Enrollment and Claims - Benefits Division

Enrollment & Claims

Learn how to appeal a denied or unreimbursed benefit claim. The Appeals page explains when and how to file an appeal, outlines supporting documentation requirements, and provides contact information to help you navigate the process.

Appealing Unreimbursed Claims Page

Find information on how to file and manage claims for your State of Montana employee benefits. The Claiming Benefits page outlines the steps for submitting medical, dental, vision, and flexible spending account claims, including deadlines, documentation, and payment details.

Claiming Benefits Page

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COBRA Main Page

Learn when and how you can change your State Plan benefits during the year after a qualifying life event. The Mid-Year Changes page explains eligible events, required timeframes and documentation, and how to update your coverage through the benefits enrollment system.

Mid-Year Changes Page

New employees or newly eligible employees can visit here complete their State Plan benefits enrollment online.

  • Enrollment must be completed within 31 days of your date of hire.
  • Your benefits will be effective retroactive to the date you became eligible.
  • If you do not complete your benefit enrollment within 31 days of your date of hire, you will not be enrolled in the State Plan and ALL of your benefit options will be waived.

If you have any questions, contact HCBD at (800) 287-8266, TTY (406) 444-1421, or BenefitsQuestions@mt.gov.

Initial Enrollment Period

Enroll within 31 days of your date of hire in order to take full advantage of all State Plan benefits available to you. Your coverage is effective on your date of hire. Flexible spending accounts become effective on the first day of the month following your hire date.

Joint Core

If you and your spouse both work for the State (as an Employee or Legislator) and have at least one dependent child who needs to be enrolled on the State Plan, you can elect to be Joint Core. Your family shares one family Maximum Out-of-Pocket and your bi-weekly contribution is less.

Late Enrollment

If you waive coverage, or do not enroll within 31 days of your date of hire, you may be able to join the State Plan at a later date, but you will only be eligible for State Plan benefits for yourself. You will not be able to add a spouse/domestic partner or dependent child(ren) to the plan or elect optional benefits without a Special Enrollment Period. If you enroll after the first 31 days of your date of hire, the effective date of coverage will be the 1st of the month following receipt of your request for enrollment.

Medical Benefits

Employees who enroll in the State Plan must enroll in Medical Benefits.

Optional Benefits

Employer Contribution

The State contributes $1,080/month per eligible employee to the State of Montana Benefit Plan.

Paying for Coverage

The State of Montana employer contribution may not cover all of your benefit costs. Any extra cost is automatically deducted from your bi-weekly paycheck. You start owing your benefit contribution the day your coverage begins. If you submit your benefit elections within 31 days of your date of hire, but after your first pay period, you will see two pay periods worth of contributions come out of your second paycheck. After that, the contributions will be distributed evenly.

Tax Information

Most of your benefit contribution will be deducted pre-tax out of your paycheck with the exception of the following:

  • Life Insurance coverage for yourself and your dependents
  • Long Term Disability insurance coverage, and
  • Non-tax dependent coverage (i.e. domestic partner)

Benefit Identification Cards

You will receive medical, dental, vision, and prescription drug plan identification cards within two to three weeks of completing your enrollment.

Open Enrollment

You will have the opportunity to make changes to your State Plan options during the annual two-week Open Enrollment Period that takes place each fall. These changes take effect January 1 of the following Plan Year. Be sure to read all mail and email communications from HCBD for details about Open Enrollment.

Additional Resources

New legislators may complete their State Plan benefits enrollment by visiting here to complete their State Plan benefits enrollment online or by submitting a paper enrollment form to HCBD.

  • Enrollment must be completed within 31 days from the date you are appointed.
  • Your benefits will be effective retroactive to the date you were appointed.
  • If you do not complete your benefit enrollment within 31 days from the date you were appointed, you will not be enrolled in the State Plan and all of your benefit options will be waived.
  • Instructions for how to complete your online benefit enrollment.

If you have any questions, contact HCBD at (800) 287-8266, (406) 444-7462, TTY (406) 444-1421, or BenefitsQuestions@mt.gov

Initial Enrollment Period

Legislators have 31 days from the date they are appointed to complete their State Plan enrollment. Coverage is effective on the date you are appointed.

Joint Core

If you and your spouse both work for the State (as an Employee or Legislator) and have at least one dependent child who needs to be enrolled on the State Plan, you can elect to be Joint Core. The family shares one family maximum out-of-pocket for medical expenses, one family maximum out-of-pocket for prescription expenses, and your bi-weekly/monthly contributions are less.

Late Enrollment

If you want to waive coverage, or do not enroll within the Initial Enrollment Period, you may be able to join the State Plan at a later date but will only be eligible for State Plan benefits for yourself. You will not be able to add a spouse/domestic partner or dependent child(ren) to the plan or elect optional benefits without a Special Enrollment Period. If you enroll after the Initial Enrollment Period, the effective date of coverage will be the 1st of the month following receipt of the request for enrollment.

