NOTICES
Income Limits and Copayments for the Subsidized Child Day Care Program
[32 Pa.B. 2820] Effective April 1, 2002, the Department of Public Welfare (Department) updates the copayment chart codified at 55 Pa. Code § 3040.62(b) and Chapter 3040 Appendix B (relating to availability and use of the FPIG; and co-payment chart family co-payment scale (based on the 2002 Federal Poverty Income Guidelines)) and increases the income limits codified at 55 Pa. Code § 3040.32(f) and (g) (relating to financial eligibility).
The regulation at 55 Pa. Code § 3040.62(a) and (b) requires the Department to update 55 Pa. Code Chapter 3040 Appendix B, the copayment schedule, to reflect changes in the Federal Poverty Income Guidelines (FPIG). Effective April 1, 2002, the income limits for the subsidized child day care program are increased due to the increase in the FPIG. The copayment schedule is adjusted to reflect the increases. Appendix B also establishes the family copayment levels according to the family's computed annual income. Appendix B lists the weekly family copayment based on the annual family income.
At 55 Pa. Code § 3040.62(b), the Department revises the copayment charts at 55 Pa. Code § 3040.32(f) and (g), the Department increases the income limits for the subsidized child day care program effective April 1, 2002. The revisions are set forth in Appendix B, which is recommended for codification at 55 Pa. Code Chapter 3040 (relating to subsidized child daycare eligibility).
FEATHER O. HOUSTOUN,
SecretaryFiscal Note: 14-NOT-322. No fiscal impact; (8) recommends adoption.
APPENDIX B
CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE
(BASED ON THE 2002 FEDERAL PROVERTY INCOME GUIDELINES)
Weekly Family Size: 1 Family Size: 2 Family Size: 3 Co-pay Annual Income Annual Income Annual Income
$5.00 Less than: $6,860 Less than: $9,940 Less than: $11,020 $10.00 $6,860.01 $8,860 $9,940.01 $11,940 $11,020.01 $13,020 $15.00 $8,860.01 $10,860 $11,940.01 $13,940 $13,020.01 $15,020 $20.00 $10,860.01 $12,860 $13,940.01 $15,940 $15,020.01 $17,020 $25.00 $12,860.01 $14,860 $15,940.01 $17,940 $17,020.01 $19,020 $30.00 $14,860.01 $16,860 $17,940.01 $19,940 $19,020.01 $21,020 $35.00 $16,860.01 $18,860 $19,940.01 $21,940 $21,020.01 $23,020 $40.00 $18,860.01 $20,821 $21,940.01 $23,940 $23,020.01 $25,020 $45.00 $23,940.01 $25,940 $25,020.01 $27,020 $50.00 $25,940.01 $27,940 $27,020.01 $29,020 $55.00 $27,940.01 $28,059 $29,020.01 $31,020 $60.00 $31,020.01 $33,020 $65.00 $33,020.01 $35,020 $70.00 $35,020.01 $35,297 200% FPIG $17,720 200% FPIG $23,880 200% FPIG $30,040
