826 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

[43 Pa.B. 2515]
[Saturday, May 4, 2013]

 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 6, 2013 (based on the 2013 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 6, 2013.

 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 6, 2013, 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, 
Acting Secretary

 Fiscal Note: 14-NOT-815. No fiscal impact; (8) recommends adoption.

CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE MAY 6, 2013
(BASED ON THE 2013 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:	$9,490	$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$9,490.01	$11,490	$10.00	$8,660.01	$13,000	$10.00	$8,660.01	$13,900
$15.00	$11,490.01	$13,490	$16.00	$13,000.01	$13,250	$17.00	$13,900.01	$15,570
$20.00	$13,490.01	$15,490	$20.00	$13,250.01	$15,510	$22.00	$15,570.01	$17,570
$25.00	$15,490.01	$17,490	$24.00	$15,510.01	$17,510	$27.00	$17,570.01	$19,530
$30.00	$17,490.01	$19,490	$28.00	$17,510.01	$19,510	$31.00	$19,530.01	$21,530
$35.00	$19,490.01	$21,490	$32.00	$19,510.01	$21,510	$35.00	$21,530.01	$23,530
$40.00	$21,490.01	$23,490	$36.00	$21,510.01	$23,510	$39.00	$23,530.01	$25,530
$45.00	$23,490.01	$25,490	$41.00	$23,510.01	$25,510	$43.00	$25,530.01	$27,530
$50.00	$25,490.01	$27,002	$46.00	$25,510.01	$27,510	$48.00	$27,530.01	$29,530
			$51.00	$27,510.01	$29,510	$53.00	$29,530.01	$31,530
			$57.00	$29,510.01	$31,510	$58.00	$31,530.01	$33,530
			$63.00	$31,510.01	$33,510	$63.00	$33,530.01	$35,530
			$69.00	$33,510.01	$35,510	$68.00	$35,530.01	$37,530
			$74.00	$35,510.01	$36,449	$73.00	$37,530.01	$39,530
						$79.00	$39,530.01	$41,530
						$85.00	$41,530.01	$43,530
						$90.00	$43,530.01	$45,530
						$95.00	$45,530.01	$45,896
	200% FPIG	$22,980		200% FPIG	$31,020		200% FPIG	$39,060

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	$15,000	$10.00	$8,660.01	$15,600	$10.00	$8,660.01	$17,000
$18.00	$15,000.01	$17,250	$18.00	$15,600.01	$17,500	$20.00	$17,000.01	$19,000
$23.00	$17,250.01	$19,550	$21.00	$17,500.01	$19,570	$23.00	$19,000.01	$21,590
$28.00	$19,550.01	$21,550	$27.00	$19,570.01	$21,570	$28.00	$21,590.01	$23,590
$33.00	$21,550.01	$23,550	$31.00	$21,570.01	$23,570	$32.00	$23,590.01	$25,590
$37.00	$23,550.01	$25,550	$35.00	$23,570.01	$25,570	$36.00	$25,590.01	$27,590
$41.00	$25,550.01	$27,550	$39.00	$25,570.01	$27,570	$40.00	$27,590.01	$29,590
$45.00	$27,550.01	$29,550	$43.00	$27,570.01	$29,570	$45.00	$29,590.01	$31,590
$49.00	$29,550.01	$31,550	$47.00	$29,570.01	$31,570	$49.00	$31,590.01	$33,590
$53.00	$31,550.01	$33,550	$51.00	$31,570.01	$33,570	$53.00	$33,590.01	$35,590
$58.00	$33,550.01	$35,550	$55.00	$33,570.01	$35,570	$57.00	$35,590.01	$37,590
$63.00	$35,550.01	$37,550	$59.00	$35,570.01	$37,570	$61.00	$37,590.01	$39,590
$68.00	$37,550.01	$39,550	$63.00	$37,570.01	$39,570	$65.00	$39,590.01	$41,590
$73.00	$39,550.01	$41,550	$68.00	$39,570.01	$41,570	$69.00	$41,590.01	$43,590
$78.00	$41,550.01	$43,550	$73.00	$41,570.01	$43,570	$73.00	$43,590.01	$45,590
$83.00	$43,550.01	$45,550	$78.00	$43,570.01	$45,570	$78.00	$45,590.01	$47,590
$89.00	$45,550.01	$47,550	$83.00	$45,570.01	$47,570	$83.00	$47,590.01	$49,590
$95.00	$47,550.01	$49,550	$88.00	$47,570.01	$49,570	$88.00	$49,590.01	$51,590
$101.00	$49,550.01	$51,550	$93.00	$49,570.01	$51,570	$93.00	$51,590.01	$53,590
$107.00	$51,550.01	$53,550	$98.00	$51,570.01	$53,570	$98.00	$53,590.01	$55,590
$112.00	$53,550.01	$55,343	$103.00	$53,570.01	$55,570	$103.00	$55,590.01	$57,590
			$109.00	$55,570.01	$57,570	$108.00	$57,590.01	$59,590
			$115.00	$57,570.01	$59,570	$113.00	$59,590.01	$61,590
