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 seal of New Mexico

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
(138-175% FPL)		 Group 2
(175-212% FPL)		 Group 3
(212-250% FPL)		 Group 4*
(>250%)
*Salary $39,1250 - $50,000

Household Information

Number of people in your household

Total annual income for all members of your household

Coverage for employee only

Coverage for employee and spouse/partner

Coverage for employee and children

Coverage for employee, spouse/partner, and children

Coverage Information