Health Care & Benefits Division

Plan Information

Wrap Plan Documents

Summary of Benefits and Coverage (SBC)

Summary of Benefits and Coverage (SBC) - Effective 1/1/22
Summary of Benefits and Coverage (SBC) - Effective 1/1/21
Summary of Benefits and Coverage (SBC) - Effective 1/1/20
Summary of Benefits and Coverage (SBC) - Effective 1/1/19
Summary of Benefits and Coverage (SBC) - Effective 1/1/18
  •   

Legal Notices

Legal Notices Document - 12/2021
  •  
  • Cigna Vision Summary of Benefits

MedicareRX Prescription Drug Program Information

Navitus MedicareRx Evidence of Coverage - Effective 1/1/22 
Navitus MedicareRx Summary of Benefits - Effective 1/1/22 
Navitus MedicareRx Annual Notice of Changes - Effective 1/1/22 
Navitus MedicareRx Evidence of Coverage - Effective 1/1/21 - 12/31/21
Navitus MedicareRx Summary of Benefits - Effective 1/1/21 - 12/31/21
Navitus MedicareRx Annual Notice of Changes - Effective 1/1/21 - 12/31/21

 

Life Insurance Certificates

Effective January 1, 2022, Blue Cross Blue Shield of Montana will serve as the vendor for the State Plan's Life Insurance, Accidental Death & Dismemberment, and Long Term Disability products. 

Active Employee Life Insurance Certificate
Retiree Life Insurance Certificate
Supplemental Life Insurance Certificate
Accidental Death and Dismemberment Certificate
Long Term Disability Certificate

Certificates for coverage prior to January 1, 2022
Life Insurance Certificate
Accidental Death and Dismemberment Certificate
Long Term Disability Certificate

 

HR/Payroll Publications

2022 ACA and the State Plan - presentation

  •  

Workers' Compensation Management Bureau Publications

  • Documents related to safety and return to work can be found on the WCMB website
  •  

HIPAA Notice

Hi, I can help answer your questions!