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couple (after unearned income disregards are applied) and are assigned a premium as follows: a.

Income Monthly Premium Less than 150% FPL No premium At least 150% and less than 185% FPL $ 61.00 At least 185% and less than 200% FPL $ 77.00 At least 200% and less than 250% FPL $ 92.00 At least 250% and less than 300% FPL $ 110.00 At least 300% and less than 350% FPL $ 130.00 At least 350% and less than 400% FPL $ 150.00 At least 400% and less than 450% FPL $ 170.00 At least 450% and less than 500% FPL $ 190.00 At least 500% and less than 550% FPL $ 210.00 At least 550% and less than 600% FPL $ 230.00 At least 600% and less than 650% FPL $ 250.00 At least 650% and less than 700% FPL $ 270.00 At least 700% and less than 750% FPL $ 290.00