Lion Traditional Plan
The Lion Traditional plan is a lower deductible health plan option with a higher employee contribution. Keep in mind that this plan also has a separate prescription out-of-pocket maximum.
Members of 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.
Below are details regarding the plan design. For more information regarding payroll contributions examples, please use the Healthcare Calculator.
Condition Care Program
Lion Traditional members who have been diagnosed with the following chronic conditions will experience enhanced benefits with the Condition Care Program. This program encourages individuals to manage these health conditions by keeping the individual's out-of-pocket expenses low. With this program, all office visits, lab work and medical supplies related to these conditions are covered at 100% with no co-pays or coinsurance. Enrollment is not required with Highmark or CVS Caremark; eligible claims will process at the 100% level automatically.
You may contact Highmark at (844) 945-5509 or CVS Caremark at (833) 298-7175 with any questions regarding coverage under the Condition Care Program.
- Diabetes (type 1 or type 2)
- High Cholesterol
- Hypertension
2026 Lion Traditional Plan Design: Faculty, Staff, and Postdoctoral Appointee
Medical
Medical services are administered by Highmark Blue Shield.
In-network Deductible
| Salary Range | < = $45,000 | $45,001 - $60,000 | $60,001 - $90,000 | > $90,000 |
|---|---|---|---|---|
| Individual | $250 | $375 | $500 | $625 |
| Family | $500 | $750 | $1,000 | $1,250 |
Coinsurance Maximum (paid after Deductible): In-network coinsurance percentage = 10%
| Individual | $2,000 |
| Family | $4,000 |
In-network Out-of-Pocket Maximum (Deductible + Coinsurance Max)
| Salary Range | < = $45,000 | $45,001 - $60,000 | $60,001 - $90,000 | > $90,000 |
| Individual | $2,250 | $2,375 | $2,500 | $2,625 |
| Family | $4,500 | $4,750 | $5,000 | $5,250 |
In-Network Services
| Preventive Care Highmark Preventive Schedule | Covered at 100% |
| Office Visit | $20 copay |
| Well360 Virtual Health Telemedicine | $0 copay |
| Specialist Visit | $30 copay |
| Urgent Care | $30 copay |
| Emergency Room (waived if admitted) | $150 copay |
Prescription
CVS Caremark will begin as our prescription coverage administrator beginning January 1, 2026.
With the Lion Traditional plan, there is a separate out-of-pocket maximum for prescriptions. For individual coverage, the prescription out-of-pocket maximum is $2,000. For family coverage, the prescription out-of-pocket maximum is $8,000.
| 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) | 50% Coinsurance | 50% Coinsurance | 70% Coinsurance |
| Retail 90 (83-day supply or less, picked up at in-network retail pharmacy) | 50% Coinsurance | 50% Coinsurance | 70% Coinsurance |
| Retail 90 (84-day supply up to 90-day supply, picked up at in-network retail pharmacy) | 20% Coinsurance | 20% Coinsurance | 70% Coinsurance |
| Mail Order (90-day or less supply, mailed to home from CVS mail order pharmacy) | 20% Coinsurance | 20% Coinsurance | 70% Coinsurance |
| Specialty | 50% Coinsurance, $100 Maximum | 50% Coinsurance, $100 Maximum | 70% Coinsurance, $200 Maximum |
| CVS ACA Preventive Drug List | 0% Coinsurance |
|---|
2026 Lion Traditional Plan Design: Technical Service
Medical
Medical services are administered by Highmark Blue Shield.
