2025 Lion Advantage Flex
This plan is specifically for faculty, staff, and postdoctoral appointees who may already be enrolled in Medicare, or employees enrolled in Tricare or other health insurance. Keep in mind that if you will be turning age 65 in calendar year 2025 and enrolling in Medicare, you may want to also consider this plan option.
The Lion Advantage Flex plan is a high deductible health plan option with a lower employee contribution, which DOES NOT pair with a Health Savings Account (HSA).
Faculty, Staff, and Postdoctoral Scholars enrolled in this plan will be able to enroll in the pre-tax Health Care Flexible Savings Account (FSA) to help with medical expenses and reduce tax liability.
Postdoctoral Fellows are ineligible to participate in a FSA.
Below are important guidelines for participation in this plan.
- CANNOT have a J or F Visa because of deductible amounts; these Visa holders are eligible for the Lion Traditional plan only.
- CANNOT be classified as a Technical Service employee.
Below are details regarding the plan design. For more information regarding payroll contributions examples, please visit the Premium Comparison page with Health care Calculator.
Lion Advantage Flex - Detailed Coverage Chart
Lion Advantage Flex - Summary of Benefit Coverage (SBC)
Deductible, Coinsurance, Out-of-Pocket Maximum, & Cost Sharing
Deductible
| Individual Coverage | Family Coverage | |
|---|---|---|
| Deductible | $1,650 | $3,300 |
Coinsurance Out-of-Pocket Maximum
| Individual Coverage | Family Coverage | |
|---|---|---|
| Coinsurance Maximum | $1,975 | $3,950 |
| Member Coinsurance (after deductible) | 10% | 10% |
Total Out-of-Pocket Maximum
| Individual Coverage | Family Coverage | |
|---|---|---|
| Total Out-of-Pocket Maximum | $3,625 | $7,250 |
Cost Sharing
| Coverage | |
|---|---|
| Preventive Care | Covered at 100% |
| Office Visit | Deductible and Coinsurance apply |
| Well360 Virtual Health Telemedicine | $0 after Deductible |
| Specialist | Deductible and Coinsurance apply |
| Urgent Care | Deductible and Coinsurance apply |
| Emergency Room (waive if admitted) | Deductible and Coinsurance apply |
Prescription Coverage
| Medication Type | Generic Medications | Preferred Brand Medications | Non-Preferred Brand Medications |
|---|---|---|---|
| Preventive Medications | 10% Coinsurance | 20% Coinsurance | 40% Coinsurance |
| Retail (30-day supply) | 10% Coinsurance | 20% Coinsurance | 40% Coinsurance |
| Mail (90-day supply) | 10% Coinsurance | 20% Coinsurance | 40% Coinsurance |
| Preferred Brand Medications | 20% Coinsurance, $65 Minimum |
|---|---|
| Non-Preferred Brand Medications | 40% Coinsurance, $100 Minimum |
| Preferred Brand Medications | Integrated with Medical |