Medical Coverage
As a benefits eligible Brandeis University employee, you have access to comprehensive medical coverage to protect you and your family from catastrophic medical costs. The University offers four medical plan options administered through Harvard Pilgrim Health Care from which you can choose. All plans use a network of doctors, hospitals and other health care providers to deliver high quality care.
- Medical Plans Comparison Chart
- Member Guide (pdf) | Spanish Member Guide (pdf)
- Look up a prescription drug on Optum Rx
Medical Plans
Visit the HPHC/Brandeis Microsite for details about each plan, including plan summaries, statement of benefits, and provider directories.
Note: Employees who reside outside of Massachusetts and who do not live within the HMO service area (New Hampshire, Maine, Rhode Island, Vermont and some parts of Connecticut) are not eligible to enroll in the HMO Plans. Your option for medical insurance coverage is the PPO Plan.
HMO
The HMO plan includes in-network coverage only. You must choose a primary care physician (PCP) and receive referrals to specialists. PCP and specialist office visits are covered with copays and in-network services are covered 100%.
PPO
The PPO Plan offers a nationwide network of healthcare providers through United Health Care (UHC) to choose from and your cost varies based on your use of that network. You are not required to choose a PCP for your care.
If you choose a provider within the HPHC network for covered services, you pay an office visit copayment. If you choose an out-of-network provider, you pay coinsurance for covered services after you meet the plan’s deductible. There is both an individual and a family deductible for out-of-network care under this plan. You always have the choice to go to any provider, but you’ll pay less if you use a HPHC network doctor or hospital.
Best Buy HMO
The BestBuy HMO plan includes in-network coverage only. You must choose a primary care physician (PCP) and receive referrals to specialists in the HPHC network. PCP and specialist office visits are covered with copays and in-network services are covered 100%. A deductible applies to non-routine services, labs and diagnostic testing. In patient stays and day surgery have higher co-pays and must meet the deductible ($500 per individual/$1,000 per family).
Best Buy HSA HMO
Best Buy HSA HMO is a High Deductible Health Plan (HDHP) and includes in-network coverage only. You must choose a primary care physician (PCP) and receive referrals to specialists within the HPHC network. The deductible of $1,600 for an individual and $3,200 for a family applies to all both medical and pharmacy services. The family deductible is an aggregate and not capped individually.
Plan Rates
- Semi-Monthly Medical Rates (Exempt Staff, Faculty, Postdoctoral Scholars)
- Weekly Medical Rates (Non-Exempt Staff)
Exempt vs. Non-Exempt Employees
The Fair Labor Standards Act (FLSA) exempts some employees from overtime pay and minimum wage. Exempt employees are not subject to FLSA overtime regulations and are not entitled to overtime pay. Nonexempt employees are subject to FLSA overtime regulations and are entitled to overtime pay for hours worked beyond 40 in a work week.
Exempt employees usually hold administrative, professional, or executive positions. They're “exempt” from the Fair Labor Standards Act's (FLSA) overtime regulations and, therefore, are not entitled to overtime pay. Nonexempt employees are typically paid hourly and perform more manual or technical duties.
Need help choosing a plan?
- MyConnect: A member Advocate service that is your direct connection to HPHC for assistance with questions about your coverage
- Decision Doc: An interactive tool to help guide you in making decisions about medical care
Additional Resources
- Behavioral Health Information
- Estimate My Cost Tool
- Find a Provider
- Know Your Care Options
- Secure Member Account & Mobile Access (pdf)
- Terminology Definitions
- COBRA Continuation
When does medical coverage begin?
Medical benefits are generally effective on the employee's first day of employment.
When does medical coverage end?
The date that your benefits will end depends on various factors. To learn more about end of benefits, visit End of Benefits Eligibility.
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Flexible Spending Accounts
Flexible spending accounts enable employees to pay for eligible health (medical, dental and vision) expenses with pretax dollars, thereby reducing their tax burden.
Optum Rx
HPHC subscribers are eligible to participate in the prescription drug delivery and clinical management program administrated by Optum Rx.
Notices and Forms
Contact the Benefits Team
Email the Human Resources Benefits Team at benefits@brandeis.edu.
Medical Plan Transition
Learn more about the merger between Tufts Health Plan and Harvard Pilgrim Health Care.