Life and Accident - Benefits Division

Life & Accident Insurance

Blue Cross Blue Shield of Montana (BCBSMT) is the State Plan’s insurance provider for its fully insured Group Term Life and Accidental Death and Dismemberment (AD&D) insurance policies. Plans are term life, provide inexpensive protection, do not earn cash value, and are paid after tax.

Employees are eligible until separation from service, contact BCBSMT for portability or conversion options. If State Plan retiree benefits are elected, Basic Life Insurance will be continued until the retiree is Medicare eligible. Basic Life insurance may be converted once a retiree becomes Medicare eligible.

EOI is also known as "evidence of good health." It is the process that determines if a person is healthy enough to be considered eligible for the amount of insurance coverage they are requesting. Depending upon when you enroll for coverage, or the amount of coverage you are requesting, you may be required to complete EOI prior to coverage becoming effective.

EOI requests are submitted to BCBSMT using one of the following methods:

  • Complete the form online using BCBSMT's secure EOI application. OR
  • Print and fill out the EOI form then submit to BlueCross BlueShield of Montana, Attn: Medical Underwriting Department, PO Box 7072, Downers Grove, IL 60515.
    • Insurance Group #F026969

Basic Life Insurance is part of the medical benefit for all active Employees, Legislators, and non-Medicare Retirees. It provides $14,000 of term life coverage and is paid for via the employer contribution, no employee contribution required.

Supplemental Employee Life Insurance

  • Available during initial 31-day enrollment period without EOI up to the employee's annual salary.
  • Enrollment after the initial 31-day enrollment period requires EOI.
  • Coverage may be elected/increased at anytime with EOI.
  • Minimum election of annual salary rounded to the next highest $5,000, up to maximum of $1 million with EOI.
  • During the annual Open Enrollment, employees may add, increase, or decrease Employee Supplemental Life Insurance coverage in increments of $5,000. An increase of more than $10,000 will require EOI.

Supplemental Spouse Life Insurance

  • Available during initial 31-day enrollment period up to $10,000 without EOI.
  • Employee must be enrolled in Supplemental Employee Life for the spouse to be eligible.
  • Spouse’s rate is based on the employee’s age, not the spouse’s age.
  • Coverage is for a minimum of $5,000. Additional amounts are available in $5,000 increments, up to the amount of Employee Supplemental Life Insurance with a maximum election amount of $500,000. Coverage of more than $10,000 will require EOI
  • Coverage may be elected/increased at anytime with EOI.
  • During the annual Open Enrollment Period, employees may add, increase or decrease Supplemental Spouse Life Insurance. Coverage of more than $10,000 will require EOI.

Dependent Life Insurance

  • Dependent Life Insurance elections are available during initial 31-day enrollment period or within the first 60 days of marrying or 91 days of having your first child. Eligible members may choose from Option A or Option B.
    • Dependent Life Option A:
      • $2,000 of coverage for a spouse/domestic partner
      • $1,000 of coverage per dependent child
    • Dependent Life Option B:
      • $4,000 of coverage for a spouse/domestic partner
      • $2,000 of coverage per dependent child
  • During the annual Open Enrollment Period, if employee is currently enrolled in Option A, they may increase coverage to Option B.

Accidental Death & Dismemberment (AD&D) Insurance

  • Available during 31-day initial enrollment period. If coverage is not elected during 31-day enrollment period, it may be elected/increased at any time.
  • Employee Only may elected $25,000 - $1 million of coverage in increments of $25,000.
  • Employee and Dependents: A spouse with no children is eligible for 50% of the employee coverage. A spouse with children is eligible for 40% of the employee coverage. Children are eligible for 10% of the employee coverage.
  • During the annual Open Enrollment Period, employees may add, increase, or decrease AD&D Insurance.

  • At retirement, Basic Life Insurance will be continued until age 65 or Medicare eligible.
  • If you are retiring and are eligible to port or convert some of your coverage, your rates will change. Click for information about porting or converting coverage.

Your enrollment in State Plan Life Insurance and/or Accidental Death & Dismemberment (AD&D) Insurance coverage requires you to designate a beneficiary. It is important you have designated beneficiaries in the event of your death. You can add, delete, or change your beneficiary information at any time.