			$121.00	$59,570.01	$61,570	$119.00	$61,590.01	$63,590
			$127.00	$61,570.01	$63,570	$125.00	$63,590.01	$65,590
			$133.00	$63,570.01	$64,790	$131.00	$65,590.01	$67,590
						$137.00	$67,590.01	$69,590
						$143.00	$69,590.01	$71,590
						$149.00	$71,590.01	$73,590
						$154.00	$73,590.01	$74,237
	200% FPIG	$47,100		200% FPIG	$55,140		200% FPIG	$63,180

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	$20,600	$22.00	$18,800.01	$22,000	$23.00	$19,700.01	$23,700
$25.00	$20,600.01	$23,610	$26.00	$22,000.01	$25,630	$28.00	$23,700.01	$27,650
$30.00	$23,610.01	$25,610	$32.00	$25,630.01	$27,630	$34.00	$27,650.01	$29,650
$34.00	$25,610.01	$27,610	$36.00	$27,630.01	$29,630	$38.00	$29,650.01	$31,650
$38.00	$27,610.01	$29,610	$40.00	$29,630.01	$31,630	$42.00	$31,650.01	$33,650
$42.00	$29,610.01	$31,610	$44.00	$31,630.01	$33,630	$46.00	$33,650.01	$35,650
$46.00	$31,610.01	$33,610	$48.00	$33,630.01	$35,630	$50.00	$35,650.01	$37,650
$51.00	$33,610.01	$35,610	$52.00	$35,630.01	$37,630	$54.00	$37,650.01	$39,650
$55.00	$35,610.01	$37,610	$57.00	$37,630.01	$39,630	$59.00	$39,650.01	$41,650
$59.00	$37,610.01	$39,610	$61.00	$39,630.01	$41,630	$64.00	$41,650.01	$43,650
$63.00	$39,610.01	$41,610	$65.00	$41,630.01	$43,630	$68.00	$43,650.01	$45,650
$67.00	$41,610.01	$43,610	$69.00	$43,630.01	$45,630	$72.00	$45,650.01	$47,650
$71.00	$43,610.01	$45,610	$73.00	$45,630.01	$47,630	$76.00	$47,650.01	$49,650
$75.00	$45,610.01	$47,610	$77.00	$47,630.01	$49,630	$80.00	$49,650.01	$51,650
$79.00	$47,610.01	$49,610	$81.00	$49,630.01	$51,630	$84.00	$51,650.01	$53,650
$84.00	$49,610.01	$51,610	$85.00	$51,630.01	$53,630	$88.00	$53,650.01	$55,650
$89.00	$51,610.01	$53,610	$89.00	$53,630.01	$55,630	$92.00	$55,650.01	$57,650
$94.00	$53,610.01	$55,610	$94.00	$55,630.01	$57,630	$96.00	$57,650.01	$59,650
$99.00	$55,610.01	$57,610	$99.00	$57,630.01	$59,630	$101.00	$59,650.01	$61,650
$104.00	$57,610.01	$59,610	$104.00	$59,630.01	$61,630	$106.00	$61,650.01	$63,650
$109.00	$59,610.01	$61,610	$109.00	$61,630.01	$63,630	$111.00	$63,650.01	$65,650
$114.00	$61,610.01	$63,610	$114.00	$63,630.01	$65,630	$116.00	$65,650.01	$67,650
$119.00	$63,610.01	$65,610	$119.00	$65,630.01	$67,630	$121.00	$67,650.01	$69,650
$124.00	$65,610.01	$67,610	$124.00	$67,630.01	$69,630	$126.00	$69,650.01	$71,650
$129.00	$67,610.01	$69,610	$129.00	$69,630.01	$71,630	$131.00	$71,650.01	$73,650
$135.00	$69,610.01	$71,610	$134.00	$71,630.01	$73,630	$136.00	$73,650.01	$75,650
$141.00	$71,610.01	$73,610	$139.00	$73,630.01	$75,630	$141.00	$75,650.01	$77,650
$147.00	$73,610.01	$75,610	$144.00	$75,630.01	$77,630	$146.00	$77,650.01	$79,650
$153.00	$75,610.01	$77,610	$150.00	$77,630.01	$79,630	$151.00	$79,650.01	$81,650
$159.00	$77,610.01	$79,610	$156.00	$79,630.01	$81,630	$156.00	$81,650.01	$83,650
$165.00	$79,610.01	$81,610	$162.00	$81,630.01	$83,630	$161.00	$83,650.01	$85,650
$171.00	$81,610.01	$83,684	$168.00	$83,630.01	$85,630	$167.00	$85,650.01	$87,650
			$174.00	$85,630.01	$87,630	$173.00	$87,650.01	$89,650
			$180.00	$87,630.01	$89,630	$179.00	$89,650.01	$91,650
			$186.00	$89,630.01	$91,630	$185.00	$91,650.01	$93,650
			$192.00	$91,630.01	$93,131	$191.00	$93,650.01	$95,650
						$197.00	$95,650.01	$97,650
						$203.00	$97,650.01	$99,650
						$208.00	$99,650.01	$101,650
						$213.00	$101,650.01	$102,578
	200% FPIG	$71,220		200% FPIG	$79,260		200% FPIG	$87,300

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	$26,500	$26.00	$22,500.01	$28,000
$30.00	$25,000.01	$29,670	$32.00	$26,500.01	$31,690	$33.00	$28,000.01	$33,710
$37.00	$29,670.01	$31,670	$39.00	$31,690.01	$33,690	$41.00	$33,710.01	$35,710
