Retiree Benefits

Eligibility for State Plan Coverage in Retirement

To continue your State Plan coverage when you retire, you must be eligible to receive retirement benefits under the applicable provisions of your retirement system when you leave active State employment. You must notify the State Plan of your decision to elect retiree benefits by submitting the Retiree Election Form within 60 days of the end of your State of Montana service.

A member of the judges’ retirement system who leaves judicial office but continues to be an inactive vested member of the judges’ retirement system may continue coverage under the State Plan if the judge notifies the State Plan by completing and submitting the Retiree Election Form within 90 days of the end of the judge’s judicial service.

A surviving spouse or domestic partner and dependent children of a deceased retiree may be eligible to continue coverage under the State Plan. If eligible, HCBD will provide instructions. Required forms and payment must be submitted within 60 days of the retiree’s date of death.

Effective Date of Coverage

Your retiree coverage begins retroactive to the day your active service coverage ended as soon as the required forms and payment are received.

Grandfathered Month

If you were hired prior to (and enrolled in benefits) and have had no break in coverage since August 1, 1998, you are entitled to an additional month of employer contribution upon termination. If your monthly benefit deductions exceed the employer contribution, HCBD will withhold this amount from your final check. If the total amount is less than the employer contribution, HCBD will withhold nothing. Contact HCBD to find out if you are eligible for the additional month of employer contribution.

Retiree Benefits Enrollment

HCBD will mail eligible retirees an enrollment packet after their active service has ended. Complete the following forms and return them along with payment to HCBD:

  • Retiree Election Form (Required): Complete form by circling the coverage you wish to continue, the dependents you wish to cover, and your preferred method of payment. Return this form, and any of the following forms that pertain to you, within 60 days of the date your active service ends.

  • BlueCross BlueShield of Montana Beneficiary Designation/Change Form for Non-Medicare Retirees Only (Optional): Non-Medicare-eligible retirees are required to continue the $14,000 Basic Life Insurance coverage until Medicare-eligible. The Beneficiary Designation/Change Form allows you to update your beneficiaries. If you have more beneficiaries than the form allows, you may add more to the back of the form. 

  • Electronic Benefits Payment Deduction Authorization Form (Optional): Complete this form if you would like to have your monthly contributions withheld electronically from your checking or savings account (occurs on the 5th of every month).

  • Montana Public Employees Retirement Administration (MPERA) Authorization for Deduction of Health Insurance Premiums (Optional): Complete this form if you would like to have your monthly contributions withheld electronically from your MPERA retirement benefit. This option may take up to 60 days to become effective. 

Transferring State Plan Coverage to Spouse or Domestic Partner

  • A retiree may choose to become a dependent of an employed or retired spouse or domestic partner on the State Plan while keeping their right to return to State Plan coverage under their own name at a later date.

  • A retiree who transfers to another State Plan member’s coverage does not have to begin a new deductible for the remainder of the Plan Year.

  • If you transfer to your spouse or domestic partner’s State Plan coverage, and your spouse or domestic partner is an active employee, you may be able to transfer some or all of your Supplemental Life Insurance.

  • If you transfer to your retired spouse or domestic partner’s State Plan coverage, you lose all life insurance coverage.

  • If your retiree coverage is reinstated due to loss of eligibility for other State Plan coverage (ie., your spouse or domestic partner’s termination of employment, death, or divorce) and you are not Medicare eligible, Basic Life Insurance coverage is reinstated. 

Terminating Coverage

Retirees may terminate State Plan coverage at any time by submitting a written request or completing the Retiree Termination Form.

Coverage will terminate the month after we receive the request form. If contributions are deducted from your State retirement check or checking account, HCBD may be unable to stop the next deduction. Any contributions deducted after coverage ends will be refunded. 

If you choose not to enroll in the State of Montana Benefit Plan as a retiree, there are alternative coverages available. Many retirees have had State Plan coverage for years and may not know about other options. A lot has changed in the health insurance market, including the cost, benefits, and availability of private and marketplace plans. Please take the time to educate yourself and find the best insurance option for you and your family.

If you elect to terminate State Plan coverage for any reason, you will not be eligible to return to the State Plan in the future. Once you terminate coverage, you are no longer eligible for the State Plan.

Not Yet Medicare Eligible and Unable to Work

Public Consulting Group (PCG) helps State Plan members with applying for Social Security Disability Insurance (SSDI) and early Medicare coverage. This service applies to retirees, their spouses, and dependents who have health conditions that prevent them from working full-time. The State pays for these services, at no cost to you.
PCG is a nationally recognized leader in Social Security disability advocacy and has helped plan members navigate what can be a complex process. If you or your dependents are interested in learning more about these services, PCG is ready to answer questions and provide you with assistance - call (800) 805-8329 or email disability@pcgus.com.

Alternative Coverage Non-Medicare Eligible

If you are not eligible for Medicare, you may be able to get coverage through the Health Insurance Marketplace that costs less than State Plan retiree coverage.

