Preferred Provider Organization (PPO) — Groups 2 – 50 AmeriHealth Forms Online — New Jersey Option Copay Integrated Rx PPO 520/80/50 $20   PPO 1020/80/50 $20   PPO 2020/80/50 $20   PPO 2520/80/50 $20   PPO C201 — $1,000 Deductible $20 x PPO D201 — $1,000 Deductible $20 x PPO D201 — $1,000 Deductible w/ Rx Card $20   PPO C201 — $500 Deductible $20 x PPO D201 — $500 Deductible $20 x PPO C20 — $1,000 Deductible w/ Rx Card $20   PPO D20 — $1,000 Deductible w/ Rx Card $20   PPO C20 — $1,000 Deductible $20 x PPO D20 — $1,000 Deductible $20 x PPO C20 — $500 Deductible w/ Rx Card $20   PPO D20 — $500 Deductible $20 x PPO D20 — $500 Deductible w/ Rx Card $20   PPO C301 — $1,000 Deductible w/ Rx Card $30   PPO C301 — $1,000 Deductible $30 x PPO C301 — $2,500 Deductible w/ Rx Card $30   PPO C301 — $2,500 Deductible $30 x PPO C30 — $1,000 Deductible w/ Rx Card $30   PPO C30 — $1,000 Deductible $30 x PPO C30 — $2,500 Deductible w/ Rx Card $30   PPO C30 — $2,500 Deductible $30 x