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Health Care Plans

As part of your Total Rewards package, the University of Rochester offers two health care plans: the YOUR HSA-Eligible Plan and the YOUR PPO Plan. These plans are administered through Excellus BlueCross BlueShield.

This page explains the differences between the two plans, and includes helpful forms and information if you’re already on one of our plans.

Comparing your options

The chart below goes through key differences between the two health care plan options. In addition, you can find more specific details, like deductibles, in our 2024 health plans comparison chart. You can also explore rate information for these plans.

Need help choosing a health plan? Use the 2024 ALEX tool, an interactive online benefits decision tool that will assist you in understanding your benefit options and enable you to make an informed decision when making your benefit elections.

YOUR PPO Plan YOUR HSA-Eligible Plan
Premiums Higher premiums Lower premiums
Plan deductible Deductible applies to some services for example Inpatient, Outpatient, Emergency Room, Urgent Care, see comparison chart for more details Deductible applies to all medical and pharmacy services except for preventive care services
Preventive care services Preventive care services are covered at 100% for Tier 1 and Tier 2 providers. Deductible does not apply
Out-of-pocket maximum After meeting out-of-pocket maximum, plan covers services at 100%
Prescription drug coverage You pay your share of the copay or coinsurance until you reach the out-of-pocket maximum After meeting the deductible, you pay your share of the copay or coinsurance until you reach the out-of-pocket maximum
Health Savings Account (HSA) or Flexible Spending Account (FSA)
You will have the option to contribute to a Flexible Spending Account (FSA) You will have the option to contribute to a Health Saving Account (HSA)Limited Purpose FSA, or Health Care FSA


Additional support

Explore additional resources, and find links and forms that could be relevant to you.

Forms and resources

Employee benefit forms
Find forms relevant to your health care plan.

Glossary of terms
As you read through your benefit materials, refer back to this list for the definitions of terms that are commonly unknown or misunderstood.

2024 ALEX tool
An interactive online benefits decision tool that will assist you in understanding your benefit options.

2024 Health Program Guide
An in-depth PDF brochure detailing University’s Health Care Plan, Prescription Drug Plan, Dental Plans, FSA, HSA, Personal Health Management, and Well-U benefits.

Medical plan basics
Review the medical plan basics with this webpage and video.

A video helping explain the important distinctions between a Health Savings Account (HSA) and a Flexible Spending Account (FSA)

Health Care FSA video overview

Limited Purpose FSA video overview

Dependent Care FSA video overview

2024 pharmacy coverage

Effective January 1, 2024, Navitus will be the administrator of the University pharmacy benefits that are included in the health plan enrollment.

If you enroll in one of the University of Rochester Health Care Plans, you will automatically receive prescription drug benefits in conjunction with your plan. New health plan ID cards will be mailed by Excellus prior to the start of the plan year effective January 1, 2024, that will include the necessary information for both medical and pharmacy coverage. The Navitus drug formulary is used to determine the level of copay(s) or coinsurance you will be responsible for depending on the medication prescribed.

Through Navitus, you have the opportunity to utilize a mail-order pharmacy – Costco. You can conveniently fill your prescriptions via phone or online and have them delivered to your home. Visit for additional information.

The UR Employee Pharmacy offers a discount to all employees and their eligible dependents enrolled in a University of Rochester Health Care Plan. The pharmacy is located in the Medical Center, though they do offer courier services for employees located in off-site locations. Visit the UR Employee Pharmacy website for additional information.

Employees on the PPO Plan will have a plan feature called Access Guidance Services through the University’s partnership with Navitus. The program offers savings for certain specialty prescription medications. Employees are only eligible while enrolled on the PPO Plan due to rules and regulations surrounding High Deductible Health Care Plans (HSA-Eligible Plan).

For additional information on the transition to Navitus, please refer to our frequently asked questions or informative overview slides.

Accountable Health Partners (AHP)

AHP is a clinically integrated network of hospitals and physicians with a proven record of improving quality outcomes and delivering value. When visiting an AHP provider, also referred to as a Tier 1 provider, you will have a lower deductible, copay, and out-of-pocket maximum than Tier 2 or Tier 3 providers. To find Accountable Health Partners providers in your area or learn more about the AHP network, visit the AHP provider search website.

While you receive the highest level of benefits when you visit AHP providers, you can receive care through a combination of AHP, Tier 2 and Tier 3 providers. You do not need to choose a tier when enrolling, your level of savings will vary as you visit providers in different tiers throughout the Plan year.

The out of area payment program is available for University employees who, due to the business need of their position, must work and live outside of the AHP network area and therefore cannot participate with Tier 1 health care providers. As a result, these employee will receive a stipend to assist with their health care costs. If you believe you are eligible for this program, please have your supervisor or manager contact the Office of Total Rewards. View the 2024 Health Program Guide for more information.

Find providers and estimate costs

To find providers in the Excellus National Network, use their Doctor Search tool. When prompted, select “Choose a location and plan”. Enter your address, city, or zip code. Enter your plan prefix as “URL” and select “Continue”.

Excellus also offers treatment cost advisor and provider selection advisor tools. To access, log in to Excellus BCBS and select “Excellus BCBS administers my UR Health Care Plan”.

Health care when traveling

You take your healthcare coverage with you wherever you travel. Excellus has nationwide networks and offer international coverage which means you have access to medical assistance services, doctors and hospitals around the world. Review important coverage information available online:

Special extended health care coverage for certain adult children through age 29

Special extended health coverage is available for adult children, who are not otherwise eligible for coverage under his or her parent’s University Health Care Plan due to age, student status, or federal income tax dependent may be eligible to elect continuation coverage through age 29 under the University Health Care Plan. Eligible adult children are those who:

  • Are under age 30;
  • Are unmarried;
  • Live, work or reside in the state of New York or the service area of the insurer;
  • Are not covered by Medicare; and
  • Are not covered by or eligible for health insurance coverage through another employer’s group health plan (e.g. their own employer’s plan, or the plan of their other parent’s employer).

To enroll for coverage, the employee and/or the employee’s child will need to complete an Excellus enrollment form and may be asked to verify the child’s state of residency or other requirements for this coverage. Rate information is available through the providers. Enrollment opportunities are available at the following times:

  • Within 60 days prior to or following the date the child’s coverage under the University Health Care Plan ends due to age, student status, or federal income tax dependent status
  • Within 60 days of meeting the eligibility criteria for adult child status, when coverage for the child under the University Health Care Plan had previously terminated (e.g., within 60 days of moving back into New York State, losing employer coverage, becoming unmarried, etc.)
  • During the University’s annual open enrollment period

If you or a covered dependent lose coverage through the University Health and/or Dental Plans, COBRA coverage may be available. View the COBRA notice for additional information.

Transparency in Coverage Final Rules

The Transparency in Coverage Final Rules require certain group health plans to disclose on a public website information regarding in-network provider rates and historical out-of-network allowed amounts and billed charges for covered items and services in two separate machine-readable files (MRFs).  The MRFs for the benefit package options under the Health Care Plans for Faculty & Staff of the University of Rochester can be found here.

Frequently asked questions

Answers to your health care plan questions

Get in-depth information on definitions, coverage, and more.

See FAQs

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