2026 State Plan Rates
2026 State Plan Rates
HCBD works with an independent actuary each year to set rates for the State of Montana Benefit Plan, which is self-funded. To make sure there is enough money available to cover plan costs, HCBD projects claims expenses, administrative fees, and other costs for the upcoming plan year. Based on these estimates, HCBD determines the amount of contributions needed to cover costs while maintaining an adequate reserve. Since the State Plan is self-funded, third-party administrators, like BlueCross BlueShield of Montana and Navitus Health Solutions, assume no financial risk related to claims expenses. This allows the State to set rates based on historical plan costs.
Montana's 69th legislative session passing of HB13, along with union negotiations that wrapped up in the fall of 2024, secured important financial changes starting January 1, 2026, to the State Plan to help maintain its long-term financial stability.
Changes effective January 1, 2026:
- Employer contributions increased to $1,080 for the first time since 2017
- Employee/Legislator medical benefit contributions increased for the first time since 2016
- Live Life Well Incentive increased to $60 per month
- Tobacco Surcharge increased to $60 per month
The State Plan is currently negotiating with Montana facilities (hospitals) to ensure the contributions collected from the State of Montana (employer contribution) and employees, legislators, and retirees are used to maintain equitable and sustainable benefits, as well as cover the cost of health care services for all State Plan members.
If some facilities choose not to negotiate fair rates, the State may need to make adjustments to the medical benefit (deductibles, coinsurance, copayments for office or urgent care visits, or the maximum out-of-pocket amount) to help keep the plan affordable and sustainable without adjusting contributions (the bi-weekly amount you pay for benefits from your paycheck).
If your medical benefit will change in 2026, you will receive a 60-day notice from HCBD.
Employee Monthly Contributions A contribution of $1,080 per month per eligible employee is made to the State Plan by the State of Montana (employer contribution). Below are your out-of-pocket costs after the employer contribution is applied.
| Plans | Medical* | Dental | Vision Hardware | Potential Live Life Well Incentive |
|---|---|---|---|---|
| Employee Only | $60.00 | +$0.00 | +$7.64 | up to $60 off |
| Employee & Spouse | $318.00 | +$21.40 | +$14.42 | up to $120 off |
| Employee & Child(ren) | $134.00 | +$19.90 | +$15.18 | up to $60 off |
| Employee & Family | $397.00 | +$28.90 | +$22.26 | up to $120 off |
| Joint Core | $60.00 per Employee/Legislator (Includes Family Dental) | +$0.00 | +$22.26 (Primary Member Only) | up to $60 off |
*Medical includes medical, prescription drug, basic vision ($10 copay for an annual eye exam per member at an In-Network VSP Vision Care provider) and basic life insurance.
Long Term Disability (LTD) Insurance
$8.46 per employee per month after tax for employees only.
Life and Accident Insurance Contributions Premiums are withheld after tax.
| Plans | Monthly Contributions |
|---|---|
| Accidental Death & Dismemberment Insurance (AD&D) - Employee Only | $0.020 per $1,000 of coverage |
|
Accidental Death & Dismemberment Insurance (AD&D) - Employee Plus Dependents |
$0.030 per $1,000 of coverage |
|
Basic Life Insurance ($14,000 term life coverage) |
$0.00 (included when enrolled on Medical benefits) $0.63 for non-Medicare retirees |
| Dependent Life Insurance Option A | $0.44 per month |
| Dependent Life Insurance Option B | $0.88 per month |
| Employee Supplemental Life Insurance | (every $1,000 of coverage) x (Age Rate*) |
| Spouse Supplemental Life Insurance | (every $1,000 of coverage) x (Age Rate*) |
*Age Rates
Age Rates for Employee and Spouse Supplemental Life Insurance coverages are based on the employee’s age on the last day of the month coverage becomes effective. Once coverage is effective, rates change the first of the month following the employees' attainment of age based on the rate schedule below.
- 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
COBRA Monthly Contributions COBRA applies to individuals who become qualified beneficiaries due to loss of State Plan coverage on an active employee or retiree policy.
| Plans | Medical* | Dental | Vision Hardware | Potential Live Life Well Incentive |
|---|---|---|---|---|
| Employee Only | $721.30 | +$32.60 | +$7.71 | up to $60 off |
| Employee & Spouse | $1,514.73 | +$65.20 | +$15.43 | up to $120 off |
| Employee & Children | $1,298.35 | +$60.31 | +$14.27 | up to $60 off |
| Employee & Family | $2,163.91 | +$97.80 | +$23.14 | up to $120 off |
| Medicare Retiree Only | $484.09 | +$32.60 | +$7.71 | up to $60 off |
| Medicare Retiree & Children | $1,147.25 | +$60.31 | +$14.27 | up to $60 off |
| Non-Medicare Retiree Only | $1,326.30 | +$32.60 | +$7.71 | up to $60 off |
| Non-Medicare Retiree & Children | $1,989.44 | +$60.31 | +$14.27 | up to $60 off |
*Medical includes medical, prescription drug, and basic vision ($10 copay for an annual eye exam per member at an In-Network VSP Vision Care provider).
Medicare Retiree Monthly Contributions
| Plans | Medical* | Dental | Vision Hardware | Potential Live Life Well Incentive |
|---|---|---|---|---|
| Medicare Retiree Only | $575.00 | +$42.37 | +$7.64 | up to $60 off |
| Medicare Retiree & Non-Medicare Spouse | $1,533.00 | +$63.77 | +$14.42 | up to $120 off |
| Medicare Retiree & Medicare Spouse | $1,031.00 | +$63.77 | +$14.42 | up to $120 off |
| Medicare Retiree & Child(ren) | $940.00 | +$62.27 | +$15.18 | up to $60 off |
| Medicare Retiree, Non-Medicare Spouse, and Child(ren) | $1,760.00 | +$71.27 | +$22.26 | up to $120 off |
| Medicare Retiree, Medicare Spouse & Child(ren) | $1,198.00 | +$71.27 | +$22.26 | up to $120 off |
Non-Medicare Retiree Monthly Contributions
| Plans | Medical* | Dental | Vision Hardware | Potential Live Life Well Incentive |
|---|---|---|---|---|
| Non-Medicare Retiree Only | $1,529.00 | +$42.37 | +$7.64 | up to $60 off |
| Non-Medicare Retiree & Non-Medicare Spouse | $2,451.00 | +$63.77 | +$14.42 | up to $120 off |
| Non-Medicare Retiree & Medicare Spouse | $1,807.00 | +$63.77 | +$14.42 | up to $120 off |
| Non-Medicare Retiree & Child(ren) | $1,963.00 | +$62.27 | +$15.18 | up to $60 off |
| Non-Medicare Retiree, Non-Medicare Spouse & Child(ren) | $2,717.00 | +$71.27 | +$22.26 | up to $120 off |
| Non-Medicare Retiree, Medicare Spouse & Child(ren) | $2,281.00 | +$71.27 | +$22.26 | up to $60 off |
*Medical includes medical, prescription drug, basic vision ($10 copay for an annual eye exam per member at an In-Network VSP Vision Care provider).
Basic Life Insurance
Non-Medicare retirees must also pay $0.63 per month for Basic Life Insurance coverage.