NOTICES

DEPARTMENT OF PUBLIC WELFARE

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

[42 Pa.B. 2853]
[Saturday, May 19, 2012]

 This notice increases the income limits codified in 55 Pa. Code Chapter 3041, Appendix B (relating to co-payment chart family co-payment scale effective May 7, 2012 (based on the 2012 Federal Poverty Income Guidelines) under 55 Pa. Code § 3041.107(b) (relating to availability and use of the Federal Poverty Income Guidelines). This increase became effective May 7, 2012.

 Section 3041.107(b) of 55 Pa. Code requires the Department of Public Welfare to update the copayment schedule in 55 Pa. Code Chapter 3041, Appendix B to reflect changes in the Federal Poverty Income Guidelines (FPIG). Effective May 7, 2012, 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 copayment schedule is adjusted in incremental amounts to reflect the increases. Chapter 3041, Appendix B of 55 Pa. Code also establishes the family copayment levels according to the family's computed annual income and lists the weekly family copayment based on the annual family income.

GARY D. ALEXANDER, 
Secretary

 Fiscal Note: 14-NOT-756. No fiscal impact; (8) recommends adoption.

CO-PAYMENT CHART
FAMILY CO-PAYMENT SCALE EFFECTIVE MAY 7, 2012
(BASED ON THE 2012 FEDERAL POVERTY INCOME GUIDELINES)

Weekly	Family Size:	1	Weekly	Family Size:	2
Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$9,170	$5.00	Less than:	$8,660
$10.00	$9,170.01	$11,170	$10.00	$8,660.01	$13,000
$15.00	$11,170.01	$13,170	$15.00	$13,000.01	$13,130
$20.00	$13,170.01	$15,170	$20.00	$13,130.01	$15,130
$25.00	$15,170.01	$17,170	$24.00	$15,130.01	$17,130
$30.00	$17,170.01	$19,170	$28.00	$17,130.01	$19,130
$35.00	$19,170.01	$21,170	$32.00	$19,130.01	$21,130
$40.00	$21,170.01	$23,170	$36.00	$21,130.01	$23,130
$45.00	$23,170.01	$25,170	$41.00	$23,130.01	$25,130
$50.00	$25,170.01	$26,250	$46.00	$25,130.01	$27,130
			$51.00	$27,130.01	$29,130
			$57.00	$29,130.01	$31,130
			$63.00	$31,130.01	$33,130
			$69.00	$33,130.01	$35,130
			$74.00	$35,130.01	$35,556
	200% FPIG	$22,340		200% FPIG	$30,260

Weekly	Family Size:	3	Weekly	Family Size:	4
Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$13,870	$10.00	$8,660.01	$14,730
$16.00	$13,870.01	$15,090	$17.00	$14,730.01	$17,050
$21.00	$15,090.01	$17,090	$23.00	$17,050.01	$19,050
$26.00	$17,090.01	$19,090	$27.00	$19,050.01	$21,050
$30.00	$19,090.01	$21,090	$32.00	$21,050.01	$23,050
$34.00	$21,090.01	$23,090	$36.00	$23,050.01	$25,050
$38.00	$23,090.01	$25,090	$40.00	$25,050.01	$27,050
$42.00	$25,090.01	$27,090	$44.00	$27,050.01	$29,050
$47.00	$27,090.01	$29,090	$48.00	$29,050.01	$31,050
$52.00	$29,090.01	$31,090	$52.00	$31,050.01	$33,050
$57.00	$31,090.01	$33,090	$57.00	$33,050.01	$35,050
$62.00	$33,090.01	$35,090	$62.00	$35,050.01	$37,050
$67.00	$35,090.01	$37,090	$67.00	$37,050.01	$39,050
$73.00	$37,090.01	$39,090	$72.00	$39,050.01	$41,050
$79.00	$39,090.01	$41,090	$77.00	$41,050.01	$43,050
$85.00	$41,090.01	$43,090	$82.00	$43,050.01	$45,050
$90.00	$43,090.01	$44,862	$87.00	$45,050.01	$47,050
			$93.00	$47,050.01	$49,050
			$99.00	$49,050.01	$51,050
			$105.00	$51,050.01	$53,050
			$111.00	$53,050.01	$54,168
	200% FPIG	$38,180		200% FPIG	$46,100

Weekly	Family Size:	5	Weekly	Family Size:	6
Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$15,600	$10.00	$8,660.01	$16,470
$18.00	$15,600.01	$19,010	$19.00	$16,470.01	$20,970
$25.00	$19,010.01	$21,010	$27.00	$20,970.01	$22,970
$29.00	$21,010.01	$23,010	$31.00	$22,970.01	$24,970
$33.00	$23,010.01	$25,010	$35.00	$24,970.01	$26,970
$38.00	$25,010.01	$27,010	$39.00	$26,970.01	$28,970
$42.00	$27,010.01	$29,010	$44.00	$28,970.01	$30,970
$46.00	$29,010.01	$31,010	$48.00	$30,970.01	$32,970
$50.00	$31,010.01	$33,010	$52.00	$32,970.01	$34,970
$54.00	$33,010.01	$35,010	$56.00	$34,970.01	$36,970
$58.00	$35,010.01	$37,010	$60.00	$36,970.01	$38,970
$62.00	$37,010.01	$39,010	$64.00	$38,970.01	$40,970
$67.00	$39,010.01	$41,010	$68.00	$40,970.01	$42,970
$72.00	$41,010.01	$43,010	$73.00	$42,970.01	$44,970
$77.00	$43,010.01	$45,010	$78.00	$44,970.01	$46,970
$82.00	$45,010.01	$47,010	$83.00	$46,970.01	$48,970
$87.00	$47,010.01	$49,010	$88.00	$48,970.01	$50,970
$92.00	$49,010.01	$51,010	$93.00	$50,970.01	$52,970
$97.00	$51,010.01	$53,010	$98.00	$52,970.01	$54,970
$103.00	$53,010.01	$55,010	$103.00	$54,970.01	$56,970
$109.00	$55,010.01	$57,010	$108.00	$56,970.01	$58,970
$115.00	$57,010.01	$59,010	$113.00	$58,970.01	$60,970
$121.00	$59,010.01	$61,010	$119.00	$60,970.01	$62,970
$127.00	$61,010.01	$63,010	$125.00	$62,970.01	$64,970
$132.00	$63,010.01	$63,474	$131.00	$64,970.01	$66,970
			$137.00	$66,970.01	$68,970
			$143.00	$68,970.01	$70,970
			$149.00	$70,970.01	$72,780
	200% FPIG	$54,020		200% FPIG	$61,940