$41.00	$31,670.01	$33,670	$43.00	$33,690.01	$35,690	$45.00	$35,710.01	$37,710
$45.00	$33,670.01	$35,670	$47.00	$35,690.01	$37,690	$49.00	$37,710.01	$39,710
$49.00	$35,670.01	$37,670	$51.00	$37,690.01	$39,690	$53.00	$39,710.01	$41,710
$53.00	$37,670.01	$39,670	$55.00	$39,690.01	$41,690	$57.00	$41,710.01	$43,710
$57.00	$39,670.01	$41,670	$59.00	$41,690.01	$43,690	$61.00	$43,710.01	$45,710
$61.00	$41,670.01	$43,670	$63.00	$43,690.01	$45,690	$65.00	$45,710.01	$47,710
$65.00	$43,670.01	$45,670	$67.00	$45,690.01	$47,690	$69.00	$47,710.01	$49,710
$70.00	$45,670.01	$47,670	$71.00	$47,690.01	$49,690	$73.00	$49,710.01	$51,710
$74.00	$47,670.01	$49,670	$76.00	$49,690.01	$51,690	$77.00	$51,710.01	$53,710
$78.00	$49,670.01	$51,670	$80.00	$51,690.01	$53,690	$82.00	$53,710.01	$55,710
$82.00	$51,670.01	$53,670	$84.00	$53,690.01	$55,690	$86.00	$55,710.01	$57,710
$86.00	$53,670.01	$55,670	$88.00	$55,690.01	$57,690	$90.00	$57,710.01	$59,710
$90.00	$55,670.01	$57,670	$92.00	$57,690.01	$59,690	$94.00	$59,710.01	$61,710
$94.00	$57,670.01	$59,670	$96.00	$59,690.01	$61,690	$98.00	$61,710.01	$63,710
$98.00	$59,670.01	$61,670	$100.00	$61,690.01	$63,690	$102.00	$63,710.01	$65,710
$102.00	$61,670.01	$63,670	$104.00	$63,690.01	$65,690	$106.00	$65,710.01	$67,710
$106.00	$63,670.01	$65,670	$108.00	$65,690.01	$67,690	$110.00	$67,710.01	$69,710
$111.00	$65,670.01	$67,670	$112.00	$67,690.01	$69,690	$114.00	$69,710.01	$71,710
$116.00	$67,670.01	$69,670	$116.00	$69,690.01	$71,690	$118.00	$71,710.01	$73,710
$121.00	$69,670.01	$71,670	$121.00	$71,690.01	$73,690	$122.00	$73,710.01	$75,710
$126.00	$71,670.01	$73,670	$126.00	$73,690.01	$75,690	$126.00	$75,710.01	$77,710
$131.00	$73,670.01	$75,670	$131.00	$75,690.01	$77,690	$131.00	$77,710.01	$79,710
$136.00	$75,670.01	$77,670	$136.00	$77,690.01	$79,690	$136.00	$79,710.01	$81,710
$141.00	$77,670.01	$79,670	$141.00	$79,690.01	$81,690	$141.00	$81,710.01	$83,710
$146.00	$79,670.01	$81,670	$146.00	$81,690.01	$83,690	$146.00	$83,710.01	$85,710
$151.00	$81,670.01	$83,670	$151.00	$83,690.01	$85,690	$151.00	$85,710.01	$87,710
$156.00	$83,670.01	$85,670	$156.00	$85,690.01	$87,690	$156.00	$87,710.01	$89,710
$161.00	$85,670.01	$87,670	$161.00	$87,690.01	$89,690	$161.00	$89,710.01	$91,710
$166.00	$87,670.01	$89,670	$166.00	$89,690.01	$91,690	$166.00	$91,710.01	$93,710
$171.00	$89,670.01	$91,670	$171.00	$91,690.01	$93,690	$171.00	$93,710.01	$95,710
$177.00	$91,670.01	$93,670	$176.00	$93,690.01	$95,690	$176.00	$95,710.01	$97,710
$183.00	$93,670.01	$95,670	$181.00	$95,690.01	$97,690	$181.00	$97,710.01	$99,710
$189.00	$95,670.01	$97,670	$186.00	$97,690.01	$99,690	$186.00	$99,710.01	$101,710
$195.00	$97,670.01	$99,670	$192.00	$99,690.01	$101,690	$191.00	$101,710.01	$103,710
$201.00	$99,670.01	$101,670	$198.00	$101,690.01	$103,690	$196.00	$103,710.01	$105,710
$207.00	$101,670.01	$103,670	$204.00	$103,690.01	$105,690	$201.00	$105,710.01	$107,710
$213.00	$103,670.01	$105,670	$210.00	$105,690.01	$107,690	$206.00	$107,710.01	$109,710
$219.00	$105,670.01	$107,670	$216.00	$107,690.01	$109,690	$212.00	$109,710.01	$111,710
$225.00	$107,670.01	$109,670	$222.00	$109,690.01	$111,690	$218.00	$111,710.01	$113,710
$230.00	$109,670.01	$112,025	$228.00	$111,690.01	$113,690	$224.00	$113,710.01	$115,710
			$234.00	$113,690.01	$115,690	$230.00	$115,710.01	$117,710
			$240.00	$115,690.01	$117,690	$236.00	$117,710.01	$119,710
			$246.00	$117,690.01	$119,690	$242.00	$119,710.01	$121,710
			$251.00	$119,690.01	$121,472	$248.00	$121,710.01	$123,710
						$254.00	$123,710.01	$125,710
						$260.00	$125,710.01	$127,710
						$266.00	$127,710.01	$129,710
