calculate catamount health premium subsidy

Calculate your Premium Subsidy

# in Household **	1	2	3	4	Cost Per Person for Catamount Blue:	Cost Per Person for MVP Catamount Choice:
If your total monthly/yearly household income is:	$1,862/ $22,344	$2,522/ $30,264	$3,182/ $38,184	$3,842/ $46,104	$60/mo 200% FPL	$119/mo 200% FPL
If your total monthly/yearly household income is:	$2,095/ $25,140	$2,837/ $34,044	$3,580/ $42,960	$4,322/ $51,864	$124/mo 225% FPL	$183/mo 225% FPL
If your total monthly/yearly household income is:	$2,328/ $27,936	$3,153/ $37,836	$3,978/ $47,736	$4,803/ $57,636	$152/mo 250% FPL	$211/mo 250% FPL
If your total monthly/yearly household income is:	$2,560/ $30,720	$3,468/ $41,616	$4,375/ $51,500	$5,283/ $63,396	$180/mo 275% FPL	$239/mo 275% FPL
If your total monthly/yearly household income is:	$2,793/ $33,156	$3,783/ $45,396	$4,773/ $57,276	$5,763/ $69,156	$208/mo 300% FPL	$267/mo 300% FPL
If your total monthly/yearly household income is:	Over $2,793/ $33,516	Over $3,783/ $45,396	Over $4,773/ $57,276	Over $5,763/ $69,156	$454/mo*	$513/mo*

* reflects $45/month “participation fee” for those over 300% FPL
** A household is defined as the number of related people living in the same house. Some exceptions apply. Please call 1 800 250 8427 for details. Rates effective January 1, 2012.

July 2009 Calculation tool: http://www.policyintegrity.com/Eligibility.html

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