100% to 400% FPL thresholds · Sliding scale contribution caps · 2026 rules
| Benchmark Silver Plan Premium: | $1,052 / mo |
| Your Expected Monthly Contribution: | $36 / mo |
| Net Out-of-Pocket Payment: | $36 / mo |
| Required Income Contribution Rate: | 0.97% of Income |
The Federal Poverty Level (FPL) established annually by HHS is the core statutory yardstick determining ACA Premium Tax Credit percentages and Cost-Sharing Reduction eligibility.
| Income | % FPL | Cap % | Subsidy | Net Silver |
|---|---|---|---|---|
| $38,730 | 150% | 0.00% | $1,052 | $0 |
| $51,640 | 200% | 2.00% | $966 | $86 |
| $64,550 | 250% | 4.00% | $837 | $215 |
| $77,460 | 300% | 6.00% | $665 | $387 |
| $103,280 | 400% | 8.50% | $320 | $732 |
| $129,100 | 500% | 8.50% | $138 | $914 |
Your income is compared to the Federal Poverty Guidelines to find your exact FPL percentage.
Federal law caps your health insurance cost to between 0% and 8.5% of your household income.
The difference between the benchmark plan cost and your capped contribution is paid as a subsidy.
For the 48 contiguous states, the baseline FPL is $15,060 for an individual plus $5,380 for each additional family member ($20,440 for 2, $25,820 for 3, and $31,200 for 4).
Under current enhanced statutory rules, required contributions range from 0.0% of income at 150% FPL up to a maximum cap of 8.5% of income above 400% FPL.
Federal law establishes higher poverty guidelines for Alaska and Hawaii to reflect significantly higher local costs of living, resulting in higher subsidy qualifying thresholds.