.01	$13,000	$10.00	$8,660.01	$13,900
$15.00	$11,670.01	$13,670	$16.00	$13,000.01	$13,730	$17.00	$13,900.01	$15,570
$20.00	$13,670.01	$15,670	$21.00	$13,730.01	$15,730	$22.00	$15,570.01	$17,570
$25.00	$15,670.01	$17,670	$25.00	$15,730.01	$17,730	$27.00	$17,570.01	$19,790
$30.00	$17,670.01	$19,670	$29.00	$17,730.01	$19,730	$31.00	$19,790.01	$21,790
$35.00	$19,670.01	$21,670	$33.00	$19,730.01	$21,730	$35.00	$21,790.01	$23,790
$40.00	$21,670.01	$23,670	$38.00	$21,730.01	$23,730	$39.00	$23,790.01	$25,790
$45.00	$23,670.01	$25,670	$43.00	$23,730.01	$25,730	$43.00	$25,790.01	$27,790
$50.00	$25,670.01	$27,425	$48.00	$25,730.01	$27,730	$48.00	$27,790.01	$29,790
			$53.00	$27,730.01	$29,730	$53.00	$29,790.01	$31,790
			$58.00	$29,730.01	$31,730	$58.00	$31,790.01	$33,790
			$64.00	$31,730.01	$33,730	$63.00	$33,790.01	$35,790
			$70.00	$33,730.01	$35,730	$68.00	$35,790.01	$37,790
			$75.00	$35,730.01	$36,966	$73.00	$37,790.01	$39,790
						$79.00	$39,790.01	$41,790
						$85.00	$41,790.01	$43,790
						$91.00	$43,790.01	$45,790
						$96.00	$45,790.01	$46,507
	200% FPIG	$23,340		200% FPIG	$31,460		200% FPIG	$39,580

Weekly	Family Size:	4	Weekly	Family Size:	5	Weekly	Family Size:	6
Co-pay	Annual Income		Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$15,850	$10.00	$8,660.01	$15,850	$10.00	$8,660.01	$17,000
$19.00	$15,850.01	$17,850	$19.00	$15,850.01	$17,910	$20.00	$17,000.01	$19,970
$24.00	$17,850.01	$19,850	$23.00	$17,910.01	$19,910	$24.00	$19,970.01	$21,970
$28.00	$19,850.01	$21,850	$27.00	$19,910.01	$21,910	$28.00	$21,970.01	$23,970
$33.00	$21,850.01	$23,850	$31.00	$21,910.01	$23,910	$32.00	$23,970.01	$25,970
$37.00	$23,850.01	$25,850	$35.00	$23,910.01	$25,910	$36.00	$25,970.01	$27,970
$41.00	$25,850.01	$27,850	$39.00	$25,910.01	$27,910	$41.00	$27,970.01	$29,970
$45.00	$27,850.01	$29,850	$43.00	$27,910.01	$29,910	$46.00	$29,970.01	$31,970
$49.00	$29,850.01	$31,850	$47.00	$29,910.01	$31,910	$50.00	$31,970.01	$33,970
$53.00	$31,850.01	$33,850	$51.00	$31,910.01	$33,910	$54.00	$33,970.01	$35,970
$58.00	$33,850.01	$35,850	$55.00	$33,910.01	$35,910	$58.00	$35,970.01	$37,970
$63.00	$35,850.01	$37,850	$59.00	$35,910.01	$37,910	$62.00	$37,970.01	$39,970
$68.00	$37,850.01	$39,850	$63.00	$37,910.01	$39,910	$66.00	$39,970.01	$41,970
$73.00	$39,850.01	$41,850	$68.00	$39,910.01	$41,910	$70.00	$41,970.01	$43,970
$78.00	$41,850.01	$43,850	$73.00	$41,910.01	$43,910	$75.00	$43,970.01	$45,970
$83.00	$43,850.01	$45,850	$78.00	$43,910.01	$45,910	$80.00	$45,970.01	$47,970
$89.00	$45,850.01	$47,850	$83.00	$45,910.01	$47,910	$85.00	$47,970.01	$49,970
$95.00	$47,850.01	$49,850	$88.00	$47,910.01	$49,910	$90.00	$49,970.01	$51,970
$101.00	$49,850.01	$51,850	$93.00	$49,910.01	$51,910	$95.00	$51,970.01	$53,970
$107.00	$51,850.01	$53,850	$98.00	$51,910.01	$53,910	$100.00	$53,970.01	$55,970
$112.00	$53,850.01	$55,850	$103.00	$53,910.01	$55,910	$105.00	$55,970.01	$57,970
$117.00	$55,850.01	$56,048	$109.00	$55,910.01	$57,910	$110.00	$57,970.01	$59,970
			$115.00	$57,910.01	$59,910	$115.00	$59,970.01	$61,970
			$121.00	$59,910.01	$61,910	$121.00	$61,970.01	$63,970
			$127.00	$61,910.01	$63,910	$127.00	$63,970.01	$65,970
			$134.00	$63,910.01	$65,589	$133.00	$65,970.01	$67,970
						$139.00	$67,970.01	$69,970
						$145.00	$69,970.01	$71,970
						$150.00	$71,970.01	$73,970
						$155.00	$73,970.01	$75,130
	200% FPIG	$47,700		200% FPIG	$55,820		200% FPIG	$63,940

Weekly	Family Size:	7	Weekly	Family Size:	8	Weekly	Family Size:	9
Co-pay	Annual Income		Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$17,600	$10.00	$8,660.01	$18,800	$10.00	$8,660.01	$19,700
$21.00	$17,600.01	$20,000	$22.00	$18,800.01	$22,000	$23.00	$19,700.01	$23,700
