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Effective Date: April 1, 2009

Approval Date: ____________ 17

employment;

• $135.00 per month per child age two or older, or incapacitated adult, for part-time employment

• $150.00 per month, per child under age two, for part-time employment

Methods for evaluating family income include verification through wage stubs or documentation from the employer. All earned and unearned income received within a four week period must be verified and documented. On-line access to wage, unemployment, and disability files is available through the Department of Labor.

For children in families with gross income at or below 200% of the federal poverty level (NJ FamilyCare Plans B and C), a modified benefit package is available, with cost sharing required for families with income above 150% of federal poverty level (NJ FamilyCare Plan C). Determining whether a family meets either the 200% or 150% limit is a simple calculation of gross income with no deductions or disregards. Household and family income is defined as the gross income of the family including the gross income of all legally responsible adults in the household, the gross income of the minor child(ren), and all other income or support in-kind actually received in the household, including child support.

Methods for evaluating family income include pay check stubs, W-2 forms, letters from employers on company letterhead, or statement of the gross benefit amount from any governmental agency providing benefits. In addition, access to the Department of Labor’s Wage and Unemployment Files is available.

For children in families with gross income at or below 350% of the federal poverty level before disregards (NJ FamilyCare Plan D), a commercial benefit package is available, with cost sharing required for all families based on income. Net household and family income is defined as the gross income of the family including the gross income of all legally responsible adults in the household, the gross income of the minor child(ren) and all of the other income or support in-kind actually received in the household, including child support, less the applicable income disregards described below. Determining income for purposes of setting the premium amount, is a simple calculation of gross income with no deductions or disregards. Children under 150% FPL do not pay premiums.