Exclusive Provider Organization (EPO) — Groups 51+ AmeriHealth Forms Online — New Jersey Option Copay Integrated Rx EPO $30/$50/80% 80% ER $30   EPO with National Access $30/$50/80% 80% ER $30   EPO $30/$50/80% w/$100 ER copay $30   EPO with National Access $30/$50/80% w/$100 ER copay $30   EPO $30 50% /50% $30   EPO with National Access $30 50%/50% $30   EPO $30 $50 70% $30   EPO with National Access $30 $50 70% $30   EPO $1,500 70% 70%   EPO with National Access $1,500 70% 70%   EPO HSA $1,500 70% 50% 70% x EPO HSA $1,500 70% 50%/$125 max 70% x EPO HSA $1,500 70% $7/50%/$125 max 70% x EPO HSA $1,500 70% $10/$40/$60 70% x EPO HSA with National Access $1,500 70% 50% 70% x EPO HSA with National Access $1,500 70% 50%/$125 max 70% x EPO HSA with National Access $1,500 70% $7/50%/$125 max 70% x EPO HSA with National Access $1,500 70% $10/$40/$60 M 70% x EPO $1,250 80% 80%   EPO with National Access $1,250 80% 80%   EPO HSA $1,250 80% 50% 80% x EPO HSA $1,250 80% 50%/$125 max 80% x EPO HSA $1,250 80% $7/50%/$125 max 80% x EPO HSA $1,250 80% $10/$40/$60 80% x EPO HSA with National Access $1,250 80% 50% 80% x EPO HSA with National Access $1,250 80% 50%/$125 max 80% x EPO HSA with National Access $1,250 80% $7/50%/$125 max 80% x EPO HSA with National Access $1,250 80% $10/$40/$60 80% x EPO $1,250 50% 50%   EPO with National Access $1,250 50% 50%   EPO HSA $1,250 50% 50% 50% x EPO HSA $1,250 50% 50%/$125 max 50% x EPO HSA $1,250 50% $7/50%/$125 max 50% x EPO HSA $1,250 50% $10/$40/$60 50% x EPO HSA with National Access $1,250 50% 50% 50% x EPO HSA with National Access $1,250 50% 50%/$125 max 50% x EPO HSA with National Access $1,250 50% $7/50%/$125 max 50% x EPO HSA with National Access $1,250 50% $10/$40/$60 50% x EPO $20/$40/$250 $20   EPO $20/$40/$250 with National Access $20   EPO $30/$50/$500 $30   EPO with National Access $30/$50/$500 $30