Weekly Family Size: 4 Family Size: 5 Family Size: 6 Co-pay Annual Income Annual Income Annual Income
$5.00 Less than: $12,100 Less than: $13,180 Less than: $14,260 $10.00 $12,100.01 $14,100 $13,180.01 $15,180 $14,260.01 $16,260 $15.00 $14,100.01 $16,100 $15,180.01 $17,180 $16,260.01 $18,260 $20.00 $16,100.01 $18,100 $17,180.01 $19,180 $18,260.01 $20,260 $25.00 $18,100.01 $20,100 $19,180.01 $21,180 $20,260.01 $22,260 $30.00 $20,100.01 $22,100 $21,180.01 $23,180 $22,260.01 $24,260 $35.00 $22,100.01 $24,100 $23,180.01 $25,180 $24,260.01 $26,260 $40.00 $24,100.01 $26,100 $25,180.01 $27,180 $26,260.01 $28,260 $45.00 $26,100.01 $28,100 $27,180.01 $29,180 $28,260.01 $30,260 $50.00 $28,100.01 $30,100 $29,180.01 $31,180 $30,260.01 $32,260 $55.00 $30,100.01 $32,100 $31,180.01 $33,180 $32,260.01 $34,260 $60.00 $32,100.01 $34,100 $33,180.01 $35,180 $34,260.01 $36,260 $65.00 $34,100.01 $36,100 $35,180.01 $37,180 $36,260.01 $38,260 $70.00 $36,100.01 $38,100 $37,180.01 $39,180 $38,260.01 $40,260 $75.00 $38,100.01 $40,100 $39,180.01 $41,180 $40,260.01 $42,260 $80.00 $40,100.01 $42,100 $41,180.01 $43,180 $42,260.01 $44,260 $85.00 $42,100.01 $42,535 $43,180.01 $45,180 $44,260.01 $46,260 $90.00 $45,180.01 $47,180 $46,260.01 $48,260 $95.00 $47,180.01 $49,180 $48,260.01 $50,260 $100.00 $49,180.01 $49,773 $50,260.01 $52,260 $105.00 $52,260.01 $54,260 $110.00 $54,260.01 $56,260 $115.00 $56,260.01 $57,011 200% FPIG $36,200 200% FPIG $42,360 200% FPIG $48,520
Weekly Family Size: 7 Family Size: 8 Family Size: 9 Co-pay Annual Income Annual Income Annual Income
$5.00 Less than: $15,340 Less than: $16,420 Less than: $17,500 $10.00 $15,340.01 $17,340 $16,420.01 $18,420 $17,500.01 $19,500 $15.00 $17,340.01 $19,340 $18,420.01 $20,420 $19,500.01 $21,500 $20.00 $19,340.01 $21,340 $20,420.01 $22,420 $21,500.01 $23,500 $25.00 $21,340.01 $23,340 $22,420.01 $24,420 $23,500.01 $25,500 $30.00 $23,340.01 $25,340 $24,420.01 $26,420 $25,500.01 $27,500 $35.00 $25,340.01 $27,340 $26,420.01 $28,420 $27,500.01 $29,500 $40.00 $27,340.01 $29,340 $28,420.01 $30,420 $29,500.01 $31,500 $45.00 $29,340.01 $31,340 $30,420.01 $32,420 $31,500.01 $33,500 $50.00 $31,340.01 $33,340 $32,420.01 $34,420 $33,500.01 $35,500 $55.00 $33,340.01 $35,340 $34,420.01 $36,420 $35,500.01 $37,500 $60.00 $35,340.01 $37,340 $36,420.01 $38,420 $37,500.01 $39,500 $65.00 $37,340.01 $39,340 $38,420.01 $40,420 $39,500.01 $41,500 $70.00 $39,340.01 $41,340 $40,420.01 $42,420 $41,500.01 $43,500 $75.00 $41,340.01 $43,340 $42,420.01 $44,420 $43,500.01 $45,500 $80.00 $43,340.01 $45,340 $44,420.01 $46,420 $45,500.01 $47,500 $85.00 $45,340.01 $47,340 $46,420.01 $48,420 $47,500.01 $49,500 $90.00 $47,340.01 $49,340 $48,420.01 $50,420 $49,500.01 $51,500 $95.00 $49,340.01 $51,340 $50,420.01 $52,420 $51,500.01 $53,500 $100.00 $51,340.01 $53,340 $52,420.01 $54,420 $53,500.01 $55,500 $105.00 $53,340.01 $55,340 $54,420.01 $56,420 $55,500.01 $57,500 $110.00 $55,340.01 $57,340 $56,420.01 $58,420 $57,500.01 $59,500 $115.00 $57,340.01 $59,340 $58,420.01 $60,420 $59,500.01 $61,500 $120.00 $59,340.01 $61,340 $60,420.01 $62,420 $61,500.01 $63,500 $125.00 $61,340.01 $63,340 $62,420.01 $64,420 $63,500.01 $65,500 $130.00 $63,340.01 $64,249 $64,420.01 $66,420 $65,500.01 $67,500 $135.00 $66,420.01 $68,420 $67,500.01 $69,500 $140.00 $68,420.01 $70,420 $69,500.01 $71,500 $145.00 $70,420.01 $71,487 $71,500.01 $73,500 $150.00 $73,500.01 $75,500 $155.00 $75,500.01 $77,500 $160.00 $77,500.01 $78,725 200% FPIG $54,680 200% FPIG $60,840 200% FPIG $67,000
Weekly Family Size: 10 Family Size: 11 Family Size: 12 Co-pay Annual Income Annual Income Annual Income $5.00 Less than: $18,580 Less than: $19,660 Less than: $20,740 $10.00 $18,580.01 $20,580 $19,660.01 $21,660 $20,740.01 $22,740 $15.00 $20,580.01 $22,580 $21,660.01 $23,660 $22,740.01 $24,740 $20.00 $22,580.01 $24,580 $23,660.01 $25,660 $24,740.01 $26,740 $25.00 $24,580.01 $26,580 $25,660.01 $27,660 $26,740.01 $28,740 $30.00 $26,580.01 $28,580 $27,660.01 $29,660 $28,740.01 $30,740 $35.00 $28,580.01 $30,580 $29,660.01 $31,660 $30,740.01 $32,740 $40.00 $30,580.01 $32,580 $31,660.01 $33,660 $32,740.01 $34,740 $45.00 $32,580.01 $34,580 $33,660.01 $35,660 $34,740.01 $36,740 $50.00 $34,580.01 $36,580 $35,660.01 $37,660 $36,740.01 $38,740 $55.00 $36,580.01 $38,580 $37,660.01 $39,660 $38,740.01 $40,740 $60.00 $38,580.01 $40,580 $39,660.01 $41,660 $40,740.01 $42,740 $65.00 $40,580.01 $42,580 $41,660.01 $43,660 $42,740.01 $44,740 $70.00 $42,580.01 $44,580 $43,660.01 $45,660 $44,740.01 $46,740 $75.00 $44,580.01 $46,580 $45,660.01 $47,660 $46,740.01 $48,740 $80.00 $46,580.01 $48,580 $47,660.01 $49,660 $48,740.01 $50,740 $85.00 $48,580.01 $50,580 $49,660.01 $51,660 $50,740.01 $52,740 $90.00 $50,580.01 $52,580 $51,660.01 $53,660 $52,740.01 $54,740 $95.00 $52,580.01 $54,580 $53,660.01 $55,660 $54,740.01 $56,740 $100.00 $54,580.01 $56,580 $55,660.01 $57,660 $56,740.01 $58,740 $105.00 $56,580.01 $58,580 $57,660.01 $59,660 $58,740.01 $60,740 $110.00 $58,580.01 $60,580 $59,660.01 $61,660 $60,740.01 $62,740 $115.00 $60,580.01 $62,580 $61,660.01 $63,660 $62,740.01 $64,740 $120.00 $62,580.01 $64,580 $63,660.01 $65,660 $64,740.01 $66,740 $125.00 $64,580.01 $66,580 $65,660.01 $67,660 $66,740.01 $68,740 $130.00 $66,580.01 $68,580 $67,660.01 $69,660 $68,740.01 $70,740 $135.00 $68,580.01 $70,580 $69,660.01 $71,660 $70,740.01 $72,740 $140.00 $70,580.01 $72,580 $71,660.01 $73,660 $72,740.01 $74,740 $145.00 $72,580.01 $74,580 $73,660.01 $75,660 $74,740.01 $76,740 $150.00 $74,580.01 $76,580 $75,660.01 $77,660 $76,740.01 $78,740 $155.00 $76,580.01 $78,580 $77,660.01 $79,660 $78,740.01 $80,740 $160.00 $78,580.01 $80,580 $79,660.01 $81,660 $80,740.01 $82,740 $165.00 $80,580.01 $82,580 $81,660.01 $83,660 $82,740.01 $84,740 $170.00 $82,580.01 $84,580 $83,660.01 $85,660 $84,740.01 $86,740 $175.00 $84,580.01 $85,963 $85,660.01 $87,660 $86,740.01 $88,740 $180.00 $87,660.01 $89,660 $88,740.01 $90,740 $185.00 $89,660.01 $91,660 $90,740.01 $92,740 $190.00 $91,660.01 $93,201 $92,740.01 $94,740 $195.00 $94,740.01 $96,740 $200.00 $96,740.01 $98,740 $205.00 $98,740.01 $100,439 200% FPIG $73,160 200% FPIG $79,320 200% FPIG $85,480
Weekly Family Size: 13 Family Size: 14 Family Size: 15 Co-pay Annual Income Annual Income Annual Income $5.00 Less than: $21,820 Less than: $22,900 Less than: $23,980 $10.00 $21,820.01 $23,820 $22,900.01 $24,900 $23,980.01 $25,980 $15.00 $23,820.01 $25,820 $24,900.01 $26,900 $25,980.01 $27,980 $20.00 $25,820.01 $27,820 $26,900.01 $28,900 $27,980.01 $29,980 $25.00 $27,820.01 $29,820 $28,900.01 $30,900 $29,980.01 $31,980 $30.00 $29,820.01 $31,820 $30,900.01 $32,900 $31,980.01 $33,980 $35.00 $31,820.01 $33,820 $32,900.01 $34,900 $33,980.01 $35,980 $40.00 $33,820.01 $35,820 $34,900.01 $36,900 $35,980.01 $37,980 $45.00 $35,820.01 $37,820 $36,900.01 $38,900 $37,980.01 $39,980 $50.00 $37,820.01 $39,820 $38,900.01 $40,900 $39,980.01 $41,980 $55.00 $39,820.01 $41,820 $40,900.01 $42,900 $41,980.01 $43,980 $60.00 $41,820.01 $43,820 $42,900.01 $44,900 $43,980.01 $45,980 $65.00 $43,820.01 $45,820 $44,900.01 $46,900 $45,980.01 $47,980 $70.00 $45,820.01 $47,820 $46,900.01 $48,900 $47,980.01 $49,980 $75.00 $47,820.01 $49,820 $48,900.01 $50,900 $49,980.01 $51,980 $80.00 $49,820.01 $51,820 $50,900.01 $52,900 $51,980.01 $53,980 $85.00 $51,820.01 $53,820 $52,900.01 $54,900 $53,980.01 $55,980 $90.00 $53,820.01 $55,820 $54,900.01 $56,900 $55,980.01 $57,980 $95.00 $55,820.01 $57,820 $56,900.01 $58,900 $57,980.01 $59,980 $100.00 $57,820.01 $59,820 $58,900.01 $60,900 $59,980.01 $61,980 $105.00 $59,820.01 $61,820 $60,900.01 $62,900 $61,980.01 $63,980 $110.00 $61,820.01 $63,820 $62,900.01 $64,900 $63,980.01 $65,980 $115.00 $63,820.01 $65,820 $64,900.01 $66,900 $65,980.01 $67,980 $120.00 $65,820.01 $67,820 $66,900.01 $68,900 $67,980.01 $69,980 $125.00 $67,820.01 $69,820 $68,900.01 $70,900 $69,980.01 $71,980 $130.00 $69,820.01 $71,820 $70,900.01 $72,900 $71,980.01 $73,980 $135.00 $71,820.01 $73,820 $72,900.01 $74,900 $73,980.01 $75,980 $140.00 $73,820.01 $75,820 $74,900.01 $76,900 $75,980.01 $77,980 $145.00 $75,820.01 $77,820 $76,900.01 $78,900 $77,980.01 $79,980 $150.00 $77,820.01 $79,820 $78,900.01 $80,900 $79,980.01 $81,980 $155.00 $79,820.01 $81,820 $80,900.01 $82,900 $81,980.01 $83,980 $160.00 $81,820.01 $83,820 $82,900.01 $84,900 $83,980.01 $85,980 $165.00 $83,820.01 $85,820 $84,900.01 $86,900 $85,980.01 $87,980 $170.00 $85,820.01 $87,820 $86,900.01 $88,900 $87,980.01 $89,980 $175.00 $87,820.01 $89,820 $88,900.01 $90,900 $89,980.01 $91,980 $180.00 $89,820.01 $91,820 $90,900.01 $92,900 $91,980.01 $93,980 $185.00 $91,820.01 $93,820 $92,900.01 $94,900 $93,980.01 $95,980 $190.00 $93,820.01 $95,820 $94,900.01 $96,900 $95,980.01 $97,980 $195.00 $95,820.01 $97,820 $96,900.01 $98,900 $97,980.01 $99,980 $200.00 $97,820.01 $99,820 $98,900.01 $100,900 $99,980.01 $101,980 $205.00 $99,820.01 $101,820 $100,900.01 $102,900 $101,980.01 $103,980 $210.00 $101,820.01 $103,820 $102,900.01 $104,900 $103,980.01 $105,980 $215.00 $103,820.01 $105,820 $104,900.01 $106,900 $105,980.01 $107,980 $220.00 $105,820.01 $107,677 $106,900.01 $108,900 $107,980.01 $109,980 $225.00 $108,900.01 $110,900 $109,980.01 $111,980 $230.00 $110,900.01 $112,900 $111,980.01 $113,980 $235.00 $112,900.01 $114,900 $113,980.01 $115,980 $240.00 $114,900.01 $114,915 $115,980.01 $117,980 $245.00 $117,980.01 $119,980 $250.00 $119,980.01 $121,980 $255.00 $121,980.01 $122,153 200% FPIG $91,640 200% FPIG $97,800 200% FPIG $103,960
Weekly Family Size: 16 Family Size: 17 Family Size: 18 Co-pay Annual Income Annual Income Annual Income $5.00 Less than: $27,060 Less than: $28,140 Less than: $29,220 $10.00 $27,060.01 $29,060 $28,140.01 $30,140 $29,220.01 $31,220 $15.00 $29,060.01 $31,060 $30,140.01 $32,140 $31,220.01 $33,220 $20.00 $31,060.01 $33,060 $32,140.01 $34,140 $33,220.01 $35,220 $25.00 $33,060.01 $35,060 $34,140.01 $36,140 $35,220.01 $37,220 $30.00 $35,060.01 $37,060 $36,140.01 $38,140 $37,220.01 $39,220 $35.00 $37,060.01 $39,060 $38,140.01 $40,140 $39,220.01 $41,220 $40.00 $39,060.01 $41,060 $40,140.01 $42,140 $41,220.01 $43,220 $45.00 $41,060.01 $43,060 $42,140.01 $44,140 $43,220.01 $45,220 $50.00 $43,060.01 $45,060 $44,140.01 $46,140 $45,220.01 $47,220 $55.00 $45,060.01 $47,060 $46,140.01 $48,140 $47,220.01 $49,220 $60.00 $47,060.01 $49,060 $48,140.01 $50,140 $49,220.01 $51,220 $65.00 $49,060.01 $51,060 $50,140.01 $52,140 $51,220.01 $53,220 $70.00 $51,060.01 $53,060 $52,140.01 $54,140 $53,220.01 $55,220 $75.00 $53,060.01 $55,060 $54,140.01 $56,140 $55,220.01 $57,220 $80.00 $55,060.01 $57,060 $56,140.01 $58,140 $57,220.01 $59,220 $85.00 $57,060.01 $59,060 $58,140.01 $60,140 $59,220.01 $61,220 $90.00 $59,060.01 $61,060 $60,140.01 $62,140 $61,220.01 $63,220 $95.00 $61,060.01 $63,060 $62,140.01 $64,140 $63,220.01 $65,220 $100.00 $63,060.01 $65,060 $64,140.01 $66,140 $65,220.01 $67,220 $105.00 $65,060.01 $67,060 $66,140.01 $68,140 $67,220.01 $69,220 $110.00 $67,060.01 $69,060 $68,140.01 $70,140 $69,220.01 $71,220 $115.00 $69,060.01 $71,060 $70,140.01 $72,140 $71,220.01 $73,220 $120.00 $71,060.01 $73,060 $72,140.01 $74,140 $73,220.01 $75,220 $125.00 $73,060.01 $75,060 $74,140.01 $76,140 $75,220.01 $77,220 $130.00 $75,060.01 $77,060 $76,140.01 $78,140 $77,220.01 $79,220 $135.00 $77,060.01 $79,060 $78,140.01 $80,140 $79,220.01 $81,220 $140.00 $79,060.01 $81,060 $80,140.01 $82,140 $81,220.01 $83,220 $145.00 $81,060.01 $83,060 $82,140.01 $84,140 $83,220.01 $85,220 $150.00 $83,060.01 $85,060 $84,140.01 $86,140 $85,220.01 $87,220 $155.00 $85,060.01 $87,060 $86,140.01 $88,140 $87,220.01 $89,220 $160.00 $87,060.01 $89,060 $88,140.01 $90,140 $89,220.01 $91,220 $165.00 $89,060.01 $91,060 $90,140.01 $92,140 $91,220.01 $93,220 $170.00 $91,060.01 $93,060 $92,140.01 $94,140 $93,220.01 $95,220 $175.00 $93,060.01 $95,060 $94,140.01 $96,140 $95,220.01 $97,220 $180.00 $95,060.01 $97,060 $96,140.01 $98,140 $97,220.01 $99,220 $185.00 $97,060.01 $99,060 $98,140.01 $100,140 $99,220.01 $101,220 $190.00 $99,060.01 $101,060 $100,140.01 $102,140 $101,220.01 $103,220 $195.00 $101,060.01 $103,060 $102,140.01 $104,140 $103,220.01 $105,220 $200.00 $103,060.01 $105,060 $104,140.01 $106,140 $105,220.01 $107,220 $205.00 $105,060.01 $107,060 $106,140.01 $108,140 $107,220.01 $109,220 $210.00 $107,060.01 $109,060 $108,140.01 $110,140 $109,220.01 $111,220 $215.00 $109,060.01 $111,060 $110,140.01 $112,140 $111,220.01 $113,220 $220.00 $111,060.01 $113,060 $112,140.01 $114,140 $113,220.01 $115,220 $225.00 $113,060.01 $115,060 $114,140.01 $116,140 $115,220.01 $117,220 $230.00 $115,060.01 $117,060 $116,140.01 $118,140 $117,220.01 $119,220 $235.00 $117,060.01 $119,060 $118,140.01 $120,140 $119,220.01 $121,220 $240.00 $119,060.01 $121,060 $120,140.01 $122,140 $121,220.01 $123,220 $245.00 $121,060.01 $123,060 $122,140.01 $124,140 $123,220.01 $125,220 $250.00 $123,060.01 $125,060 $124,140.01 $126,140 $125,220.01 $127,220 $255.00 $125,060.01 $127,060 $126,140.01 $128,140 $127,220.01 $129,220 $260.00 $127,060.01 $129,060 $128,140.01 $130,140 $129,220.01 $131,220 $265.00 $129,060.01 $129,391 $130,140.01 $132,140 $131,220.01 $133,220 $270.00 $132,140.01 $134,140 $133,220.01 $135,220 $275.00 $134,140.01 $136,140 $135,220.01 $137,220 $280.00 $136,140.01 $136,629 $137,220.01 $139,220 $285.00 $139,220.01 $141,220 $290.00 $141,220.01 $143,220 $295.00 $143,220.01 $143,867 200% FPIG $110,120 200% FPIG $116,280 200% FPIG $122,440
