2026 Lion Advantage Flex Plan
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). This affords faculty, staff, or Postdoctoral Scholars another option to have lower employee payroll contributions when they may already be enrolled in or planning to enroll in Medicare (Part A or Part B) or another health plan.
Guidelines for participation in this plan:
- CANNOT have a J or F Visa; these Visa holders are eligible for the Lion Traditional plan only.
- CANNOT be classified as a Technical Service employee.
- CANNOT have a spouse enrolled in a Health Savings Account (HSA).
- 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.
Faculty, Staff, and Postdoctoral Scholars enrolled in this plan are also able to enroll in the pre-tax Health Care Flexible Savings Account (FSA) to help with medical expenses and reduce your tax liability, keeping in mind the above participation guidance. Please note that Postdoctoral Fellows are ineligible to participate in a FSA.
Below are details regarding the plan design. For more information regarding payroll contributions examples, please visit Health Care Contribution Comparison or or use the Healthcare Calculator.
2026 Lion Advantage Flex
Highmark Blue Shield continues as the medical services plan administrator.
Deductible
| Individual Coverage | Family Coverage | |
|---|---|---|
| Deductible | $1,700 | $3,400 |
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 | $3,675 | $7,350 |
Cost Sharing
| 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 Flex 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 |
20% Coinsurance, $65 Minimum |
40% Coinsurance, $100 Minimum |
| CVS ACA Preventive Drug List | 0% Coinsurance |
|---|
Additional Lion Advantage Flex Details
2026 Lion Advantage Flex Coverage Grids
2026 Lion Advantage Flex Summary of Benefit Coverage (SBC)