HMO Benefits at a Glance AmeriHealth Forms Online — Delaware Forms are in PDF format. Option PCP Copay HMO 2 $2 HMO 5 $5 HMO 10 $10 HMO 15 $15 HMO Select 10 $10 HMO Select 15 $15 HMO 15/80 $15 HMO 15/90 $15 HMO Small Business Basic Plan Coverage $0/$10 HMO Small Business Standard Plan Coverage $0/$10