Weekly	Family Size:	7	Weekly	Family Size:	8
Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$17,330	$10.00	$8,660.01	$18,200
$20.00	$17,330.01	$22,930	$21.00	$18,200.01	$24,890
$29.00	$22,930.01	$24,930	$31.00	$24,890.01	$26,890
$33.00	$24,930.01	$26,930	$35.00	$26,890.01	$28,890
$37.00	$26,930.01	$28,930	$39.00	$28,890.01	$30,890
$41.00	$28,930.01	$30,930	$43.00	$30,890.01	$32,890
$45.00	$30,930.01	$32,930	$47.00	$32,890.01	$34,890
$50.00	$32,930.01	$34,930	$51.00	$34,890.01	$36,890
$54.00	$34,930.01	$36,930	$56.00	$36,890.01	$38,890
$58.00	$36,930.01	$38,930	$60.00	$38,890.01	$40,890
$62.00	$38,930.01	$40,930	$64.00	$40,890.01	$42,890
$66.00	$40,930.01	$42,930	$68.00	$42,890.01	$44,890
$70.00	$42,930.01	$44,930	$72.00	$44,890.01	$46,890
$74.00	$44,930.01	$46,930	$76.00	$46,890.01	$48,890
$78.00	$46,930.01	$48,930	$80.00	$48,890.01	$50,890
$83.00	$48,930.01	$50,930	$84.00	$50,890.01	$52,890
$88.00	$50,930.01	$52,930	$88.00	$52,890.01	$54,890
$93.00	$52,930.01	$54,930	$93.00	$54,890.01	$56,890
$98.00	$54,930.01	$56,930	$98.00	$56,890.01	$58,890
$103.00	$56,930.01	$58,930	$103.00	$58,890.01	$60,890
$108.00	$58,930.01	$60,930	$108.00	$60,890.01	$62,890
$113.00	$60,930.01	$62,930	$113.00	$62,890.01	$64,890
$118.00	$62,930.01	$64,930	$118.00	$64,890.01	$66,890
$123.00	$64,930.01	$66,930	$123.00	$66,890.01	$68,890
$128.00	$66,930.01	$68,930	$128.00	$68,890.01	$70,890
$134.00	$68,930.01	$70,930	$133.00	$70,890.01	$72,890
$140.00	$70,930.01	$72,930	$138.00	$72,890.01	$74,890
$146.00	$72,930.01	$74,930	$143.00	$74,890.01	$76,890
$152.00	$74,930.01	$76,930	$149.00	$76,890.01	$78,890
$158.00	$76,930.01	$78,930	$155.00	$78,890.01	$80,890
$164.00	$78,930.01	$80,930	$161.00	$80,890.01	$82,890
$170.00	$80,930.01	$82,086	$167.00	$82,890.01	$84,890
			$173.00	$84,890.01	$86,890
			$179.00	$86,890.01	$88,890
			$185.00	$88,890.01	$90,890
			$191.00	$90,890.01	$91,392
	200% FPIG	$69,860		200% FPIG	$77,780