						$272.00	$129,710.01	$130,919
	200% FPIG	$95,340		200% FPIG	$103,380		200% FPIG	$111,420

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	$23,400	$10.00	$8,660.01	$24,250	$10.00	$8,660.01	$26,000
$27.00	$23,400.01	$29,500	$28.00	$24,250.01	$30,300	$30.00	$26,000.01	$33,030
$35.00	$29,500.01	$35,730	$36.00	$30,300.01	$37,750	$39.00	$33,030.01	$39,770
$44.00	$35,730.01	$37,730	$46.00	$37,750.01	$39,750	$48.00	$39,770.01	$41,770
$47.00	$37,730.01	$39,730	$49.00	$39,750.01	$41,750	$51.00	$41,770.01	$43,770
$51.00	$39,730.01	$41,730	$53.00	$41,750.01	$43,750	$55.00	$43,770.01	$45,770
$55.00	$41,730.01	$43,730	$57.00	$43,750.01	$45,750	$59.00	$45,770.01	$47,770
$59.00	$43,730.01	$45,730	$61.00	$45,750.01	$47,750	$63.00	$47,770.01	$49,770
$63.00	$45,730.01	$47,730	$65.00	$47,750.01	$49,750	$67.00	$49,770.01	$51,770
$67.00	$47,730.01	$49,730	$69.00	$49,750.01	$51,750	$71.00	$51,770.01	$53,770
$71.00	$49,730.01	$51,730	$73.00	$51,750.01	$53,750	$75.00	$53,770.01	$55,770
$75.00	$51,730.01	$53,730	$77.00	$53,750.01	$55,750	$79.00	$55,770.01	$57,770
$79.00	$53,730.01	$55,730	$81.00	$55,750.01	$57,750	$83.00	$57,770.01	$59,770
$83.00	$55,730.01	$57,730	$85.00	$57,750.01	$59,750	$87.00	$59,770.01	$61,770
$88.00	$57,730.01	$59,730	$90.00	$59,750.01	$61,750	$91.00	$61,770.01	$63,770
$92.00	$59,730.01	$61,730	$95.00	$61,750.01	$63,750	$96.00	$63,770.01	$65,770
$96.00	$61,730.01	$63,730	$99.00	$63,750.01	$65,750	$101.00	$65,770.01	$67,770
$100.00	$63,730.01	$65,730	$103.00	$65,750.01	$67,750	$105.00	$67,770.01	$69,770
$104.00	$65,730.01	$67,730	$107.00	$67,750.01	$69,750	$109.00	$69,770.01	$71,770
$108.00	$67,730.01	$69,730	$111.00	$69,750.01	$71,750	$113.00	$71,770.01	$73,770
$112.00	$69,730.01	$71,730	$115.00	$71,750.01	$73,750	$117.00	$73,770.01	$75,770
$116.00	$71,730.01	$73,730	$119.00	$73,750.01	$75,750	$121.00	$75,770.01	$77,770
$120.00	$73,730.01	$75,730	$123.00	$75,750.01	$77,750	$125.00	$77,770.01	$79,770
$124.00	$75,730.01	$77,730	$127.00	$77,750.01	$79,750	$129.00	$79,770.01	$81,770
$128.00	$77,730.01	$79,730	$131.00	$79,750.01	$81,750	$133.00	$81,770.01	$83,770
$132.00	$79,730.01	$81,730	$135.00	$81,750.01	$83,750	$137.00	$83,770.01	$85,770
$136.00	$81,730.01	$83,730	$139.00	$83,750.01	$85,750	$141.00	$85,770.01	$87,770
$141.00	$83,730.01	$85,730	$144.00	$85,750.01	$87,750	$145.00	$87,770.01	$89,770
$146.00	$85,730.01	$87,730	$149.00	$87,750.01	$89,750	$149.00	$89,770.01	$91,770
$151.00	$87,730.01	$89,730	$154.00	$89,750.01	$91,750	$154.00	$91,770.01	$93,770
$156.00	$89,730.01	$91,730	$159.00	$91,750.01	$93,750	$159.00	$93,770.01	$95,770
$161.00	$91,730.01	$93,730	$164.00	$93,750.01	$95,750	$164.00	$95,770.01	$97,770
$166.00	$93,730.01	$95,730	$169.00	$95,750.01	$97,750	$169.00	$97,770.01	$99,770
$171.00	$95,730.01	$97,730	$174.00	$97,750.01	$99,750	$174.00	$99,770.01	$101,770
$176.00	$97,730.01	$99,730	$179.00	$99,750.01	$101,750	$179.00	$101,770.01	$103,770
$181.00	$99,730.01	$101,730	$184.00	$101,750.01	$103,750	$184.00	$103,770.01	$105,770
$186.00	$101,730.01	$103,730	$189.00	$103,750.01	$105,750	$189.00	$105,770.01	$107,770
$191.00	$103,730.01	$105,730	$194.00	$105,750.01	$107,750	$194.00	$107,770.01	$109,770
$196.00	$105,730.01	$107,730	$199.00	$107,750.01	$109,750	$199.00	$109,770.01	$111,770
$201.00	$107,730.01	$109,730	$204.00	$109,750.01	$111,750	$204.00	$111,770.01	$113,770
$206.00	$109,730.01	$111,730	$209.00	$111,750.01	$113,750	$209.00	$113,770.01	$115,770
$211.00	$111,730.01	$113,730	$214.00	$113,750.01	$115,750	$214.00	$115,770.01	$117,770
$216.00	$113,730.01	$115,730	$219.00	$115,750.01	$117,750	$219.00	$117,770.01	$119,770