Health Insurance Marketplace
The Marketplace offers “one-stop shopping” to find and compare most private health insurance options. You can access the Montana Marketplace at HealthCare.gov. 
  • You can see what your premium, deductibles, and out-of-pocket costs will be before you make a decision to enroll. 
  • You can learn if you qualify for free or low-cost coverage from Medicaid.

Being offered State Plan Retiree coverage won’t limit your eligibility for coverage through the Health Insurance Marketplace.

Contact an Expert for Free

Insurance professionals available to assist with alternative coverage options include:

  • Certified Insurance Agents or Certified Exchange Producers (CEPs) are registered Montana Insurance Agents who have taken special training to understand the Health Insurance Marketplace. CEPs are found throughout the state.

  • Certified Application Counselors (CACs) are health care provider staff trained to help people understand, apply for, and enroll in insurance coverage through the Health Insurance Marketplace. You will find these individuals in hospitals and community health centers throughout the state.

  • Navigators are public advisors who help people compare the health insurance options on the Health Insurance Marketplace website. Navigators have completed Federal and State training, have been fingerprinted, and have undergone a Montana background check.

Consult only insurance professionals certified by the Montana Insurance Commissioner.

For assistance finding an expert in your area, contact the Office of the Commissioner of Securities and Insurance at (800) 332-6148, TTY (406) 444-3246, or visit CSImt.gov. 

Alternative Coverage Medicare Eligible

If you are eligible for Medicare, you do not qualify for a plan on the Health Insurance Marketplace, but you might want to consider Medicare Supplemental Insurance or Medicare Advantage Plans.

Montana State Health Insurance Assistance Program

The Montana State Health Insurance Assistance Program (SHIP) provides free health benefits, counseling, and advocacy for Medicare beneficiaries and their families or caregivers. Its mission is to educate, advocate for, counsel, and empower people to make informed benefit decisions. 

The Montana SHIP is an independent, objective, and confidential assistance program funded by the Administration on Community Living and is not affiliated with the insurance industry. The Montana Office on Aging administers it.

For more information, contact SHIP at (800) 551-3191 or visit dphhs.mt.gov/sltc/aging/SHIP.

Certified Insurance Agent
You may also consult a Certified Insurance Agent trained in Medicare Supplement Insurance or Medicare Advantage Plans.

General Healthcare Coverage Considerations

  • Drug Formularies: If you’re currently taking medication, a change in your health insurance may affect the cost of your medication, and your medication may not be covered by another insurance plan. Check whether your current medications are listed in the drug formularies for other health insurance coverage.

  • Other Cost-Sharing: In addition to premiums or contributions for health insurance coverage, consider copays, deductibles, coinsurance, and other cost-sharing amounts when comparing insurance options. Cost sharing can vary significantly among plans, so shop carefully for a plan that fits your health and financial needs. For example, one option may have much lower monthly premiums but much higher deductibles, coinsurance, and maximum out-of-pocket costs.

  • Out-of-Network: Healthcare services from out-of-network providers or facilities may have high cost-sharing. Be aware of how going out of network or using non-participating providers or facilities could affect you.

  • Providers: If you’re currently getting care or treatment for a condition, a change in your health insurance may affect your access to a particular health care provider. You should verify if your current health care providers will accept any new insurance coverage you consider.

  • Premiums: Coverage sold through the Health Insurance Marketplace or Medicare Supplements may be less expensive than State Plan coverage.

  • Preexisting Conditions: Non-Medicare eligible retirees cannot be denied coverage or charged more for coverage because of preexisting conditions for plans on the Health Insurance Marketplace.

  • Service Areas: Some plans do not have extensive out-of-state healthcare provider access. Check out-of-state provider access if you travel for extended periods. If you move permanently to another area of the country or out of the country, you must inform your insurer immediately, and you may need to change your health plan or Medicare supplement coverage. Some Health Insurance Marketplace plans have narrower provider access, but they are often cheaper.

State Plan Retiree Coverage Options The following chart gives you an outline of your State Plan coverage options in retirement.

Benefit Non-Medicare Eligible Medicare Eligible Dependents
Medical Required Required Optional
Prescription Drug Required Required Optional
Dental Optional Optional Optional 
Basic Life Insurance Required (Terms when Medicare eligible) May port/convert N/A
Optional Life Insurance Plans May port/convert May port/convert May port/convert
Accidental Death & Dismemberment (AD&D) Insurance Not eligible Not eligible Not eligible
Vision Hardware Optional Optional Optional 
Medical Flexible Spending Account

1. Available through the end of the Plan Year when you elect retiree benefits and prepay all benefit contributions.

OR 

2. You may be eligible to elect COBRA Continuation Coverage due to termination of employment. 

If you do not prepay or elect COBRA Continuation Coverage, you have 120 days from the date of termination to submit claims for eligible services incurred prior to the termination date. 

1. Available through the end of the Plan Year when you elect retiree benefits and prepay all benefit contributions.

OR 

2. You may be eligible to elect COBRA Continuation Coverage due to termination of employment. 

If you do not prepay or elect COBRA Continuation Coverage, you have 120 days from the date of termination to submit claims for eligible services incurred prior to the termination date. 