$24.00	$20,000.01	$22,200	$26.00	$22,000.01	$24,090	$28.00	$23,700.01	$26,000
$27.00	$22,200.01	$24,030	$29.00	$24,090.01	$26,090	$31.00	$26,000.01	$28,000
$30.00	$24,030.01	$26,030	$33.00	$26,090.01	$28,090	$35.00	$28,000.01	$30,000
$34.00	$26,030.01	$28,030	$37.00	$28,090.01	$30,090	$39.00	$30,000.01	$32,000
$38.00	$28,030.01	$30,030	$41.00	$30,090.01	$32,090	$43.00	$32,000.01	$34,000
$42.00	$30,030.01	$32,030	$45.00	$32,090.01	$34,090	$47.00	$34,000.01	$36,000
$47.00	$32,030.01	$34,030	$49.00	$34,090.01	$36,090	$51.00	$36,000.01	$38,000
$52.00	$34,030.01	$36,030	$53.00	$36,090.01	$38,090	$55.00	$38,000.01	$40,000
$56.00	$36,030.01	$38,030	$58.00	$38,090.01	$40,090	$59.00	$40,000.01	$42,000
$60.00	$38,030.01	$40,030	$62.00	$40,090.01	$42,090	$64.00	$42,000.01	$44,150
$64.00	$40,030.01	$42,030	$66.00	$42,090.01	$44,090	$68.00	$44,150.01	$46,150
$68.00	$42,030.01	$44,030	$70.00	$44,090.01	$46,090	$72.00	$46,150.01	$48,150
$72.00	$44,030.01	$46,030	$74.00	$46,090.01	$48,090	$76.00	$48,150.01	$50,150
$76.00	$46,030.01	$48,030	$78.00	$48,090.01	$50,090	$80.00	$50,150.01	$52,150
$80.00	$48,030.01	$50,030	$82.00	$50,090.01	$52,090	$84.00	$52,150.01	$54,150
$85.00	$50,030.01	$52,030	$86.00	$52,090.01	$54,090	$88.00	$54,150.01	$56,150
$90.00	$52,030.01	$54,030	$90.00	$54,090.01	$56,090	$92.00	$56,150.01	$58,150
$95.00	$54,030.01	$56,030	$95.00	$56,090.01	$58,090	$96.00	$58,150.01	$60,150
$100.00	$56,030.01	$58,030	$100.00	$58,090.01	$60,090	$101.00	$60,150.01	$62,150
$105.00	$58,030.01	$60,030	$105.00	$60,090.01	$62,090	$106.00	$62,150.01	$64,150
$110.00	$60,030.01	$62,030	$110.00	$62,090.01	$64,090	$111.00	$64,150.01	$66,150
$115.00	$62,030.01	$64,030	$115.00	$64,090.01	$66,090	$116.00	$66,150.01	$68,150
$120.00	$64,030.01	$66,030	$120.00	$66,090.01	$68,090	$121.00	$68,150.01	$70,150
$125.00	$66,030.01	$68,030	$125.00	$68,090.01	$70,090	$126.00	$70,150.01	$72,150
$130.00	$68,030.01	$70,030	$130.00	$70,090.01	$72,090	$131.00	$72,150.01	$74,150
$136.00	$70,030.01	$72,030	$135.00	$72,090.01	$74,090	$136.00	$74,150.01	$76,150
$142.00	$72,030.01	$74,030	$140.00	$74,090.01	$76,090	$141.00	$76,150.01	$78,150
$148.00	$74,030.01	$76,030	$145.00	$76,090.01	$78,090	$146.00	$78,150.01	$80,150
$154.00	$76,030.01	$78,030	$151.00	$78,090.01	$80,090	$151.00	$80,150.01	$82,150
$160.00	$78,030.01	$80,030	$157.00	$80,090.01	$82,090	$156.00	$82,150.01	$84,150
$166.00	$80,030.01	$82,030	$163.00	$82,090.01	$84,090	$161.00	$84,150.01	$86,150
$172.00	$82,030.01	$84,671	$169.00	$84,090.01	$86,090	$167.00	$86,150.01	$88,150
			$175.00	$86,090.01	$88,090	$173.00	$88,150.01	$90,150
			$181.00	$88,090.01	$90,090	$179.00	$90,150.01	$92,150
			$187.00	$90,090.01	$92,090	$185.00	$92,150.01	$94,150
			$192.00	$92,090.01	$94,090	$191.00	$94,150.01	$96,150
			$197.00	$94,090.01	$94,212	$197.00	$96,150.01	$98,150
						$203.00	$98,150.01	$100,150
						$209.00	$100,150.01	$102,150
						$214.00	$102,150.01	$103,753
	200% FPIG	$72,060		200% FPIG	$80,180		200% FPIG	$88,300

Weekly	Family Size:	10	Weekly	Family Size:	11	Weekly	Family Size:	12
Co-pay	Annual Income		Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$20,500	$10.00	$8,660.01	$21,500	$10.00	$8,660.01	$22,500
$24.00	$20,500.01	$25,000	$25.00	$21,500.01	$28,270	$26.00	$22,500.01	$28,000
$30.00	$25,000.01	$28,000	$33.00	$28,270.01	$30,270	$33.00	$28,000.01	$34,330
$34.00	$28,000.01	$30,000	$36.00	$30,270.01	$32,270	$41.00	$34,330.01	$36,330
$37.00	$30,000.01	$32,000	$39.00	$32,270.01	$34,270	$45.00	$36,330.01	$38,330
$41.00	$32,000.01	$34,000	$43.00	$34,270.01	$36,270	$49.00	$38,330.01	$40,330
$45.00	$34,000.01	$36,000	$47.00	$36,270.01	$38,270	$53.00	$40,330.01	$42,330
$49.00	$36,000.01	$38,000	$51.00	$38,270.01	$40,270	$57.00	$42,330.01	$44,330
