Lion Advantage HSA Plan
The Lion Advantage HSA plan is a high-deductible health plan option with a lower employee contribution. This plan is automatically paired with a Health Savings Account (HSA), for which Penn State will provide employer contributions to your HSA as applicable in January.
Guidelines for participation in this plan
While all full-time, benefits-eligible employees are eligible, the EMPLOYEE:
- CANNOT be enrolled in Medicare or be collecting Social Security benefits. It is recommended that employees who are returning from retirement consult with their financial advisor regarding implications of dis-enrolling from Medicare to be eligible for the HSA, as they will not be able to collect Social Security benefits unless they are enrolled in Medicare. Once an individual dis-enrolls from Medicare, that person can contribute to the HSA.
- If you are enrolled in Medicare, or plan to be during the next benefit plan year, you may want to consider different health plan options to avoid issues with your HSA enrollment.
- Please refer to Penn State Employee Benefits detailed information; If you are retiring at the age of 65 1/2 or older.
- CANNOT be enrolled in another non-HDHP health plan (including Tricare).
- If you are enrolled in another non-HDHP health plan, or plan to be during the next benefit plan year, you may want to consider different health plan options to avoid issues with your HSA enrollment.
- CANNOT have a balance in a HEALTH CARE Flexible Spending Account (FSA).
- Due to IRS regulations governing HSA plans, Lion Advantage plan members are not eligible to enroll in the Health Care Flexible Spending Account (FSA). If an employee currently has money in an FSA - either through themselves or through a spouse - that person must use all the money in the FSA before enrolling in the Lion Advantage Plan.
- If two Penn State employees are married and have elected FAMILY coverage under the Lion Advantage with HSA, a Health Care FSA cannot be opened under either employee. In addition, if you are the Penn State employee and your spouse is employed elsewhere and enrolled in a high-deductible health plan with an HSA, a Health Care FSA cannot be opened by either employee. The IRS does not permit use of a Health Care FSA when contributing to an HSA.
- CANNOT have a J or F Visa; these Visa holders are eligible for the Lion Traditional plan only.
- CANNOT be classified as a Postdoctoral Fellow; Postdoctoral Fellows are eligible for the Lion Traditional plan only.
Below are details regarding the plan design. For more information regarding payroll contributions examples, please use the Healthcare Calculator.
2026 Lion Advantage HSA Plan Design
Highmark Blue Shield continues as the medical services plan administrator.
In-Network Deductible
| Individual Coverage | Family Coverage | |
|---|---|---|
| Deductible | $1,700 | $3,400 |
Coinsurance Maximum: In-network coinsurance percentage = 10%
| Individual Coverage | Family Coverage | |
|---|---|---|
| Coinsurance Maximum | $1,975 | $3,950 |
In-Network Out-of-Pocket Maximum (Deductible + Coinsurance Maximum)
| Individual Coverage | Family Coverage | |
|---|---|---|
| Total Out-of-Pocket Maximum | $3,675 | $7,350 |
In-Network Services
| Coverage | |
|---|---|
| Preventive Care Highmark Preventive Schedule | Covered at 100% |
| Office Visit | Deductible and Coinsurance apply |
| Well360 Virtual Health (Telemedicine) | Faculty, Staff, Postdoctoral Appointee $0 BEFORE Deductible Technical Service $0 AFTER Deductible |
| Specialist | Deductible and Coinsurance apply |
| Urgent Care | Deductible and Coinsurance apply |
| Emergency Room (waive if admitted) | Deductible and Coinsurance apply |
2026 Lion Advantage HSA Prescription Coverage
CVS Caremark will begin as our prescription coverage administrator beginning January 1, 2026.
All medication cost will be owed until plan deductible has been met. After deductible has been met, the below coinsurance amounts will apply.
| Medication Type | Generic Medications | Preferred Brand Medications | Non-Preferred Brand Medications | |
|---|---|---|---|---|
| Preventive Medications CVS Preventive Drug List | 10% Coinsurance | 20% Coinsurance | 40% Coinsurance | |
| Retail Pharmacy (31-day supply or less, picked up at an in-network retail pharmacy) | 10% Coinsurance | 20% Coinsurance | 40% Coinsurance | |
| Retail 90 (83-day supply or less, picked up at in-network retail pharmacy) | 10% Coinsurance | 20% Coinsurance | 40% Coinsurance | |
| Retail 90 (84-day supply up to 90-day supply, picked up at in-network retail pharmacy) | 10% Coinsurance | 20% Coinsurance | 40% Coinsurance | |
| Mail Order (90-day or less supply, mailed to home from CVS mail order pharmacy) | 10% Coinsurance | 20% Coinsurance | 40% Coinsurance | |
| Specialty |
| 20% Coinsurance, $65 Minimum | 40% Coinsurance, $100 Minimum |
| CVS ACA Preventive Drug List | 0% Coinsurance |
|---|
2026 Payroll Premium Contributions
Faculty, Staff, or Postdoctoral Appointee: Monthly premium contributions - Lion Advantage HSA or Lion Advantage Flex Plan
| Coverage | Salary % | $30,000 | $40,000 | $55,000 | $75,000 | $85,000 | $100,000 | $140,000 | $175,000 | $200,000 |
|---|---|---|---|---|---|---|---|---|---|---|
| Individual | 0.92% | $23.00 | $30.67 | $42.17 | $57.50 | $65.17 | $76.67 | $107.33 | $134.17 | $153.33 |
| Two-Person | 2.23% | $555.75 | $74.33 | $102.21 | $139.38 | $157.96 | $185.83 | $260.17 | $325.21 | $371.67 |
| Parent/Child(ren) | 2.06% | $51.50 | $68.67 | $94.42 | $128.75 | $145.92 | $171.67 | $240.33 | $300.42 | $343.33 |
| Family | 2.83% | $70.75 | $94.33 | $129.71 | $176.88 | $200.46 | $235.83 | $330.17 | $412.1 | $471.67 |
Technical Service: Bi-weekly premium contributions - Lion Advantage HSA Plan
| Coverage | Salary % | $30,000 | $40,000 | $50,000 | $60,000 | $75,000 |
| Individual | 2.50% | $28.85 | $38.46 | $48.08 | $57.69 | $72.12 |
| Two-Person | 4.75% | $54.81 | $73.08 | $91.35 | $109.62 | $137.02 |
| Parent/Child(ren) | 4.38% | $50.54 | $67.38 | $84.23 | $101.08 | $126.35 |
| Family | 5.75% | $66.35 | $88.46 | $110.58 | $132.69 | $165.87 |
Lion Advantage HSA - Detailed Coverage Charts
Summary of Benefits Coverage
Lion Advantage HSA - Highmark Coverage Booklets
COVID-Related Testing
COVID-related testing is not covered at 100% and will be subject to deductible and coinsurance under the Penn State medical plans.
We strongly encourage you to discuss with your physician the financial impact of any COVID testing that may be prescribed – certain tests can cost ~$1,500 or more, which will apply to your deductible and/or coinsurance amounts for the plan year.
One such test is Procedure Code (CPT) 0202U, which is a medical procedural code to detect multiple respiratory pathogen targets and is performed in the provider’s office. For example, instead of this costly test, you can avoid significant out of pocket costs by using an at-home COVID test. Your physician will make an appropriate recommendation based on your own health needs; however, you should be aware and discuss the cost implications before having a test.
Employees can contact the Penn State Highmark concierge customer service team at 844-945-5509 with further questions.