 Not eligible
Dependent Care Flexible Spending Account Account terminates at the end of the retirement month. Not eligible to be prepaid. You have 120 days from the date of termination to submit claims for eligible expenses incurred prior to the termination date. Account terminates at the end of the retirement month. Not eligible to be prepaid. You have 120 days from the date of termination to submit claims for eligible expenses incurred prior to the termination date. Not eligible
Long Term Disability (LTD) Insurance Not eligible Not eligible Not eligible
Dependents may be enrolled only in the benefit option they were enrolled in while the retiree was an active employee. You may add a dependent to other benefit options only if they qualify for a Special Enrollment Period or during the Annual Open Enrollment Period.

 

Life Insurance Options

Non-Medicare Retirees: Basic Life Insurance is required if you stay on the State Plan. However, you are no longer eligible for supplemental life insurance benefits. Coverage for Basic Life Insurance terminates when you become Medicare eligible.

Medicare Eligible Retirees: If you are Medicare eligible when you retire or become Medicare eligible after retirement, you are no longer eligible for any group life insurance. 

Disability Waiver of Life Insurance Payments: If you are retiring prior to age 60 and are permanently and totally disabled, you may qualify for waiver of life insurance premiums through BCBSMT. Contact BCBSMT for more information about the disability waiver. 

Portability and Conversion Information: When you lose eligibility for group life insurance coverage, you are eligible to port or convert your life insurance coverage to an individual policy by making an application to BCBSMT. The deadline to apply and pay the premium for portability is 31 days after employment terminates. For conversion, you must apply and pay the premium within 31 days after coverage was reduced or ended. Note the termination date for employment may differ from the termination date for coverage. As you plan for retirement, contact BCBSMT to discuss the portability and conversion options available to you for your current life insurance coverage.

  • Portability: Allows you to “port” (or buy) group life insurance coverage when you lose coverage because your employment is being voluntarily or involuntarily terminated.
  • Conversion: Allows you to convert some or all of your group life insurance coverage to an individual whole life insurance policy when your coverage is reduced or terminated for any reason other than non-payment of premiums.

Note: Portability and conversion is not available for Accidental Death and Dismemberment (AD&D) coverage.

Retirees and their spouse or domestic partner and/or dependents covered by the State Plan should enroll in Medicare Parts A and B when they become eligible. When you become eligible for Medicare Parts A and B, the State Plan will coordinate your State Plan benefits with the benefits you are eligible for with Medicare. If you do not enroll in Medicare Parts A and B, the State Plan will pay claims as if you were enrolled, which will result in higher out-of-pocket costs for you.

  • Medicare Retiree Rate: Your monthly premium contribution amount will automatically be reduced to the Medicare Retiree Rate on the first of the month following the date you or your spouse or domestic partner become Medicare eligible.

  • Medicare Part A and B Enrollment Upon Retirement: If you or your spouse or domestic partner are a) over age 65, b) waived Medicare Parts A and/or B at the time you turned 65 because you were an active employee, and c) plan to elect Medicare Parts A and B now due to retirement, you must act promptly to avoid penalties by Medicare for late enrollment. Contact HCBD for a letter verifying your State Plan coverage for Medicare purposes.

  • Medicare Part D Coverage: As a State Plan retiree, you and your spouse or domestic partner and/or dependent’s Medicare Part D prescription drug coverage is provided by the State Plan. When enrolled in State Plan coverage, you may NOT purchase Medicare Part D coverage with any other provider. If you enroll in other Medicare Part D coverage, all of your State Plan coverage (medical, prescription drug, vision, dental, and life insurance) will be terminated. Contact Navitus Medicare Rx for more information at (866) 270-3877 or MedicareRX.Navitus.com.

You will need to indicate your method of payment when you complete your enrollment. Once your enrollment is completed and payment is received, your retiree coverage begins retroactive to the day your active service coverage ended as soon as the required forms and payment are received.

  1. Prepayment from Your Final Paycheck: You may prepay benefit contributions from your final paycheck for any months remaining in the current Plan Year. This option is only available if your final paycheck has not yet been issued. To prepay, you must complete and return the Retiree Election Form and a Retiree Prepayment Option Form (available from your agency payroll) to your agency payroll before your final pay period ends. 

  2. Electronic Deduction of Benefit Contributions from a Checking or Savings Account: Benefit contributions are deducted from your designated account on the 5th of each month. If the 5th falls on a Saturday, payment will be withheld on Friday the 4th. If the 5th falls on a Sunday, payment will be withheld on Monday the 6th. You must self-pay benefit contributions to HCBD for any months prior to the date electronic deductions begin.

  3. Automatic Deduction from MPERA Retirement Benefit: Contact HCBD to find out when your first payment can be deducted from your MPERA retirement benefit. You must self-pay benefit contributions to HCBD for any months before MPERA deductions begin. This option normally takes 60 days to start.

Montana Voluntary Employees’ Beneficiary Association (VEBA) Health Reimbursement Account (HRA)

If you will have a Montana VEBA HRA, you can select any of the payment options above. However, you may not be eligible to prepay based on the VEBA HRA group you are enrolled in. With Montana VEBA HRA, you will pay the State Plan for your benefits, and Montana VEBA HRA will reimburse you.