Medical Care Plan

Juniata will be offering three Highmark Medical Plan Options starting in 2025. Juniata will continue to offer the current PPO option with a $350/700 deductible (PPO Gold), the Qualified High Deductible Health Plan coupled with a Health Savings Account (HSA), as well as a new PPO option with a $2,000/4,000 deductible (PPO Blue). 

Plan features:
  • Benefits will be paid at a higher level when a participating physician and/or facility rather than at a non-participating provider who renders services.
  • Participating Provider Search (please ensure "BCBS PPO" is selected for network)
  • There is also a mail in prescription program offered for medications you take on a regular, long-term basis. You will receive up to a 90 day supply at a reduced rate. Prescription Formulary can be accessed here.
  • The plan requires pre-certification 15 days prior to inpatient admission. More information is available here.
  •  100% paid after deductible unless co-pays apply to the service. Co-pays do not count towards the deductible. 
    • PPO Gold Plan - $350 Individual/$700 Two Person or Family Deductible
    • PPO Blue Plan- $2,000 Individual/ $4,000 Two Person or Family Deductible
    • QHDHP- $1650 Individual/ $3300 Two Person or Family Deducible ($1600 Individual/$3200 Family Deductible for 2024 Plan Year) Juniata College continues to make an annual Employer Contribution to an HSA account for those enrolled in the QHDHP. The amount contributed is $700.00 for Employee Only coverage and $1,400 for Two-Person or Family coverage
  • Information on the new PPO Plan ( PPO Blue $2,000/4,000): The PPO Blue plan will function in the same way as our current PPO plan; same co-pays, network, covered services and medication formulary, with a higher deductible in exchange for lower monthly premiums. The services that apply to your deductible are the same under both the PPO Gold and PPO Blue plan and remain unchanged from prior years. Please note that all Juniata plans fall under Highmark's PPO Blue Network. This is different than the name differentiation using the colors Gold and Blue, chosen for Juniata's colors.

What applies to the deductible under each plan?

PPO Plans ( both Gold and Blue): Inpatient care, lab work and diagnostic services (MRI, CAT, PET scan etc.), Basic Diagnostic Services ( standard imaging, labs/pathology and allergy testing), maternity services, Other Therapy Services ( cardiac rehab, infusion therapy, chemotherapy, radiation therapy and dialysis), vasectomy, home health care, hospice, Infertility counseling, Testing and Treatments, and Private Duty Nursing.

The family deductible is a specified dollar amount of covered services that must be incurred by covered family members before the program begins to provide payment for certain benefits. For a family with several covered dependents, the deductible you pay for all covered family members, regardless of family size, is specified under family deductible. To reach this total, you can count the expenses incurred by two or more covered family members. However, the deductible contributed towards the total by any one covered family member will not be more than the amount of the individual deductible ( $350 for the PPO Gold of $2,000 for the PPO Blue). If one family member meets the individual deductible and needs to use benefits, the program would begin to pay for that person's covered services even if the deductible for the entire family has not been met.

QHDHP Plan: All services (outside of preventive care) ; therefore, this plan requires the employee to meet the deductible before the plan pays for any covered services or prescriptions. 

For a family with several covered dependents, the deductible you pay for all covered family members, regardless of family size, is specified under family deductible. To reach this total, the entire family deductible must be satisfied in one benefit period by one or more family members. Benefits for any individual member of the family will not be payable until the family deductible has been satisfied. Once the family deductible is met, no further deductible amounts must be satisfied by any covered family member.

Be Well @ Juniata Incentive:
  • A 20% contribution by the employee is required for employee only coverage, which is referred to as the Base Rate. Employees who have completed the volunary Be Well @ Juniata Incentive will receive a discount, which is referred to as the Wellness Rate. For persons electing dependent coverage, the employee will contribute 20% of the monthly dependent premium. These premiums can be contributed on a pre-tax basis through a Section 125 Premium Conversion Plan. The monthly premium paid by the employee:
Medical Plan Rates:

2025 Rates:

PPO Gold Plan ($350/700): employee only coverage is $210.73 for Base Rate and $158.04 for the Wellness Rate, two person coverage is $486.80 for Base Rate and $434.12 for the Wellness Rate, family coverage is $581.61 for Base Rate and $528.93 for the Wellness Rate.

PPO Blue Plan ($2,000/4,000): employee only coverage is $149.50 for Base Rate and $119.60 for the Wellness Rate, two person coverage is $409.67 for Base Rate and $379.77 for the Wellness Rate, family coverage is $499.35 for Base Rate and $469.45 for the Wellness Rate.

Qualfied High Deductible Health plan (QHDHP):employee only coverage is $200.31 for Base Rate and $150.23 for the Wellness Rate, two person coverage is $462.73 for Base Rate and $412.66 for the Wellness Rate, family coverage is $552.86 for Base Rate and $502.78 for the Wellness Rate.

Employees who choose to waive health plan participation can receive a $1,000 annual incentive upon receipt of proof of other non-Juniata health plan coverage. The incentive will be paid through payroll (taxed).

2024 Rates:

PPO- employee only coverage is $169. 25 for Base Rate and $126.93 for the Wellness Rate, two person coverage is $391.31 for Base Rate and $349.00 for the Wellness Rate, family coverage is $467.53 for Base Rate and $425.22 for the Wellness Rate.

QHDHP-employee only coverage is $155.32 for Base Rate and $116.49 for the Wellness Rate, two person coverage is $358.80 for Base Rate and $319.97 for the Wellness Rate, family coverage is $428.68 for Base Rate and $389.85 for the Wellness Rate.

Useful Benefits through our Medical Plan:
  • You can access Virtual Healthcare through Well360. This benefit can be accessed any time of the day or night by calling 866-883-7358 or by clicking HERE.
  • Connect Care 3 (CC3) offers nurse navigators, health coaching, registered dietitians, and patient advocacy. It’s a no-cost benefit for all health plan participants and can be accessed by calling 877-223-2350 or clicking HERE.
  • Blues on Call is offered through Highmark and offers free triage services by registered nurses, health coaching and health care navigation. Blues on Call can be reached by calling 888-258-3428.
  • Substance Use Resources available through Highmark to navigate the path to recovery. 
  • Mental Health Resources available through Highmark to navigate the path to recovery.
  • Preventive Care is provided at no cost to health plan members when received in-network. We encourage you to seek Preventive Care. Please review the Preventive Schedule HERE.