Weekly	Family Size:	9	Weekly	Family Size:	10
Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$19,070	$10.00	$8,660.01	$19,930
$22.00	$19,070.01	$26,850	$23.00	$19,930.01	$28,810
$33.00	$26,850.01	$28,850	$35.00	$28,810.01	$30,810
$37.00	$28,850.01	$30,850	$39.00	$30,810.01	$32,810
$41.00	$30,850.01	$32,850	$43.00	$32,810.01	$34,810
$45.00	$32,850.01	$34,850	$47.00	$34,810.01	$36,810
$49.00	$34,850.01	$36,850	$51.00	$36,810.01	$38,810
$53.00	$36,850.01	$38,850	$55.00	$38,810.01	$40,810
$57.00	$38,850.01	$40,850	$59.00	$40,810.01	$42,810
$62.00	$40,850.01	$42,850	$63.00	$42,810.01	$44,810
$66.00	$42,850.01	$44,850	$68.00	$44,810.01	$46,810
$70.00	$44,850.01	$46,850	$72.00	$46,810.01	$48,810
$74.00	$46,850.01	$48,850	$76.00	$48,810.01	$50,810
$78.00	$48,850.01	$50,850	$80.00	$50,810.01	$52,810
$82.00	$50,850.01	$52,850	$84.00	$52,810.01	$54,810
$86.00	$52,850.01	$54,850	$88.00	$54,810.01	$56,810
$90.00	$54,850.01	$56,850	$92.00	$56,810.01	$58,810
$94.00	$56,850.01	$58,850	$96.00	$58,810.01	$60,810
$99.00	$58,850.01	$60,850	$100.00	$60,810.01	$62,810
$104.00	$60,850.01	$62,850	$104.00	$62,810.01	$64,810
$109.00	$62,850.01	$64,850	$109.00	$64,810.01	$66,810
$114.00	$64,850.01	$66,850	$114.00	$66,810.01	$68,810
$119.00	$66,850.01	$68,850	$119.00	$68,810.01	$70,810
$124.00	$68,850.01	$70,850	$124.00	$70,810.01	$72,810
$129.00	$70,850.01	$72,850	$129.00	$72,810.01	$74,810
$134.00	$72,850.01	$74,850	$134.00	$74,810.01	$76,810
$139.00	$74,850.01	$76,850	$139.00	$76,810.01	$78,810
$144.00	$76,850.01	$78,850	$144.00	$78,810.01	$80,810
$149.00	$78,850.01	$80,850	$149.00	$80,810.01	$82,810
$154.00	$80,850.01	$82,850	$154.00	$82,810.01	$84,810
$160.00	$82,850.01	$84,850	$159.00	$84,810.01	$86,810
$166.00	$84,850.01	$86,850	$164.00	$86,810.01	$88,810
$172.00	$86,850.01	$88,850	$169.00	$88,810.01	$90,810
$178.00	$88,850.01	$90,850	$174.00	$90,810.01	$92,810
$184.00	$90,850.01	$92,850	$180.00	$92,810.01	$94,810
$190.00	$92,850.01	$94,850	$186.00	$94,810.01	$96,810
$196.00	$94,850.01	$96,850	$192.00	$96,810.01	$98,810
$202.00	$96,850.01	$98,850	$198.00	$98,810.01	$100,810
$207.00	$98,850.01	$100,698	$204.00	$100,810.01	$102,810
			$210.00	$102,810.01	$104,810
			$216.00	$104,810.01	$106,810
			$222.00	$106,810.01	$108,810
			$228.00	$108,810.01	$110,004
	200% FPIG	$85,700		200% FPIG	$93,620

Weekly	Family Size:	11	Weekly	Family Size:	12
Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$20,800	$10.00	$8,660.01	$21,670
$24.00	$20,800.01	$30,770	$25.00	$21,670.01	$32,730
$37.00	$30,770.01	$32,770	$40.00	$32,730.01	$34,730
$41.00	$32,770.01	$34,770	$43.00	$34,730.01	$36,730
$45.00	$34,770.01	$36,770	$47.00	$36,730.01	$38,730
$49.00	$36,770.01	$38,770	$51.00	$38,730.01	$40,730
$53.00	$38,770.01	$40,770	$55.00	$40,730.01	$42,730
$57.00	$40,770.01	$42,770	$59.00	$42,730.01	$44,730
$61.00	$42,770.01	$44,770	$63.00	$44,730.01	$46,730
$65.00	$44,770.01	$46,770	$67.00	$46,730.01	$48,730
$69.00	$46,770.01	$48,770	$71.00	$48,730.01	$50,730
$74.00	$48,770.01	$50,770	$75.00	$50,730.01	$52,730
$78.00	$50,770.01	$52,770	$80.00	$52,730.01	$54,730
$82.00	$52,770.01	$54,770	$84.00	$54,730.01	$56,730
$86.00	$54,770.01	$56,770	$88.00	$56,730.01	$58,730
$90.00	$56,770.01	$58,770	$92.00	$58,730.01	$60,730
$94.00	$58,770.01	$60,770	$96.00	$60,730.01	$62,730
$98.00	$60,770.01	$62,770	$100.00	$62,730.01	$64,730
$102.00	$62,770.01	$64,770	$104.00	$64,730.01	$66,730
$106.00	$64,770.01	$66,770	$108.00	$66,730.01	$68,730
$110.00	$66,770.01	$68,770	$112.00	$68,730.01	$70,730
$114.00	$68,770.01	$70,770	$116.00	$70,730.01	$72,730
$119.00	$70,770.01	$72,770	$120.00	$72,730.01	$74,730
$124.00	$72,770.01	$74,770	$125.00	$74,730.01	$76,730
$129.00	$74,770.01	$76,770	$130.00	$76,730.01	$78,730
$134.00	$76,770.01	$78,770	$135.00	$78,730.01	$80,730
$139.00	$78,770.01	$80,770	$140.00	$80,730.01	$82,730
$144.00	$80,770.01	$82,770	$145.00	$82,730.01	$84,730
$149.00	$82,770.01	$84,770	$150.00	$84,730.01	$86,730
$154.00	$84,770.01	$86,770	$155.00	$86,730.01	$88,730
$159.00	$86,770.01	$88,770	$160.00	$88,730.01	$90,730
$164.00	$88,770.01	$90,770	$165.00	$90,730.01	$92,730
$169.00	$90,770.01	$92,770	$170.00	$92,730.01	$94,730
$174.00	$92,770.01	$94,770	$175.00	$94,730.01	$96,730
$179.00	$94,770.01	$96,770	$180.00	$96,730.01	$98,730
$184.00	$96,770.01	$98,770	$185.00	$98,730.01	$100,730
$189.00	$98,770.01	$100,770	$190.00	$100,730.01	$102,730
$195.00	$100,770.01	$102,770	$195.00	$102,730.01	$104,730
$201.00	$102,770.01	$104,770	$200.00	$104,730.01	$106,730
$207.00	$104,770.01	$106,770	$206.00	$106,730.01	$108,730
$213.00	$106,770.01	$108,770	$212.00	$108,730.01	$110,730
$219.00	$108,770.01	$110,770	$218.00	$110,730.01	$112,730
$225.00	$110,770.01	$112,770	$224.00	$112,730.01	$114,730
$231.00	$112,770.01	$114,770	$230.00	$114,730.01	$116,730
$237.00	$114,770.01	$116,770	$236.00	$116,730.01	$118,730
$243.00	$116,770.01	$118,770	$242.00	$118,730.01	$120,730
$249.00	$118,770.01	$119,310	$248.00	$120,730.01	$122,730
			$254.00	$122,730.01	$124,730
			$260.00	$124,730.01	$126,730
			$266.00	$126,730.01	$128,616
	200% FPIG	$101,540		200% FPIG	$109,460