$53.00	$38,000.01	$40,000	$55.00	$40,270.01	$42,270	$61.00	$44,330.01	$46,330
$57.00	$40,000.01	$42,000	$59.00	$42,270.01	$44,270	$65.00	$46,330.01	$48,330
$61.00	$42,000.01	$44,000	$63.00	$44,270.01	$46,270	$69.00	$48,330.01	$50,330
$65.00	$44,000.01	$46,000	$67.00	$46,270.01	$48,270	$73.00	$50,330.01	$52,330
$70.00	$46,000.01	$48,210	$71.00	$48,270.01	$50,270	$78.00	$52,330.01	$54,330
$74.00	$48,210.01	$50,210	$76.00	$50,270.01	$52,270	$83.00	$54,330.01	$56,330
$78.00	$50,210.01	$52,210	$80.00	$52,270.01	$54,270	$87.00	$56,330.01	$58,330
$82.00	$52,210.01	$54,210	$84.00	$54,270.01	$56,270	$91.00	$58,330.01	$60,330
$86.00	$54,210.01	$56,210	$88.00	$56,270.01	$58,270	$95.00	$60,330.01	$62,330
$90.00	$56,210.01	$58,210	$92.00	$58,270.01	$60,270	$99.00	$62,330.01	$64,330
$94.00	$58,210.01	$60,210	$96.00	$60,270.01	$62,270	$103.00	$64,330.01	$66,330
$98.00	$60,210.01	$62,210	$100.00	$62,270.01	$64,270	$107.00	$66,330.01	$68,330
$102.00	$62,210.01	$64,210	$104.00	$64,270.01	$66,270	$111.00	$68,330.01	$70,330
$106.00	$64,210.01	$66,210	$108.00	$66,270.01	$68,270	$115.00	$70,330.01	$72,330
$111.00	$66,210.01	$68,210	$112.00	$68,270.01	$70,270	$119.00	$72,330.01	$74,330
$116.00	$68,210.01	$70,210	$116.00	$70,270.01	$72,270	$123.00	$74,330.01	$76,330
$121.00	$70,210.01	$72,210	$121.00	$72,270.01	$74,270	$128.00	$76,330.01	$78,330
$126.00	$72,210.01	$74,210	$126.00	$74,270.01	$76,270	$133.00	$78,330.01	$80,330
$131.00	$74,210.01	$76,210	$131.00	$76,270.01	$78,270	$138.00	$80,330.01	$82,330
$136.00	$76,210.01	$78,210	$136.00	$78,270.01	$80,270	$143.00	$82,330.01	$84,330
$141.00	$78,210.01	$80,210	$141.00	$80,270.01	$82,270	$148.00	$84,330.01	$86,330
$146.00	$80,210.01	$82,210	$146.00	$82,270.01	$84,270	$153.00	$86,330.01	$88,330
$151.00	$82,210.01	$84,210	$151.00	$84,270.01	$86,270	$158.00	$88,330.01	$90,330
$156.00	$84,210.01	$86,210	$156.00	$86,270.01	$88,270	$163.00	$90,330.01	$92,330
$161.00	$86,210.01	$88,210	$161.00	$88,270.01	$90,270	$168.00	$92,330.01	$94,330
$166.00	$88,210.01	$90,210	$166.00	$90,270.01	$92,270	$173.00	$94,330.01	$96,330
$171.00	$90,210.01	$92,210	$171.00	$92,270.01	$94,270	$178.00	$96,330.01	$98,330
$177.00	$92,210.01	$94,210	$176.00	$94,270.01	$96,270	$183.00	$98,330.01	$100,330
$183.00	$94,210.01	$96,210	$181.00	$96,270.01	$98,270	$188.00	$100,330.01	$102,330
$189.00	$96,210.01	$98,210	$186.00	$98,270.01	$100,270	$193.00	$102,330.01	$104,330
$195.00	$98,210.01	$100,210	$192.00	$100,270.01	$102,270	$198.00	$104,330.01	$106,330
$201.00	$100,210.01	$102,210	$198.00	$102,270.01	$104,270	$203.00	$106,330.01	$108,330
$207.00	$102,210.01	$104,210	$204.00	$104,270.01	$106,270	$209.00	$108,330.01	$110,330
$213.00	$104,210.01	$106,210	$210.00	$106,270.01	$108,270	$215.00	$110,330.01	$112,330
$219.00	$106,210.01	$108,210	$216.00	$108,270.01	$110,270	$221.00	$112,330.01	$114,330
$225.00	$108,210.01	$110,210	$222.00	$110,270.01	$112,270	$227.00	$114,330.01	$116,330
$231.00	$110,210.01	$113,294	$228.00	$112,270.01	$114,270	$233.00	$116,330.01	$118,330
			$234.00	$114,270.01	$116,270	$239.00	$118,330.01	$120,330
			$240.00	$116,270.01	$118,270	$245.00	$120,330.01	$122,330
			$246.00	$118,270.01	$120,270	$251.00	$122,330.01	$124,330
			$251.00	$120,270.01	$122,270	$257.00	$124,330.01	$126,330
			$256.00	$122,270.01	$122,835	$263.00	$126,330.01	$128,330
						$268.00	$128,330.01	$130,330
						$273.00	$130,330.01	$132,330
						$278.00	$132,330.01	$132,376
	200% FPIG	$96,420		200% FPIG	$104,540		200% FPIG	$112,660

Weekly	Family Size:	13	Weekly	Family Size:	14	Weekly	Family Size:	15
Co-pay	Annual Income		Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$24,150	$10.00	$8,660.01	$24,250	$10.00	$8,660.01	$28,510
