Instructions
Step 1: Use the SEPA Calculator below to check your eligibility and discount.Step 2: If eligible, complete the Enrollment Form and upload your documents.

State Employee Premium Assistance
SEPA Calculator
SEPA Reference Tables
Family Income Thresholds
Family Size | 138% FPL | 175% FPL | 212% FPL | 250% FPL |
---|
Payment and Discount Percentages by Coverage Tier
Coverage Tier | Group 1 (≤138% FPL) |
Group 2 (139-175% FPL) |
Group 3 (176-212% FPL) |
Group 4 (213-250% FPL) |
Group 5 (>250% FPL) |
---|