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
Visit the HPHC/Brandeis Microsite for details about each plan, including plan summaries, statement of benefits, and provider directories.
Plan Rates
2024
- Semi-Monthly Medical Rates (Exempt Staff, Faculty, Postdoctoral Scholars)
- Weekly Medical Rates (Non-Exempt Staff)
2025
- Semi-Monthly Medical Rates (Exempt Staff, Faculty, Postdoctoral Scholars)
- Weekly Medical Rates (Non-Exempt Staff)
HMO
The HMO plan includes in-network coverage only. You must choose a primary care provider (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 provider (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) first.
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 provider (PCP) and receive referrals to specialists within the HPHC network. The 2024 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. A HDHP allows you to contribute and invest in a Health Savings Account HSA.
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: Call (866) 623-0184 - Your member advocate member service team 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.
Who is eligible to be enrolled?
- Eligible Staff, Faculty, Postdocs
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Spouse
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Ex-spouse
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If you and your spouse divorce or legally separate, your former spouse may continue coverage as a dependent under your family coverage in accordance with Massachusetts law (documentation is required).
- Note: If you remarry, your former spouse’s coverage as a dependent under your family coverage will end. Your former spouse may be able continue coverage through COBRA. If your former spouse remarries, coverage will end unless continuation is required under federal law.
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Children. The term “children” includes the following individuals until their 26th birthday:
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your or your spouse’s natural child, stepchild, or legally adoptive child; or
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the child of your natural child, stepchild, or legally adoptive child;
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any other child for whom you have legal guardianship; or
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any other child who meets the IRS Code definition of your dependent or your spouse’s dependent
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A child who is over age 26 and resides with you or your spouse and became permanently physically or mentally disabled before age 26 and is incapable of supporting himself or herself due to a disability (dependent verification is required).
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Verification Required: Anyone requesting multi-tier coverage under a medical, dental or supplemental vision plan must submit a copy of a marriage certificate, a copy of a signed tax form, or other documentation, satisfactory to the Benefits Office, that confirms spouse status. Birth Certificates, adoption, guardianship documents are required for children.
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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
More Information
Nadynne Stamps
Benefits Specialist
stamps@brandeis.edu