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2026 Open Enrollment FAQs

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Medical Plan FAQs

Why are we changing our healthcare benefits?

By changing our benefits, we will avoid a double-digit percentage increase in employee premiums and slow the overall growth in annual cost increases. Without these changes, employees would pay more and the University would be forced to make additional cuts in other areas beyond what we have already announced earlier this week. Our goal is to balance our healthcare coverage and costs with our community’s needs and expectations.

Why is Northwestern changing vendors now?

Northwestern has a responsibility to monitor the vendors that administer our health plans to ensure they are charging reasonable fees for their services and administering our plan in accordance with NU plan documents and in the best interest of the plan and plan participants. The decision to change NU plans’ claim administrators was not taken lightly, and the impact to our community was considered each step of the way.

Who was involved in the vendor decision-making process?

These decisions are made by the Northwestern University Welfare Plan Administrators (NUWPA) Committee, which acts solely in the best interest of plan participants and beneficiaries. Current members of NUWPA include the University’s Vice President and Chief Financial Officer, Vice President and Chief Human Resources Officer, and the Director of Benefits.

How were the new vendors selected?

Northwestern, in consultation with our insurance broker, conducted an RFP process to select the vendor who would best benefit Northwestern’s plan participants. The decision process included months of meetings, proposals, benchmarking and final offers after which NUWPA determined that it was in the interest of plan participants to change the claim administrators for Northwestern’s health and welfare plans. Ensuring a large and accessible in-network list of providers was an important part of the analysis.

How come there is no rate or deductible information now?

Final decisions regarding rates, deductibles, co-pays and other plan details have not been finalized at this time.  This information will be communicated later in the summer, providing you with appropriate time to review your options. At that time, we will roll out a support tool to help you consider what will best suit your needs.

Do I have to sign up for all these new benefits?

During the upcoming Open Enrollment period, faculty and staff who want to remain covered under a Northwestern sponsored health plan will need to take action for coverage in 2026.

What do I need to do if I decide to go on my spouse/partner’s plan?

If you take no action for medical coverage during Open Enrollment, your coverage will end and you can enroll in your spouse/partner’s coverage during that plan’s Open Enrollment period.  Coverage will continue for all other plans, including dental and vision.  If you do not want other coverage in 2026, you will need to drop coverage during Open Enrollment.

How can I get help determining in-network providers?

Follow these steps: 
  • For PPO coverage, you can contact your provider and ask if they are in-network for UHC’s Choice Plus network. Or, you can use UHC’s PPO Provider Finder.  
  • For HMO coverage, you can contact your provider and ask if they are in-network for UHC’s HMO, Navigate Balanced HMO or Navigate Plus HMO networks. Or you can use UHC’s HMO Provider Finder. 

When you refer to “providers” being in-network and out-of-network, does the reference to providers include mental health providers?

Yes, “providers” refers to all healthcare professionals who have various specialty areas.

My provider(s) is out-of-network, what are my options?

If you are enrolled in the HMO plan, you must change to an in-network provider.  For those enrolled in the PPO plans, you have coverage when you see an out-of-network provider.  Your level of coverage will be reduced when services are provided by an out-of-network provider due to higher coinsurance, out-of-pocket maximums, and deductibles.  You will receive the highest level of coverage at an in-network facility.

How long will I have access to BCBSIL claims and Explanation of Benefits (EOBs)?

EOBs will be available in BCBSIL’s portal for 18 months after the claim is incurred.

Is there international coverage with UnitedHealthcare?

Yes, the UHC PPO plans will offer international coverage, and the HMO plan will offer emergency coverage when traveling abroad.  More information will be available about the plans later in the summer.

I have a point solution (e.g., Hinge, Omada, etc.) through BCBSIL, what will be the impact?

The plan design is still being finalized, which includes the availability of point solutions such as Hinge or Omada.  More information will be available later in the year.

When will I get my new ID card for UnitedHealthcare?

ID cards will be mailed to homes before the start of the new plan year.

Do I need to enroll in prescription drug coverage separately from my health insurance?

Anyone who enrolls in a PPO or the HMO with UHC will automatically be enrolled in prescription drug coverage with CVS. You do not need to take separate action to enroll in drug coverage.

Do I have fill my prescriptions at only CVS?