$221.00	$115,730.01	$117,730	$224.00	$117,750.01	$119,750	$224.00	$119,770.01	$121,770
$227.00	$117,730.01	$119,730	$229.00	$119,750.01	$121,750	$229.00	$121,770.01	$123,770
$233.00	$119,730.01	$121,730	$235.00	$121,750.01	$123,750	$234.00	$123,770.01	$125,770
$239.00	$121,730.01	$123,730	$241.00	$123,750.01	$125,750	$239.00	$125,770.01	$127,770
$245.00	$123,730.01	$125,730	$247.00	$125,750.01	$127,750	$244.00	$127,770.01	$129,770
$251.00	$125,730.01	$127,730	$253.00	$127,750.01	$129,750	$250.00	$129,770.01	$131,770
$257.00	$127,730.01	$129,730	$259.00	$129,750.01	$131,750	$256.00	$131,770.01	$133,770
$263.00	$129,730.01	$131,730	$265.00	$131,750.01	$133,750	$262.00	$133,770.01	$135,770
$269.00	$131,730.01	$133,730	$271.00	$133,750.01	$135,750	$268.00	$135,770.01	$137,770
$275.00	$133,730.01	$135,730	$277.00	$135,750.01	$137,750	$274.00	$137,770.01	$139,770
$281.00	$135,730.01	$137,730	$283.00	$137,750.01	$139,750	$280.00	$139,770.01	$141,770
$287.00	$137,730.01	$139,730	$289.00	$139,750.01	$141,750	$286.00	$141,770.01	$143,770
$293.00	$139,730.01	$140,366	$295.00	$141,750.01	$143,750	$292.00	$143,770.01	$145,770
			$301.00	$143,750.01	$145,750	$298.00	$145,770.01	$147,770
			$306.00	$145,750.01	$147,750	$304.00	$147,770.01	$149,770
			$311.00	$147,750.01	$149,813	$310.00	$149,770.01	$151,770
						$316.00	$151,770.01	$153,770
						$322.00	$153,770.01	$155,770
						$327.00	$155,770.01	$157,770
						$332.00	$157,770.01	$159,260
	200% FPIG	$119,460		200% FPIG	$127,500		200% FPIG	$135,540

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	$29,500
$32.00	$27,700.01	$35,750	$33.00	$28,600.01	$36,800	$35.00	$29,500.01	$38,500
$42.00	$35,750.01	$43,790	$43.00	$36,800.01	$45,810	$46.00	$38,500.01	$47,830
$52.00	$43,790.01	$45,790	$55.00	$45,810.01	$47,810	$58.00	$47,830.01	$49,830
$56.00	$45,790.01	$47,790	$59.00	$47,810.01	$49,810	$61.00	$49,830.01	$51,830
$60.00	$47,790.01	$49,790	$63.00	$49,810.01	$51,810	$65.00	$51,830.01	$53,830
$64.00	$49,790.01	$51,790	$67.00	$51,810.01	$53,810	$69.00	$53,830.01	$55,830
$68.00	$51,790.01	$53,790	$71.00	$53,810.01	$55,810	$73.00	$55,830.01	$57,830
$72.00	$53,790.01	$55,790	$75.00	$55,810.01	$57,810	$77.00	$57,830.01	$59,830
$76.00	$55,790.01	$57,790	$79.00	$57,810.01	$59,810	$81.00	$59,830.01	$61,830
$80.00	$57,790.01	$59,790	$83.00	$59,810.01	$61,810	$85.00	$61,830.01	$63,830
$84.00	$59,790.01	$61,790	$87.00	$61,810.01	$63,810	$89.00	$63,830.01	$65,830
$88.00	$61,790.01	$63,790	$91.00	$63,810.01	$65,810	$93.00	$65,830.01	$67,830
$92.00	$63,790.01	$65,790	$95.00	$65,810.01	$67,810	$97.00	$67,830.01	$69,830
$97.00	$65,790.01	$67,790	$99.00	$67,810.01	$69,810	$101.00	$69,830.01	$71,830
$102.00	$67,790.01	$69,790	$103.00	$69,810.01	$71,810	$105.00	$71,830.01	$73,830
$107.00	$69,790.01	$71,790	$108.00	$71,810.01	$73,810	$109.00	$73,830.01	$75,830
$111.00	$71,790.01	$73,790	$113.00	$73,810.01	$75,810	$114.00	$75,830.01	$77,830
$115.00	$73,790.01	$75,790	$117.00	$75,810.01	$77,810	$119.00	$77,830.01	$79,830
$119.00	$75,790.01	$77,790	$121.00	$77,810.01	$79,810	$123.00	$79,830.01	$81,830
$123.00	$77,790.01	$79,790	$125.00	$79,810.01	$81,810	$127.00	$81,830.01	$83,830
$127.00	$79,790.01	$81,790	$129.00	$81,810.01	$83,810	$131.00	$83,830.01	$85,830
$131.00	$81,790.01	$83,790	$133.00	$83,810.01	$85,810	$135.00	$85,830.01	$87,830
$135.00	$83,790.01	$85,790	$137.00	$85,810.01	$87,810	$139.00	$87,830.01	$89,830
$139.00	$85,790.01	$87,790	$141.00	$87,810.01	$89,810	$143.00	$89,830.01	$91,830
$143.00	$87,790.01	$89,790	$145.00	$89,810.01	$91,810	$147.00	$91,830.01	$93,830
