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Appendix Page A-3-a COE-073- Children Age 6 to 19 HH Size 194% FPL 194% + 5% Disregard 143% FPL 143% + 5% Disregard 107% FPL (no 5% disregard) 133% FPL 133% + 5% Disregard 209% FPL 209% + 5% Disregard State Set Income Limit Limit + 5% Disregard 1 $1,888 $1,937 $1,392 $1,441 $1,042 $1,295 $1,344 $2,034 $2,083 $227 $276 2 $2,544 $2,610 $1,875 $1,941 $1,403 $1,744 $1,810 $2,740 $2,806 $306 $372 3 $3,201 $3,284 $2,360 $2,443 $1,766 $2,195 $2,278 $3,449 $3,532 $384 $467 4 $3,857 $3,956 $2,843 $2,942 $2,128 $2,645 $2,744 $4,155 $4,254 $462 $561 5 $4,513 $4,629 $3,327 $3,443 $2,489 $3,094 $3,210 $4,862 $4,978 $541 $657 6 $5,171 $5,304 $3,811 $3,944 $2,852 $3,545 $3,678 $5,570 $5,703 $619 $752 7 $5,826 $5,976 $4,295 $4,445 $3,214 $3,994 $4,144 $6,277 $6,427 $697 $847 8 $6,482 $6,649 $4,778 $4,945 $3,575 $4,444 $4,611 $6,983 $7,150 $775 $942 9 $7,138 $7,322 $5,262 $5,446 $3,937 $4,894 $5,078 $7,690 $7,874 $853 $1,037 10 $7,794 $7,995 $5,746 $5,947 $4,299 $5,344 $5,545 $8,397 $8,598 $931 $1,132 11 $8,451 $8,669 $6,229 $6,447 $4,661 $5,794 $6,012 $9,104 $9,322 $1,009 $1,227 12 $9,107 $9,342 $6,713 $6,948 $5,023 $6,244 $6,479 $9,811 $10,046 $1,087 $1,322 For more than 12, add: $363 for each additional person to increase the FPL. 13 14 15 16 17 18 19 20 $252 $269 $286 $302 $319 $336 $353 $370 * Family Planning Waiver increased to 194% FPL effective 01/01/2015 HH Size 5% Disregard Amt $658 for each additional person to increase the FPL. $485 for each additional person to increase the FPL. $451 for each additional person to increase the FPL. $709 for each additional person to increase the FPL. For more than 8 persons, add $78 for each additional person to the State Set Income Limit Use the chart below for the correct 5% disregard amount to use for households with more than 12 persons. 2014 MAGI INCOME LIMITS EFFECTIVE MARCH 1, 2014 COE-088-Pregnant Women, COE-071 - Infants to Age 1, COE-029 Family Planning Waiver* COE-072 - Children Age 1 to Age 6 COE-074- Children Age 6 to Age 19 COE-099 - CHIP COE-075 - Low-Income Parents & Caretaker Relatives