In the event you are divorced, please be aware of the following: Unless set forth by the express terms of a governing instrument, court order, or contract relating to the division of the marital estate between the divorced individuals, a life insurance beneficiary designation to an ex-spouse will be revoked. It is important that you update your beneficiaries upon divorce.

If a beneficiary is a minor (under age 18) or cannot give consent for payment of benefits made, a Trust must be established for the designed beneficiary.

If a beneficiary is not designated or no designated beneficiary survives you, the below will occur if payment of benefits is made:

  1. to your spouse, if living; if not,
  2. in equal shares to your living children (over age 18), if any; if none,
  3. in equal shares to your parents, if living; if not,
  4. in equal shares to your siblings, if living; if not,
  5. to your estate.

How to Update Your Life Insurance Beneficiary

  1. Click on one of the following links:

  2. Click "Change My Benefits"
  3. Under the "Basic Info" section, click "Change of Beneficiary"
  4. Enter the date you are making the change, then click "Continue"
  5. Update your beneficiary information and follow the prompts
    • Primary beneficiary percentages must total 100% and Contingent beneficiary percentages must total 100%.
  6. You must click “I agree” on the confirmation pop-up for the changes to be effective.
    • Your transaction is complete and a confirmation number will be displayed.

Travel Resource Services

BlueCross BlueShield Montana (BCBSMT) Travel Resource Services provider, Assist America, offers around-the-clock emergency and information services that can help you access emergency assistance when you are traveling 100 or more miles away from home.

Beneficiary Resource Services

BCBSMT's Beneficiary Resource Services combines family wellness and security during difficult times. Services include grief and financial counseling, funeral planning, legal support, and online will preparation.

Disability Resource Services

BCBSMT teamed up with ComPsych® Corporation to offer Disability Resource Services to employees who are covered by the Long-Term Disability (LTD) policy and their immediate family. Disability Resource Services provides convenient resources to help address emotional, legal, and financial issues.

DearbornCares

DearbornCares provides an advance payment of the employer-paid basic life insurance benefit to help beneficiaries cover their immediate expenses, such as funeral costs and medical bills.

BlueCross BlueShield Montana Logo

Dearborn Life Insurance Company doing business as:
Blue Cross Blue Shield of Montana

Phone: (866) 739-4090

Website: bcbsmt.com/ancillary

General Inquiries: service.ancillary.bcbsmt.com

Submit Paper EOI Forms To:

BlueCross BlueShield of Montana
Attn: Medical Underwriting Department
PO Box 7072
Downers Grove, IL 60515

Fax: (855) 691-7157

Insurance Group Number: F026969

For claims related questions, contact HCBD at (800) 287-8266 or benefitsquestions@mt.gov.

Life Insurance Rates

Coverage Type Monthly Premium Rate

Basic Life Insurance ($14,000 Coverage)

$0.00 (included when enrolled on Medical benefits)
$0.63 for Retirees without Medicare

Employee Supplemental Life Insurance

(every $1,000 of coverage) x (Age Rate*)
Spouse Supplemental Life Insurance (every $1,000 of coverage) x (Age Rate*)
Dependent Life Insurance Option A - Spouse/Child $0.44 per month
Dependent Life Insurance Option B - Spouse/Child $0.88 per month
Accidental Death & Dismemberment Insurance - Employee Only $0.02 / $1,000 of coverage
Accidental Death & Dismemberment Insurance - Employee Plus Dependents $0.03 / $1,000 of coverage

Age Rates for Employee and Spouse Supplemental Life

Based on employee’s age on the last day of the month coverage becomes effective.

  • 0-29 -- $0.019
  • 30-34 -- $0.033
  • 35-39 -- $0.052
  • 40-44 -- $0.065
  • 45-49 -- $0.098
  • 50-54 -- $0.151
  • 55-59 -- $0.282
  • 60-64 -- $0.433
  • 65+ -- $0.644

* Note for Employee and Spouse Supplemental Life Insurance: Once coverage is effective, rates change the first of the month following the Employee’s attainment of age based on the rate schedule above.