<thead>
<tr class="footable-header">
                                                                        <th scope="col"  class="ninja_column_0 ninja_clmn_nm_ninja_column_1 "></th><th scope="col"  class="ninja_column_1 ninja_clmn_nm_value ">UHC PPO Core</th><th scope="col"  class="ninja_column_2 ninja_clmn_nm_premier ">UHC $3,200 HDHP w/Optional HSA</th><th scope="col"  class="ninja_column_3 ninja_clmn_nm_choiceplus ">Surest PPO</th></tr>
</thead>
<tbody>

        <tr data-row_id="1" class="ninja_table_row_0 nt_row_id_1">
            <td><b>HSA eligible</td><td><b>No</td><td><b>Yes</td><td><b>No</td>        </tr>
            <tr data-row_id="2" class="ninja_table_row_1 nt_row_id_2">
            <td><b>Company matching contribution to HSA</td><td>N/A</td><td>• $300 (teammate only)<br> • $425 (teammate + spouse/domestic partner/child(ren))<br> • $600 (teammate + family)<br> • See <b><span style="color: #68ace5;">HSA page</b></span> for details<br> You must contribute to your HSA in order to receive the company match</td><td>Lower deductible</td>        </tr>
            <tr data-row_id="3" class="ninja_table_row_2 nt_row_id_3">
            <td><strong>In-network care: your costs</td><td></td><td></td><td></td>        </tr>
            <tr data-row_id="4" class="ninja_table_row_3 nt_row_id_4">
            <td><strong>Preventive care</td><td>$0; plan pays 100%</td><td>$0; plan pays 100%</td><td>$0; plan pays 100%</td>        </tr>
            <tr data-row_id="5" class="ninja_table_row_4 nt_row_id_5">
            <td><b>Individual/family deductible</td><td><b>$2,000/$4,000</td><td><b>$3,200/$6,400</td><td><b>$0/$0</td>        </tr>
            <tr data-row_id="6" class="ninja_table_row_5 nt_row_id_6">
            <td><b>Individual/family out-ofpocket maximum (includes deductible)</td><td>$6,000/$12,000</td><td>$6,550/$13,100</td><td>$6,000/$12,000</td>        </tr>
            <tr data-row_id="7" class="ninja_table_row_6 nt_row_id_7">
            <td><b>Your coinsurance</td><td><b>20% after deductible</td><td><b>30% after deductible</td><td><b>N/A</td>        </tr>
            <tr data-row_id="8" class="ninja_table_row_7 nt_row_id_8">
            <td><b>Office visit (primary care/ specialist)</td><td>$30 copay/$60 copay</td><td>30% after deductible</td><td>$40-$140 copay<sup>1</sup></td>        </tr>
            <tr data-row_id="9" class="ninja_table_row_8 nt_row_id_9">
            <td><b>Telemedicine visit</td><td><b>$30</td><td><b>30% after deductible30% after deductible</td><td><b>$0-$90 copay</td>        </tr>
            <tr data-row_id="10" class="ninja_table_row_9 nt_row_id_10">
            <td><b>Emergency room visit</td><td>20% after deductible</td><td>30% after deductible</td><td>$850 copay<sup>2</sup></td>        </tr>
            <tr data-row_id="11" class="ninja_table_row_10 nt_row_id_11">
            <td><b>Prescriptions: your costs</td><td></td><td></td><td></td>        </tr>
            <tr data-row_id="12" class="ninja_table_row_11 nt_row_id_12">
            <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><td>30% after deductible*</td><td>Tier 1-$10 copay<br> Tier 2-$90 copay<br> Tier 3-$160<br> Tier1-$440/Tier 2-$480/<br> Tier 3-$530</td>        </tr>
            <tr data-row_id="13" class="ninja_table_row_12 nt_row_id_13">
            <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><td>Tier 1—30% after deductible<br> Tier 2—30% after deductible<br> Tier 3—30% after deductible<br> Tier 4: N/A</td><td>Tier1-$25 copay<br> Tier 2-$225 copay<br> Tier 3-$400 copay<br> Not covered</td>        </tr>
            <tr data-row_id="14" class="ninja_table_row_13 nt_row_id_14">
            <td colspan="4"><b>Preventive maintenance drugs are covered at 100% on all three plans.</td><td class="ninja_temp_cell"></td><td class="ninja_temp_cell"></td><td class="ninja_temp_cell"></td>        </tr>
    </tbody><!--ninja_tobody_rendering_done-->