$28.00	$24,150.01	$29,500	$28.00	$24,250.01	$30,300	$33.00	$28,510.01	$36,510
$35.00	$29,500.01	$34,390	$35.00	$30,300.01	$36,450	$43.00	$36,510.01	$38,510
$41.00	$34,390.01	$36,390	$43.00	$36,450.01	$38,450	$46.00	$38,510.01	$40,510
$44.00	$36,390.01	$38,390	$46.00	$38,450.01	$40,450	$49.00	$40,510.01	$42,510
$47.00	$38,390.01	$40,390	$49.00	$40,450.01	$42,450	$52.00	$42,510.01	$44,510
$51.00	$40,390.01	$42,390	$53.00	$42,450.01	$44,450	$56.00	$44,510.01	$46,510
$55.00	$42,390.01	$44,390	$57.00	$44,450.01	$46,450	$60.00	$46,510.01	$48,510
$59.00	$44,390.01	$46,390	$61.00	$46,450.01	$48,450	$64.00	$48,510.01	$50,510
$63.00	$46,390.01	$48,390	$65.00	$48,450.01	$50,450	$68.00	$50,510.01	$52,510
$67.00	$48,390.01	$50,390	$69.00	$50,450.01	$52,450	$72.00	$52,510.01	$54,510
$71.00	$50,390.01	$52,390	$73.00	$52,450.01	$54,450	$76.00	$54,510.01	$56,510
$75.00	$52,390.01	$54,390	$77.00	$54,450.01	$56,450	$80.00	$56,510.01	$58,510
$79.00	$54,390.01	$56,390	$81.00	$56,450.01	$58,450	$84.00	$58,510.01	$60,510
$84.00	$56,390.01	$58,390	$85.00	$58,450.01	$60,450	$88.00	$60,510.01	$62,510
$89.00	$58,390.01	$60,390	$90.00	$60,450.01	$62,450	$92.00	$62,510.01	$64,510
$93.00	$60,390.01	$62,390	$95.00	$62,450.01	$64,450	$96.00	$64,510.01	$66,510
$97.00	$62,390.01	$64,390	$99.00	$64,450.01	$66,450	$101.00	$66,510.01	$68,510
$101.00	$64,390.01	$66,390	$103.00	$66,450.01	$68,450	$105.00	$68,510.01	$70,510
$105.00	$66,390.01	$68,390	$107.00	$68,450.01	$70,450	$109.00	$70,510.01	$72,510
$109.00	$68,390.01	$70,390	$111.00	$70,450.01	$72,450	$113.00	$72,510.01	$74,510
$113.00	$70,390.01	$72,390	$115.00	$72,450.01	$74,450	$117.00	$74,510.01	$76,510
$117.00	$72,390.01	$74,390	$119.00	$74,450.01	$76,450	$121.00	$76,510.01	$78,510
$121.00	$74,390.01	$76,390	$123.00	$76,450.01	$78,450	$125.00	$78,510.01	$80,510
$125.00	$76,390.01	$78,390	$127.00	$78,450.01	$80,450	$129.00	$80,510.01	$82,510
$129.00	$78,390.01	$80,390	$131.00	$80,450.01	$82,450	$133.00	$82,510.01	$84,510
$133.00	$80,390.01	$82,390	$135.00	$82,450.01	$84,450	$137.00	$84,510.01	$86,510
$138.00	$82,390.01	$84,390	$139.00	$84,450.01	$86,450	$141.00	$86,510.01	$88,510
$143.00	$84,390.01	$86,390	$144.00	$86,450.01	$88,450	$145.00	$88,510.01	$90,510
$148.00	$86,390.01	$88,390	$149.00	$88,450.01	$90,450	$149.00	$90,510.01	$92,510
$153.00	$88,390.01	$90,390	$154.00	$90,450.01	$92,450	$154.00	$92,510.01	$94,510
$158.00	$90,390.01	$92,390	$159.00	$92,450.01	$94,450	$159.00	$94,510.01	$96,510
$163.00	$92,390.01	$94,390	$164.00	$94,450.01	$96,450	$164.00	$96,510.01	$98,510
$168.00	$94,390.01	$96,390	$169.00	$96,450.01	$98,450	$169.00	$98,510.01	$100,510
$173.00	$96,390.01	$98,390	$174.00	$98,450.01	$100,450	$174.00	$100,510.01	$102,510
$178.00	$98,390.01	$100,390	$179.00	$100,450.01	$102,450	$179.00	$102,510.01	$104,510
$183.00	$100,390.01	$102,390	$184.00	$102,450.01	$104,450	$184.00	$104,510.01	$106,510
$188.00	$102,390.01	$104,390	$189.00	$104,450.01	$106,450	$189.00	$106,510.01	$108,510
$193.00	$104,390.01	$106,390	$194.00	$106,450.01	$108,450	$194.00	$108,510.01	$110,510
$198.00	$106,390.01	$108,390	$199.00	$108,450.01	$110,450	$199.00	$110,510.01	$112,510
$203.00	$108,390.01	$110,390	$204.00	$110,450.01	$112,450	$204.00	$112,510.01	$114,510
$208.00	$110,390.01	$112,390	$209.00	$112,450.01	$114,450	$209.00	$114,510.01	$116,510
$213.00	$112,390.01	$114,390	$214.00	$114,450.01	$116,450	$214.00	$116,510.01	$118,510
$218.00	$114,390.01	$116,390	$219.00	$116,450.01	$118,450	$219.00	$118,510.01	$120,510
$224.00	$116,390.01	$118,390	$224.00	$118,450.01	$120,450	$224.00	$120,510.01	$122,510
$230.00	$118,390.01	$120,390	$229.00	$120,450.01	$122,450	$229.00	$122,510.01	$124,510