Weekly	Family Size:	13	Weekly	Family Size:	14
Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$22,530	$10.00	$8,660.01	$23,400
$26.00	$22,530.01	$34,690	$27.00	$23,400.01	$36,650
$42.00	$34,690.01	$36,690	$44.00	$36,650.01	$38,650
$45.00	$36,690.01	$38,690	$47.00	$38,650.01	$40,650
$49.00	$38,690.01	$40,690	$51.00	$40,650.01	$42,650
$53.00	$40,690.01	$42,690	$55.00	$42,650.01	$44,650
$57.00	$42,690.01	$44,690	$59.00	$44,650.01	$46,650
$61.00	$44,690.01	$46,690	$63.00	$46,650.01	$48,650
$65.00	$46,690.01	$48,690	$67.00	$48,650.01	$50,650
$69.00	$48,690.01	$50,690	$71.00	$50,650.01	$52,650
$73.00	$50,690.01	$52,690	$75.00	$52,650.01	$54,650
$77.00	$52,690.01	$54,690	$79.00	$54,650.01	$56,650
$81.00	$54,690.01	$56,690	$83.00	$56,650.01	$58,650
$86.00	$56,690.01	$58,690	$87.00	$58,650.01	$60,650
$90.00	$58,690.01	$60,690	$92.00	$60,650.01	$62,650
$94.00	$60,690.01	$62,690	$96.00	$62,650.01	$64,650
$98.00	$62,690.01	$64,690	$100.00	$64,650.01	$66,650
$102.00	$64,690.01	$66,690	$104.00	$66,650.01	$68,650
$106.00	$66,690.01	$68,690	$108.00	$68,650.01	$70,650
$110.00	$68,690.01	$70,690	$112.00	$70,650.01	$72,650
$114.00	$70,690.01	$72,690	$116.00	$72,650.01	$74,650
$118.00	$72,690.01	$74,690	$120.00	$74,650.01	$76,650
$122.00	$74,690.01	$76,690	$124.00	$76,650.01	$78,650
$126.00	$76,690.01	$78,690	$128.00	$78,650.01	$80,650
$130.00	$78,690.01	$80,690	$132.00	$80,650.01	$82,650
$135.00	$80,690.01	$82,690	$136.00	$82,650.01	$84,650
$140.00	$82,690.01	$84,690	$140.00	$84,650.01	$86,650
$145.00	$84,690.01	$86,690	$145.00	$86,650.01	$88,650
$150.00	$86,690.01	$88,690	$150.00	$88,650.01	$90,650
$155.00	$88,690.01	$90,690	$155.00	$90,650.01	$92,650
$160.00	$90,690.01	$92,690	$160.00	$92,650.01	$94,650
$165.00	$92,690.01	$94,690	$165.00	$94,650.01	$96,650
$170.00	$94,690.01	$96,690	$170.00	$96,650.01	$98,650
$175.00	$96,690.01	$98,690	$175.00	$98,650.01	$100,650
$180.00	$98,690.01	$100,690	$180.00	$100,650.01	$102,650
$185.00	$100,690.01	$102,690	$185.00	$102,650.01	$104,650
$190.00	$102,690.01	$104,690	$190.00	$104,650.01	$106,650
$195.00	$104,690.01	$106,690	$195.00	$106,650.01	$108,650
$200.00	$106,690.01	$108,690	$200.00	$108,650.01	$110,650
$205.00	$108,690.01	$110,690	$205.00	$110,650.01	$112,650
$210.00	$110,690.01	$112,690	$210.00	$112,650.01	$114,650
$215.00	$112,690.01	$114,690	$215.00	$114,650.01	$116,650
$221.00	$114,690.01	$116,690	$220.00	$116,650.01	$118,650
$227.00	$116,690.01	$118,690	$225.00	$118,650.01	$120,650
$233.00	$118,690.01	$120,690	$230.00	$120,650.01	$122,650
$239.00	$120,690.01	$122,690	$236.00	$122,650.01	$124,650
$245.00	$122,690.01	$124,690	$242.00	$124,650.01	$126,650
$251.00	$124,690.01	$126,690	$248.00	$126,650.01	$128,650
$257.00	$126,690.01	$128,690	$254.00	$128,650.01	$130,650
$263.00	$128,690.01	$130,690	$260.00	$130,650.01	$132,650
$269.00	$130,690.01	$132,690	$266.00	$132,650.01	$134,650
$275.00	$132,690.01	$134,690	$272.00	$134,650.01	$136,650
$281.00	$134,690.01	$136,690	$278.00	$136,650.01	$138,650
$287.00	$136,690.01	$137,922	$284.00	$138,650.01	$140,650
			$290.00	$140,650.01	$142,650
			$296.00	$142,650.01	$144,650
			$302.00	$144,650.01	$146,650
			$307.00	$146,650.01	$147,228
	200% FPIG	$117,380		200% FPIG	$125,300

