New Legislator Enrollment

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 Coverage
• Prescription Drug Coverage 
• Basic Vision ($10 copay for an eye exam per member at an in-network provider), 
• Basic Life Insurance ($14,000 of coverage)
• Montana Health Centers 
  • Locations  in Anaconda, Billings, Butte, Helena, and Missoula. The clinics offer the same kinds of services found at a regular doctor’s office at no-cost to eligible plan members and a much lower cost to the self-funded State Plan.
  • Virtual Telehealth offers no-cost virtual access to a board certified physician 24 hours a day/7 days a week. 

• Medical coverage for spouse/domestic partner and/or child(ren)
• Dental coverage
• Vision Hardware coverage
• Additional life insurance for you and/or your spouse/domestic partner or child(ren)
• Accidental Death & Dismemberment (AD&D) coverage 

*Proof of Dependent Eligibility - To add a spouse/domestic partner, or child(ren) to the State Plan, you must provide proof of 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 $1,054 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. 

• 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.