$236.00	$120,390.01	$122,390	$235.00	$122,450.01	$124,450	$234.00	$124,510.01	$126,510
$242.00	$122,390.01	$124,390	$241.00	$124,450.01	$126,450	$239.00	$126,510.01	$128,510
$248.00	$124,390.01	$126,390	$247.00	$126,450.01	$128,450	$244.00	$128,510.01	$130,510
$254.00	$126,390.01	$128,390	$253.00	$128,450.01	$130,450	$250.00	$130,510.01	$132,510
$260.00	$128,390.01	$130,390	$259.00	$130,450.01	$132,450	$256.00	$132,510.01	$134,510
$266.00	$130,390.01	$132,390	$265.00	$132,450.01	$134,450	$262.00	$134,510.01	$136,510
$272.00	$132,390.01	$134,390	$271.00	$134,450.01	$136,450	$268.00	$136,510.01	$138,510
$278.00	$134,390.01	$136,390	$277.00	$136,450.01	$138,450	$274.00	$138,510.01	$140,510
$284.00	$136,390.01	$138,390	$283.00	$138,450.01	$140,450	$280.00	$140,510.01	$142,510
$289.00	$138,390.01	$140,390	$289.00	$140,450.01	$142,450	$286.00	$142,510.01	$144,510
$294.00	$140,390.01	$141,917	$295.00	$142,450.01	$144,450	$292.00	$144,510.01	$146,510
			$301.00	$144,450.01	$146,450	$298.00	$146,510.01	$148,510
			$306.00	$146,450.01	$148,450	$304.00	$148,510.01	$150,510
			$311.00	$148,450.01	$151,458	$310.00	$150,510.01	$152,510
						$316.00	$152,510.01	$154,510
						$322.00	$154,510.01	$156,510
						$328.00	$156,510.01	$158,510
						$333.00	$158,510.01	$160,510
						$338.00	$160,510.01	$160,999
	200% FPIG	$120,780		200% FPIG	$128,900		200% FPIG	$137,020

Weekly	Family Size:	16	Weekly	Family Size:	17	Weekly	Family Size:	18
Co-pay	Annual Income		Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$27,700	$10.00	$8,660.01	$28,600	$10.00	$8,660.01	$30,000
$32.00	$27,700.01	$36,300	$33.00	$28,600.01	$36,800	$35.00	$30,000.01	$38,500
$42.00	$36,300.01	$42,570	$43.00	$36,800.01	$44,630	$45.00	$38,500.01	$46,690
$50.00	$42,570.01	$44,570	$53.00	$44,630.01	$46,630	$55.00	$46,690.01	$48,690
$53.00	$44,570.01	$46,570	$56.00	$46,630.01	$48,630	$58.00	$48,690.01	$50,690
$57.00	$46,570.01	$48,570	$59.00	$48,630.01	$50,630	$61.00	$50,690.01	$52,690
$61.00	$48,570.01	$50,570	$63.00	$50,630.01	$52,630	$65.00	$52,690.01	$54,690
$65.00	$50,570.01	$52,570	$67.00	$52,630.01	$54,630	$69.00	$54,690.01	$56,690
$69.00	$52,570.01	$54,570	$71.00	$54,630.01	$56,630	$73.00	$56,690.01	$58,690
$73.00	$54,570.01	$56,570	$75.00	$56,630.01	$58,630	$77.00	$58,690.01	$60,690
$77.00	$56,570.01	$58,570	$79.00	$58,630.01	$60,630	$81.00	$60,690.01	$62,690
$81.00	$58,570.01	$60,570	$83.00	$60,630.01	$62,630	$85.00	$62,690.01	$64,690
$85.00	$60,570.01	$62,570	$87.00	$62,630.01	$64,630	$89.00	$64,690.01	$66,690
$89.00	$62,570.01	$64,570	$91.00	$64,630.01	$66,630	$93.00	$66,690.01	$68,690
$93.00	$64,570.01	$66,570	$95.00	$66,630.01	$68,630	$97.00	$68,690.01	$70,690
$97.00	$66,570.01	$68,570	$99.00	$68,630.01	$70,630	$101.00	$70,690.01	$72,690
$102.00	$68,570.01	$70,570	$103.00	$70,630.01	$72,630	$105.00	$72,690.01	$74,690
$107.00	$70,570.01	$72,570	$108.00	$72,630.01	$74,630	$110.00	$74,690.01	$76,690
$111.00	$72,570.01	$74,570	$113.00	$74,630.01	$76,630	$115.00	$76,690.01	$78,690
$115.00	$74,570.01	$76,570	$117.00	$76,630.01	$78,630	$120.00	$78,690.01	$80,690
$119.00	$76,570.01	$78,570	$121.00	$78,630.01	$80,630	$124.00	$80,690.01	$82,690
$123.00	$78,570.01	$80,570	$125.00	$80,630.01	$82,630	$128.00	$82,690.01	$84,690
$127.00	$80,570.01	$82,570	$129.00	$82,630.01	$84,630	$132.00	$84,690.01	$86,690
$131.00	$82,570.01	$84,570	$133.00	$84,630.01	$86,630	$136.00	$86,690.01	$88,690
$135.00	$84,570.01	$86,570	$137.00	$86,630.01	$88,630	$140.00	$88,690.01	$90,690
$139.00	$86,570.01	$88,570	$141.00	$88,630.01	$90,630	$144.00	$90,690.01	$92,690
$143.00	$88,570.01	$90,570	$145.00	$90,630.01	$92,630	$148.00	$92,690.01	$94,690
