Your image doesn’t include the cost of the premiums. My work offers similar types of plans except the HDHP is ‘free’ while the PPO has premiums totalling $5-6k per year. For us, it makes zero sense to use the PPO since it’s guaranteed to cost at least $5-6k whether we see a doctor or not. With the HDHP, the theoretical minimum cost for the year is $0 if we never go to the doctor but realistically we usually get close or hit our family deductible but it’s still cheaper than the PPO.