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Certified Public Accountant, New Jersey
Manny Forlenza CPA

Income Limits and Cost

To qualify for the insurance coverage through the Health Insurance Marketplaces, income will be based on a percentage of the Federal Poverty Limit (FPL) Guidelines. This will also control the maximum amount of net health insurance premiums individual will pay through the Marketplace.


Income Limits Based On Federal Poverty Limit (FPL) Guidelines
 Household Size 
 100% of FPL 
 133% of FPL 
 150% of FPL 
 200% of FPL 
 250% of FPL 
 300% of FPL 
 350% of FPL 
 400% of FPL 
1 11,490 
15,282 
17,235 
22,980 
28,725 
34,470 
40,215 
45,960 
2 15,510 
20,628 
23,265 
31,020 
38,775 
 46,530 
54,285 
62,040 
3 19,530 
25,975 
29,295 
39,060 
48,825 
58,590 
68,355 
78,120 
4 23,550 
31,322 
35,325 
47,100 
58,875 
70,650 
82,425 
94,200 
5 27,570 
36,668 
41,355 
55,140 
68,925 
82,710 
96,495 
110,280 
6 31,590 
42,015 
47,385 
63,180 
78,975 
94,770 
110,565 
126,360 
7 35,610 
47,361 
53,415 
71,220 
89,025 
 106,830 
124,635 
142,440 
8 39,630 
52,708 
59,445  79,260 
99,075  118,890 
138,705  158,520 

Cost
By definition an insurance plan premium that exceeds 9.5% of a person’s income (after the Premium Tax Credit) does not meet the law’s requirement to be affordable.

Maximum Net Premium Contribution As Percentage of Income
Household Income Level  
 (% Above Federal Poverty Level)   
  Maximum Net Premium Contribution As A
  Percentage of Income After Premium Tax Credit 

 Less than 133%
2%
 At Least 133% But Less Than 150%  3.0% to 4.0%
 At Least 150% But Less Than 200% 
4.0 % to 6.3%
 At Least 200% But Less Than 250% 
6.3% to 8.05%
 At Least 250% But Less Than 300% 
8.05% to 9.5%
 At Least 300% But Less Than 400% 
9.50%