<thead>
<tr class="footable-header">
                                <th scope="col" colspan="2" class="ninja_column_0 ninja_clmn_nm_ninja_column_1 ">UHC $3,200 HDHP w/Optional HSA</th><td class="ninja_temp_cell"></td></tr>
</thead>
<tbody>

        <tr data-row_id="110" class="ninja_table_row_0 nt_row_id_110">
            <td><b>HSA eligible</td><td><b>Yes</td>        </tr>
            <tr data-row_id="111" class="ninja_table_row_1 nt_row_id_111">
            <td><b>Company matching contribution to HSA</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>        </tr>
            <tr data-row_id="112" class="ninja_table_row_2 nt_row_id_112">
            <td colspan="2"><center><strong>In-network care: your costs</td><td class="ninja_temp_cell"></td>        </tr>
            <tr data-row_id="113" class="ninja_table_row_3 nt_row_id_113">
            <td><strong>Preventive care</td><td>$0; plan pays 100%</td>        </tr>
            <tr data-row_id="114" class="ninja_table_row_4 nt_row_id_114">
            <td><b>Individual/family deductible</td><td><b>$3,200/$6,400</td>        </tr>
            <tr data-row_id="115" class="ninja_table_row_5 nt_row_id_115">
            <td><b>Individual/family out-ofpocket maximum (includes deductible)</td><td>$6,550/$13,100</td>        </tr>
            <tr data-row_id="116" class="ninja_table_row_6 nt_row_id_116">
            <td><b>Your coinsurance</td><td><b>30% after deductible</td>        </tr>
            <tr data-row_id="117" class="ninja_table_row_7 nt_row_id_117">
            <td><b>Office visit (primary care/ specialist)</td><td>30% after deductible</td>        </tr>
            <tr data-row_id="118" class="ninja_table_row_8 nt_row_id_118">
            <td><b>Telemedicine visit</td><td><b>30% after deductible30% after deductible</td>        </tr>
            <tr data-row_id="119" class="ninja_table_row_9 nt_row_id_119">
            <td><b>Emergency room visit</td><td>30% after deductible</td>        </tr>
            <tr data-row_id="120" class="ninja_table_row_10 nt_row_id_120">
            <td colspan="2"><center><b>Prescriptions: your costs</td><td class="ninja_temp_cell"></td>        </tr>
            <tr data-row_id="121" class="ninja_table_row_11 nt_row_id_121">
            <td><b>Retail: 30-day supply</b></br> Generic</br> Formulary</br> Non-formulary</br> Specialty</td><td>30% after deductible*</td>        </tr>
            <tr data-row_id="122" class="ninja_table_row_12 nt_row_id_122">
            <td><b>Mail order: 90-day supply</b><br> Generic<br> Formulary<br> Non-formulary<br> Specialty</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>        </tr>
            <tr data-row_id="123" class="ninja_table_row_13 nt_row_id_123">
            <td colspan="2"><b>Preventive maintenance drugs are covered at 100% on all three plans.</td><td class="ninja_temp_cell"></td>        </tr>
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