Weekly	Family Size:	15	Weekly	Family Size:	16
Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$25,130	$10.00	$8,660.01	$26,870
$29.00	$25,130.01	$38,610	$31.00	$26,870.01	$42,570
$47.00	$38,610.01	$40,610	$51.00	$42,570.01	$44,570
$50.00	$40,610.01	$42,610	$54.00	$44,570.01	$46,570
$53.00	$42,610.01	$44,610	$58.00	$46,570.01	$48,570
$57.00	$44,610.01	$46,610	$62.00	$48,570.01	$50,570
$61.00	$46,610.01	$48,610	$66.00	$50,570.01	$52,570
$65.00	$48,610.01	$50,610	$70.00	$52,570.01	$54,570
$69.00	$50,610.01	$52,610	$74.00	$54,570.01	$56,570
$73.00	$52,610.01	$54,610	$78.00	$56,570.01	$58,570
$77.00	$54,610.01	$56,610	$82.00	$58,570.01	$60,570
$81.00	$56,610.01	$58,610	$86.00	$60,570.01	$62,570
$85.00	$58,610.01	$60,610	$90.00	$62,570.01	$64,570
$89.00	$60,610.01	$62,610	$94.00	$64,570.01	$66,570
$93.00	$62,610.01	$64,610	$99.00	$66,570.01	$68,570
$98.00	$64,610.01	$66,610	$104.00	$68,570.01	$70,570
$102.00	$66,610.01	$68,610	$108.00	$70,570.01	$72,570
$106.00	$68,610.01	$70,610	$112.00	$72,570.01	$74,570
$110.00	$70,610.01	$72,610	$116.00	$74,570.01	$76,570
$114.00	$72,610.01	$74,610	$120.00	$76,570.01	$78,570
$118.00	$74,610.01	$76,610	$124.00	$78,570.01	$80,570
$122.00	$76,610.01	$78,610	$128.00	$80,570.01	$82,570
$126.00	$78,610.01	$80,610	$132.00	$82,570.01	$84,570
$130.00	$80,610.01	$82,610	$136.00	$84,570.01	$86,570
$134.00	$82,610.01	$84,610	$140.00	$86,570.01	$88,570
$138.00	$84,610.01	$86,610	$144.00	$88,570.01	$90,570
$142.00	$86,610.01	$88,610	$148.00	$90,570.01	$92,570
$146.00	$88,610.01	$90,610	$152.00	$92,570.01	$94,570
$150.00	$90,610.01	$92,610	$156.00	$94,570.01	$96,570
$155.00	$92,610.01	$94,610	$160.00	$96,570.01	$98,570
$160.00	$94,610.01	$96,610	$165.00	$98,570.01	$100,570
$165.00	$96,610.01	$98,610	$170.00	$100,570.01	$102,570
$170.00	$98,610.01	$100,610	$175.00	$102,570.01	$104,570
$175.00	$100,610.01	$102,610	$180.00	$104,570.01	$106,570
$180.00	$102,610.01	$104,610	$185.00	$106,570.01	$108,570
$185.00	$104,610.01	$106,610	$190.00	$108,570.01	$110,570
$190.00	$106,610.01	$108,610	$195.00	$110,570.01	$112,570
$195.00	$108,610.01	$110,610	$200.00	$112,570.01	$114,570
$200.00	$110,610.01	$112,610	$205.00	$114,570.01	$116,570
$205.00	$112,610.01	$114,610	$210.00	$116,570.01	$118,570
$210.00	$114,610.01	$116,610	$215.00	$118,570.01	$120,570
$215.00	$116,610.01	$118,610	$220.00	$120,570.01	$122,570
$220.00	$118,610.01	$120,610	$225.00	$122,570.01	$124,570
$225.00	$120,610.01	$122,610	$230.00	$124,570.01	$126,570
$230.00	$122,610.01	$124,610	$235.00	$126,570.01	$128,570
$235.00	$124,610.01	$126,610	$240.00	$128,570.01	$130,570
$240.00	$126,610.01	$128,610	$245.00	$130,570.01	$132,570
$245.00	$128,610.01	$130,610	$250.00	$132,570.01	$134,570
$251.00	$130,610.01	$132,610	$255.00	$134,570.01	$136,570
$257.00	$132,610.01	$134,610	$260.00	$136,570.01	$138,570
$263.00	$134,610.01	$136,610	$266.00	$138,570.01	$140,570
$269.00	$136,610.01	$138,610	$272.00	$140,570.01	$142,570
$275.00	$138,610.01	$140,610	$278.00	$142,570.01	$144,570
$281.00	$140,610.01	$142,610	$284.00	$144,570.01	$146,570
$287.00	$142,610.01	$144,610	$290.00	$146,570.01	$148,570
$293.00	$144,610.01	$146,610	$296.00	$148,570.01	$150,570
$299.00	$146,610.01	$148,610	$302.00	$150,570.01	$152,570
$305.00	$148,610.01	$150,610	$308.00	$152,570.01	$154,570
$311.00	$150,610.01	$152,610	$314.00	$154,570.01	$156,570
$317.00	$152,610.01	$154,610	$320.00	$156,570.01	$158,570
$324.00	$154,610.01	$156,534	$326.00	$158,570.01	$160,570
			$332.00	$160,570.01	$162,570
			$338.00	$162,570.01	$164,570
			$345.00	$164,570.01	$165,840
	200% FPIG	$133,220		200% FPIG	$141,140

