Medical Insurance

Tufts Health Plan and Harvard Pilgrim Health Care Announcement

Tufts Health Plan and Harvard Pilgrim Health Care announced their intent to combine their nonprofit organizations. There will be more news to follow, however we want to let you all know how this will impact you in the short-term.

We have been assured that at this time there will be no impact on existing relationships, contracts, networks, pricing, etc. There will be no disruption to you or your dependents; you will continue to have the same coverage and excellent service you have become accustomed to. While the merger was announced 08/14/2019, it will be “business as usual” until at least sometime between the 2nd quarter and 3rd quarter of 2020 as the review process takes place. This merger still needs state and regulatory approval which can take up to one year, or more. During this period, the two organizations remain separate and distinct and in fact, remain competitors.

If you have questions, please call the toll-free number on the back of your insurance card: 877-658-36300. Please do not hesitate to reach out to the Benefits team with any questions or concerns. For additional information, please see the press release.

Tufts Health Plan

Brandeis University offers eligible employees a choice of three plans from Tufts Health Plan. Look here for the 2019 comparison chart.

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Health Insurance Rates and Comparison
Health Insurance Plan Documents

Tufts EPO Value Deductible Plan

Tufts EPO Premium Plan

 Tufts PPO Documents

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. 

1095-C Form(s): According to the ACA, employers are required to send out an IRS form to anyone who was a benefit eligible employee for one or more months of the calendar year 2018. This form, 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 is required to be mailed to employees by January 31, 2019, or an IRS extended deadline of March 4th, 2019. 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-Cwww.paperlessemployee.com/brandeis.
You can 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: www.irs.gov/Affordable-Care-Act/Affordable-Care-Act-Tax-Provisions

View the Health Insurance Marketplace Notice.

OptumRx

Prescription Drug Administrator

The administrator for the Brandeis prescription drug program is OptumRx.com.

OprumRx information found on your Tufts Health Plan Card:

RxBin: 610011
RXPCN: IRX
RxGroup: EdHealth
  • There are three-tier prescription co-pay amounts ($15, $30, $50).
  • OptumRx participates with all national pharmacy chains and many local pharmacies
  • Home-delivery service for maintenance medications is with OptumRx

To reach OptumRx with questions, call 855-546-3439 of find them on at OptumRx.com.

Updates from OptumRx:

Zero CoPayment for Opioid-Related Doctor Visits

Zero CoPayment for Certain Statin Prescriptions

 

Teladoc Virtual Care

Feeling Under the Weather? Own a Mobile Device? Take Advantage of Teladoc!

A hectic schedule shouldn’t keep you from seeing a healthcare provider. But life gets in the way sometimes; we’ve all been there before!

Lucky for you, if you are pressed for time and have a non-emergency issue, in less than 10 minutes you can use your mobile device to go on a virtual visit through Teladoc with a network of board-certified doctors available 24 hours a day, 365 days of the year. Virtual care allows you to see a provider in real-time through a secured two-way video call with no traveling needed.

Teladoc is an innovative and affordable way to access quality care ranging from general medicine, dermatology, and behavioral health services. Prescriptions can even be sent to your local pharmacy when medically necessary. So whether you connect with a provider from the comfort of your own home or while on vacation across the country, your health needs will be met along at the convenience of Teladoc.

Common conditions or needs Teladoc can address are:

  • Allergies
  • Upper respiratory infection
  • Flu
  • Earache
  • Skin rash
  • Urinary tract infection
  • Sinus infection
  • Upset stomach
  • Behavioral health consultations

For a $25 copay every virtual visit, Brandeis employees under Tufts Health Plan can access an array of services at the ease of turning on a mobile device. With 92 percent of issues resolved after the first visit, it’s no wonder that there are 20+ million members who are utilizing Teladoc!


To learn more, visit teledoc.com. To set up a consultation by phone, please contact 1-800-835-2362.

Voluntary Vision Plan

VSP Vision Care

Get access to the best in eye care and eyewear with the new benefit plan VSP Vision Care.

  • VSP Choice plan effective 01/01/2018
  • Annual eye exam $10 copay
  • VSP eye care providers
  • Glasses, lenses or contacts every year (not both in the same year)
  • Frame allowance every other year
  • Discounts and savings off additional glasses or sunglasses, retinal screenings and laser vision correction

This plan is in addition to the vision exam and eyewear discounts through the Tufts plan.

VSP Welcome Flyer