Health Management Organization (HMO) Plus — Groups 51+ AmeriHealth Forms Online — New Jersey Option Copay Integrated Rx HMO Plus $15/$30 $0 Day $15   HMO Plus $15/$30 $200 Day $15   HMO Plus $20/$40 $0 Day $20   HMO Plus $20/$40 $300 Day $20   HMO Plus $30/$50 $0 Day $20   HMO Plus $30/$50 $400 Day $20   HMO Plus Coinsurance Option 1 $20   HMO Plus Coinsurance Option 2 $25   HMO Plus Coinsurance Option 3 $30