<thead>
<tr class="footable-header">
                                <th scope="col" colspan="2" class="ninja_column_0 ninja_clmn_nm_ninja_column_1 ">UHC PPO Core</th><td class="ninja_temp_cell"></td></tr>
</thead>
<tbody>

        <tr data-row_id="81" class="ninja_table_row_0 nt_row_id_81">
            <td><b>HSA eligible</td><td><b>No</td>        </tr>
            <tr data-row_id="82" class="ninja_table_row_1 nt_row_id_82">
            <td><b>Company matching contribution to HSA</td><td>N/A</td>        </tr>
            <tr data-row_id="83" class="ninja_table_row_2 nt_row_id_83">
            <td colspan="2"><center><strong>In-network care: your costs</td><td class="ninja_temp_cell"></td>        </tr>
            <tr data-row_id="84" class="ninja_table_row_3 nt_row_id_84">
            <td><strong>Preventive care</td><td>$0; plan pays 100%</td>        </tr>
            <tr data-row_id="85" class="ninja_table_row_4 nt_row_id_85">
            <td><b>Individual/family deductible</td><td><b>$2,000/$4,000</td>        </tr>
            <tr data-row_id="86" class="ninja_table_row_5 nt_row_id_86">
            <td><b>Individual/family out-ofpocket maximum (includes deductible)</td><td>$6,000/$12,000</td>        </tr>
            <tr data-row_id="87" class="ninja_table_row_6 nt_row_id_87">
            <td><b>Your coinsurance</td><td><b>20% after deductible</td>        </tr>
            <tr data-row_id="88" class="ninja_table_row_7 nt_row_id_88">
            <td><b>Office visit (primary care/ specialist)</td><td>$30 copay/$60 copay</td>        </tr>
            <tr data-row_id="89" class="ninja_table_row_8 nt_row_id_89">
            <td><b>Telemedicine visit</td><td><b>$30</td>        </tr>
            <tr data-row_id="90" class="ninja_table_row_9 nt_row_id_90">
            <td><b>Emergency room visit</td><td>20% after deductible</td>        </tr>
            <tr data-row_id="91" class="ninja_table_row_10 nt_row_id_91">
            <td colspan="2"><center><b>Prescriptions: your costs</td><td class="ninja_temp_cell"></td>        </tr>
            <tr data-row_id="92" class="ninja_table_row_11 nt_row_id_92">
            <td><b>Retail: 30-day supply</b></br> Generic</br> Formulary</br> Non-formulary</br> Specialty</td><td>Deductible does not apply:<br> Tier 1—$15<br> Tier 2—$60<br> Tier 3—$75<br> Tier 4—50%<br> Coinsurance up to $125 max*</td>        </tr>
            <tr data-row_id="93" class="ninja_table_row_12 nt_row_id_93">
            <td><b>Mail order: 90-day supply</b><br> Generic<br> Formulary<br> Non-formulary<br> Specialty</td><td>Deductible does not apply:<br> Tier 1—$38<br> Tier 2—$125<br> Tier 3—$188<br> Tier 4—N/A</td>        </tr>
            <tr data-row_id="94" class="ninja_table_row_13 nt_row_id_94">
            <td colspan="2"><b>Preventive maintenance drugs are covered at 100% on all three plans.</td><td class="ninja_temp_cell"></td>        </tr>
    </tbody><!--ninja_tobody_rendering_done-->
