University Human Resources
2026 Medical Plans FAQ
Key Terms
The out-of-pocket maximum (OOPM) is the highest amount you'll pay for covered medical services in a year. Once you reach this limit, the plan will cover 100% of the remaining covered costs for the rest of the year.
The out-of-pocket maximum includes your deductible, copayments, and coinsurance. There is a separate out-of-pocket maximum for pharmacy benefits.
A deductible is the amount you pay out-of-pocket for covered services before your medical plan starts paying its share. Deductibles do not apply to in-network preventive care services. These services are covered 100% by your medical plan.
What accounts can help me pay for deductibles?
- For the PPO Plans: Flexible Spending Account (you contribute tax-free)
- For the CDHP with HSA Plan: Health Savings Account (HSA; you can contribute tax-free, and Brown provides a contribution to help cover your deductible)
Coinsurance is the percentage of medical bill costs you pay after you've met your medical plan's deductible. You stop paying coinsurance when you’ve met your out-of-pocket maximum.
What are copays versus coinsurance?
Copays are fixed amounts you pay for certain services, while coinsurance is a percentage of the bill. For example, you might pay a copay for a doctor's visit, and then coinsurance for the cost of tests or procedures ordered during that visit.
Actuarial value (AV) is a measure used in health insurance to estimate the percentage of health care costs that a plan will cover on average.
2026 Medical Plan Changes
To support a smooth transition, we will be offering:
- Virtual and in-person information sessions
- A dedicated transition support line and information about continuity of care if you are transitioning from the UHC network
- A comprehensive online resource hub with FAQs, provider lookup tools, and decision guides
- An updated Consumer-Directed Health Plan with Health Savings Account guide, with detailed examples of how to use this plan. Watch for Today@Brown announcements about Open Enrollment starting in October 2025.
After a comprehensive review, the University will be transitioning from our current two providers to a single medical plan provider:
- We will continue our BCBS PPO plan, which will now be referred to as the BCBS Premier PPO Plan
- The Consumer-Directed Health Plan (CDHP) will be administered by BCBS
- We will introduce a new BCBS Core PPO medical plan
We will no longer offer the UnitedHealthcare (UHC) plans.
The BCBS Premier PPO plan will have the following changes:
- 9.5% increase in employee contributions
- A new deductible
- An increased out-of-pocket maximum
- Minimal copay changes
- 9.5% increase in employee contributions
- An increased deductible
- An increased out-of-pocket maximum
- The Consumer-Directed Health Plan (CDHP) will be administered by BCBS
- A new HSA administrator (to be announced)
Brown’s contribution to the HSA will remain the same.
We will introduce a new medical plan, referred to as BCBS Core PPO Plan, which will have:
- 0% increase in employee contributions (from the current Premier PPO plan) unless you have a compensation change that would move you to the next salary tier
- A deductible
- An out-of-pocket maximum
- 10% coinsurance once the deductible is met
The out-of-pocket maximum includes your deductible, copayments, and coinsurance. There is a separate out-of-pocket maximum for pharmacy benefits.
Yes, there is a separate out-of-pocket maximum that applies to pharmacy benefits for the PPO Plans.
The out-of-pocket maximum includes your deductible, copayments, coinsurance, and pharmacy copays. There is no separate out-of-pocket maximum for pharmacy benefits for the CDHP with HSA Plan.
Action(s) For You
Yes! All Brown employees electing medical coverage must actively enroll during the annual Open Enrollment period.
If you are currently enrolled in Brown's medical coverage and you do not make an active election for 2026 medical coverage, you will be defaulted into the new BCBS Core PPO medical plan.
Watch for Today@Brown announcements about Open Enrollment, which will start in October 2025.
Access the Blue Cross Blue Shield Find A Provider Tool. Employees who are not currently enrolled in the plan can type the first three characters of the member ID, “BOU”, to see providers that are in network.
You’re encouraged to be sure that your current provider is in the BCBS network using the Blue Cross Blue Shield Find A Provider Tool. Use the first three characters of the member ID, “BOU”. Over 99% of providers used by the Brown community in-network with UHC will continue to be in-network with BCBS.
You will receive communications from BCBS about the transition of care if you are currently receiving ongoing medical care
Need Assistance?
Virtual and in-person information sessions are coming soon. We will notify you via Today@Brown when scheduling is available on this page.