The Office of Human Resources

Medical Insurance

Transition- Tufts Health Plan to Harvard Pilgrim Health Care (HPHC)

As we previously communicated, Tufts Health Plan and Harvard Pilgrim Health Care are now combined into a single health and well-being organization - Point 32 Health.   There are several important transitional items that you need to be aware of:

• As of January 1, 2024, your current Tufts Health Plan will transition to Harvard Pilgrim Health Care.
• You will receive new member ID cards effective 1/1/2024 with the HPHC logo and new group and subscriber ID numbers.
• MyConnect,  (866-623-0184) is a Member Advocate service that is your direct connection to HPHC for assistance with questions about your coverage.
• If you are actively receiving care from a Tufts Health Plan provider who is not available as a HPHC provider, you will be able to continue receiving care from this provider for 90 days or through March 31st, 2024, whichever is greater. 
• As HPHC members, you will continue to have access to a robust New England network of providers, with nearly 80,000 doctors and specialists and 153 hospitals, including a broad network of behavioral health providers and services.
• For PPO participants, a national network provided by UnitedHealthCare (formerly CIGNA) with access to more than 1.5 million providers nation-wide.
• Telehealth services through 'Doctor on Demand' for 24/7 virtual urgent care and Behavioral Health needs.

New High Deductible Health Plan (HDHP) and Health Savings Account (HSA)

As announced last month in a letter from Vice President Robin Switzer, we have added a consumer driven HDHP as a new option in addition to the current medical plans effective on January 1, 2024. The HDHP is designed to allow you to be more proactive in your medical care and includes a higher deductible than our other medical plans, but offers a lower rate to employees.

Key points for the HDHP:

• You must choose a primary care physician (PCP) from the Harvard PilgrimHealth Care (HPHC) network. This physician will coordinate all of your care, including referrals to specialists.

• There is an annual deductible of $1,600 for individuals and $3,200 for a family. The deductible applies to both medical and pharmacy services. The family deductible is an aggregate and not capped individually.
• The out-of-pocket maximum (OOP Max) is $2,500 for an individual and $5,000 for a family. The family OOP Max is an aggregate and not capped individually.
• Enrolling in the HDHP allows you to enroll in a Heath Savings Account (HSA).
• Because the HDHP works differently than our other medical plans, it is important that you review the plan summary carefully and attend an information session on the HDHP and HSA before you enroll (see below).

Additional Resource

Decision Doc is an interactive tool that is free and available to all benefit eligible employees. This confidential platform takes just a few minutes to complete and can help you learn which health plan will work best for you.

Key points of the Health Savings Account (HSA):

The HDHP will include a Health Savings Account (HSA), which allows you to set-aside money on a pre-tax basis to pay for qualified medical expenses. As an additional benefit, the University will contribute $500 in January 2024 to the HSAs for employees who enroll in the HDHP. Unlike a Flexible Spending Account (FSA), you own your HSA account and therefore it’s portable, which means that if you separate from Brandeis, you can take your HSA funds with you.

 But unlike an FSA, you must qualify for and meet the following IRS requirements to contribute to an HSA:

• You are covered under the HDHP, and
• You are not claimed as a dependent on anyone else’s tax return, and
• You are not enrolled in Medicare, and
• You cannot have contributions to a HealthCare FSA as of 1/1/2024 (see below).

2024 HSA Contribution Limits
For 2024, you can contribute up to $4,150 if you have employee-only HDHP coverage or $8,300 for family HDHP coverage. These limits include both employee and Brandeis contributions. Unlike FSAs, which give you a restriction on the time you can use your funds or a limited amount to roll over, an HSA is different. In the event you don’t use your funds before the end of your plan year, you won’t lose them. Your unused HSA funds are eligible to roll over each year without any limitations or restrictions.

Investing and Using HSA Funds
Another key difference between an FSA and an HSA is the ability to invest your HSA funds. Please review the following HSA information to learn more.

 4 Things to know about HSAs         HSA Reference Guide pdf          

(video)  Get started with an HSA

Key 2024 Plan upgrades to HMO Value, HMO Premium, PPO and HMO HDHP/HSA:

• Acupuncture and Chiropractor services increasing from 30 visits per year to unlimited visits.
• Short term rehab therapy (Occupational and Physical) increasing from 30 to 60 visits per calendar year.

Medical Plan Rates

The cost of Healthcare continues to rise for both medical services and pharmacy drugs with an average trend of 6-8% nationwide. We are pleased to report a modest 4% increase in plan rates for 2024. (See below for 2024 plan summary and rates).

Dental Insurance

We are pleased to report that there will be no increase to the dental plan rates for 2024! We have added an implant rider which increases covered services for bridges and implants. (See below for 2024 plan summary and rates).

Voluntary Vision Insurance

We are pleased to report that that there will be no increase to the vision plan rates for 2024. (See below for 2024 plan summary and rates).