Weekly	Family Size:	17	Weekly	Family Size:	18
Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$27,730	$10.00	$8,660.01	$28,600
$32.00	$27,730.01	$44,530	$33.00	$28,600.01	$46,490
$53.00	$44,530.01	$46,530	$56.00	$46,490.01	$48,490
$56.00	$46,530.01	$48,530	$59.00	$48,490.01	$50,490
$60.00	$48,530.01	$50,530	$62.00	$50,490.01	$52,490
$64.00	$50,530.01	$52,530	$66.00	$52,490.01	$54,490
$68.00	$52,530.01	$54,530	$70.00	$54,490.01	$56,490
$72.00	$54,530.01	$56,530	$74.00	$56,490.01	$58,490
$76.00	$56,530.01	$58,530	$78.00	$58,490.01	$60,490
$80.00	$58,530.01	$60,530	$82.00	$60,490.01	$62,490
$84.00	$60,530.01	$62,530	$86.00	$62,490.01	$64,490
$88.00	$62,530.01	$64,530	$90.00	$64,490.01	$66,490
$92.00	$64,530.01	$66,530	$94.00	$66,490.01	$68,490
$96.00	$66,530.01	$68,530	$98.00	$68,490.01	$70,490
$100.00	$68,530.01	$70,530	$102.00	$70,490.01	$72,490
$105.00	$70,530.01	$72,530	$106.00	$72,490.01	$74,490
$110.00	$72,530.01	$74,530	$111.00	$74,490.01	$76,490
$114.00	$74,530.01	$76,530	$116.00	$76,490.01	$78,490
$118.00	$76,530.01	$78,530	$120.00	$78,490.01	$80,490
$122.00	$78,530.01	$80,530	$124.00	$80,490.01	$82,490
$126.00	$80,530.01	$82,530	$128.00	$82,490.01	$84,490
$130.00	$82,530.01	$84,530	$132.00	$84,490.01	$86,490
$134.00	$84,530.01	$86,530	$136.00	$86,490.01	$88,490
$138.00	$86,530.01	$88,530	$140.00	$88,490.01	$90,490
$142.00	$88,530.01	$90,530	$144.00	$90,490.01	$92,490
$146.00	$90,530.01	$92,530	$148.00	$92,490.01	$94,490
$150.00	$92,530.01	$94,530	$152.00	$94,490.01	$96,490
$154.00	$94,530.01	$96,530	$156.00	$96,490.01	$98,490
$158.00	$96,530.01	$98,530	$160.00	$98,490.01	$100,490
$162.00	$98,530.01	$100,530	$164.00	$100,490.01	$102,490
$166.00	$100,530.01	$102,530	$168.00	$102,490.01	$104,490
$171.00	$102,530.01	$104,530	$172.00	$104,490.01	$106,490
$176.00	$104,530.01	$106,530	$176.00	$106,490.01	$108,490
$181.00	$106,530.01	$108,530	$181.00	$108,490.01	$110,490
$186.00	$108,530.01	$110,530	$186.00	$110,490.01	$112,490
$191.00	$110,530.01	$112,530	$191.00	$112,490.01	$114,490
$196.00	$112,530.01	$114,530	$196.00	$114,490.01	$116,490
$201.00	$114,530.01	$116,530	$201.00	$116,490.01	$118,490
$206.00	$116,530.01	$118,530	$206.00	$118,490.01	$120,490
$211.00	$118,530.01	$120,530	$211.00	$120,490.01	$122,490
$216.00	$120,530.01	$122,530	$216.00	$122,490.01	$124,490
$221.00	$122,530.01	$124,530	$221.00	$124,490.01	$126,490
$226.00	$124,530.01	$126,530	$226.00	$126,490.01	$128,490
$231.00	$126,530.01	$128,530	$231.00	$128,490.01	$130,490
$236.00	$128,530.01	$130,530	$236.00	$130,490.01	$132,490
$241.00	$130,530.01	$132,530	$241.00	$132,490.01	$134,490
$246.00	$132,530.01	$134,530	$246.00	$134,490.01	$136,490
$251.00	$134,530.01	$136,530	$251.00	$136,490.01	$138,490
$256.00	$136,530.01	$138,530	$256.00	$138,490.01	$140,490
$261.00	$138,530.01	$140,530	$261.00	$140,490.01	$142,490
$266.00	$140,530.01	$142,530	$266.00	$142,490.01	$144,490
$271.00	$142,530.01	$144,530	$271.00	$144,490.01	$146,490
$276.00	$144,530.01	$146,530	$276.00	$146,490.01	$148,490
$282.00	$146,530.01	$148,530	$281.00	$148,490.01	$150,490
$288.00	$148,530.01	$150,530	$286.00	$150,490.01	$152,490
$294.00	$150,530.01	$152,530	$292.00	$152,490.01	$154,490
$300.00	$152,530.01	$154,530	$298.00	$154,490.01	$156,490
$306.00	$154,530.01	$156,530	$304.00	$156,490.01	$158,490
$312.00	$156,530.01	$158,530	$310.00	$158,490.01	$160,490
$318.00	$158,530.01	$160,530	$316.00	$160,490.01	$162,490
$324.00	$160,530.01	$162,530	$322.00	$162,490.01	$164,490
$330.00	$162,530.01	$164,530	$328.00	$164,490.01	$166,490
$336.00	$164,530.01	$166,530	$334.00	$166,490.01	$168,490
$342.00	$166,530.01	$168,530	$340.00	$168,490.01	$170,490
$348.00	$168,530.01	$170,530	$346.00	$170,490.01	$172,490
$354.00	$170,530.01	$172,530	$352.00	$172,490.01	$174,490
$360.00	$172,530.01	$174,530	$358.00	$174,490.01	$176,490
$366.00	$174,530.01	$175,146	$364.00	$176,490.01	$178,490
			$370.00	$178,490.01	$180,490
			$376.00	$180,490.01	$182,490
			$383.00	$182,490.01	$184,452
	200% FPIG	$149,060		200% FPIG	$156,980