$147.00	$90,570.01	$92,570	$149.00	$92,630.01	$94,630	$152.00	$94,690.01	$96,690
$151.00	$92,570.01	$94,570	$153.00	$94,630.01	$96,630	$156.00	$96,690.01	$98,690
$155.00	$94,570.01	$96,570	$157.00	$96,630.01	$98,630	$160.00	$98,690.01	$100,690
$159.00	$96,570.01	$98,570	$161.00	$98,630.01	$100,630	$164.00	$100,690.01	$102,690
$164.00	$98,570.01	$100,570	$165.00	$100,630.01	$102,630	$168.00	$102,690.01	$104,690
$169.00	$100,570.01	$102,570	$169.00	$102,630.01	$104,630	$172.00	$104,690.01	$106,690
$174.00	$102,570.01	$104,570	$174.00	$104,630.01	$106,630	$176.00	$106,690.01	$108,690
$179.00	$104,570.01	$106,570	$179.00	$106,630.01	$108,630	$180.00	$108,690.01	$110,690
$184.00	$106,570.01	$108,570	$184.00	$108,630.01	$110,630	$185.00	$110,690.01	$112,690
$189.00	$108,570.01	$110,570	$189.00	$110,630.01	$112,630	$190.00	$112,690.01	$114,690
$194.00	$110,570.01	$112,570	$194.00	$112,630.01	$114,630	$195.00	$114,690.01	$116,690
$199.00	$112,570.01	$114,570	$199.00	$114,630.01	$116,630	$200.00	$116,690.01	$118,690
$204.00	$114,570.01	$116,570	$204.00	$116,630.01	$118,630	$205.00	$118,690.01	$120,690
$209.00	$116,570.01	$118,570	$209.00	$118,630.01	$120,630	$210.00	$120,690.01	$122,690
$214.00	$118,570.01	$120,570	$214.00	$120,630.01	$122,630	$215.00	$122,690.01	$124,690
$219.00	$120,570.01	$122,570	$219.00	$122,630.01	$124,630	$220.00	$124,690.01	$126,690
$224.00	$122,570.01	$124,570	$224.00	$124,630.01	$126,630	$225.00	$126,690.01	$128,690
$229.00	$124,570.01	$126,570	$229.00	$126,630.01	$128,630	$230.00	$128,690.01	$130,690
$234.00	$126,570.01	$128,570	$234.00	$128,630.01	$130,630	$235.00	$130,690.01	$132,690
$239.00	$128,570.01	$130,570	$239.00	$130,630.01	$132,630	$240.00	$132,690.01	$134,690
$244.00	$130,570.01	$132,570	$244.00	$132,630.01	$134,630	$245.00	$134,690.01	$136,690
$249.00	$132,570.01	$134,570	$249.00	$134,630.01	$136,630	$250.00	$136,690.01	$138,690
$254.00	$134,570.01	$136,570	$254.00	$136,630.01	$138,630	$255.00	$138,690.01	$140,690
$259.00	$136,570.01	$138,570	$259.00	$138,630.01	$140,630	$260.00	$140,690.01	$142,690
$264.00	$138,570.01	$140,570	$264.00	$140,630.01	$142,630	$265.00	$142,690.01	$144,690
$270.00	$140,570.01	$142,570	$269.00	$142,630.01	$144,630	$270.00	$144,690.01	$146,690
$276.00	$142,570.01	$144,570	$274.00	$144,630.01	$146,630	$275.00	$146,690.01	$148,690
$282.00	$144,570.01	$146,570	$280.00	$146,630.01	$148,630	$280.00	$148,690.01	$150,690
$288.00	$146,570.01	$148,570	$286.00	$148,630.01	$150,630	$285.00	$150,690.01	$152,690
$294.00	$148,570.01	$150,570	$292.00	$150,630.01	$152,630	$290.00	$152,690.01	$154,690
$300.00	$150,570.01	$152,570	$298.00	$152,630.01	$154,630	$296.00	$154,690.01	$156,690
$306.00	$152,570.01	$154,570	$304.00	$154,630.01	$156,630	$302.00	$156,690.01	$158,690
$312.00	$154,570.01	$156,570	$310.00	$156,630.01	$158,630	$308.00	$158,690.01	$160,690
$318.00	$156,570.01	$158,570	$316.00	$158,630.01	$160,630	$314.00	$160,690.01	$162,690
$324.00	$158,570.01	$160,570	$322.00	$160,630.01	$162,630	$320.00	$162,690.01	$164,690
$330.00	$160,570.01	$162,570	$328.00	$162,630.01	$164,630	$326.00	$164,690.01	$166,690
$336.00	$162,570.01	$164,570	$334.00	$164,630.01	$166,630	$332.00	$166,690.01	$168,690
$342.00	$164,570.01	$166,570	$340.00	$166,630.01	$168,630	$338.00	$168,690.01	$170,690
$348.00	$166,570.01	$168,570	$346.00	$168,630.01	$170,630	$344.00	$170,690.01	$172,690
$353.00	$168,570.01	$170,540	$352.00	$170,630.01	$172,630	$350.00	$172,690.01	$174,690
			$358.00	$172,630.01	$174,630	$356.00	$174,690.01	$176,690
			$364.00	$174,630.01	$176,630	$362.00	$176,690.01	$178,690
			$370.00	$176,630.01	$180,081	$368.00	$178,690.01	$180,690
						$374.00	$180,690.01	$182,690
						$380.00	$182,690.01	$184,690
