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Revision 11-3; Effective September 1, 2011
Premium amounts vary based on whether the family does or does not have ESI and whether HIPP is involved or not. Premium amounts are automatically determined by TIERS.
The charts in Section N-7410, Charts for Premium Amounts, outline the premium amounts for persons with:
- no ESI;
- ESI and state-paid HIPP; or
- ESI and no state-paid HIPP.
N-7410 Charts for Premium Amounts
Revision 22-3; Effective September 1, 2022
No ESI
Note: These premium amounts are current. These amounts are subject to change when FPL limits change.
| Family Income | Family of One or Two Premium Amount | Family of Three or More Premium Amount |
|---|---|---|
| At or below 150% FPL | $0 | $0 |
| 151–200% FPL | $90 | $115 |
| 201–300% FPL | $180 | $230 |
ESI with State-Paid HIPP
Note: These premium amounts are current. These amounts are subject to change when FPIL limits change.
| Family Income | Family of One or Two Premium Amount | Family of Three or More Premium Amount |
|---|---|---|
| At or below 150% FPL | $0 | $0 |
| 151–200% FPL | $25 | $35 |
| 201–300% FPL | $50 | $70 |
ESI and No State-Paid HIPP
No premiums are required for families with ESI who are not eligible for HIPP. These families are paying their full share of the premium for ESI and are not expected to also pay a premium for MBIC.