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Family Income and Contribution Schedule Revised February 21, 2022 State of Alaska Department of Health Division of Public Assistance Child Care Program Office AK State Median Income by Family Size l2D15 - 2019 ACS Estimates\ $ 5897 $7285 $8673 $10 060 $11 448 $11 708 $11 968 Percent i SM/ i 1% Percent Copay 1% 2p Gross Income $59 2p Copay Amt $1 3p Gross Income $73 3p Copay Amt $1 4p Gross Income $87 4p Copay Amt $1 5p Gross Income $101 5p Copay Amt $1 6p Gross Income $114 6p Copay Amt $1 7p Gross Income $117 7p Copay Amt $1 Bp Gross Income $120 Bp Copay Amt $1 2% 1% $118 $1 $146 $1 $173 $2 $201 $2 $229 $2 $234 $2 $239 $2 3% 1% $177 $2 $219 $2 $260 $3 $302 $3 $343 $3 $351 $4 $359 $4 4% 1% $236 $2 $291 $3 $347 $3 $402 $4 $458 $5 $468 $5 $479 $5 5% 1% $295 $3 $364 $4 $434 $4 $503 $5 $572 $6 $585 $6 $598 $6 6% 1% $354 $4 $437 $4 $520 $5 $604 $6 $687 $7 $702 $7 $718 $7 7% 1% $413 $4 $510 $5 $607 $6 $704 $7 $801 $8 $820 $8 $838 $8 8% 1% $472 $5 $583 $6 $694 $7 $805 $8 $916 $9 $937 $9 $957 $10 9% 2% $531 $11 $656 $13 $781 $16 $905 $18 $1 030 $21 $1 054 $21 $1 077 $22 10% 2% $590 $12 $729 $15 $867 $17 $1,006 $20 $1,145 $23 $1,171 $23 $1,197 $24 11% 2% $649 $13 $801 $16 $954 $19 $1 107 $22 $1 259 $25 $1 288 $26 $1 316 $26 12% 2% $708 $14 $874 $17 $1 041 $21 $1 207 $24 $1 374 $27 $1 405 $28 $1 436 $29 13% 2% $767 $15 $947 $19 $1 127 $23 $1 308 $26 $1 488 $30 $1 522 $30 $1 556 $31 14% 2% $826 $17 $1 020 $20 $1 214 $24 $1 408 $28 $1 603 $32 $1 639 $33 $1 676 $34 15% 2% $885 $18 $1 093 $22 $1 301 $26 $1 509 $30 $1 717 $34 $1 756 $35 $1 795 $36 16% 2% $944 $19 $1 166 $23 $1 388 $28 $1 610 $32 $1 832 $37 $1 873 $37 $1 915 $38 17% 2% $1 002 $20 $1 238 $25 $1 474 $29 $1 710 $34 $1 946 $39 $1 990 $40 $2 035 $41 18% 3% $1 061 $32 $1 311 $39 $1 561 $47 $1 811 $54 $2 061 $62 $2 107 $63 $2 154 $65 19% 3% $1,120 $34 $1,384 $42 $1,648 $49 $1,911 $57 $2,175 $65 $2,225 $67 $2,274 $68 20% 3% $1 179 $35 $1 457 $44 $1 735 $52 $2 012 $60 $2 290 $69 $2 342 $70 $2 394 $72 21% 3% $1,238 $37 $1,530 $46 $1,821 $55 $2,113 $63 $2,404 $72 $2,459 $74 $2,513 $75 22% 3% $1 297 $39 $1 603 $48 $1 908 $57 $2 213 $66 $2 519 $76 $2 576 $77 $2 633 $79 23% 3% $1,356 $41 $1,676 $50 $1,995 $60 $2,314 $69 $2,633 $79 $2,693 $81 $2,753 $83 24% 3% $1 415 $42 $1 748 $52 $2 082 $62 $2 414 $72 $2 748 $82 $2 810 $84 $2 872 $86 25% 3% $1 474 $44 $1 821 $55 $2,168 $65 $2,515 $75 $2,862 $86 $2,927 $88 $2,992 $90 26% 4% $1 533 $61 $1 894 $76 $2 255 $90 $2 616 $105 $2 976 $119 $3 044 $122 $3 112 $124 27% 4% $1 592 $64 $1 967 $79 $2 342 $94 $2 716 $109 $3 091 $124 $3 161 $126 $3 231 $129 28% 4% $1 