For More Information
See Frequently Asked Questions on medical and dental coverage.
- 1095-C Form - View/Download/Reprint
- How My Tufts Health Plan Works
- Medicaid and the Children's Health Insurance Program (CHIP)
- Find a Doctor
- Tufts Member Reimbursement Medical Claim Form
- Tufts Member Acupuncture Reimbursement Form
- Tufts Fitness Reimbursement Form
- Tufts Weight Management Reimbursement Form
- Health Insurance Marketplace Notice
Health Insurance Rates and Comparison
- 2016 Nonexempt Staff Rates(PDF)
- 2016 Exempt Staff/Faculty/PostDoc Rates (PDF)
- 2016 Health Plan(s) Comparison Chart (PDF)
Health Insurance Plan Documents
Tufts EPO Value Plan
- Tufts EPO Value Description of Benefits (PDF)
- 2016 Tufts EPO Value Summary of Benefits Coverave (PDF)
- 2017 Tufts EPO Value Summary of Benefits Coverage (PDF)
Tufts EPO Premium Plan
- Tufts EPO Premium Description of Benefits (PDF)
- 2016 Tufts EPO Premium Summary of Benefits Coverage (PDF)
- 2017 Tufts EPO Premium Summary of Benefits Coverage (PDF)
Tufts PPO Documents
- Tufts PPO Description of Benefits (PDF)
- 2016 Tufts PPO Summary of Benefits Coverage (PDF)
- 2017 Tufts PPO Summary of Benefits Coverage (PDF)
For Out of Service Area Employees
Federal and State Health Care Reform - Affordable Care Act (ACA)
As part of Federal Health Care Reform, the Affordable Care Act (ACA) was signed into law on March 23, 2010. Brandeis University remains compliant with the many employer required provisions of the law. There are a number of new requirements for employers that became effective January 1, 2015 and many more reporting requirements which take effect January 2016.
1095-C Form(s): According to the Affordable Care Act (ACA), employers are required to send out a new IRS form to anyone who was a benefit eligible employee for one or more months of the calendar year 2015. This form, called the 1095-C Form, is an annual statement that describes the insurance available to eligible employees. The primary purpose of this form is to inform employees what their employer will report to the IRS regarding whether they were offered health care benefits and also whether those benefits met ACA standards for coverage and affordability. Employers will meet the requirement to furnish Form 1095-C to an employee if the form is properly addressed and mailed on or before the due date.
The 1095-C Form was originally scheduled to be mailed to employees by January 31, 2016. However the IRS made changes to the requirement in December 2015 delaying that deadline until March 31, 2016. In their update, the IRS clearly states that the 1095-C Form is not required by employees for filing income tax returns. Employees can complete their returns without the form and need only keep the form, when it arrives, with their other tax documents.
To access your 1095-C Form visit: www.paperlessemployee.com/brandeis
You will have the opportunity to opt in for electronic notification of future 1095-C's. You will also be able to view, download and/or re-print your 1095-C.
For more information on Health Care Reform in Massachusetts: www.mahealthconnector.org
For more information on Affordable Care Act (ACA): www.irs.gov/Affordable-Care-Act/Affordable-Care-Act-Tax-Provisions
View the Health Insurance Marketplace Notice.
New Prescription Drug Administrator
New OptumRx information found on your Tufts Health Plan card:RxBin: 610011 RxPCN: IRX RxGroup: EdHealth Phone: 855-546-3439 OptumRx website
Effective January 1, 2017, we will be changing the administrator for our prescription drug program from Tufts Health Plan to OptumRx. Please note that Tufts will remain our administrator for medical claims.
Brandeis University partners with several Colleges and Universities to purchase our medical coverage through edHEALTH, a program that allows the College to leverage cost savings for the plan and for participants. This past year the edHEALTH collaborative conducted a thorough review of the administration of the prescription drug claims under the medical plan and made the decision to move the administration of the drug program to OptumRx, a leader in this field.
Brandeis OptumRx Portal - This is a tool members can use to check the pharmacies in the OptumRx network, search the formulary and get an estimated cost for their medication. Our member services team will also be available to answer questions if the member feels more comfortable with that option.
Please note that this move is being made solely for the purpose of reducing overall prescription drug costs. The reduction in cost will benefit both the university and the participating employee since any premium savings are shared by the two parties. There should be little, if any, impact on most participants. Some important points:
- Our PPO and EPO medical coverage will remain as it is with Tufts Health
- Our prescription drug coverage is not changing, nor are our three-tier co-payamounts ($15, $30, $50). The tiers for some drugs may change. Therefore, some people may see a co-pay decrease and for others a co-pay increase.
- OptumRx participates with all national pharmacy chains and many local pharmacies
- Home delivery service for maintenance medications will continue , and in most cases will be automatically transferred to OptumRx
- New ID cards will be issued by Tufts Health prior to January 1, 2017 and will include the OptumRx information and phone number
The OptumRx phone number is 855-546-3439.