Flex HMO Benefits at a Glance AmeriHealth Forms Online — Delaware Forms are in PDF format. Option PCP Copay HMO C1-F1 $10 HMO C1-F2 $10 HMO C1-F3 $10 HMO C1-F4 $10 HMO C2-F1 $20 HMO C1-F2 $20 HMO C2-F3 $20 HMO C1-F4 $20 HMO C3-F1 $30 HMO C3-F2 $30 HMO C3-F3 $30 HMO C3-F4 $30 HMO C1-F1 $10