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Six Person Household 47% Entrance Level: $89,336 67% Exit Level (at redetermination): $127,352 85% Exit Level (during eligibility period): $161,565 Gross income range Biweekly copayment From To $0 $32,362 $0 $32,363 $43,149 $2 $43,150 $52,707 $53 $52,708 $55,216 $55 $55,217 $57,725 $58 $57,726 $60,234 $60 $60,235 $62,743 $70 $62,744 $65,252 $73 $65,253 $67,780 $76 $67,781 $70,270 $78 $70,271 $72,798 $90 $72,799 $75,308 $93 $75,309 $77,817 $96 $77,818 $80,326 $119 $80,327 $82,835 $122 $82,836 $85,344 $146 $85,345 $87,853 $161 $87,854 $90,362 $175 $90,363 $92,871 $202 $92,872 $95,380 $218 $95,381 $97,889 $235 $97,890 $100,398 $264 $100,399 $102,907 $300 $102,908 $105,416 $338 $105,417 $107,925 $382 $107,926 $110,434 $428 $110,435 $112,943 $475 $112,944 $115,452 $513 $115,453 $117,980 $552 $117,981 $120,489 $592 $120,490 $122,998 $633 $122,999 $127,352 $686

Seven Person Household 47% Entrance Level: $91,367 67% Exit Level (at redetermination): $130,246 85% Exit Level (during eligibility period): $165,237 Gross income range Biweekly copayment From To $0 $36,487 $0 $36,488 $48,649 $2 $48,650 $53,905 $54 $53,906 $56,471 $57 $56,472 $59,037 $59 $59,038 $61,603 $62 $61,604 $64,169 $72 $64,170 $66,735 $75 $66,736 $69,321 $78 $69,322 $71,868 $80 $71,869 $74,453 $92 $74,454 $77,019 $95 $77,020 $79,585 $98 $79,586 $82,151 $121 $82,152 $84,717 $125 $84,718 $87,283 $150 $87,284 $89,849 $164 $89,850 $92,415 $180 $92,416 $94,981 $206 $94,982 $97,547 $223 $97,548 $100,113 $240 $100,114 $102,679 $270 $102,680 $105,246 $307 $105,247 $107,812 $345 $107,813 $110,378 $390 $110,379 $112,944 $438 $112,945 $115,510 $486 $115,511 $118,076 $524 $118,077 $120,661 $564 $120,662 $123,227 $605 $123,228 $125,793 $648 $125,794 $130,246 $702