						$386.00	$184,690.01	$186,690
						$391.00	$186,690.01	$188,690
						$396.00	$188,690.01	$189,622
	200% FPIG	$145,140		200% FPIG	$153,260		200% FPIG	$161,380

Weekly	Family Size:	19	Weekly	Family Size:	20	Weekly	Family Size:	21
Co-pay	Annual Income		Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$30,300	$10.00	$8,660.01	$32,000	$10.00	$8,660.01	$33,770
$35.00	$30,300.01	$40,300	$37.00	$32,000.01	$41,330	$39.00	$33,770.01	$44,400
$47.00	$40,300.01	$48,750	$48.00	$41,330.01	$50,810	$52.00	$44,400.01	$52,870
$57.00	$48,750.01	$50,750	$60.00	$50,810.01	$52,810	$63.00	$52,870.01	$54,870
$60.00	$50,750.01	$52,750	$63.00	$52,810.01	$54,810	$66.00	$54,870.01	$56,870
$63.00	$52,750.01	$54,750	$66.00	$54,810.01	$56,810	$69.00	$56,870.01	$58,870
$67.00	$54,750.01	$56,750	$69.00	$56,810.01	$58,810	$72.00	$58,870.01	$60,870
$71.00	$56,750.01	$58,750	$73.00	$58,810.01	$60,810	$76.00	$60,870.01	$62,870
$75.00	$58,750.01	$60,750	$77.00	$60,810.01	$62,810	$80.00	$62,870.01	$64,870
$79.00	$60,750.01	$62,750	$81.00	$62,810.01	$64,810	$84.00	$64,870.01	$66,870
$83.00	$62,750.01	$64,750	$85.00	$64,810.01	$66,810	$88.00	$66,870.01	$68,870
$87.00	$64,750.01	$66,750	$89.00	$66,810.01	$68,810	$92.00	$68,870.01	$70,870
$91.00	$66,750.01	$68,750	$93.00	$68,810.01	$70,810	$96.00	$70,870.01	$72,870
$95.00	$68,750.01	$70,750	$97.00	$70,810.01	$72,810	$100.00	$72,870.01	$74,870
$99.00	$70,750.01	$72,750	$101.00	$72,810.01	$74,810	$104.00	$74,870.01	$76,870
$103.00	$72,750.01	$74,750	$105.00	$74,810.01	$76,810	$108.00	$76,870.01	$78,870
$107.00	$74,750.01	$76,750	$109.00	$76,810.01	$78,810	$112.00	$78,870.01	$80,870
$111.00	$76,750.01	$78,750	$113.00	$78,810.01	$80,810	$116.00	$80,870.01	$82,870
$116.00	$78,750.01	$80,750	$117.00	$80,810.01	$82,810	$120.00	$82,870.01	$84,870
$121.00	$80,750.01	$82,750	$122.00	$82,810.01	$84,810	$124.00	$84,870.01	$86,870
$126.00	$82,750.01	$84,750	$127.00	$84,810.01	$86,810	$128.00	$86,870.01	$88,870
$130.00	$84,750.01	$86,750	$132.00	$86,810.01	$88,810	$133.00	$88,870.01	$90,870
$134.00	$86,750.01	$88,750	$136.00	$88,810.01	$90,810	$138.00	$90,870.01	$92,870
$138.00	$88,750.01	$90,750	$140.00	$90,810.01	$92,810	$142.00	$92,870.01	$94,870
$142.00	$90,750.01	$92,750	$144.00	$92,810.01	$94,810	$146.00	$94,870.01	$96,870
$146.00	$92,750.01	$94,750	$148.00	$94,810.01	$96,810	$150.00	$96,870.01	$98,870
$150.00	$94,750.01	$96,750	$152.00	$96,810.01	$98,810	$154.00	$98,870.01	$100,870
$154.00	$96,750.01	$98,750	$156.00	$98,810.01	$100,810	$158.00	$100,870.01	$102,870
$158.00	$98,750.01	$100,750	$160.00	$100,810.01	$102,810	$162.00	$102,870.01	$104,870
$162.00	$100,750.01	$102,750	$164.00	$102,810.01	$104,810	$166.00	$104,870.01	$106,870
$166.00	$102,750.01	$104,750	$168.00	$104,810.01	$106,810	$170.00	$106,870.01	$108,870
$170.00	$104,750.01	$106,750	$172.00	$106,810.01	$108,810	$174.00	$108,870.01	$110,870
$174.00	$106,750.01	$108,750	$176.00	$108,810.01	$110,810	$178.00	$110,870.01	$112,870
$178.00	$108,750.01	$110,750	$180.00	$110,810.01	$112,810	$182.00	$112,870.01	$114,870
$182.00	$110,750.01	$112,750	$184.00	$112,810.01	$114,810	$186.00	$114,870.01	$116,870
$186.00	$112,750.01	$114,750	$188.00	$114,810.01	$116,810	$190.00	$116,870.01	$118,870
$190.00	$114,750.01	$116,750	$192.00	$116,810.01	$118,810	$194.00	$118,870.01	$120,870
$195.00	$116,750.01	$118,750	$196.00	$118,810.01	$120,810	$198.00	$120,870.01	$122,870
$200.00	$118,750.01	$120,750	$201.00	$120,810.01	$122,810	$202.00	$122,870.01	$124,870
$205.00	$120,750.01	$122,750	$206.00	$122,810.01	$124,810	$207.00	$124,870.01	$126,870
$210.00	$122,750.01	$124,750	$211.00	$124,810.01	$126,810	$212.00	$126,870.01	$128,870
$215.00	$124,750.01	$126,750	$216.00	$126,810.01	$128,810	$217.00	$128,870.01	$130,870