Flexible Spending Accounts (FSA)

During Open Enrollment, you can sign up to participate in the health care or dependent care flexible spending accounts. Both of these accounts allow you to put money aside before taxes to pay for eligible health care costs and child or elder care costs, respectively. Annual reenrollment is required for both plans.

ACTION IS REQUIRED if you wish to renew or set up a health care or dependent care (day care) flexible spending account for 2024. Due to the pre-tax nature of these programs, IRS regulations require that an active election be made each year and that flexible spending accounts DO NOT renew automatically.

Remember: If you take no action during Open Enrollment

• Your existing medical plan elections (plan and tier) will continue for 2024 under Harvard Pilgrim Health Care (HPHC).

• Your existing dental and/or vision coverage elections will continue for 2024.

• If you have a 2023 health care and/or dependent care flexible spending account, and you take no action, you will not be enrolled in the 2024 program(s).

IRS regulations prohibit participation in an HSA IF there is a continued balance in an existing 2023 HealthCare FSA when the HSA becomes effective. If you currently have a Health FSA with a balance in 2023, but you want to choose to enroll in the HDHP and HSA for 2024, you must spend your entire Health FSA account balance by 12/31/2023. You must have a zero balance before 1/1/2024 or you will not be eligible to participate in the HSA for 2024. Important items:

• Provided you do NOT have a HealthCare FSA balance as of 12/31/2023, you become HSA-eligible on 1/1/24 (assuming that you are otherwise HSA-eligible as noted above).
• As you and your spouse may be eligible to use HealthCare FSA funds (either through Brandeis or another employer), your spouse cannot be enrolled or have unreimbursed funds in the FSA (as of 1/1/24) through their employer either and enrolled in a HSA (also known as “double dipping”).
• The Brandeis Health FSA allows a 2.5-month grace period (through March 15, 2024). The IRS prohibits contributions to an HSA if funds remain in the health FSA, even if during a grace period. Employees may be able to enroll in the HSA on April 1, following the grace period, however, specific provisions apply in these situations and we encourage you to contact Human Resources.

Please review the plan summaries carefully before making your 2024 benefit plan elections.

Medical Insurance options administered through Harvard Pilgrim Health Care:

•  Medical Plans Comparison Chart     (Comparison pdf )   OptumRx Information
•  What's Changing 2023 vs. 2024      Decision Doc         Plan Summaries/Schedule of  Benefits      
• Semi-Monthly Medical Rates | Weekly Medical Rates

Dental Insurance plan options administered by Delta Dental of Massachusetts:

• Dental Plans Comparison Chart
• DPPO High Plan Summary | DPPO Low Plan Summary
• Semi-Monthly Dental  Rates  | Weekly Dental Rates

Voluntary vision coverage administered by VSP.com

• Vision Care Plan
• Semi Monthly Vision Rates  | Weekly Vision Rates

• Which medical plan best meets your needs and the needs of your covered family members? Brandeis University now offers four different medical plans through HPHC. Carefully consider any known preventive or wellbeing care, any specific medical conditions, in network or out of network care, etc.
• Will you cover yourself and/or dependents for dental and vision insurance? Brandeis offers dental and vision plans that generally cover eye exams, lenses, and frames.
• Do you have eligible medical or dependent care expenses that you would like to receive reimbursement for? During Open Enrollment, you can sign up to participate in the health care or dependent care flexible spending accounts. Both of these accounts allow you to put money aside before taxes to pay for eligible health care costs and child or elder care costs, respectively. Annual reenrollment is required for both plans.

• If you are enrolling in the HDHP and HSA, you must use all 2023 HealthCare FSA monies on or before 12/31/23.  Due to IRS regulations, failure to do so will prevent you from being able to participate in a HSA for 1/1/24 (except in certain grace period situations as noted above).

Remember: If you take no action during Open Enrollment

• Your existing medical plan elections (plan and tier) will continue for 2024 under Harvard Pilgrim Health Care (HPHC).
• Your existing our dental and/or vision coverage elections will continue for 2024.
• If you have a 2023 health care and/or dependent care flexible spending account, and you take no action, you will not be enrolled in the 2024 program(s).

As a reminder, this is also your opportunity to enroll in or change supplemental life insurance for 2024. As this is a pre-tax benefit, it is also subject to qualifying events and open enrollment rules.

• Employee Life Insurance Benefit
• Spouse Supplemental Life Insurance Rates
• Child Life Insurance Rates

Harvard Pilgrim Health Care-Brandeis Microsite

• Member Guides, Provider Directory, Plan Summaries, Schedule of Benefits

Harvard Pilgrim Health Care  - MyConnect  866.623.0184

• Call for help with plan options, coverage, claims, pre approved appointments, providers.

Fidelity HSA service specialist - 800.544.3716

• Call for help with eligibility and how the plan works.
• Decision Doc - is free and available to all benefit eligible employees. This confidential platform takes just a few minutes to complete and can help you learn which health plan will work best for you.

Benefits Website

All current plans and information.