$147.00	$89,790.01	$91,790	$149.00	$91,810.01	$93,810	$151.00	$93,830.01	$95,830
$151.00	$91,790.01	$93,790	$153.00	$93,810.01	$95,810	$155.00	$95,830.01	$97,830
$155.00	$93,790.01	$95,790	$157.00	$95,810.01	$97,810	$159.00	$97,830.01	$99,830
$159.00	$95,790.01	$97,790	$161.00	$97,810.01	$99,810	$163.00	$99,830.01	$101,830
$164.00	$97,790.01	$99,790	$165.00	$99,810.01	$101,810	$167.00	$101,830.01	$103,830
$169.00	$99,790.01	$101,790	$169.00	$101,810.01	$103,810	$171.00	$103,830.01	$105,830
$174.00	$101,790.01	$103,790	$174.00	$103,810.01	$105,810	$175.00	$105,830.01	$107,830
$179.00	$103,790.01	$105,790	$179.00	$105,810.01	$107,810	$179.00	$107,830.01	$109,830
$184.00	$105,790.01	$107,790	$184.00	$107,810.01	$109,810	$184.00	$109,830.01	$111,830
$189.00	$107,790.01	$109,790	$189.00	$109,810.01	$111,810	$189.00	$111,830.01	$113,830
$194.00	$109,790.01	$111,790	$194.00	$111,810.01	$113,810	$194.00	$113,830.01	$115,830
$199.00	$111,790.01	$113,790	$199.00	$113,810.01	$115,810	$199.00	$115,830.01	$117,830
$204.00	$113,790.01	$115,790	$204.00	$115,810.01	$117,810	$204.00	$117,830.01	$119,830
$209.00	$115,790.01	$117,790	$209.00	$117,810.01	$119,810	$209.00	$119,830.01	$121,830
$214.00	$117,790.01	$119,790	$214.00	$119,810.01	$121,810	$214.00	$121,830.01	$123,830
$219.00	$119,790.01	$121,790	$219.00	$121,810.01	$123,810	$219.00	$123,830.01	$125,830
$224.00	$121,790.01	$123,790	$224.00	$123,810.01	$125,810	$224.00	$125,830.01	$127,830
$229.00	$123,790.01	$125,790	$229.00	$125,810.01	$127,810	$229.00	$127,830.01	$129,830
$234.00	$125,790.01	$127,790	$234.00	$127,810.01	$129,810	$234.00	$129,830.01	$131,830
$239.00	$127,790.01	$129,790	$239.00	$129,810.01	$131,810	$239.00	$131,830.01	$133,830
$244.00	$129,790.01	$131,790	$244.00	$131,810.01	$133,810	$244.00	$133,830.01	$135,830
$249.00	$131,790.01	$133,790	$249.00	$133,810.01	$135,810	$249.00	$135,830.01	$137,830
$254.00	$133,790.01	$135,790	$254.00	$135,810.01	$137,810	$254.00	$137,830.01	$139,830
$259.00	$135,790.01	$137,790	$259.00	$137,810.01	$139,810	$259.00	$139,830.01	$141,830
$264.00	$137,790.01	$139,790	$264.00	$139,810.01	$141,810	$264.00	$141,830.01	$143,830
$270.00	$139,790.01	$141,790	$269.00	$141,810.01	$143,810	$269.00	$143,830.01	$145,830
$276.00	$141,790.01	$143,790	$274.00	$143,810.01	$145,810	$274.00	$145,830.01	$147,830
$282.00	$143,790.01	$145,790	$280.00	$145,810.01	$147,810	$279.00	$147,830.01	$149,830
$288.00	$145,790.01	$147,790	$286.00	$147,810.01	$149,810	$284.00	$149,830.01	$151,830
$294.00	$147,790.01	$149,790	$292.00	$149,810.01	$151,810	$289.00	$151,830.01	$153,830
$300.00	$149,790.01	$151,790	$298.00	$151,810.01	$153,810	$295.00	$153,830.01	$155,830
$306.00	$151,790.01	$153,790	$304.00	$153,810.01	$155,810	$301.00	$155,830.01	$157,830
$312.00	$153,790.01	$155,790	$310.00	$155,810.01	$157,810	$307.00	$157,830.01	$159,830
$318.00	$155,790.01	$157,790	$316.00	$157,810.01	$159,810	$313.00	$159,830.01	$161,830
$324.00	$157,790.01	$159,790	$322.00	$159,810.01	$161,810	$319.00	$161,830.01	$163,830
$330.00	$159,790.01	$161,790	$328.00	$161,810.01	$163,810	$325.00	$163,830.01	$165,830
$336.00	$161,790.01	$163,790	$334.00	$163,810.01	$165,810	$331.00	$165,830.01	$167,830
$342.00	$163,790.01	$165,790	$340.00	$165,810.01	$167,810	$337.00	$167,830.01	$169,830
$348.00	$165,790.01	$167,790	$346.00	$167,810.01	$169,810	$343.00	$169,830.01	$171,830
$353.00	$167,790.01	$168,707	$352.00	$169,810.01	$171,810	$349.00	$171,830.01	$173,830
			$358.00	$171,810.01	$173,810	$355.00	$173,830.01	$175,830
			$364.00	$173,810.01	$175,810	$361.00	$175,830.01	$177,830
			$369.00	$175,810.01	$178,154	$367.00	$177,830.01	$179,830