Weekly	Family Size:	19	Weekly	Family Size:	20
Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$5.00	Less than:	$8,660
$10.00	$8,660.01	$29,470	$10.00	$8,660.01	$30,330
$34.00	$29,470.01	$48,450	$35.00	$30,330.01	$50,410
$58.00	$48,450.01	$50,450	$60.00	$50,410.01	$52,410
$61.00	$50,450.01	$52,450	$63.00	$52,410.01	$54,410
$64.00	$52,450.01	$54,450	$66.00	$54,410.01	$56,410
$68.00	$54,450.01	$56,450	$70.00	$56,410.01	$58,410
$72.00	$56,450.01	$58,450	$74.00	$58,410.01	$60,410
$76.00	$58,450.01	$60,450	$78.00	$60,410.01	$62,410
$80.00	$60,450.01	$62,450	$82.00	$62,410.01	$64,410
$84.00	$62,450.01	$64,450	$86.00	$64,410.01	$66,410
$88.00	$64,450.01	$66,450	$90.00	$66,410.01	$68,410
$92.00	$66,450.01	$68,450	$94.00	$68,410.01	$70,410
$96.00	$68,450.01	$70,450	$98.00	$70,410.01	$72,410
$100.00	$70,450.01	$72,450	$102.00	$72,410.01	$74,410
$104.00	$72,450.01	$74,450	$106.00	$74,410.01	$76,410
$108.00	$74,450.01	$76,450	$110.00	$76,410.01	$78,410
$112.00	$76,450.01	$78,450	$114.00	$78,410.01	$80,410
$117.00	$78,450.01	$80,450	$118.00	$80,410.01	$82,410
$122.00	$80,450.01	$82,450	$123.00	$82,410.01	$84,410
$126.00	$82,450.01	$84,450	$128.00	$84,410.01	$86,410
$130.00	$84,450.01	$86,450	$132.00	$86,410.01	$88,410
$134.00	$86,450.01	$88,450	$136.00	$88,410.01	$90,410
$138.00	$88,450.01	$90,450	$140.00	$90,410.01	$92,410
$142.00	$90,450.01	$92,450	$144.00	$92,410.01	$94,410
$146.00	$92,450.01	$94,450	$148.00	$94,410.01	$96,410
$150.00	$94,450.01	$96,450	$152.00	$96,410.01	$98,410
$154.00	$96,450.01	$98,450	$156.00	$98,410.01	$100,410
$158.00	$98,450.01	$100,450	$160.00	$100,410.01	$102,410
$162.00	$100,450.01	$102,450	$164.00	$102,410.01	$104,410
$166.00	$102,450.01	$104,450	$168.00	$104,410.01	$106,410
$170.00	$104,450.01	$106,450	$172.00	$106,410.01	$108,410
$174.00	$106,450.01	$108,450	$176.00	$108,410.01	$110,410
$178.00	$108,450.01	$110,450	$180.00	$110,410.01	$112,410
$182.00	$110,450.01	$112,450	$184.00	$112,410.01	$114,410
$186.00	$112,450.01	$114,450	$188.00	$114,410.01	$116,410
$191.00	$114,450.01	$116,450	$192.00	$116,410.01	$118,410
$196.00	$116,450.01	$118,450	$196.00	$118,410.01	$120,410
$201.00	$118,450.01	$120,450	$201.00	$120,410.01	$122,410
$206.00	$120,450.01	$122,450	$206.00	$122,410.01	$124,410
$211.00	$122,450.01	$124,450	$211.00	$124,410.01	$126,410
$216.00	$124,450.01	$126,450	$216.00	$126,410.01	$128,410
$221.00	$126,450.01	$128,450	$221.00	$128,410.01	$130,410
$226.00	$128,450.01	$130,450	$226.00	$130,410.01	$132,410
$231.00	$130,450.01	$132,450	$231.00	$132,410.01	$134,410
$236.00	$132,450.01	$134,450	$236.00	$134,410.01	$136,410
$241.00	$134,450.01	$136,450	$241.00	$136,410.01	$138,410
$246.00	$136,450.01	$138,450	$246.00	$138,410.01	$140,410
$251.00	$138,450.01	$140,450	$251.00	$140,410.01	$142,410
$256.00	$140,450.01	$142,450	$256.00	$142,410.01	$144,410
$261.00	$142,450.01	$144,450	$261.00	$144,410.01	$146,410
$266.00	$144,450.01	$146,450	$266.00	$146,410.01	$148,410
$271.00	$146,450.01	$148,450	$271.00	$148,410.01	$150,410
$276.00	$148,450.01	$150,450	$276.00	$150,410.01	$152,410
$281.00	$150,450.01	$152,450	$281.00	$152,410.01	$154,410
$286.00	$152,450.01	$154,450	$286.00	$154,410.01	$156,410
$291.00	$154,450.01	$156,450	$291.00	$156,410.01	$158,410
$296.00	$156,450.01	$158,450	$296.00	$158,410.01	$160,410
$301.00	$158,450.01	$160,450	$301.00	$160,410.01	$162,410
$307.00	$160,450.01	$162,450	$306.00	$162,410.01	$164,410
$313.00	$162,450.01	$164,450	$311.00	$164,410.01	$166,410
$319.00	$164,450.01	$166,450	$316.00	$166,410.01	$168,410
$325.00	$166,450.01	$168,450	$321.00	$168,410.01	$170,410
$331.00	$168,450.01	$170,450	$327.00	$170,410.01	$172,410
$337.00	$170,450.01	$172,450	$333.00	$172,410.01	$174,410
$343.00	$172,450.01	$174,450	$339.00	$174,410.01	$176,410
$349.00	$174,450.01	$176,450	$345.00	$176,410.01	$178,410
$355.00	$176,450.01	$178,450	$351.00	$178,410.01	$180,410
$361.00	$178,450.01	$180,450	$357.00	$180,410.01	$182,410
$367.00	$180,450.01	$182,450	$363.00	$182,410.01	$184,410
$373.00	$182,450.01	$184,450	$369.00	$184,410.01	$186,410
$379.00	$184,450.01	$186,450	$375.00	$186,410.01	$188,410
$385.00	$186,450.01	$188,450	$381.00	$188,410.01	$190,410
$391.00	$188,450.01	$190,450	$387.00	$190,410.01	$192,410
$397.00	$190,450.01	$192,450	$393.00	$192,410.01	$194,410
$403.00	$192,450.01	$193,758	$399.00	$194,410.01	$196,410
			$405.00	$196,410.01	$198,410
			$411.00	$198,410.01	$200,410
			$417.00	$200,410.01	$202,410
			$424.00	$202,410.01	$203,064
	200% FPIG	$164,900		200% FPIG	$172,820

