Your Business Assistant. Manage your company's benefits online, 24/7.

Point-of-Service (POS) — Groups 2 – 50

AmeriHealth Forms Online — New Jersey

PDF icon Forms are in PDF format.

Option Copay Integrated Rx
POS $15/$30 $0 Day $15  
POS $15/$30 $0 Day $15 x
POS $15/$30 $200 Day $15  
POS $15/$30 $200 Day $15 x
POS $20/$40 $0 Day $20  
POS $20/$40 $0 Day $20 x
POS $20/$40 $300 Day $20  
POS $20/$40 $300 Day $20 x
POS $25/$50 $500 Day $25  
POS $25/$50 $500 Day $25 x
POS $30/$50 $0 Day $30  
POS $30/$50 $0 Day $30 x
POS $30/$50 $400 Day $30  
POS $30/$50 $400 Day $30 x
POS 10 Premium Option 1 $10  
POS 10 Premium Option 3 $10  
POS 10 Premium Option 4 $10  
POS 10 Premium Option 5 $10  
POS 10 Premium Option 6 $10  
POS 10 Option 1 $10  
POS 10 Option 2 $10  
POS 10 Option 3 $10  
POS 10 Option 4 $10  
POS 10 Option 5 $10  
POS 10 Option 6 $10  
POS 15 Premium Option 1 $15  
POS 15 Premium Option 3 $15  
POS 15 Premium Option 4 $15  
POS 15 Premium Option 5 $15  
POS 15 Premium Option 6 $15  
POS 15 Option 1 $15  
POS 15 Option 2 $15  
POS 15 Option 3 $15  
POS 15 Option 4 $15  
POS 15 Option 5 $15  
POS 15 Option 6 $15  
POS 20 Premium Option 1 $20  
POS 20 Premium Option 3 $20  
POS 20 Premium Option 4 $20  
POS 20 Premium Option 5 $20  
POS 20 Premium Option 6 $20  
POS 20 Option 1 $20  
POS 20 Option 2 $20  
POS 20 Option 3 $20  
POS 20 Option 4 $20  
POS 20 Option 5 $20  
POS 20 Option 6 $20  
POS 30 Premium Option 4 $30  
POS 30 Premium Option 6 $30  
POS 30 Premium Option 7 $30  
POS 30 Option 6 $30  
POS 30 Option 7 $30  
POS 40 Premium Option 6 $40  
POS 40 Premium Option 7 $40  
POS 40 Option 6 $40  
POS 40 Option 7 $40  
POS Coinsurance Option 1 $20  
POS Coinsurance Option 1 $20 x
POS Coinsurance Option 2 $30  
POS Coinsurance Option 2 $30 x
POS Coinsurance Option 3 $30  
POS Coinsurance Option 3 $30 x