Lion Advantage Plan
The Lion Advantage plan is a Qualified High-Deductible Health Plan (QHDHP). It has a lower payroll contribution but a higher deductible than the Lion Traditional plan.
Following are some features of the Lion Advantage plan:
- Medical coverage is the same as for the Lion Traditional plan
- Physician network is the same as for the Lion Traditional plan
- Drug formulary is the same as for the Lion Traditional plan
- In-network preventive care is covered at 100% with no deductible or coinsurance
- Includes a Health Savings Account (HSA) that allows subscribers to use pre-tax funds to pay for future and current health care expenses
Additional plan details can be reviewed within the Summary of Benefit Coverage (SBC) and Coverage Grids are found on the Lion Advantage Overview of Coverage.
Eligibility Limitations for the Lion Advantage plan with the Health Savings Account (HSA)
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 in order 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 is able to contribute to the HSA.
- CANNOT be enrolled in another health plan (including Tricare).
- 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 a 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.
Health Savings Account (HSA) Information
If you have elected to enroll in the Lion Advantage plan, a Health Savings Account (HSA) is automatically opened on your behalf through HealthEquity. Funds to this account are contributed on a tax-free basis and can be used for eligible health expenses and will roll over from calendar year to calendar year. These funds also remain yours should you leave Penn State employment in the future or are no longer eligible to participate in a Penn State medical plan.
Employees enrolled in the HSA and still actively working at Penn State will have a monthly account management fee of $1.00 automatically deducted from their HSA account by HealthEquity. Employees who leave or retire from Penn State will see the monthly account management fee deducted by HealthEquity increase to $3.95 after separated from university employment.
To help get you started, Penn State contributes "seed" money into your account as a new hire, newly eligible due to an IRS qualifying life event, or in January due to your benefits open enrollment based on eligibility. The below seed funding amounts must be taken into account when calculating the maximum annual contributions the IRS allows into an HSA, also outlined below:
| Salary | Penn State Contribution/Coverage |
|---|---|
| $45,000 or less | $800/Individual $1,600/Family |
| $45,000.01 to $60,000 | $600/Individual $1,200/Family |
| $60,000.01 to $90,000 | $400/Individual $800/Family |
| More than $90,000 | $200/Individual $400/Family |
|
2024 HSA Contribution Maximums |
|
|---|---|
| Coverage | Maximum |
| Individual | $4,150 |
| Family | $8,300 |
Paying for Out-of-Pocket Medical Expenses
With the Lion Advantage plan, there is generally no payment due at the time of service; however, the subscriber will receive a bill from their provider. The subscriber may then choose to pay the bill from a Health Savings Account (HSA) or from other personal accounts. If the bill is paid from a Health Savings account, the subscriber may use the Health Equity debit card, or may pay the provider directly through the claims portal.
Qualified medical expenses are those incurred by the following individuals:
- Employee and spouse
- Dependents who are claimed on the account holder's tax return
- Any person claimed as a dependent on the account holder's tax return except if:
- the person filed a joint tax return
- the person had a gross income of $3,900 or more
- the account holder, or the account holder's spouse if filling jointly, could be claimed as a dependent on someone else's tax return
See Health Savings Account (HSA) for more information about employer contributions to the HSA, maximum allowable annual contributions to the HSA, and how this type of account may be used to pay for medical expenses throughout the life span.
Premiums
Faculty & Staff
| Coverage | Salary % | $30,000 | $40,000 | $50,000 | $60,000 | $75,000 | $85,000 | $100,000 | $140,000 | $160,000 | $180,000 | $200,000 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Individual | 0.80% | $20.00 | $26.67 | $33.33 | $40.00 | $50.00 | $56.67 | $66.67 | $93.33 | $106.67 | $120.00 | $133.33 |
| Two-Person | 1.93% | $48.25 | $64.33 | $80.42 | $96.50 | $120.63 | $136.71 | $160.83 | $225.17 | $257.33 | $289.50 | $321.67 |
| Parent/Child(ren) | 1.79% | $44.75 | $59.67 | $74.58 | $89.50 | $111.88 | $126.79 | $149.17 | $208.83 | $238.67 | $268.50 | $298.33 |
| Family | 2.46% | $61.50 | $82.00 | $102.50 | $123.00 | $153.75 | $174.25 | $205.00 | $287.00 | $328.00 | $369.00 | $410.00 |
Technical Service
| Coverage | Salary % | $30,000 | $40,000 | $50,000 | $60,000 | $75,000 |
|---|---|---|---|---|---|---|
| Individual | 1.45% | $16.73 | $22.31 | $27.88 | $33.46 | $41.83 |
| Two-Person | 3.14% | $36.23 | $48.31 | $60.38 | $72.46 | $90.58 |
| Parent/Child(ren) | 2.93% | $33.81 | $45.08 | $56.35 | $67.62 | $84.52 |
| Family | 3.94% | $45.46 | $60.62 | $75.77 | $90.92 | $113.65 |