Medical Benefits

Legislators who enroll in the State Plan must enroll in Medical Benefits. Medical Benefits include all of the following:

Optional Benefits

Proof of Dependent Eligibility

To add a spouse/domestic partner, or child(ren) to the State Plan, you must provide proof of dependent eligibility. Once verification is provided, dependent coverage is placed retroactively to the effective date and any retroactive contributions will be billed.

Employer Contribution

The State contributes $1,080 per month per eligible legislator to the State of Montana Benefit Plan.

Paying for Coverage

The State of Montana employer contribution may not cover all of your benefit costs. Any extra cost is automatically deducted from your bi-weekly paycheck while in session or paid monthly after session ends. You start owing your benefit contribution the day your coverage begins. If you submit your benefit elections within 31 days of your appointment date, but after your first pay period, you will see two pay periods worth of contributions come out of your second paycheck. After that, the contributions will be distributed evenly.

Tax Information

Most of your benefit contribution will be deducted pre-tax out of your paycheck with the exception of the following:

  • Life Insurance coverage for yourself and your dependents
  • Non-tax dependent coverage (i.e. domestic partner)

Benefit Identification Cards

You will receive medical, dental, vision, and prescription drug plan identification cards within two to three weeks of completing your enrollment.

Open Enrollment

State Plan members have an opportunity to make changes to their State Plan options during the annual two-week Open Enrollment Period that takes place each fall. These changes take effect January 1 of the following Plan Year.

Waiving Coverage

If you choose to opt out/waive State Plan coverage you may be eligible to receive reimbursement, up to $1,054 per month, for premiums paid in conjunction with an Employer Group Health Plan or premiums paid for certain types of disability and life insurance. The State Plan is restricted by federal regulation from providing reimbursement for Medicare, Medicare Supplement, Medicare Advantage, individual coverage through an insurance carrier, or Health Insurance Marketplace premiums. Additionally, reimbursement of any kind is not available if the legislator enrolls on the State Plan. To opt out/waive State Plan coverage and receive the Option 2 reimbursement, complete the Legislator Opt Out/Waiver Form.

Additional Resources

Get information about the annual opportunity to review and change your State of Montana employee benefits. The Open Enrollment page explains when open enrollment occurs, what changes you can make, key deadlines, and where to find plan details and enrollment materials.

Open Enrollment Page

Find information about your State Plan benefits if your job ends due to a reduction in force. The Reduction in Force page explains what benefit programs may be available, how long you can continue coverage, and important options and timelines to consider during your employment transition.

Reduction in Force Page

For each applicable Dependent enrolled, the plan member shall submit the following information. If a dependent is enrolled due to a mid-year change qualifying event, additional verification may be required.

Spouse

  1. A copy of the certified marriage certificate; or
  2. A copy of the front page of the most recent tax-return showing the tax filing status as “married”. Any financial information may be blacked out; or
  3. A copy of the recorded and notarized Affidavit of Common Law Marriage (available on the forms page).

Domestic Partner

  1. Declaration of Domestic Partner Relationship and Affidavit of Shared Residence forms (available on the forms page); and
  2. A copy of mutually-granted powers of attorney or health care powers of attorney; or
  3. A copy of mutual designations of primary beneficiary in will, life insurance policies or retirement plans. Domestic partners are automatically defaulted to a non-qualified tax dependent status.

Dependent Children

  1. A copy of the Dependent child’s birth certificate, adoption order or pre-adoption papers, or
  2. A copy of a court-ordered parenting plan, custody agreement or guardianship order.

Stepchildren and Domestic Partner Children

  1. Required documentation listed above for spouse or domestic partner, if individual is not enrolled; and
  2. A copy of the stepchild’s or domestic partner child's birth certificate, adoption order or pre-adoption papers; or
  3. A copy of a court-ordered parenting plan, custody agreement or guardianship order.

Incapacitated Children

It is the plan member's responsibility to provide the required documentation, listed below, to continue State Plan benefits for an incapacitated child(red) over the age of 26.
  1. The incapacity commenced before the date the child’s Plan coverage would otherwise terminate. Eligibility Provisions State of Montana Benefit Plan (State Plan) Document on the forms page.
  2. The child is dependent upon the eligible Participant or Retiree for support and maintenance within the current meaning of the COBRA disability continuation criteria. In other words, the Social Security Administration (SSA) must have determined that the child is disabled and qualifies for disability benefits through Social Security Disability Insurance (SSDI) or Supplemental Security Insurance (SSI) (SSA documentation must be provided).
  3. Notification, SSA documentation and tax documentation must be submitted to the Plan Administrator within thirty-one (31) days of the date the child’s coverage would otherwise terminate.
  4. Must submit the most recent tax return or other documentation which indicates the disabled child is a qualified tax dependent of the Participant or Retiree. Other documentation must show the Participant or Retiree provides more than 50% of the disabled child’s support and maintenance.
  5. Re-certification of the disability may be required annually by the Plan.

Grandchildren

  1. A copy of the grandchild’s adoption order or pre-adoption papers; or
  2. A copy of a court-ordered custody agreement or legal guardianship.