NOTICES
DEPARTMENT OF HUMAN SERVICES
Co-payments for the Subsidized Child Care Program
[52 Pa.B. 6425]
[Saturday, October 8, 2022]This notice expands co-payments codified at 55 Pa. Code Chapter 3041, Appendix B (relating to co-payment chart family co-payment scale (based on the 2022 Federal Poverty Income Guidelines)) under 55 Pa. Code § 3041.107(b) (relating to availability and use of the Federal Poverty Income Guidelines). 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. This change is effective September 12, 2022.
Under section 408.3(b) of the Human Services Code (62 P.S. § 408.3(b)), the co-payment schedule is adjusted by notice published in the Pennsylvania Bulletin. Effective September 12, 2022, co-payments will be expanded to include families whose income is between 235% in the Federal Poverty Income Guidelines (FPIG) and 300% FPIG. Families with income between 235% FPIG and 300% FPIG will pay 7% to 12% of their income. The initiative will not change any family's co-payment if their income is 235% FPIG or less, who pay 3% to 7% of their income.
MEG SNEAD,
Acting SecretaryFiscal Note: 14-NOT-1538. (1) General Fund; (2) Implementing Year 2022-23 is $25,000,000; (3) 1st Succeeding Year 2023-24 through 5th Succeeding Year 2027-28 are $0; (4) 2021-22 Program—$156,482,000; 2020-21 Program—$156,482,000; 2019-20 Program—$156,332,000; (7) Child Care Services; (8) recommends adoption. Funds have been included in the budget to cover this increase.
CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE SEPTEMBER 12, 2022
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 $0.00 $7,186 $5 $0.00 $7,530 $5 $0.00 $8,118 $6 $7,186.01 $7,984 $6 $7,530.01 $8,606 $6 $8,118.01 $9,471 $6 $7,984.01 $8,783 $7 $8,606.01 $9,681 $7 $9,471.01 $10,824 $7 $8,783.01 $9,581 $8 $9,681.01 $10,757 $8 $10,824.01 $12,177 $8 $9,581.01 $10,379 $9 $10,757.01 $11,833 $10 $12,177.01 $13,530 $9 $10,379.01 $11,178 $10 $11,833.01 $12,909 $11 $13,530.01 $14,883 $10 $11,178.01 $11,976 $11 $12,909.01 $13,984 $12 $14,883.01 $16,236 $11 $11,976.01 $12,775 $12 $13,984.01 $15,060 $14 $16,236.01 $17,589 $12 $12,775.01 $13,573 $13 $15,060.01 $16,136 $15 $17,589.01 $18,942 $13 $13,573.01 $14,371 $15 $16,136.01 $17,211 $17 $18,942.01 $20,295 $14 $14,371.01 $15,170 $16 $17,211.01 $18,287 $19 $20,295.01 $21,648 $15 $15,170.01 $15,968 $18 $18,287.01 $19,363 $20 $21,648.01 $23,001 $16 $15,968.01 $16,767 $19 $19,363.01 $20,439 $22 $23,001.01 $24,354 $17 $16,767.01 $17,565 $20 $20,439.01 $21,514 $24 $24,354.01 $25,707 $18 $17,565.01 $18,363 $22 $21,514.01 $22,590 $26 $25,707.01 $27,060 $20 $18,363.01 $19,162 $23 $22,590.01 $23,666 $27 $27,060.01 $28,413 $21 $19,162.01 $19,960 $25 $23,666.01 $24,741 $29 $28,413.01 $29,766 $22 $19,960.01 $20,759 $26 $24,741.01 $25,817 $31 $29,766.01 $31,119 $23 $20,759.01 $21,557 $28 $25,817.01 $26,893 $33 $31,119.01 $32,472 $24 $21,557.01 $22,356 $30 $26,893.01 $27,969 $35 $32,472.01 $33,825 $26 $22,356.01 $23,154 $31 $27,969.01 $29,044 $37 $33,825.01 $35,178 $27 $23,154.01 $23,952 $33 $29,044.01 $30,120 $39 $35,178.01 $36,531 $28 $23,952.01 $24,751 $35 $30,120.01 $31,196 $42 $36,531.01 $37,884 $30 $24,751.01 $25,549 $37 $31,196.01 $32,271 $44 $37,884.01 $39,237 $31 $25,549.01 $26,348 $38 $32,271.01 $33,347 $46 $39,237.01 $40,590 $33 $26,348.01 $27,146 $40 $33,347.01 $34,423 $48 $40,590.01 $41,943 $34 $27,146.01 $27,944 $42 $34,423.01 $35,499 $51 $41,943.01 $43,296 $36 $27,944.01 $28,743 $44 $35,499.01 $36,574 $53 $43,296.01 $44,649 $37 $28,743.01 $29,541 $46 $36,574.01 $37,650 $55 $44,649.01 $46,002 $39 $29,541.01 $30,340 $48 $37,650.01 $38,726 $58 $46,002.01 $47,355 $40 $30,340.01 $31,138 $50 $38,726.01 $39,801 $60 $47,355.01 $48,708 $42 $31,138.01 $31,937 $52 $39,801.01 $40,877 $63 $48,708.01 $50,061 $44 $31,937.01 $32,379 $54 $40,877.01 $41,953 $66 $50,061.01 $51,414 $46 $32,379.01 $32,820 $56 $41,953.01 $43,029 $68 $51,414.01 $52,767 $48 $32,820.01 $33,262 $59 $43,029.01 $43,624 $71 $52,767.01 $54,121 $50 $33,262.01 $33,704 $62 $43,624.01 $44,219 $74 $54,121.01 $54,869 $53 $33,704.01 $34,145 $65 $44,219.01 $44,814 $78 $54,869.01 $55,618 $55 $34,145.01 $34,587 $68 $44,814.01 $45,409 $81 $55,618.01 $56,366 $58 $34,587.01 $35,029 $71 $45,409.01 $46,004 $85 $56,366.01 $57,115 $60 $35,029.01 $35,470 $74 $46,004.01 $46,599 $89 $57,115.01 $57,863 $63 $35,470.01 $35,912 $77 $46,599.01 $47,194 $93 $57,863.01 $58,612 $65 $35,912.01 $36,354 $81 $47,194.01 $47,790 $97 $58,612.01 $59,360 $68 $36,354.01 $36,795 $84 $47,790.01 $48,385 $102 $59,360.01 $60,109 $70 $36,795.01 $37,237 $88 $48,385.01 $48,980 $106 $60,109.01 $60,857 $73 $37,237.01 $37,679 $91 $48,980.01 $49,575 $110 $60,857.01 $61,606 $76 $37,679.01 $38,120 $95 $49,575.01 $50,170 $115 $61,606.01 $62,354 $79 $38,120.01 $38,562 $98 $50,170.01 $50,765 $119 $62,354.01 $63,103 $81 $38,562.01 $39,004 $102 $50,765.01 $51,360 $124 $63,103.01 $63,851 $84 $39,004.01 $39,445 $106 $51,360.01 $51,955 $128 $63,851.01 $64,600 $87 $39,445.01 $39,887 $110 $51,955.01 $52,550 $133 $64,600.01 $65,348 $90 $39,887.01 $40,329 $113 $52,550.01 $53,145 $138 $65,348.01 $66,096 $93 $40,329.01 $40,770 $117 $53,145.01 $53,740 $143 $66,096.01 $66,845 200% FPIG $27,180 $121 $53,740.01 $54,335 $148 $66,845.01 $67,593 $125 $54,335.01 $54,930 $153 $67,593.01 $68,342 200% FPIG $36,620 $158 $68,342.01 $69,090 200% FPIG $46,060
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 $0.00 $8,152 $5 $0.00 $9,538 $5 $0.00 $8,740 $6 $8,152.01 $9,782 $7 $9,538.01 $11,446 $6 $8,740.01 $10,925 $7 $9,782.01 $11,412 $8 $11,446.01 $13,353 $8 $10,925.01 $13,109 $8 $11,412.01 $13,043 $10 $13,353.01 $15,261 $9 $13,109.01 $15,294 $10 $13,043.01 $14,673 $12 $15,261.01 $17,169 $11 $15,294.01 $17,479 $11 $14,673.01 $16,303 $13 $17,169.01 $19,076 $13 $17,479.01 $19,664 $13 $16,303.01 $17,933 $15 $19,076.01 $20,984 $15 $19,664.01 $21,849 $15 $17,933.01 $19,564 $17 $20,984.01 $22,891 $18 $21,849.01 $24,034 $17 $19,564.01 $21,194 $19 $22,891.01 $24,799 $20 $24,034.01 $26,219 $18 $21,194.01 $22,824 $22 $24,799.01 $26,707 $22 $26,219.01 $28,404 $20 $22,824.01 $24,455 $24 $26,707.01 $28,614 $25 $28,404.01 $30,589 $22 $24,455.01 $26,085 $26 $28,614.01 $30,522 $27 $30,589.01 $32,774 $24 $26,085.01 $27,715 $29 $30,522.01 $32,429 $30 $32,774.01 $34,959 $27 $27,715.01 $29,346 $31 $32,429.01 $34,337 $33 $34,959.01 $37,144 $29 $29,346.01 $30,976 $34 $34,337.01 $36,245 $36 $37,144.01 $39,328 $31 $30,976.01 $32,606 $36 $36,245.01 $38,152 $39 $39,328.01 $41,513 $33 $32,606.01 $34,237 $39 $38,152.01 $40,060 $41 $41,513.01 $43,698 $35 $34,237.01 $35,867 $41 $40,060.01 $41,967 $44 $43,698.01 $45,883 $38 $35,867.01 $37,497 $44 $41,967.01 $43,875 $47 $45,883.01 $48,068 $40 $37,497.01 $39,128 $47 $43,875.01 $45,783 $50 $48,068.01 $50,253 $42 $39,128.01 $40,758 $50 $45,783.01 $47,690 $54 $50,253.01 $52,438 $45 $40,758.01 $42,388 $53 $47,690.01 $49,598 $57 $52,438.01 $54,623 $47 $42,388.01 $44,018 $55 $49,598.01 $51,506 $60 $54,623.01 $56,808 $50 $44,018.01 $45,649 $59 $51,506.01 $53,413 $64 $56,808.01 $58,993 $53 $45,649.01 $47,279 $62 $53,413.01 $55,321 $67 $58,993.01 $61,178 $55 $47,279.01 $48,909 $65 $55,321.01 $57,228 $71 $61,178.01 $63,362 $58 $48,909.01 $50,540 $68 $57,228.01 $59,136 $74 $63,362.01 $65,547 $61 $50,540.01 $52,170 $71 $59,136.01 $61,044 $78 $65,547.01 $67,732 $64 $52,170.01 $53,800 $75 $61,044.01 $62,951 $82 $67,732.01 $69,917 $67 $53,800.01 $55,431 $78 $62,951.01 $64,859 $86 $69,917.01 $72,102 $70 $55,431.01 $57,061 $82 $64,859.01 $66,766 $89 $72,102.01 $74,287 $73 $57,061.01 $58,691 $85 $66,766.01 $68,674 $94 $74,287.01 $76,472 $76 $58,691.01 $60,322 $89 $68,674.01 $70,582 $98 $76,472.01 $78,657 $79 $60,322.01 $61,952 $93 $70,582.01 $72,489 $102 $78,657.01 $80,842 $82 $61,952.01 $63,582 $96 $72,489.01 $74,397 $106 $80,842.01 $83,027 $86 $63,582.01 $65,213 $100 $74,397.01 $76,305 $110 $83,027.01 $85,212 $89 $65,213.01 $66,115 $104 $76,305.01 $77,360 $115 $85,212.01 $87,397 $94 $66,115.01 $67,017 $109 $77,360.01 $78,416 $119 $87,397.01 $88,606 $98 $67,017.01 $67,919 $115 $78,416.01 $79,471 $125 $88,606.01 $89,814 $103 $67,919.01 $68,820 $120 $79,471.01 $80,526 $132 $89,814.01 $91,023 $108 $68,820.01 $69,722 $126 $80,526.01 $81,581 $138 $91,023.01 $92,232 $112 $69,722.01 $70,624 $132 $81,581.01 $82,637 $144 $92,232.01 $93,440 $117 $70,624.01 $71,526 $137 $82,637.01 $83,692 $151 $93,440.01 $94,649 $122 $71,526.01 $72,428 $143 $83,692.01 $84,747 $157 $94,649.01 $95,858 $128 $72,428.01 $73,330 $149 $84,747.01 $85,802 $164 $95,858.01 $97,066 $133 $73,330.01 $74,232 $155 $85,802.01 $86,858 $171 $97,066.01 $98,275 $138 $74,232.01 $75,134 $162 $86,858.01 $87,913 $178 $98,275.01 $99,484 $144 $75,134.01 $76,035 $168 $87,913.01 $88,968 $185 $99,484.01 $100,692 $149 $76,035.01 $76,937 $174 $88,968.01 $90,023 $192 $100,692.01 $101,901 $155 $76,937.01 $77,839 $181 $90,023.01 $91,079 $200 $101,901.01 $103,110 $160 $77,839.01 $78,741 $188 $91,079.01 $92,134 $207 $103,110.01 $104,318 $166 $78,741.01 $79,643 $194 $92,134.01 $93,189 $215 $104,318.01 $105,527 $172 $79,643.01 $80,545 $201 $93,189.01 $94,244 $223 $105,527.01 $106,736 $178 $80,545.01 $81,447 $208 $94,244.01 $95,300 $230 $106,736.01 $107,944 $184 $81,447.01 $82,348 $215 $95,300.01 $96,355 $238 $107,944.01 $109,153 $190 $82,348.01 $83,250 $222 $96,355.01 $97,410 $246 $109,153.01 $110,361 200% FPIG $55,500 200% FPIG $64,940 $255 $110,361.01 $111,570 200% FPIG $74,380
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 $0.00 $9,849 $5 $0.00 $10,958 $5 $0.00 $9,050 $7 $9,849.01 $12,311 $7 $10,958.01 $13,698 $6 $9,050.01 $12,067 $8 $12,311.01 $14,773 $9 $13,698.01 $16,437 $8 $12,067.01 $15,084 $11 $14,773.01 $17,235 $12 $16,437.01 $19,177 $10 $15,084.01 $18,101 $13 $17,235.01 $19,698 $14 $19,177.01 $21,916 $13 $18,101.01 $21,118 $15 $19,698.01 $22,160 $17 $21,916.01 $24,656 $16 $21,118.01 $24,135 $17 $22,160.01 $24,622 $19 $24,656.01 $27,395 $18 $24,135.01 $27,151 $20 $24,622.01 $27,084 $22 $27,395.01 $30,135 $21 $27,151.01 $30,168 $22 $27,084.01 $29,547 $25 $30,135.01 $32,874 $24 $30,168.01 $33,185 $25 $29,547.01 $32,009 $28 $32,874.01 $35,614 $27 $33,185.01 $36,202 $28 $32,009.01 $34,471 $31 $35,614.01 $38,353 $31 $36,202.01 $39,219 $31 $34,471.01 $36,933 $34 $38,353.01 $41,093 $34 $39,219.01 $42,235 $34 $36,933.01 $39,395 $38 $41,093.01 $43,832 $38 $42,235.01 $45,252 $37 $39,395.01 $41,858 $41 $43,832.01 $46,572 $41 $45,252.01 $48,269 $40 $41,858.01 $44,320 $45 $46,572.01 $49,311 $45 $48,269.01 $51,286 $43 $44,320.01 $46,782 $48 $49,311.01 $52,051 $49 $51,286.01 $54,303 $47 $46,782.01 $49,244 $52 $52,051.01 $54,790 $53 $54,303.01 $57,319 $50 $49,244.01 $51,706 $56 $54,790.01 $57,530 $57 $57,319.01 $60,336 $53 $51,706.01 $54,169 $59 $57,530.01 $60,269 $61 $60,336.01 $63,353 $57 $54,169.01 $56,631 $63 $60,269.01 $63,009 $65 $63,353.01 $66,370 $60 $56,631.01 $59,093 $67 $63,009.01 $65,748 $70 $66,370.01 $69,387 $64 $59,093.01 $61,555 $71 $65,748.01 $68,488 $74 $69,387.01 $72,404 $68 $61,555.01 $64,018 $75 $68,488.01 $71,227 $78 $72,404.01 $75,420 $72 $64,018.01 $66,480 $80 $71,227.01 $73,967 $83 $75,420.01 $78,437 $76 $66,480.01 $68,942 $84 $73,967.01 $76,706 $88 $78,437.01 $81,454 $80 $68,942.01 $71,404 $89 $76,706.01 $79,446 $93 $81,454.01 $84,471 $84 $71,404.01 $73,866 $93 $79,446.01 $82,185 $97 $84,471.01 $87,488 $88 $73,866.01 $76,329 $98 $82,185.01 $84,925 $102 $87,488.01 $90,504 $92 $76,329.01 $78,791 $102 $84,925.01 $87,664 $108 $90,504.01 $93,521 $96 $78,791.01 $81,253 $107 $87,664.01 $90,404 $113 $93,521.01 $96,538 $101 $81,253.01 $83,715 $112 $90,404.01 $93,143 $118 $96,538.01 $99,555 $105 $83,715.01 $86,177 $117 $93,143.01 $95,883 $124 $99,555.01 $102,572 $110 $86,177.01 $88,640 $122 $95,883.01 $98,622 $129 $102,572.01 $105,588 $115 $88,640.01 $91,102 $128 $98,622.01 $101,362 $135 $105,588.01 $108,605 $119 $91,102.01 $93,564 $133 $101,362.01 $104,101 $141 $108,605.01 $111,622 $124 $93,564.01 $96,026 $138 $104,101.01 $106,841 $146 $111,622.01 $114,639 $129 $96,026.01 $98,488 $144 $106,841.01 $109,581 $152 $114,639.01 $117,656 $134 $98,488.01 $99,850 $150 $109,581.01 $111,096 $158 $117,656.01 $120,673 $141 $99,850.01 $101,212 $157 $111,096.01 $112,612 $165 $120,673.01 $122,342 $148 $101,212.01 $102,574 $165 $112,612.01 $114,127 $173 $122,342.01 $124,011 $155 $102,574.01 $103,936 $173 $114,127.01 $115,643 $182 $124,011.01 $125,680 $163 $103,936.01 $105,299 $181 $115,643.01 $117,158 $190 $125,680.01 $127,348 $170 $105,299.01 $106,661 $189 $117,158.01 $118,674 $199 $127,348.01 $129,017 $177 $106,661.01 $108,023 $197 $118,674.01 $120,189 $208 $129,017.01 $130,686 $185 $108,023.01 $109,385 $206 $120,189.01 $121,705 $217 $130,686.01 $132,355 $193 $109,385.01 $110,747 $214 $121,705.01 $123,220 $227 $132,355.01 $134,024 $201 $110,747.01 $112,109 $223 $123,220.01 $124,736 $236 $134,024.01 $135,693 $209 $112,109.01 $113,471 $232 $124,736.01 $126,251 $246 $135,693.01 $137,361 $217 $113,471.01 $114,833 $241 $126,251.01 $127,766 $256 $137,361.01 $139,030 $225 $114,833.01 $116,195 $250 $127,766.01 $129,282 $266 $139,030.01 $140,699 $234 $116,195.01 $117,557 $260 $129,282.01 $130,797 $276 $140,699.01 $142,368 $242 $117,557.01 $118,920 $269 $130,797.01 $132,313 $286 $142,368.01 $144,037 $251 $118,920.01 $120,282 $279 $132,313.01 $133,828 $297 $144,037.01 $145,706 $260 $120,282.01 $121,644 $289 $133,828.01 $135,344 $307 $145,706.01 $147,375 $269 $121,644.01 $123,006 $299 $135,344.01 $136,859 $318 $147,375.01 $149,043 $278 $123,006.01 $124,368 $309 $136,859.01 $138,375 $329 $149,043.01 $150,712 $287 $124,368.01 $125,730 $319 $138,375.01 $139,890 $340 $150,712.01 $152,381 200% FPIG $83,820 200% FPIG $93,260 $352 $152,381.01 $154,050 200% FPIG $102,700
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 $0.00 $9,882 $5 $0.00 $10,714 $5 $0.00 $11,546 $6 $9,882.01 $13,176 $7 $10,714.01 $14,286 $7 $11,546.01 $15,395 $9 $13,176.01 $16,471 $10 $14,286.01 $17,857 $10 $15,395.01 $19,244 $11 $16,471.01 $19,765 $12 $17,857.01 $21,428 $13 $19,244.01 $23,092 $14 $19,765.01 $23,059 $15 $21,428.01 $25,000 $16 $23,092.01 $26,941 $17 $23,059.01 $26,353 $18 $25,000.01 $28,571 $20 $26,941.01 $30,790 $20 $26,353.01 $29,647 $22 $28,571.01 $32,143 $23 $30,790.01 $34,638 $23 $29,647.01 $32,941 $25 $32,143.01 $35,714 $27 $34,638.01 $38,487 $26 $32,941.01 $36,235 $29 $35,714.01 $39,286 $31 $38,487.01 $42,336 $30 $36,235.01 $39,529 $32 $39,286.01 $42,857 $35 $42,336.01 $46,185 $34 $39,529.01 $42,823 $36 $42,857.01 $46,428 $39 $46,185.01 $50,033 $37 $42,823.01 $46,118 $40 $46,428.01 $50,000 $44 $50,033.01 $53,882 $41 $46,118.01 $49,412 $45 $50,000.01 $53,571 $48 $53,882.01 $57,731 $45 $49,412.01 $52,706 $49 $53,571.01 $57,143 $53 $57,731.01 $61,579 $49 $52,706.01 $56,000 $54 $57,143.01 $60,714 $58 $61,579.01 $65,428 $54 $56,000.01 $59,294 $58 $60,714.01 $64,285 $63 $65,428.01 $69,277 $58 $59,294.01 $62,588 $63 $64,285.01 $67,857 $68 $69,277.01 $73,126 $62 $62,588.01 $65,882 $68 $67,857.01 $71,428 $73 $73,126.01 $76,974 $67 $65,882.01 $69,176 $72 $71,428.01 $75,000 $78 $76,974.01 $80,823 $71 $69,176.01 $72,470 $77 $75,000.01 $78,571 $83 $80,823.01 $84,672 $76 $72,470.01 $75,765 $82 $78,571.01 $82,142 $89 $84,672.01 $88,520 $81 $75,765.01 $79,059 $88 $82,142.01 $85,714 $94 $88,520.01 $92,369 $86 $79,059.01 $82,353 $93 $85,714.01 $89,285 $100 $92,369.01 $96,218 $91 $82,353.01 $85,647 $98 $89,285.01 $92,857 $106 $96,218.01 $100,067 $96 $85,647.01 $88,941 $104 $92,857.01 $96,428 $112 $100,067.01 $103,915 $101 $88,941.01 $92,235 $110 $96,428.01 $100,000 $118 $103,915.01 $107,764 $106 $92,235.01 $95,529 $115 $100,000.01 $103,571 $124 $107,764.01 $111,613 $112 $95,529.01 $98,823 $121 $103,571.01 $107,142 $131 $111,613.01 $115,461 $117 $98,823.01 $102,117 $127 $107,142.01 $110,714 $137 $115,461.01 $119,310 $123 $102,117.01 $105,412 $134 $110,714.01 $114,285 $144 $119,310.01 $123,159 $129 $105,412.01 $108,706 $140 $114,285.01 $117,857 $151 $123,159.01 $127,008 $135 $108,706.01 $112,000 $146 $117,857.01 $121,428 $158 $127,008.01 $130,856 $141 $112,000.01 $115,294 $153 $121,428.01 $124,999 $165 $130,856.01 $134,705 $147 $115,294.01 $118,588 $160 $124,999.01 $128,571 $172 $134,705.01 $138,554 $153 $118,588.01 $121,882 $166 $128,571.01 $132,142 $179 $138,554.01 $142,402 $160 $121,882.01 $125,176 $173 $132,142.01 $135,714 $187 $142,402.01 $146,251 $166 $125,176.01 $128,470 $180 $135,714.01 $139,285 $194 $146,251.01 $150,100 $173 $128,470.01 $131,765 $187 $139,285.01 $142,857 $202 $150,100.01 $153,949 $180 $131,765.01 $133,587 $195 $142,857.01 $144,833 $210 $153,949.01 $156,078 $189 $133,587.01 $135,409 $205 $144,833.01 $146,808 $221 $156,078.01 $158,207 $198 $135,409.01 $137,232 $215 $146,808.01 $148,784 $232 $158,207.01 $160,336 $208 $137,232.01 $139,054 $225 $148,784.01 $150,760 $243 $160,336.01 $162,465 $217 $139,054.01 $140,876 $236 $150,760.01 $152,735 $254 $162,465.01 $164,594 $227 $140,876.01 $142,698 $246 $152,735.01 $154,711 $266 $164,594.01 $166,723 $237 $142,698.01 $144,521 $257 $154,711.01 $156,686 $277 $166,723.01 $168,852 $247 $144,521.01 $146,343 $268 $156,686.01 $158,662 $289 $168,852.01 $170,981 $258 $146,343.01 $148,165 $280 $158,662.01 $160,638 $301 $170,981.01 $173,110 $268 $148,165.01 $149,987 $291 $160,638.01 $162,613 $314 $173,110.01 $175,239 $279 $149,987.01 $151,810 $303 $162,613.01 $164,589 $326 $175,239.01 $177,368 $290 $151,810.01 $153,632 $315 $164,589.01 $166,565 $339 $177,368.01 $179,497 $301 $153,632.01 $155,454 $327 $166,565.01 $168,540 $352 $179,497.01 $181,626 $312 $155,454.01 $157,276 $339 $168,540.01 $170,516 $365 $181,626.01 $183,756 $324 $157,276.01 $159,099 $351 $170,516.01 $172,492 $378 $183,756.01 $185,885 $336 $159,099.01 $160,921 $364 $172,492.01 $174,467 $392 $185,885.01 $188,014 $347 $160,921.01 $162,743 $377 $174,467.01 $176,443 $406 $188,014.01 $190,143 $359 $162,743.01 $164,565 $390 $176,443.01 $178,419 $420 $190,143.01 $192,272 $372 $164,565.01 $166,388 $403 $178,419.01 $180,394 $434 $192,272.01 $194,401 $384 $166,388.01 $168,210 $416 $180,394.01 $182,370 $449 $194,401.01 $196,530 200% FPIG $112,140 200% FPIG $121,580 200% FPIG $131,020
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 $0.00 $12,378 $5 $0.00 $13,210 $5 $0.00 $9,361 $8 $12,378.01 $16,504 $9 $13,210.01 $17,613 $6 $9,361.01 $14,042 $11 $16,504.01 $20,630 $12 $17,613.01 $22,017 $9 $14,042.01 $18,722 $14 $20,630.01 $24,756 $15 $22,017.01 $26,420 $12 $18,722.01 $23,403 $18 $24,756.01 $28,882 $19 $26,420.01 $30,823 $16 $23,403.01 $28,084 $21 $28,882.01 $33,008 $23 $30,823.01 $35,227 $20 $28,084.01 $32,764 $25 $33,008.01 $37,134 $27 $35,227.01 $39,630 $24 $32,764.01 $37,445 $29 $37,134.01 $41,260 $31 $39,630.01 $44,033 $28 $37,445.01 $42,126 $33 $41,260.01 $45,386 $35 $44,033.01 $48,436 $33 $42,126.01 $46,806 $37 $45,386.01 $49,512 $40 $48,436.01 $52,840 $38 $46,806.01 $51,487 $42 $49,512.01 $53,638 $45 $52,840.01 $57,243 $43 $51,487.01 $56,167 $47 $53,638.01 $57,764 $50 $57,243.01 $61,646 $48 $56,167.01 $60,848 $52 $57,764.01 $61,890 $55 $61,646.01 $66,050 $53 $60,848.01 $65,529 $57 $61,890.01 $66,016 $61 $66,050.01 $70,453 $59 $65,529.01 $70,209 $62 $66,016.01 $70,142 $66 $70,453.01 $74,856 $64 $70,209.01 $74,890 $67 $70,142.01 $74,268 $72 $74,856.01 $79,260 $70 $74,890.01 $79,570 $73 $74,268.01 $78,394 $78 $79,260.01 $83,663 $77 $79,570.01 $84,251 $78 $78,394.01 $82,520 $83 $83,663.01 $88,066 $82 $84,251.01 $88,932 $84 $82,520.01 $86,646 $89 $88,066.01 $92,470 $89 $88,932.01 $93,612 $89 $86,646.01 $90,772 $95 $92,470.01 $96,873 $95 $93,612.01 $98,293 $95 $90,772.01 $94,898 $102 $96,873.01 $101,276 $101 $98,293.01 $102,973 $101 $94,898.01 $99,024 $108 $101,276.01 $105,680 $108 $102,973.01 $107,654 $107 $99,024.01 $103,150 $115 $105,680.01 $110,083 $115 $107,654.01 $112,335 $114 $103,150.01 $107,276 $121 $110,083.01 $114,486 $122 $112,335.01 $117,015 $120 $107,276.01 $111,402 $128 $114,486.01 $118,889 $129 $117,015.01 $121,696 $127 $111,402.01 $115,528 $135 $118,889.01 $123,293 $136 $121,696.01 $126,377 $133 $115,528.01 $119,654 $142 $123,293.01 $127,696 $144 $126,377.01 $131,057 $140 $119,654.01 $123,780 $150 $127,696.01 $132,099 $151 $131,057.01 $135,738 $147 $123,780.01 $127,906 $157 $132,099.01 $136,503 $159 $135,738.01 $140,418 $154 $127,906.01 $132,032 $165 $136,503.01 $140,906 $167 $140,418.01 $145,099 $162 $132,032.01 $136,158 $172 $140,906.01 $145,309 $175 $145,099.01 $149,780 $169 $136,158.01 $140,284 $180 $145,309.01 $149,713 $183 $149,780.01 $154,460 $177 $140,284.01 $144,410 $188 $149,713.01 $154,116 $192 $154,460.01 $159,141 $184 $144,410.01 $148,536 $197 $154,116.01 $158,519 $200 $159,141.01 $163,821 $192 $148,536.01 $152,662 $205 $158,519.01 $162,923 $209 $163,821.01 $168,502 $200 $152,662.01 $156,788 $214 $162,923.01 $167,326 $218 $168,502.01 $173,183 $208 $156,788.01 $160,914 $222 $167,326.01 $171,729 $227 $173,183.01 $177,863 $217 $160,914.01 $165,041 $231 $171,729.01 $176,133 $236 $177,863.01 $182,544 $225 $165,041.01 $167,323 $240 $176,133.01 $178,569 $246 $182,544.01 $187,225 $237 $167,323.01 $169,606 $253 $178,569.01 $181,005 $256 $187,225.01 $189,814 $248 $169,606.01 $171,888 $265 $181,005.01 $183,440 $269 $189,814.01 $192,403 $260 $171,888.01 $174,171 $278 $183,440.01 $185,876 $282 $192,403.01 $194,993 $272 $174,171.01 $176,453 $291 $185,876.01 $188,312 $295 $194,993.01 $197,582 $285 $176,453.01 $178,736 $304 $188,312.01 $190,748 $309 $197,582.01 $200,171 $297 $178,736.01 $181,018 $317 $190,748.01 $193,184 $323 $200,171.01 $202,760 $310 $181,018.01 $183,300 $331 $193,184.01 $195,620 $337 $202,760.01 $205,350 $323 $183,300.01 $185,583 $345 $195,620.01 $198,055 $352 $205,350.01 $207,939 $336 $185,583.01 $187,865 $359 $198,055.01 $200,491 $366 $207,939.01 $210,528 $350 $187,865.01 $190,148 $373 $200,491.01 $202,927 $381 $210,528.01 $213,117 $363 $190,148.01 $192,430 $388 $202,927.01 $205,363 $397 $213,117.01 $215,706 $377 $192,430.01 $194,713 $403 $205,363.01 $207,799 $412 $215,706.01 $218,296 $391 $194,713.01 $196,995 $418 $207,799.01 $210,235 $428 $218,296.01 $220,885 $406 $196,995.01 $199,277 $433 $210,235.01 $212,670 $444 $220,885.01 $223,474 $420 $199,277.01 $201,560 $449 $212,670.01 $215,106 $460 $223,474.01 $226,063 $435 $201,560.01 $203,842 $464 $215,106.01 $217,542 $477 $226,063.01 $228,653 $450 $203,842.01 $206,125 $480 $217,542.01 $219,978 $494 $228,653.01 $231,242 $465 $206,125.01 $208,407 $497 $219,978.01 $222,414 $511 $231,242.01 $233,831 $481 $208,407.01 $210,690 $513 $222,414.01 $224,850 $528 $233,831.01 $236,420 200% FPIG $140,460 200% FPIG $149,900 $546 $236,420.01 $239,010 200% FPIG $159,340
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 $0.00 $9,916 $5 $0.00 $10,470 $5 $0.00 $11,025 $6 $9,916.01 $14,874 $7 $10,470.01 $15,706 $7 $11,025.01 $16,538 $10 $14,874.01 $19,832 $10 $15,706.01 $20,941 $11 $16,538.01 $22,050 $13 $19,832.01 $24,790 $14 $20,941.01 $26,176 $15 $22,050.01 $27,563 $17 $24,790.01 $29,747 $18 $26,176.01 $31,411 $19 $27,563.01 $33,075 $21 $29,747.01 $34,705 $22 $31,411.01 $36,646 $24 $33,075.01 $38,588 $26 $34,705.01 $39,663 $27 $36,646.01 $41,882 $28 $38,588.01 $44,100 $30 $39,663.01 $44,621 $32 $41,882.01 $47,117 $33 $44,100.01 $49,613 $35 $44,621.01 $49,579 $37 $47,117.01 $52,352 $39 $49,613.01 $55,125 $40 $49,579.01 $54,537 $42 $52,352.01 $57,587 $44 $55,125.01 $60,638 $45 $54,537.01 $59,495 $48 $57,587.01 $62,823 $50 $60,638.01 $66,150 $50 $59,495.01 $64,453 $53 $62,823.01 $68,058 $56 $66,150.01 $71,663 $56 $64,453.01 $69,411 $59 $68,058.01 $73,293 $62 $71,663.01 $77,175 $62 $69,411.01 $74,369 $65 $73,293.01 $78,528 $69 $77,175.01 $82,688 $68 $74,369.01 $79,327 $72 $78,528.01 $83,763 $76 $82,688.01 $88,200 $74 $79,327.01 $84,285 $79 $83,763.01 $88,999 $83 $88,200.01 $93,713 $81 $84,285.01 $89,242 $86 $88,999.01 $94,234 $90 $93,713.01 $99,225 $87 $89,242.01 $94,200 $92 $94,234.01 $99,469 $97 $99,225.01 $104,738 $94 $94,200.01 $99,158 $99 $99,469.01 $104,704 $104 $104,738.01 $110,250 $101 $99,158.01 $104,116 $106 $104,704.01 $109,939 $112 $110,250.01 $115,763 $107 $104,116.01 $109,074 $113 $109,939.01 $115,175 $119 $115,763.01 $121,275 $114 $109,074.01 $114,032 $121 $115,175.01 $120,410 $127 $121,275.01 $126,788 $122 $114,032.01 $118,990 $128 $120,410.01 $125,645 $135 $126,788.01 $132,300 $129 $118,990.01 $123,948 $136 $125,645.01 $130,880 $143 $132,300.01 $137,813 $137 $123,948.01 $128,906 $144 $130,880.01 $136,116 $152 $137,813.01 $143,325 $144 $128,906.01 $133,864 $152 $136,116.01 $141,351 $160 $143,325.01 $148,838 $152 $133,864.01 $138,822 $161 $141,351.01 $146,586 $169 $148,838.01 $154,350 $160 $138,822.01 $143,779 $169 $146,586.01 $151,821 $178 $154,350.01 $159,863 $168 $143,779.01 $148,737 $178 $151,821.01 $157,056 $187 $159,863.01 $165,375 $177 $148,737.01 $153,695 $187 $157,056.01 $162,292 $197 $165,375.01 $170,888 $185 $153,695.01 $158,653 $196 $162,292.01 $167,527 $206 $170,888.01 $176,400 $194 $158,653.01 $163,611 $205 $167,527.01 $172,762 $216 $176,400.01 $181,913 $203 $163,611.01 $168,569 $214 $172,762.01 $177,997 $226 $181,913.01 $187,425 $212 $168,569.01 $173,527 $224 $177,997.01 $183,232 $236 $187,425.01 $192,938 $221 $173,527.01 $178,485 $234 $183,232.01 $188,468 $246 $192,938.01 $198,450 $231 $178,485.01 $183,443 $244 $188,468.01 $193,703 $257 $198,450.01 $203,963 $241 $183,443.01 $188,401 $254 $193,703.01 $198,938 $267 $203,963.01 $209,475 $250 $188,401.01 $193,359 $264 $198,938.01 $204,173 $278 $209,475.01 $214,988 $260 $193,359.01 $198,317 $275 $204,173.01 $209,409 $289 $214,988.01 $220,501 $271 $198,317.01 $201,060 $286 $209,409.01 $212,305 $301 $220,501.01 $223,550 $284 $201,060.01 $203,802 $300 $212,305.01 $215,201 $316 $223,550.01 $226,600 $298 $203,802.01 $206,545 $315 $215,201.01 $218,097 $332 $226,600.01 $229,649 $313 $206,545.01 $209,288 $330 $218,097.01 $220,993 $348 $229,649.01 $232,699 $327 $209,288.01 $212,030 $346 $220,993.01 $223,889 $364 $232,699.01 $235,748 $342 $212,030.01 $214,773 $361 $223,889.01 $226,785 $380 $235,748.01 $238,798 $357 $214,773.01 $217,515 $377 $226,785.01 $229,681 $397 $238,798.01 $241,847 $373 $217,515.01 $220,258 $393 $229,681.01 $232,577 $414 $241,847.01 $244,897 $388 $220,258.01 $223,001 $410 $232,577.01 $235,473 $432 $244,897.01 $247,946 $404 $223,001.01 $225,743 $427 $235,473.01 $238,369 $449 $247,946.01 $250,996 $420 $225,743.01 $228,486 $444 $238,369.01 $241,265 $467 $250,996.01 $254,045 $437 $228,486.01 $231,229 $461 $241,265.01 $244,161 $485 $254,045.01 $257,095 $453 $231,229.01 $233,971 $479 $244,161.01 $247,057 $504 $257,095.01 $260,144 $470 $233,971.01 $236,714 $497 $247,057.01 $249,953 $523 $260,144.01 $263,194 $488 $236,714.01 $239,456 $515 $249,953.01 $252,849 $542 $263,194.01 $266,243 $505 $239,456.01 $242,199 $533 $252,849.01 $255,745 $562 $266,243.01 $269,293 $523 $242,199.01 $244,942 $552 $255,745.01 $258,641 $581 $269,293.01 $272,342 $541 $244,942.01 $247,684 $571 $258,641.01 $261,537 $601 $272,342.01 $275,392 $559 $247,684.01 $250,427 $591 $261,537.01 $264,433 $622 $275,392.01 $278,441 $578 $250,427.01 $253,170 $610 $264,433.01 $267,329 $643 $278,441.01 $281,491 200% FPIG $168,780 200% FPIG $178,220 200% FPIG $187,660
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 $0.00 $11,580 $5 $0.00 $12,134 $5 $0.00 $12,689 $7 $11,580.01 $17,369 $8 $12,134.01 $18,201 $8 $12,689.01 $19,033 $11 $17,369.01 $23,159 $12 $18,201.01 $24,268 $12 $19,033.01 $25,378 $15 $23,159.01 $28,949 $16 $24,268.01 $30,336 $17 $25,378.01 $31,722 $20 $28,949.01 $34,739 $21 $30,336.01 $36,403 $22 $31,722.01 $38,066 $25 $34,739.01 $40,529 $26 $36,403.01 $42,470 $27 $38,066.01 $44,411 $30 $40,529.01 $46,319 $31 $42,470.01 $48,537 $33 $44,411.01 $50,755 $35 $46,319.01 $52,108 $37 $48,537.01 $54,604 $38 $50,755.01 $57,100 $41 $52,108.01 $57,898 $43 $54,604.01 $60,671 $45 $57,100.01 $63,444 $47 $57,898.01 $63,688 $49 $60,671.01 $66,738 $51 $63,444.01 $69,789 $53 $63,688.01 $69,478 $55 $66,738.01 $72,805 $58 $69,789.01 $76,133 $59 $69,478.01 $75,268 $62 $72,805.01 $78,872 $65 $76,133.01 $82,477 $66 $75,268.01 $81,057 $69 $78,872.01 $84,940 $72 $82,477.01 $88,822 $72 $81,057.01 $86,847 $76 $84,940.01 $91,007 $79 $88,822.01 $95,166 $80 $86,847.01 $92,637 $83 $91,007.01 $97,074 $87 $95,166.01 $101,511 $87 $92,637.01 $98,427 $91 $97,074.01 $103,141 $95 $101,511.01 $107,855 $95 $98,427.01 $104,217 $99 $103,141.01 $109,208 $104 $107,855.01 $114,199 $102 $104,217.01 $110,006 $107 $109,208.01 $115,275 $112 $114,199.01 $120,544 $110 $110,006.01 $115,796 $115 $115,275.01 $121,342 $120 $120,544.01 $126,888 $117 $115,796.01 $121,586 $123 $121,342.01 $127,409 $129 $126,888.01 $133,233 $125 $121,586.01 $127,376 $131 $127,409.01 $133,476 $137 $133,233.01 $139,577 $134 $127,376.01 $133,166 $140 $133,476.01 $139,544 $146 $139,577.01 $145,921 $142 $133,166.01 $138,956 $149 $139,544.01 $145,611 $156 $145,921.01 $152,266 $151 $138,956.01 $144,745 $158 $145,611.01 $151,678 $165 $152,266.01 $158,610 $159 $144,745.01 $150,535 $167 $151,678.01 $157,745 $175 $158,610.01 $164,955 $168 $150,535.01 $156,325 $176 $157,745.01 $163,812 $185 $164,955.01 $171,299 $178 $156,325.01 $162,115 $186 $163,812.01 $169,879 $195 $171,299.01 $177,644 $187 $162,115.01 $167,905 $196 $169,879.01 $175,946 $205 $177,644.01 $183,988 $197 $167,905.01 $173,694 $206 $175,946.01 $182,013 $216 $183,988.01 $190,332 $206 $173,694.01 $179,484 $216 $182,013.01 $188,080 $226 $190,332.01 $196,677 $217 $179,484.01 $185,274 $227 $188,080.01 $194,148 $237 $196,677.01 $203,021 $227 $185,274.01 $191,064 $238 $194,148.01 $200,215 $248 $203,021.01 $209,366 $237 $191,064.01 $196,854 $249 $200,215.01 $206,282 $260 $209,366.01 $215,710 $248 $196,854.01 $202,643 $260 $206,282.01 $212,349 $272 $215,710.01 $222,054 $259 $202,643.01 $208,433 $271 $212,349.01 $218,416 $283 $222,054.01 $228,399 $270 $208,433.01 $214,223 $283 $218,416.01 $224,483 $295 $228,399.01 $234,743 $281 $214,223.01 $220,013 $294 $224,483.01 $230,550 $308 $234,743.01 $241,088 $292 $220,013.01 $225,803 $306 $230,550.01 $236,617 $320 $241,088.01 $247,432 $304 $225,803.01 $231,593 $319 $236,617.01 $242,685 $333 $247,432.01 $253,777 $316 $231,593.01 $234,796 $331 $242,685.01 $246,041 $347 $253,777.01 $257,287 $332 $234,796.01 $237,999 $348 $246,041.01 $249,397 $364 $257,287.01 $260,796 $349 $237,999.01 $241,201 $365 $249,397.01 $252,754 $382 $260,796.01 $264,306 $365 $241,201.01 $244,404 $383 $252,754.01 $256,110 $400 $264,306.01 $267,816 $382 $244,404.01 $247,607 $400 $256,110.01 $259,466 $419 $267,816.01 $271,325 $399 $247,607.01 $250,810 $419 $259,466.01 $262,822 $438 $271,325.01 $274,835 $417 $250,810.01 $254,013 $437 $262,822.01 $266,179 $457 $274,835.01 $278,345 $435 $254,013.01 $257,216 $456 $266,179.01 $269,535 $477 $278,345.01 $281,854 $453 $257,216.01 $260,418 $475 $269,535.01 $272,891 $497 $281,854.01 $285,364 $472 $260,418.01 $263,621 $494 $272,891.01 $276,247 $517 $285,364.01 $288,873 $491 $263,621.01 $266,824 $514 $276,247.01 $279,604 $538 $288,873.01 $292,383 $510 $266,824.01 $270,027 $534 $279,604.01 $282,960 $559 $292,383.01 $295,893 $529 $270,027.01 $273,230 $555 $282,960.01 $286,316 $580 $295,893.01 $299,402 $549 $273,230.01 $276,433 $576 $286,316.01 $289,672 $602 $299,402.01 $302,912 $569 $276,433.01 $279,635 $597 $289,672.01 $293,029 $624 $302,912.01 $306,422 $590 $279,635.01 $282,838 $618 $293,029.01 $296,385 $646 $306,422.01 $309,931 $611 $282,838.01 $286,041 $640 $296,385.01 $299,741 $669 $309,931.01 $313,441 $632 $286,041.01 $289,244 $662 $299,741.01 $303,097 $692 $313,441.01 $316,951 $653 $289,244.01 $292,447 $684 $303,097.01 $306,454 $716 $316,951.01 $320,460 $675 $292,447.01 $295,650 $707 $306,454.01 $309,810 $740 $320,460.01 $323,970 200% FPIG $197,100 200% FPIG $206,540 200% FPIG $215,980
[Pa.B. Doc. No. 22-1546. Filed for public inspection October 7, 2022, 9:00 a.m.]
No part of the information on this site may be reproduced for profit or sold for profit.This material has been drawn directly from the official Pennsylvania Bulletin full text database. Due to the limitations of HTML or differences in display capabilities of different browsers, this version may differ slightly from the official printed version.
