t\t\t\t\tBenefit\tCoverage Tiers Available\tHMO Employee Cost (biweekly)\tPPO Employee Cost (biweekly) \t\t\t\t\tMedical Insurance\tEmployee, Employee + Spouse, Employee + Child(ren), Family\t$48.82- $199.53\t$75.12- $296.58 \t\t\t\t\t \t\t\t\t\t Common Medical Event\tHMO\tPPO \t\t\t\t\tAnnual Deductible\t$250 Individual/ $500 Family\tIn-Network: $750 Individual / $1,500 Family \t\t\t\t\tOut-of-Network: $1,500 Individual / $3,000 Family \t\t\t\t\tOut-of-pocket-maximum\t$1,500 Individual / $3,000 Family \t\t\t\t\tPrescription drug expense limit: $1,000 Individual / $2,000 Family\tIn-Network: $2,000 Individual / $4,000 Family \t\t\t\t\tOut-of-Network: $4,000 Individual / $8,000 Family \t\t\t\t\tDoctors Visits\t$40/ PCP visit \t\t\t\t\t$60/ Specialist visit \t\t\t\t\tNo Charge: Preventive care/screening/ \t\t\t\t\timmunization\t$30/ PCP visit; deductible does not apply \t\t\t\t\t$50/ Specialist visit; deductible does not apply \t\t\t\t\tNo Charge: Preventive care/screening/ \t\t\t\t\timmunization; deductible does not apply. Editor toolbarsDocument Maximize Show BlocksEditing Cut Copy Paste Paste as plain text Paste from Word Clipboard Tools Undo Redo Find Spell Check As You Typeabout HelpStylesFormatFormatBasic Styles Bold Italic Underline Remove FormatParagraph Align Left Center Align Right Justify Justify Tools Insert/Remove Numbered List Insert/Remove Bulleted List Decrease Indent Increase Indent Block QuoteInsert Image Table Insert Horizontal Line Insert Special Character Insert Insert HTMLLinks Link Unlink Anchor.