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Employee Eligibility

Subsidy Amount

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Section 125 Plan

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Note: the amount shown is the annual maximum subsidy. The actual subsidy is the lesser of 50% of the total premium and the maximum shown.

Subsidy Year: 10/1/2012-9/30/2013 Registration Period 10/1/2011-9/30/2012 Registration Period 10/1/2010-9/30/2011 Registration Period 10/1/2009-9/30/2010 Registration Period 10/1/2008-9/30/2009 Registration Period

Min Wage	Max Wage	Employee Only	Employee + Children	Employee + Spouse	Family
$0	$30,000	2500	3750	5000	6250
$30,001	$31,000	2381	3571	4762	5952
$31,001	$32,000	2262	3393	4524	5655
$32,001	$33,000	2143	3214	4286	5357
$33,001	$34,000	2024	3036	4048	5060
$34,001	$35,000	1905	2857	3810	4762
$35,001	$36,000	1786	2678	3571	4464
$36,001	$37,000	1667	2500	3333	4167
$37,001	$38,000	1548	2321	3095	3869
$38,001	$39,000	1429	2143	2857	3571
$39,001	$40,000	1310	1964	2619	3274
$40,001	$41,000	1190	1785	2381	2976
$41,001	$42,000	1071	1607	2143	2679
$42,001	$43,000	952	1428	1905	2381
$43,001	$44,000	833	1250	1667	2083
$44,001	$45,000	714	1071	1429	1786
$45,001	$46,000	595	892	1190	1488
$46,001	$47,000	476	714	952	1190
$47,001	$48,000	357	535	714	893
$48,001	$49,000	238	357	476	595
$49,001	$50,000	119	178	238	298