						$373.00	$179,830.01	$181,830
						$379.00	$181,830.01	$183,830
						$385.00	$183,830.01	$185,830
						$390.00	$185,830.01	$187,601
	200% FPIG	$143,580		200% FPIG	$151,620		200% FPIG	$159,660

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	$31,230	$10.00	$8,660.01	$33,070
$35.00	$30,300.01	$40,300	$37.00	$31,230.01	$41,330	$39.00	$33,070.01	$43,400
$48.00	$40,300.01	$49,850	$49.00	$41,330.01	$51,870	$52.00	$43,400.01	$53,890
$60.00	$49,850.01	$51,850	$62.00	$51,870.01	$53,870	$65.00	$53,890.01	$55,890
$63.00	$51,850.01	$53,850	$65.00	$53,870.01	$55,870	$68.00	$55,890.01	$57,890
$67.00	$53,850.01	$55,850	$69.00	$55,870.01	$57,870	$71.00	$57,890.01	$59,890
$71.00	$55,850.01	$57,850	$73.00	$57,870.01	$59,870	$75.00	$59,890.01	$61,890
$75.00	$57,850.01	$59,850	$77.00	$59,870.01	$61,870	$79.00	$61,890.01	$63,890
$79.00	$59,850.01	$61,850	$81.00	$61,870.01	$63,870	$83.00	$63,890.01	$65,890
$83.00	$61,850.01	$63,850	$85.00	$63,870.01	$65,870	$87.00	$65,890.01	$67,890
$87.00	$63,850.01	$65,850	$89.00	$65,870.01	$67,870	$91.00	$67,890.01	$69,890
$91.00	$65,850.01	$67,850	$93.00	$67,870.01	$69,870	$95.00	$69,890.01	$71,890
$95.00	$67,850.01	$69,850	$97.00	$69,870.01	$71,870	$99.00	$71,890.01	$73,890
$99.00	$69,850.01	$71,850	$101.00	$71,870.01	$73,870	$103.00	$73,890.01	$75,890
$103.00	$71,850.01	$73,850	$105.00	$73,870.01	$75,870	$107.00	$75,890.01	$77,890
$107.00	$73,850.01	$75,850	$109.00	$75,870.01	$77,870	$111.00	$77,890.01	$79,890
$111.00	$75,850.01	$77,850	$113.00	$77,870.01	$79,870	$115.00	$79,890.01	$81,890
$115.00	$77,850.01	$79,850	$117.00	$79,870.01	$81,870	$119.00	$81,890.01	$83,890
$120.00	$79,850.01	$81,850	$122.00	$81,870.01	$83,870	$123.00	$83,890.01	$85,890
$125.00	$81,850.01	$83,850	$127.00	$83,870.01	$85,870	$128.00	$85,890.01	$87,890
$129.00	$83,850.01	$85,850	$132.00	$85,870.01	$87,870	$133.00	$87,890.01	$89,890
$133.00	$85,850.01	$87,850	$136.00	$87,870.01	$89,870	$138.00	$89,890.01	$91,890
$137.00	$87,850.01	$89,850	$140.00	$89,870.01	$91,870	$142.00	$91,890.01	$93,890
$141.00	$89,850.01	$91,850	$144.00	$91,870.01	$93,870	$146.00	$93,890.01	$95,890
$145.00	$91,850.01	$93,850	$148.00	$93,870.01	$95,870	$150.00	$95,890.01	$97,890
$149.00	$93,850.01	$95,850	$152.00	$95,870.01	$97,870	$154.00	$97,890.01	$99,890
$153.00	$95,850.01	$97,850	$156.00	$97,870.01	$99,870	$158.00	$99,890.01	$101,890
$157.00	$97,850.01	$99,850	$160.00	$99,870.01	$101,870	$162.00	$101,890.01	$103,890
$161.00	$99,850.01	$101,850	$164.00	$101,870.01	$103,870	$166.00	$103,890.01	$105,890
$165.00	$101,850.01	$103,850	$168.00	$103,870.01	$105,870	$170.00	$105,890.01	$107,890
$169.00	$103,850.01	$105,850	$172.00	$105,870.01	$107,870	$174.00	$107,890.01	$109,890
$173.00	$105,850.01	$107,850	$176.00	$107,870.01	$109,870	$178.00	$109,890.01	$111,890
$177.00	$107,850.01	$109,850	$180.00	$109,870.01	$111,870	$182.00	$111,890.01	$113,890
$181.00	$109,850.01	$111,850	$184.00	$111,870.01	$113,870	$186.00	$113,890.01	$115,890
$185.00	$111,850.01	$113,850	$188.00	$113,870.01	$115,870	$190.00	$115,890.01	$117,890
$189.00	$113,850.01	$115,850	$192.00	$115,870.01	$117,870	$194.00	$117,890.01	$119,890
$194.00	$115,850.01	$117,850	$196.00	$117,870.01	$119,870	$198.00	$119,890.01	$121,890
$199.00	$117,850.01	$119,850	$201.00	$119,870.01	$121,870	$202.00	$121,890.01	$123,890
$204.00	$119,850.01	$121,850	$206.00	$121,870.01	$123,870	$207.00	$123,890.01	$125,890
$209.00	$121,850.01	$123,850	$211.00	$123,870.01	$125,870	$212.00	$125,890.01	$127,890
$214.00	$123,850.01	$125,850	$216.00	$125,870.01	$127,870	$217.00	$127,890.01	$129,890