651 $66 $2 040 $82 $2 428 $97 $2 817 $113 $3 205 $128 $3 278 $131 $3 351 $134 29% 4% $1 710 $68 $2 113 $85 $2 515 $101 $2 917 $117 $3 320 $133 $3 395 $136 $3 471 $139 30% 4% $1 769 $71 $2 186 $87 $2 602 $104 $3 018 $121 $3 434 $137 $3 512 $140 $3 590 $144 31% 4% $1 828 $73 $2 258 $90 $2 689 $108 $3 119 $125 $3 549 $142 $3 629 $145 $3 710 $148 32% 4% $1,887 $75 $2,331 $93 $2,775 $111 $3,219 $129 $3,663 $147 $3,747 $150 $3,830 $153 33% 4% $1,946 $78 $2,404 $96 $2,862 $114 $3,320 $133 $3,778 $151 $3,864 $155 $3,949 $158 34% 4% $2,005 $80 $2,477 $99 $2,949 $118 $3,420 $137 $3,892 $156 $3,981 $159 $4,069 $163 35% 5% $2 064 $103 $2 550 $128 $3 036 $152 $3 521 $176 $4 007 $200 $4 098 $205 $4 189 $209 36% 5% $2,123 $106 $2,623 $131 $3,122 $156 $3,622 $181 $4,121 $206 $4,215 $211 $4,308 $215 37% 5% $2 182 $109 $2 695 $135 $3 209 $160 $3 722 $186 $4 236 $212 $4 332 $217 $4 428 $221 38% 5% $2,241 $112 $2,768 $138 $3 296 $165 $3,823 $191 $4,350 $218 $4,449 $222 $4,548 $227 39% 5% $2 300 $115 $2 841 $142 $3 382 $169 $3 923 $196 $4 465 $223 $4 566 $228 $4 668 $233 40% 5% $2 359 $118 $2 914 $146 $3 469 $173 $4 024 $201 $4 579 $229 $4 683 $234 $4 787 $239 41% 5% $2 418 $121 $2 987 $149 $3 556 $178 $4 125 $206 $4 694 $235 $4 800 $240 $4 907 $245 42% 5% $2 477 $124 $3 060 $153 $3 643 $182 $4 225 $211 $4 808 $240 $4 917 $246 $5 027 $251 43% 6% $2 536 $152 $3 133 $188 $3 729 $224 $4 326 $260 $4 923 $295 $5 034 $302 $5 146 $309 44% 6% $2 595 $156 $3 205 $192 $3 816 $229 $4 426 $266 $5 037 $302 $5 152 $309 $5 266 $316 45% 6% $2 654 $159 $3 278 $197 $3 903 $234 $4 527 $272 $5 152 $309 $5 269 $316 $5 386 $323 46% 6% $2 713 $163 $3 351 $201 $3 990 $239 $4 628 $278 $5 266 $316 $5 386 $323 $5,505 $330 47% 6% $2,772 $166 $3,424 $205 $4,076 $245 $4,728 $284 $5,381 $323 $5,503 $330 $5,625 $338 48% 6% $2 831 $170 $3 497 $210 $4 163 $250 $4 829 $290 $5 495 $330 $5 620 $337 $5 745 $345 49% 6% $2,890 $173 $3,570 $214 $4,250 $255 $4,929 $296 $5,610 $337 $5,737 $344 $5,864 $352 50% 6% $2 949 $177 $3 643 $219 $4 337 $260 $5 030 $302 $5 724 $343 $5 854 $351 $5 984 $359 51% 6% $3,007 $180 $3,715 $223 $4,423 $265 $5,131 $308 $5,838 $350 $5,971 $358 $6,104 $366 52% 7% $3 066 $215 $3 788 $265 $4 510 $316 $5 231 $366 $5 953 $417 $6 088 $426 $6 223 $436 53% 7% $3 125 $219 $3 861 $270 $4 597 $322 $5 332 $373 $6 067 $425 $6 205 $434 $6 343 $444 54% 7% $3 184 $223 $3 934 $275 $4 683 $328 $5 432 $380 $6 182 $433 $6 322 $443 $6 463 $452 55% 7% $3 243 $227 $4 007 $280 $4 770 $334 $5 533 $387 $6 296 $441 $6 439 $451 $6 582 $461 56% 7% $3 302 $231 $4 080 $286 $4 857 $340 $5 634 $394 $6 411 $449 $6 556 $459 $6 702 $469 57% 7% $3 361 $235 $4 152 $291 $4 944 $346 $5 734 $401 $6 525 $457 $6 674 $467 $6 822 $478 58% 7% $3 420 $239 $4 225 $296 $5 030 $352 $5 835 $408 $6 640 $465 $6 791 $475 $6 941 $486 59% 60% 7% 7% $3,479 $3,538 $244 $248 $4,298 $4,371 $301 $306 $5,117 $5,204 $358 $364 $5,935 $6,036 $415 $423 $6 754 $6,869 $473 $481 $6 908 $7,025 $484 $492 $7 061 $7,181 $494 $503 61% 8% $3 597 $288 $4 444 $356 $5 291 $423 $6 137 $491 $6 983 $559 $7 142 $571 $7 300 $584 62% 8% $3,656 $292 $4,517 $361 $5,377 $430 $6,237 $499 $7,098 $568 $7,259 $581 $7,420 $594 63% 8% $3 715 $297 $4 590 $367 $5 464 $437 $6 338 $507 $7 212 $577 $7 376 $590 $7 540 $603 64% 8% $3,774 $302 $4,662 $373 $5,551 $444 $6,438 $515 $7,327 $586 $7,493 $599 $7,660 $613 65% 8% $3 833 $307 $4 735 $379 $5 637 $451 $6 539 $523 $7 441 $595 $7 610 $609 $7 779 $622 66% 8% $3,892 $311 $4,808 $385 $5,724 $458 $6,640 $531 $7,556 $604 $7,727 $618 $7,899 $632 67% 8% $3 951 $316 $4 881 $390 $5 811 $465 $6 740 $539 $7 670 $614 $7 844 $628 $8 019 $642 68% 8% $4 010 $321 $4 954 $396 $5 898 $472 $6 841 $547 $7 785 $623 $7 961 $637 $8 138 $651 69% 8% $4 069 $326 $5 027 $402 $5 984 $479 $6 941 $555 $7 899 $632 $8 079 $646 $8 258 $661 70% 8% $4 128 $330 $5 100 $408 $6 071 $486 $7 042 $563 $8 014 $641 $8 196 $656 $8 378 $670 71% 8% $4 187 $335 $5 172 $414 $6 158 $493 $7 143 $571 $8 128 $650 $8 313 $665 $8 497 $680 72% 8% $4 246 $340 $5 245 $420 $6 245 $500 $7 243 $579 $8 243 $659 $8 430 $674 $8 617 $689 73% 9% $4,305 $387 $5,318 $479 $6,331 $570 $7,344 $661 $8,357 $752 $8,547 $769 $8,737 $786 74% 9% $4 364 $393 $5 391 $485 $6 418 $578 $7 444 $670 $8 472 $762 $8 664 $780 $8 856 $797 75% 9% $4,423 $398 $5,464 $492 $6,505 $585 $7,545 $679 $8,586 $773 $8,781 $790 $8,976 $808 76% 9% $4 482 $403 $5 537 $498 $6 591 $593 $7 646 $688 $8 700 $783 $8 898 $801 $9 096 $819 77% 9% $4,541 $409 $5,609 $505 $6,678 $601 $7,746 $697 $8,815 $793 $9,015 $811 $9,215 $829 78% 9% $4 600 $414 $5 682 $511 $6 765 $609 $7 847 $706 $8 929 $804 $9 132 $822 $9 335 $840 79% 9% $4,659 $419 $5,755 $518 $6,852 $617 $7,947 $715 $9,044 $814 $9,249 $832 $9,455 $851 80% 9% $4 718 $425 $5 828 $525 $6 938 $624 $8 048 $724 $9 158 $824 $9 366 $843 $9 574 $862 81% 9% $4 777 $430 $5 901 $531 $7 025 $632 $8 149 $733 $9 273 $835 $9 483 $853 $9 694 $872 82% 9% $4 836 $435 $5 974 $538 $7 112 $640 $8 249 $742 $9 387 $845 $9 601 $864 $9 814 $883 83% 9% $4 895 $441 $6 047 $544 $7 199 $648 $8 350 $752 $9 502 $855 $9 718 $875 $9 933 $894 84% 9% $4 953 $446 $6 119 $551 $7 285 $656 $8 450 $761 $9 616 $865 $9 835 $885 $10 053 $905 85% 9% $5 012 $451 $6 192 $557 $7 372 $663 $8 551 $770 $9 731 $876 $9 952 $896 $10 173 $916 Page 1 of 2