In-network Deductible
| Coverage Type | Deductible |
|---|---|
| Individual | $250 |
| Parent/Child(ren) | $250/$375 |
| Family | $250/$500 |
Coinsurance Maximum (paid after Deductible): In-network coinsurance percentage = 10%
| Coverage Type | Coinsurance Maximum |
|---|---|
| Individual | $750 |
| Parent/Child(ren) | $750/$1,125 |
| Family | $750/$1,500 |
In-network Out-of-Pocket Maximum (Deductible + Coinsurance Max)
| Coverage Type | Out-of-Pocket Maximum |
|---|---|
| Individual | $1,000 |
| Parent/Child(ren) | $1,000/$1,500 |
| Family | $1,000/$2,000 |
In-Network Services
| Preventive Care Highmark Preventive Schedule | Covered at 100% |
| Office Visit | $10 copay |
| Well360 Virtual Health & Telemedicine | $0 copay |
| Specialist | $20 copay |
| Urgent Care | $20 copay |
| Emergency Room (waived if admitted) | $100 copay |
Prescription
CVS Caremark will begin as our prescription coverage administrator beginning January 1, 2026.
With the Lion Traditional plan, there is a separate out-of-pocket maximum for prescriptions. For Technical Service individual coverage, the prescription out-of-pocket maximum is $1,000. For family coverage, the prescription out-of-pocket maximum is $6,000.
| 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) | 50% Coinsurance | 50% Coinsurance | 70% Coinsurance |
| Retail 90 (83-day supply or less, picked up at in-network retail pharmacy) | 50% Coinsurance | 50% Coinsurance | 70% Coinsurance |
| Retail 90 (84-day supply up to 90-day supply, picked up at in-network retail pharmacy) | 20% Coinsurance | 20% Coinsurance | 70% Coinsurance |
| Mail Order (90-day or less supply, mailed to home from CVS mail order pharmacy) | 20% Coinsurance | 20% Coinsurance | 70% Coinsurance |
| Specialty | 50% Coinsurance, $50 Maximum | 50% Coinsurance, $50 Maximum | 70% Coinsurance, $100 Maximum |
| CVS ACA Preventive Drug List | 0% Coinsurance |
|---|
Payroll Premium Contributions
Faculty, Staff, or Postdoctoral Appointees: Monthly premium contributions - Lion Traditional Plan
| Coverage | Salary % | $30,000 | $40,000 | $55,000 | $75,000 | $85,000 | $100,000 | $140,000 | $175,000 | $200,000 |
| Individual | 1.77% | $44.25 | $59.00 | $81.13 | $110.13 | $125.38 | $147.50 | $206.50 | $258.13 | $295.00 |
| Two-Person | 4.33% | $108.25 | $144.33 | $198.46 | $270.63 | $306.71 | $360.83 | $505.17 | $631.46 | $721.67 |
| Parent/Child(ren) | 4.01% | $100.25 | $133.67 | $183.79 | $250.63 | $284.04 | $334.17 | $467.83 | $584.79 | $668.33 |
| Family | 5.51% | $137.75 | $183.67 | $252.54 | $344.38 | $390.29 | $459.17 | $642.83 | $803.54 | $918.33 |
Technical Service: Bi-Weekly premium contributions - Lion Traditional Plan
| Coverage | Salary % | $30,000 | $40,000 | $50,000 | $60,000 | $75,000 |
| Individual | 4.20% | $48.46 | $64.62 | $80.77 | $96.92 | $121.15 |
| Two-Person | 7.98% | $92.08 | $122.77 | $153.46 | $184.15 | $230.19 |
| Parent/Child(ren) | 7.35% | $84.81 | $113.08 | $141.35 | $169.62 | $212.02 |
| Family | 9.66% | $111.46 | $148.62 | $185.77 | $222.92 | $278.65 |
Lion Traditional Coverage Charts
Summary of Benefits Coverage
2026 Faculty, Staff, Postdoctoral Appointee - $250 / $500 Deductible
2026 Faculty, Staff, Postdoctoral Appointee, Non-Medicare Retiree - $375 / $750 Deductible
2026 Faculty, Staff, Postdoctoral Appointee - $500 / $1,000 Deductible
2026 Faculty, Staff, Postdoctoral Appointee - $625 / $1,250 Deductible
2026 Technical Service - Employee Only
Lion Traditional - Highmark Coverage Booklets
Coming soon
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.