$219.00	$125,850.01	$127,850	$221.00	$127,870.01	$129,870	$222.00	$129,890.01	$131,890
$224.00	$127,850.01	$129,850	$226.00	$129,870.01	$131,870	$227.00	$131,890.01	$133,890
$229.00	$129,850.01	$131,850	$231.00	$131,870.01	$133,870	$232.00	$133,890.01	$135,890
$234.00	$131,850.01	$133,850	$236.00	$133,870.01	$135,870	$237.00	$135,890.01	$137,890
$239.00	$133,850.01	$135,850	$241.00	$135,870.01	$137,870	$242.00	$137,890.01	$139,890
$244.00	$135,850.01	$137,850	$246.00	$137,870.01	$139,870	$247.00	$139,890.01	$141,890
$249.00	$137,850.01	$139,850	$251.00	$139,870.01	$141,870	$252.00	$141,890.01	$143,890
$254.00	$139,850.01	$141,850	$256.00	$141,870.01	$143,870	$257.00	$143,890.01	$145,890
$259.00	$141,850.01	$143,850	$261.00	$143,870.01	$145,870	$262.00	$145,890.01	$147,890
$264.00	$143,850.01	$145,850	$266.00	$145,870.01	$147,870	$267.00	$147,890.01	$149,890
$269.00	$145,850.01	$147,850	$271.00	$147,870.01	$149,870	$272.00	$149,890.01	$151,890
$274.00	$147,850.01	$149,850	$276.00	$149,870.01	$151,870	$277.00	$151,890.01	$153,890
$279.00	$149,850.01	$151,850	$281.00	$151,870.01	$153,870	$282.00	$153,890.01	$155,890
$284.00	$151,850.01	$153,850	$286.00	$153,870.01	$155,870	$287.00	$155,890.01	$157,890
$289.00	$153,850.01	$155,850	$291.00	$155,870.01	$157,870	$292.00	$157,890.01	$159,890
$294.00	$155,850.01	$157,850	$296.00	$157,870.01	$159,870	$297.00	$159,890.01	$161,890
$299.00	$157,850.01	$159,850	$301.00	$159,870.01	$161,870	$302.00	$161,890.01	$163,890
$304.00	$159,850.01	$161,850	$306.00	$161,870.01	$163,870	$307.00	$163,890.01	$165,890
$309.00	$161,850.01	$163,850	$311.00	$163,870.01	$165,870	$312.00	$165,890.01	$167,890
$315.00	$163,850.01	$165,850	$316.00	$165,870.01	$167,870	$317.00	$167,890.01	$169,890
$321.00	$165,850.01	$167,850	$321.00	$167,870.01	$169,870	$322.00	$169,890.01	$171,890
$327.00	$167,850.01	$169,850	$327.00	$169,870.01	$171,870	$327.00	$171,890.01	$173,890
$333.00	$169,850.01	$171,850	$333.00	$171,870.01	$173,870	$332.00	$173,890.01	$175,890
$339.00	$171,850.01	$173,850	$339.00	$173,870.01	$175,870	$338.00	$175,890.01	$177,890
$345.00	$173,850.01	$175,850	$345.00	$175,870.01	$177,870	$344.00	$177,890.01	$179,890
$351.00	$175,850.01	$177,850	$351.00	$177,870.01	$179,870	$350.00	$179,890.01	$181,890
$357.00	$177,850.01	$179,850	$357.00	$179,870.01	$181,870	$356.00	$181,890.01	$183,890
$363.00	$179,850.01	$181,850	$363.00	$181,870.01	$183,870	$362.00	$183,890.01	$185,890
$369.00	$181,850.01	$183,850	$369.00	$183,870.01	$185,870	$368.00	$185,890.01	$187,890
$375.00	$183,850.01	$185,850	$375.00	$185,870.01	$187,870	$374.00	$187,890.01	$189,890
$381.00	$185,850.01	$187,850	$381.00	$187,870.01	$189,870	$380.00	$189,890.01	$191,890
$387.00	$187,850.01	$189,850	$387.00	$189,870.01	$191,870	$386.00	$191,890.01	$193,890
$393.00	$189,850.01	$191,850	$393.00	$191,870.01	$193,870	$392.00	$193,890.01	$195,890
$399.00	$191,850.01	$193,850	$399.00	$193,870.01	$195,870	$398.00	$195,890.01	$197,890
$405.00	$193,850.01	$195,850	$405.00	$195,870.01	$197,870	$404.00	$197,890.01	$199,890
$411.00	$195,850.01	$197,048	$411.00	$197,870.01	$199,870	$410.00	$199,890.01	$201,890
			$417.00	$199,870.01	$201,870	$416.00	$201,890.01	$203,890
			$423.00	$201,870.01	$203,870	$422.00	$203,890.01	$205,890
			$428.00	$203,870.01	$205,870	$428.00	$205,890.01	$207,890
			$433.00	$205,870.01	$206,495	$434.00	$207,890.01	$209,890
						$439.00	$209,890.01	$211,890
						$444.00	$211,890.01	$213,890
						$449.00	$213,890.01	$215,942
	200% FPIG	$167,700		200% FPIG	$175,740		200% FPIG	$183,780

[Pa.B. Doc. No. 13-826. Filed for public inspection May 3, 2013, 9:00 a.m.]