Overview of Coverage - Lion Advantage HSA

Details for each plan are able to be reviewed within the Summary of Benefit Coverage (SBC) and Coverage Grids below. Please note that there are separate documents for the Faculty & Staff plan and the Technical Services plan.

2024 Lion Advantage HSA - Coverage - Faculty, Staff, & Technical Service
Health Savings Account Seed Money
Salary Range < = $45,000 $45,001 - $60,000 $60,001 - $90,000 >$90,000
Individual $800 $600 $400 $200
Family $1,600 $1,200 $800 $400
Deductible
Individual $1,600
Family $3,200
Total Out-of-Pocket Maximum
Individual $3,575
Family $7,150
Coinsurance Maximum
Individual $1,975
Family $3,950
Member Coinsurance (after deductible)
Percentage 10%
Services
Preventive Care
Highmark Preventive Schedule		 Covered at 100%
Office Visits Deductible and Coinsurance
Well360 Virtual Health Telemedicine $0 after Deductible for Faculty/Staff

Deductible and Coinsurance apply for Technical Service
Specialist Deductible and Coinsurance
Urgent Care Deductible and Coinsurance
Emergency Room (waived if admitted) Deductible and Coinsurance
Prescription (after deductible) 
Preventive drugs (Preventive Drug List)
Generic Drugs 10% Coinsurance
Preferred Brand Drugs 20% Coinsurance
Non-Preferred Brand Drugs 40% Coinsurance
Retail (30-day supply)
Generic Drugs 10% Coinsurance
Preferred Brand Drugs 20% Coinsurance
Non-Preferred Brand Drugs 40% Coinsurance
Mail (90-day supply)
Generic Drugs 10% Coinsurance
Preferred Brand Drugs 20% Coinsurance
Non-Preferred Brand Drugs 40% Coinsurance
Specialty Medications
Preferred Brand Drugs 20% Coinsurance, $65 Minimum
Non-Preferred Brand Medications 40% Coinsurance, $100 Minimum
Out-of-Pocket Maximums Integrated with Medical