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.
Evidence of Insurability (EOI)
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.How to Submit EOI
EOI requests are submitted to BCBSMT using one of the following methods:
- Complete the form online using BCBSMT's secure EOI application.
OR
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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.
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Insurance Group #F026969
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BASIC LIFE INSURANCE
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.
Optional Life Insurance Plans
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.
resources
- EOI Application - Online
- EOI Application - Paper
- Life & Accident Insurance Options Overview
- Life Insurance Certificates
- Life Insurance Rates
- Online Beneficiary Designation
- Additional Services
Dearborn Life Insurance Company doing business as:
Blue Cross Blue Shield of Montana
Phone: (866) 739-4090
Website: bcbsmt.com/ancillaryGeneral Inquiries: service.ancillary.bcbsmt.com
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
- Dependent Life Option A:
- 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.
Note for Retirees
- 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.