University Human Resources

Medical Plans

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Medical Plans

Brown offers comprehensive health benefits to our faculty and staff, supporting you and your family through every stage of life. With a variety of options, you can find the coverage that meets your needs at each stage.

No exclusions for pre-existing conditions are included in any of the plans. They all have an in-network and an out-of-network option. In-network services require a nominal copayment; out-of-network services involve claim forms, deductibles, co-insurance, and out-of-pocket maximums. If you are in the high-deductible plan, you will pay the full cost of the visit until you reach your deductible. Please refer to the Decision Guide for additional information.

Prescription drug coverage is provided separately through OptumRx and is automatically included when you enroll in a Brown medical plan. Visit the Prescription Drug Coverage page to learn more about the pharmacy benefit.

2026 Rate Sheets

Summary of Benefits & Coverage

In accordance with the Patient Protection and Affordable Care Act (PPACA), employers are required to provide a Summary of Benefits and Coverage notice to help employees make informed decisions about employer-provided health insurance.

Medical Plan Options

Core PPO Plan

BCBS Core Plan Summary
	In-Network (Employee Only/Employee + Dependent(s))	Out-of-Network (Employee Only/Employee + Dependent(s))
Deductible	$750/1,500	$1,500/$3,000
Out-of-Pocket Maximum	$3,500/$7,000	$3,500/$7,000
Coinsurance	10%	20%
PCP Visit	$25 copay	20%
Specialist Visit	$35 copay	20%
Emergency Room	$150 copay	$150 copay
Inpatient Hospital	10%	20%
Outpatient Surgery	10%	20%
Pharmacy	$10/$30/$50
Actuarial Value (AV)	88.5%

Premier PPO Plan

BCBS Premier PPO Plan Summary
	In-Network (Employee Only/Employee + Dependent(s))	Out-of-Network (Employee Only/Employee + Dependent(s))
Deductible	$250/$500	$500/$1,000
Out-of-Pocket Maximum	$3,500/$7,000	$3,500/$7,000
Coinsurance	0%	20%
PCP Visit	$20 copay	20%
Specialist Visit	$30 copay	20%
Emergency Room	$150 copay	$150 copay
Inpatient Hospital	0% after deductible	20%
Outpatient Surgery	0% after deductible	20%
Pharmacy	$10/$30/$50
Actuarial Value (AV)	92.8%

Consumer-Directed Health Plan (CDHP) with Health Savings Account (HSA)

We encourage you to consider whether the CDHP with HSA plan—the lowest-cost option—could be a good fit for you. Learn more.

Health Savings Account

If you enroll in the BCBS CDHP with HSA, you may also participate in an HSA administered through Sentinel Group. An HSA allows you to set aside pre-tax dollars to pay for eligible medical expenses or save for future health care costs.

For 2026, the HSA contribution limit is $4,400 for individul coverage and $8,750 for family coverage. These limits include both employee and employer contributions.

BCBS CDHP with HSA* Plan Summary
	In-Network (Employee Only/Employee + Dependent(s))	Out-of-Network (Employee Only/Employee + Dependent(s))
Deductible	$2,000/$4,000	$2,000/$4,000
Out-of-Pocket Maximum	$3,500/$7,000	$3,500/$7,000
Coinsurance	10%	30%
PCP Visit	10%	30%
Specialist Visit	10%	30%
Emergency Room	10%	10%
Inpatient Hospital	10%	30%
Outpatient Surgery	10%	30%
Pharmacy	$10/$30/$50 after deductible
Actuarial Value (AV)	86.2%

*For eligible employees, Health Savings Accounts will continue to be funded at the current levels: $500 for employees enrolled in employee only coverage and $1,000 for employee + dependent(s).

Plan-by-Plan Comparison

	BCBS Core Plan (Employee Only/Employee + Dependent(s))		BCBS Premier PPO Plan (Employee Only/Employee + Dependent(s))		BCBS CDHP with HSA Plan (Employee Only/Employee + Dependent(s))
	In-Network	Out-of-Network	In-Network	Out-of-Network	In-Network	Out-of-Network
Deductible	$750/1,500	$1,500/$3,000	$250/$500	$500/$1,000	$2,000/$4,000	$2,000/$4,000
OOP Max	$3,500/$7,000	$3,500/$7,000	$3,500/$7,000	$3,500/$7,000	$3,500/$7,000	$3,500/$7,000
HSA Funding	N/A	N/A	N/A	N/A	$500/$1,000*
Coinsurance	10%	20%	0%	20%	10%	30%
PCP Visit	$25 copay	20%	$20 copay	20%	10%	30%
Specialist Visit	$35 copay	20%	$30 copay	20%	10%	30%
Emergency Room	$150 copay	$150 copay	$150 copay	$150 copay	10%	10%
Inpatient Hospital	10%	20%	0% after deductible	20%	10%	20%
Outpatient Surgery	10%	20%	0% after deductible	20%	10%	20%
Pharmacy	$10/$30/$50		$10/$30/$50		$10/$30/$50 after deductible
Actuarial Value (AV)	88.5%		92.8%		86.2%

View Sample Health Plan Comparison

*Health Savings Accounts will continue to be funded at the current levels: $500 for employees enrolled in employee only coverage and $1,000 for employee + dependent(s).

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 (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.

Additional Resources

BCBS Find a Provider Tool

BCBS My Health Toolkit®

Health Savings Account (HSA) Resources

Mental Health Resources Available Through Your BCBS Plan

Transparency in Coverage

CurrentCare

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