| Use the following chart to determine if you qualify for assistance in the form of a government subsidy for health insurance premiums. | |||||
| Number of People in Household | 2013 Annual Family Income Levels to Quality | ||||
| 1 | $ 45,960 or below | ||||
| 2 | $ 62,040 or below | ||||
| 3 | $ 78,120 or below | ||||
| 4 | $ 94,200 or below | ||||
| 5 | $ 110,280 or below | ||||
| 6 | $ 126,360 or below | ||||
| 7 | $ 142,440 or below | ||||
| 8 | $ 158,520 or below | ||||
| *2013 modified adjusted gross income levels are the latest available; assistance will be based on estimated 2014 modified adjusted gross income. | |||||
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