Weekly Family Size: 19 Family Size: 20 Family Size: 21 Co-pay Annual Income Annual Income Annual Income $5.00 Less than: $30,300 Less than: $31,380 Less than: $32,460 $10.00 $30,300.01 $32,300 $31,380.01 $33,380 $32,460.01 $34,460 $15.00 $32,300.01 $34,300 $33,380.01 $35,380 $34,460.01 $36,460 $20.00 $34,300.01 $36,300 $35,380.01 $37,380 $36,460.01 $38,460 $25.00 $36,300.01 $38,300 $37,380.01 $39,380 $38,460.01 $40,460 $30.00 $38,300.01 $40,300 $39,380.01 $41,380 $40,460.01 $42,460 $35.00 $40,300.01 $42,300 $41,380.01 $43,380 $42,460.01 $44,460 $40.00 $42,300.01 $44,300 $43,380.01 $45,380 $44,460.01 $46,460 $45.00 $44,300.01 $46,300 $45,380.01 $47,380 $46,460.01 $48,460 $50.00 $46,300.01 $48,300 $47,380.01 $49,380 $48,460.01 $50,460 $55.00 $48,300.01 $50,300 $49,380.01 $51,380 $50,460.01 $52,460 $60.00 $50,300.01 $52,300 $51,380.01 $53,380 $52,460.01 $54,460 $65.00 $52,300.01 $54,300 $53,380.01 $55,380 $54,460.01 $56,460 $70.00 $54,300.01 $56,300 $55,380.01 $57,380 $56,460.01 $58,460 $75.00 $56,300.01 $58,300 $57,380.01 $59,380 $58,460.01 $60,460 $80.00 $58,300.01 $60,300 $59,380.01 $61,380 $60,460.01 $62,460 $85.00 $60,300.01 $62,300 $61,380.01 $63,380 $62,460.01 $64,460 $90.00 $62,300.01 $64,300 $63,380.01 $65,380 $64,460.01 $66,460 $95.00 $64,300.01 $66,300 $65,380.01 $67,380 $66,460.01 $68,460 $100.00 $66,300.01 $68,300 $67,380.01 $69,380 $68,460.01 $70,460 $105.00 $68,300.01 $70,300 $69,380.01 $71,380 $70,460.01 $72,460 $110.00 $70,300.01 $72,300 $71,380.01 $73,380 $72,460.01 $74,460 $115.00 $72,300.01 $74,300 $73,380.01 $75,380 $74,460.01 $76,460 $120.00 $74,300.01 $76,300 $75,380.01 $77,380 $76,460.01 $78,460 $125.00 $76,300.01 $78,300 $77,380.01 $79,380 $78,460.01 $80,460 $130.00 $78,300.01 $80,300 $79,380.01 $81,380 $80,460.01 $82,460 $135.00 $80,300.01 $82,300 $81,380.01 $83,380 $82,460.01 $84,460 $140.00 $82,300.01 $84,300 $83,380.01 $85,380 $84,460.01 $86,460 $145.00 $84,300.01 $86,300 $85,380.01 $87,380 $86,460.01 $88,460 $150.00 $86,300.01 $88,300 $87,380.01 $89,380 $88,460.01 $90,460 $155.00 $88,300.01 $90,300 $89,380.01 $91,380 $90,460.01 $92,460 $160.00 $90,300.01 $92,300 $91,380.01 $93,380 $92,460.01 $94,460 $165.00 $92,300.01 $94,300 $93,380.01 $95,380 $94,460.01 $96,460 $170.00 $94,300.01 $96,300 $95,380.01 $97,380 $96,460.01 $98,460 $175.00 $96,300.01 $98,300 $97,380.01 $99,380 $98,460.01 $100,460 $180.00 $98,300.01 $100,300 $99,380.01 $101,380 $100,460.01 $102,460 $185.00 $100,300.01 $102,300 $101,380.01 $103,380 $102,460.01 $104,460 $190.00 $102,300.01 $104,300 $103,380.01 $105,380 $104,460.01 $106,460 $195.00 $104,300.01 $106,300 $105,380.01 $107,380 $106,460.01 $108,460 $200.00 $106,300.01 $108,300 $107,380.01 $109,380 $108,460.01 $110,460 $205.00 $108,300.01 $110,300 $109,380.01 $111,380 $110,460.01 $112,460 $210.00 $110,300.01 $112,300 $111,380.01 $113,380 $112,460.01 $114,460 $215.00 $112,300.01 $114,300 $113,380.01 $115,380 $114,460.01 $116,460 $220.00 $114,300.01 $116,300 $115,380.01 $117,380 $116,460.01 $118,460 $225.00 $116,300.01 $118,300 $117,380.01 $119,380 $118,460.01 $120,460 $230.00 $118,300.01 $120,300 $119,380.01 $121,380 $120,460.01 $122,460 $235.00 $120,300.01 $122,300 $121,380.01 $123,380 $122,460.01 $124,460 $240.00 $122,300.01 $124,300 $123,380.01 $125,380 $124,460.01 $126,460 $245.00 $124,300.01 $126,300 $125,380.01 $127,380 $126,460.01 $128,460 $250.00 $126,300.01 $128,300 $127,380.01 $129,380 $128,460.01 $130,460 $255.00 $128,300.01 $130,300 $129,380.01 $131,380 $130,460.01 $132,460 $260.00 $130,300.01 $132,300 $131,380.01 $133,380 $132,460.01 $134,460
Weekly Family Size: 19 Family Size: 20 Family Size: 21 Co-pay Annual Income Annual Income Annual Income $265.00 $132,300.01 $134,300 $133,380.01 $135,380 $134,460.01 $136,460 $270.00 $134,300.01 $136,300 $135,380.01 $137,380 $136,460.01 $138,460 $275.00 $136,300.01 $138,300 $137,380.01 $139,380 $138,460.01 $140,460 $280.00 $138,300.01 $140,300 $139,380.01 $141,380 $140,460.01 $142,460 $285.00 $140,300.01 $142,300 $141,380.01 $143,380 $142,460.01 $144,460 $290.00 $142,300.01 $144,300 $143,380.01 $145,380 $144,460.01 $146,460 $295.00 $144,300.01 $146,300 $145,380.01 $147,380 $146,460.01 $148,460 $300.00 $146,300.01 $148,300 $147,380.01 $149,380 $148,460.01 $150,460 $305.00 $148,300.01 $150,300 $149,380.01 $151,380 $150,460.01 $152,460 $310.00 $150,300.01 $151,105 $151,380.01 $153,380 $152,460.01 $154,460 $315.00 $153,380.01 $155,380 $154,460.01 $156,460 $320.00 $155,380.01 $157,380 $156,460.01 $158,460 $325.00 $157,380.01 $158,343 $158,460.01 $160,460 $330.00 $160,460.01 $162,460 $335.00 $162,460.01 $164,460 $340.00 $164,460.01 $165,581 200% FPIG $128,600 200% FPIG $134,760 200% FPIG $140,920
[Pa.B. Doc. No. 02-1008. Filed for public inspection June 7, 2002, 9:00 a.m.]
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