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State of Illinois Department of Human Services IL444-3455B (R-07-25) Important Parent Copayment Information Printed by Authority of the State of Illinois -0- Copies Page 5 of 7 IMPORTANT PARENT COPAYMENT INFORMATION Effective July 1, 2025 - TABLE B Co-Pay Indicator B - For any month September through May where all children are School Age and approved for Part-Day/ School Age care.

Maximum Monthly Income and Monthly Co-Pay by Family Size and Income Level at Time of New Application. Family Size 2 Monthly Income Monthly Co-Pay 0 - 1763 .50 1764 - 1939 9.00 1940 - 2115 19.50 2116 - 2291 31.50 2292 - 2468 46.00 2469 - 2644 61.50 2645 - 2820 79.50 2821 - 2996 98.50 2997 - 3173 105.00 3174 - 3349 111.00 3350 - 3525 117.50 3526 - 3701 123.50 3702 - 3878 129.50 3879 - 3966 136.00 Family Size 3 Monthly Income Monthly Co-Pay 0 - 2221 .50 2222 - 2443 11.50 2444 - 2665 25.00 2666 - 2887 40.50 2888 - 3109 58.00 3110 - 3331 78.00 3332 - 3553 100.00 3554 - 3775 124.00 3776 - 3998 132.00 3999 - 4220 139.50 4221 - 4442 147.00 4443 - 4664 154.50 4665 - 4886 162.00 4887 - 4997 167.50 Family Size 4 Monthly Income Monthly Co-Pay 0 - 2679 .50 2680 - 2947 13.50 2948 - 3215 29.50 3216 - 3483 48.00 3484 - 3751 69.50 3752 - 4019 94.00 4020 - 4287 120.50 4288 - 4555 150.00 4556 - 4823 159.50 4824 - 5090 169.00 5091 - 5358 178.00 5359 - 5626 187.50 5627 - 5894 197.00 5895 - 6028 206.50 Income can extend to the following ranges at the time of Redetermination and qualify for a new 12-month eligibility period. Family Size 2 Monthly Income Monthly Co-Pay 3967 - 4054 139.00 4055 - 4230 142.00 4231 - 4406 148.00 4407 - 4583 154.00 4584 - 4759 160.50 4760 - 4847 166.50 Family Size 3 Monthly Income Monthly Co-Pay 4998 - 5108 175.00 5109 - 5330 179.00 5331 - 5552 186.00 5553 - 5774 194.50 5775 - 5996 202.00 5997 - 6107 210.00 Family Size 4 Monthly Income Monthly Co-Pay 6029 - 6162 211.00 6163 - 6430 215.50 6431 - 6698 225.00 6699 - 6966 234.50 6967 - 7234 244.00 7235 - 7368 253.00 Family Income in the following ranges at the time of redetermination will result in a 3-month eligibility extension, known as a Graduated Phase Out for more information, see CCAP Policy 02.03.01 https://www.dhs.state.il.us/page.aspx?item=10568 Family Size 2 Monthly Income Monthly Co-Pay 4858 - 5883 166.50 Family Size 3 Monthly Income Monthly Co-Pay 6108 - 7267 210.00 Family Size 4 Monthly Income Monthly Co-Pay 7369 - 8651 253.00