CVS Caremark has over 60,000 pharmacies in-network in which you may fill many 30-day scripts. National providers include:

  • Costco Pharmacies
  • CVS
  • Health Mart Atlas
  • Jewel-Osco / Albertsons / Safeway
  • Kroger
  • Meijer Pharmacy
  • Rite Aid
  • Sam's Club
  • Walgreens
  • Walmart

Similar to the current coverage design, prescriptions that are required to have a 90-day fill, specialty and infusion medications, and other drugs with limits will be subject to a conditional network of pharmacies.

Will the CVS/Caremark Rx ID info be separate or included as one ID card with the UHC member ID info?

The new UHC ID card will include information for both medical and Rx coverage.  Similar to how your BCBSIL ID card is structured, you will receive one ID card that is used for both medical and Rx coverage.

I am currently enrolled in COBRA for medical and/or dental coverage. How does this change impact me?

Inspira, Northwestern’s COBRA administrator, will mail you enrollment materials in late October.  If you want to continue COBRA medical and/or dental, you must enroll in one of the UHC plans for 2026.

I’ve heard that we are self-insured. What does that mean? And how are Northwestern’s medical plans funded?

With the exception of the HMO plan, Northwestern’s medical plans are self-insured, which means that Northwestern PPO plans are funded solely by contributions made by employees and additional contributions made by Northwestern. It is a third-party administrator that processes the plan’s claims, manages networks, and handles day-to-day plan operations. For many years, the third-party administrator for the medical plans was Blue Cross Blue Shield of Illinois (BCBS). Starting Jan. 1, it will be United Healthcare (UHC). The plan’s third-party administrators process our claims in accordance with the Northwestern University plan documents, which set forth the terms of eligibility and covered benefits for the plan.

I’m concerned with public sites indicating that UHC denies more claims than its competitors. Is this the case?

UHC should have no financial incentive for denying claims for Northwestern’s plans. Northwestern will regularly review and audit claims administration to ensure that claims are processed accurately and consistently in accordance with Northwestern’s plan.

My healthcare provider is out-of-network, what do I do next?

We expect that some providers who are currently out-of-network will become in-network providers after the change; however, as we do today, we will provide an out-of-network coverage option under the plan for those who do not want to change providers. Please visit this site to search for your provider.

Dental Plan FAQs

How can I determine if my dentist is in-network with Delta Dental?

Delta Dental offers more PPO dentists in-network than our current dental insurance provider. Faculty and staff can verify that their dentists are in-network by doing one of the following: 

  • Use Delta’s online provider finder.
  • Contact your dentist’s office and ask if they are in-network for Delta's PPO network. 
  • Call Delta at 800-323-1743 and ask if your dental provider(s) are in-network for Delta's PPO network.

What if my dentist is not an in-network provider?

The PPO dental plan administered by Delta Dental will offer out-of-network coverage similar to what is offered now.  You will save the most if you use a Delta Dental PPO network dentist.

What is changing for the dental HMO plan with Guardian?

No change is being made to the Guardian Dental HMO plan. The same as every year, Guardian will publish a list of updated copays for the plan later in the year.

Tuition Benefit FAQs

What is changing effective January 1, 2026?

Detailed information regarding tuition benefits updates is available here.

What courses/programs are impacted by the updated annual benefit limit of $5,250 for non-credit courses.

The impact will be on non-credit courses billed through CAESAR that do not earn credit hours toward an undergraduate or graduate degree. They are typically the professional development certificates provided by the School of Professional Studies.

What courses/programs are impacted by the elimination of the Employee Certificate program?

These courses are non-credit courses offered by Northwestern but not billed through CAESAR. They typically include Kellogg Executive Education Certificates, Summer Writers Conference with SPS, and Executive Learning & Organizational Change with SESP; please note this is not an exhaustive list. Certificate programs and professional development certificates provided by School of Professional Studies will remain covered under the Employee Reduced benefit with an annual benefits cap of $5,250.

How can I tell which programs are eligible for tuition benefits in 2026?

We will update the Northwestern Programs website closer to January 2026 with changes.

What happens to my benefit if my program begins before 2026?

Classes that begin before the Winter 2026 term will follow the terms of the current benefit. 

Will those currently enrolled in the tuition benefit retain current benefit plan terms?

Classes that start during the Winter 2026 term or after will follow the updated terms of the benefit.

Other Benefits FAQs

What plans are not changing?

  • Eligibility rules for employee and dependent coverage
  • Life insurance
  • Vision insurance
  • Long-term Disability
  • Spending account vendor

Will there be any changes to the Health Care or Dependent care FSA plans?

No, there are no planned changes for the Health Care or Dependent Care FSA plans. The IRS limits have not yet been announced for 2026.  The IRS typically makes that information available in early November.