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How to Qualify
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Charter Oak Health Plan Yearly Income Guidelines* & Expense Chart |
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Family Size |
Charter Oak Yearly Deductible** |
Charter Oak Yearly Co-Insurance |
Charter Oak Monthly Premium |
|
1 |
2 |
3 |
4 |
5 |
6 |
|
Under
$17,235 |
Under
$23,265 |
Under
$29,295 |
Under
$35,325 |
Under
$41,355 |
Under
$47,385 |
$150 Ind.; $300 Family max. |
$150 Ind.; $300 Family max. |
$589
Monthly Premium
Per Individual |
|
$17,235-$21,256 |
$23,265-$28,693 |
$29,295-$36,130 |
$35,325-$43,567 |
$41,355-$51,004 |
$47,385-$58,441 |
$200 Ind.; $350 Family max. |
$200 Ind.; $350 Family max. |
|
$21,257-$27,001 |
$28,694-$36,448 |
$36,131-$45,895 |
$43,568-$55,342 |
$51,005-$64,789 |
$58,442-$74,236 |
$400 Ind.; $600 Family max. |
$400 Ind.; $600 Family max. |
|
$27,002- $34,470 |
$36,449-$46,530 |
$45,896-$58,590 |
$55,343-$70,650 |
$64,790-$82,710 |
$74,237-$94,770 |
$750 Ind.; $1400 Family max. |
$750 Ind.; $1400 Family max. |
|
Over
$34,470 |
Over
$46,530 |
Over
$58,590 |
Over
$70,650 |
Over
$82,710 |
Over
$94,770 |
$900 Ind.; $1750 Family max. |
$900 Ind.; $1750 Family max. |
*Please note - these income levels are approximate, based on federal poverty levels
**Deductible needs to be met before co-insurance applies
See below for monthly income:
Content Last Modified on 3/6/2013 1:11:30 PM
Printable Version
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