Weekly	Family Size:	21	Weekly	Family Size:	21
Co-pay	Annual Income		Co-pay	Annual Income
$5.00	Less than:	$8,660	$222.00	$130,370.01	$132,370
$10.00	$8,660.01	$32,070	$227.00	$132,370.01	$134,370
$37.00	$32,070.01	$52,370	$232.00	$134,370.01	$136,370
$63.00	$52,370.01	$54,370	$237.00	$136,370.01	$138,370
$66.00	$54,370.01	$56,370	$242.00	$138,370.01	$140,370
$69.00	$56,370.01	$58,370	$247.00	$140,370.01	$142,370
$72.00	$58,370.01	$60,370	$252.00	$142,370.01	$144,370
$76.00	$60,370.01	$62,370	$257.00	$144,370.01	$146,370
$80.00	$62,370.01	$64,370	$262.00	$146,370.01	$148,370
$84.00	$64,370.01	$66,370	$267.00	$148,370.01	$150,370
$88.00	$66,370.01	$68,370	$272.00	$150,370.01	$152,370
$92.00	$68,370.01	$70,370	$277.00	$152,370.01	$154,370
$96.00	$70,370.01	$72,370	$282.00	$154,370.01	$156,370
$100.00	$72,370.01	$74,370	$287.00	$156,370.01	$158,370
$104.00	$74,370.01	$76,370	$292.00	$158,370.01	$160,370
$108.00	$76,370.01	$78,370	$297.00	$160,370.01	$162,370
$112.00	$78,370.01	$80,370	$302.00	$162,370.01	$164,370
$116.00	$80,370.01	$82,370	$307.00	$164,370.01	$166,370
$120.00	$82,370.01	$84,370	$312.00	$166,370.01	$168,370
$124.00	$84,370.01	$86,370	$317.00	$168,370.01	$170,370
$129.00	$86,370.01	$88,370	$322.00	$170,370.01	$172,370
$134.00	$88,370.01	$90,370	$327.00	$172,370.01	$174,370
$138.00	$90,370.01	$92,370	$332.00	$174,370.01	$176,370
$142.00	$92,370.01	$94,370	$338.00	$176,370.01	$178,370
$146.00	$94,370.01	$96,370	$344.00	$178,370.01	$180,370
$150.00	$96,370.01	$98,370	$350.00	$180,370.01	$182,370
$154.00	$98,370.01	$100,370	$356.00	$182,370.01	$184,370
$158.00	$100,370.01	$102,370	$362.00	$184,370.01	$186,370
$162.00	$102,370.01	$104,370	$368.00	$186,370.01	$188,370
$166.00	$104,370.01	$106,370	$374.00	$188,370.01	$190,370
$170.00	$106,370.01	$108,370	$380.00	$190,370.01	$192,370
$174.00	$108,370.01	$110,370	$386.00	$192,370.01	$194,370
$178.00	$110,370.01	$112,370	$392.00	$194,370.01	$196,370
$182.00	$112,370.01	$114,370	$398.00	$196,370.01	$198,370
$186.00	$114,370.01	$116,370	$404.00	$198,370.01	$200,370
$190.00	$116,370.01	$118,370	$410.00	$200,370.01	$202,370
$194.00	$118,370.01	$120,370	$416.00	$202,370.01	$204,370
$198.00	$120,370.01	$122,370	$422.00	$204,370.01	$206,370
$202.00	$122,370.01	$124,370	$428.00	$206,370.01	$208,370
$207.00	$124,370.01	$126,370	$434.00	$208,370.01	$210,370
$212.00	$126,370.01	$128,370	$441.00	$210,370.01	$212,370
$217.00	$128,370.01	$130,370
				200% FPIG		$180,740

 

[Pa.B. Doc. No. 12-946. Filed for public inspection May 18, 2012, 9:00 a.m.]

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