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Twelve Person Household 47% Entrance Level: $101,519 67% Exit Level (at redetermination): $144,718 85% Exit Level (during eligibility period): $183,597 Gross income range Biweekly copayment From To $0 $57,112 $0 $57,113 $76,149 $2 $76,150 $77,024 $86 $77,025 $79,853 $90 $79,854 $82,726 $102 $82,727 $85,577 $106 $85,578 $88,428 $109 $88,429 $91,279 $135 $91,280 $94,130 $139 $94,131 $96,982 $166 $96,983 $99,833 $183 $99,834 $102,684 $199 $102,685 $105,535 $229 $105,536 $108,386 $248 $108,387 $111,237 $267 $111,238 $114,089 $300 $114,090 $116,940 $341 $116,941 $119,791 $384 $119,792 $122,642 $434 $122,643 $125,493 $486 $125,494 $128,344 $540 $128,345 $131,196 $583 $131,197 $134,068 $627 $134,069 $136,919 $672 $136,920 $139,771 $719 $139,772 $144,718 $779

Thirteen Person Household 47% Entrance Level: $103,549 67% Exit Level (at redetermination): $147,612 85% Exit Level (during eligibility period): $187,269 Gross income range Biweekly copayment From To $0 $61,237 $0 $61,238 $81,649 $2 $81,650 $84,380 $104 $84,381 $87,289 $108 $87,290 $90,197 $111 $90,198 $93,105 $138 $93,106 $96,013 $142 $96,014 $98,921 $170 $98,922 $101,830 $186 $101,831 $104,738 $204 $104,739 $107,646 $234 $107,647 $110,554 $253 $110,555 $113,642 $272 $113,643 $116,370 $306 $116,371 $119,279 $348 $119,280 $122,187 $391 $122,188 $125,095 $443 $125,096 $128,003 $496 $128,004 $130,911 $551 $130,912 $133,820 $594 $133,821 $136,750 $640 $136,751 $139,658 $686 $139,659 $142,566 $734 $142,567 $147,612 $795