$220.00	$126,750.01	$128,750	$221.00	$128,810.01	$130,810	$222.00	$130,870.01	$132,870
$225.00	$128,750.01	$130,750	$226.00	$130,810.01	$132,810	$227.00	$132,870.01	$134,870
$230.00	$130,750.01	$132,750	$231.00	$132,810.01	$134,810	$232.00	$134,870.01	$136,870
$235.00	$132,750.01	$134,750	$236.00	$134,810.01	$136,810	$237.00	$136,870.01	$138,870
$240.00	$134,750.01	$136,750	$241.00	$136,810.01	$138,810	$242.00	$138,870.01	$140,870
$245.00	$136,750.01	$138,750	$246.00	$138,810.01	$140,810	$247.00	$140,870.01	$142,870
$250.00	$138,750.01	$140,750	$251.00	$140,810.01	$142,810	$252.00	$142,870.01	$144,870
$255.00	$140,750.01	$142,750	$256.00	$142,810.01	$144,810	$257.00	$144,870.01	$146,870
$260.00	$142,750.01	$144,750	$261.00	$144,810.01	$146,810	$262.00	$146,870.01	$148,870
$265.00	$144,750.01	$146,750	$266.00	$146,810.01	$148,810	$267.00	$148,870.01	$150,870
$270.00	$146,750.01	$148,750	$271.00	$148,810.01	$150,810	$272.00	$150,870.01	$152,870
$275.00	$148,750.01	$150,750	$276.00	$150,810.01	$152,810	$277.00	$152,870.01	$154,870
$280.00	$150,750.01	$152,750	$281.00	$152,810.01	$154,810	$282.00	$154,870.01	$156,870
$285.00	$152,750.01	$154,750	$286.00	$154,810.01	$156,810	$287.00	$156,870.01	$158,870
$290.00	$154,750.01	$156,750	$291.00	$156,810.01	$158,810	$292.00	$158,870.01	$160,870
$295.00	$156,750.01	$158,750	$296.00	$158,810.01	$160,810	$297.00	$160,870.01	$162,870
$300.00	$158,750.01	$160,750	$301.00	$160,810.01	$162,810	$302.00	$162,870.01	$164,870
$305.00	$160,750.01	$162,750	$306.00	$162,810.01	$164,810	$307.00	$164,870.01	$166,870
$310.00	$162,750.01	$164,750	$311.00	$164,810.01	$166,810	$312.00	$166,870.01	$168,870
$316.00	$164,750.01	$166,750	$316.00	$166,810.01	$168,810	$317.00	$168,870.01	$170,870
$322.00	$166,750.01	$168,750	$321.00	$168,810.01	$170,810	$322.00	$170,870.01	$172,870
$328.00	$168,750.01	$170,750	$327.00	$170,810.01	$172,810	$327.00	$172,870.01	$174,870
$334.00	$170,750.01	$172,750	$333.00	$172,810.01	$174,810	$332.00	$174,870.01	$176,870
$340.00	$172,750.01	$174,750	$339.00	$174,810.01	$176,810	$338.00	$176,870.01	$178,870
$346.00	$174,750.01	$176,750	$345.00	$176,810.01	$178,810	$344.00	$178,870.01	$180,870
$352.00	$176,750.01	$178,750	$351.00	$178,810.01	$180,810	$350.00	$180,870.01	$182,870
$358.00	$178,750.01	$180,750	$357.00	$180,810.01	$182,810	$356.00	$182,870.01	$184,870
$364.00	$180,750.01	$182,750	$363.00	$182,810.01	$184,810	$362.00	$184,870.01	$186,870
$370.00	$182,750.01	$184,750	$369.00	$184,810.01	$186,810	$368.00	$186,870.01	$188,870
$376.00	$184,750.01	$186,750	$375.00	$186,810.01	$188,810	$374.00	$188,870.01	$190,870
$382.00	$186,750.01	$188,750	$381.00	$188,810.01	$190,810	$380.00	$190,870.01	$192,870
$388.00	$188,750.01	$190,750	$387.00	$190,810.01	$192,810	$386.00	$192,870.01	$194,870
$394.00	$190,750.01	$192,750	$393.00	$192,810.01	$194,810	$392.00	$194,870.01	$196,870
$400.00	$192,750.01	$194,750	$399.00	$194,810.01	$196,810	$398.00	$196,870.01	$198,870
$406.00	$194,750.01	$196,750	$405.00	$196,810.01	$198,810	$404.00	$198,870.01	$200,870
$412.00	$196,750.01	$198,750	$411.00	$198,810.01	$200,810	$410.00	$200,870.01	$202,870
$417.00	$198,750.01	$199,163	$417.00	$200,810.01	$202,810	$416.00	$202,870.01	$204,870
			$423.00	$202,810.01	$204,810	$422.00	$204,870.01	$206,870
			$429.00	$204,810.01	$206,810	$428.00	$206,870.01	$208,870
			$434.00	$206,810.01	$208,704	$434.00	$208,870.01	$210,870
						$440.00	$210,870.01	$212,870
						$445.00	$212,870.01	$214,870
						$450.00	$214,870.01	$218,245
	200% FPIG	$169,500		200% FPIG	$177,620		200% FPIG	$185,740

[Pa.B. Doc. No. 14-943. Filed for public inspection May 2, 2014, 9:00 a.m.]