Employee Benefits

An individual employed by the Montana University System is eligible to enroll in the MUS Group Benefits Plan if qualified under one of the following categories:

1. Permanent faculty or professional staff members regularly scheduled to work at least 20 hours per week or 40 hours over two weeks for a continuous period of more than six months in a 12-month period.
   
   
2. Temporary faculty or professional staff members scheduled to work at least 20 hours per week or 40 hours over two weeks for a continuous period of six months or more, or who actually do so regardless of schedule.
   
   
3. Seasonal faculty or professional staff members regularly scheduled to work at least 20 hours per week or 40 hours over two weeks for a continuous period of six months or more, or who actually do so regardless of schedule.
   
   
4. Academic or professional employees with an individual contract under the authority of the Board of Regents which provides for eligibility under one of the above requirements.
   
   

Note: Student employees who occupy positions designated as student positions by a campus are not eligible to join the Plan.

Benefits eligible employees have the option to waive benefits coverage with the MUS Group Benefits Plan. To waive coverage, an employee must actively elect to waive coverage by the enrollment deadline. If an employee does not actively elect to waive coverage, coverages will continue (existing employees) or the employee will be defaulted into coverage (new employees) as outlined below. The cost of default coverage will be within the employer contribution amount.

Please note, there is no continuing or default coverage for Flexible Spending Accounts (FSAs), as these accounts must be actively elected each benefit Plan Year.

If an employee waives coverage, all of the following will apply:

• Coverage for the employee and their eligible dependents will be waived.
• All mandatory and optional Choices coverages, including Medical, Dental, Vision Hardware, Life/AD&D, LTD, and FSA, will be waived.
• The monthly employer contribution toward benefits coverage will be forfeited and used for the group benefit cost.
• If an employee waives coverage under the Plan, the monthly employer contribution must continue to be paid to the Plan by the campus employer to be used for the group benefit cost.
• Eligible dependent children cannot enroll unless there is a qualifying event or until the next Annual Enrollment period.
• A legal spouse cannot be added to the Medical or Dental Plans unless they have a qualifying event.
• If an employee enrolls after previously waiving coverage, they will only be allowed to enroll in the lowest benefit plan options available.

If an employee’s coverage is defaulted, coverage will consist of the following: 

• Employee Only – Medical Plan 
• Employee Only – Basic Dental Plan 
• Basic Life/AD&D – Option 1 ($15,000) 
• Long Term Disability – Option 1 (60% of pay/180-day waiting period)

1. Each benefits eligible employee receives a monthly employer contribution. The contribution amount is based on the Montana State legislature’s allocation toward the cost of benefits for state employees. The employer contribution applies to Medical, Dental, Basic Life/AD&D, LTD, and optional Vision Hardware coverage. The employer contribution may not cover all of your benefit costs if you enroll eligible dependents. The employer contribution does not apply to optional supplemental life, AD&D, or flexible spending accounts. Any benefit costs that exceed the employer contribution amount will be deducted evenly from the employee’s bi-weekly paycheck. Any excess employer contribution amount will be forfeited and used for the group benefit cost.

2. Within 31 days of first becoming eligible for benefits, during Annual Enrollment each Plan Year, or if you experience a qualifying event, you may select or make benefit changes from among the Choices benefit plan options, based on Plan rules.  Note:  Employees must enroll within 31 days of hire or make benefit changes within 63 days of a qualifying event .
3. Each benefit option in Choices has an associated monthly premium rate. Premium rates are shown in the Choices Active Benefits Workbook.

Mandatory:
- Medical Plan (includes Prescription Drug Plan)
- Dental Plan (Basic or Select)
- Basic Life/AD&D Insurance
- Long Term Disability Insurance

Optional:
- Supplemental Life Insurance
- Supplemental AD&D Insurance
- Vision Hardware Plan
- Flexible Spending Accounts

To determine the before-tax cost of benefits, add up the total cost of the benefits selected and compare it to the employer contribution provided by the Montana University System.

. . . . . If the benefits chosen cost:

• The same as the employer contribution, the employee won’t see any change in their paycheck.
  
  
• More than the employer contribution, the employee will pay the difference through automatic payroll deductions.
  
  
• Less than the employer contribution, the employee will forfeit the remaining employer contribution.

Annual Choices benefit elections remain in effect for the entire Plan Year (July 1-June 30) following enrollment, unless there is a change in status (qualifying event). 

Questions about the enrollment process or qualifying events should be directed to the campus Human Resources/Benefits office or the Montana University System Benefits office.

A new benefits eligible employee may enroll eligible dependents for benefits under Choices, including Medical, Dental, Vision Hardware, Supplemental Life and AD&D Insurance coverage. Eligible dependents include:

• Legal spouse.  Legally married or certified common-law married spouses, as defined under Montana law will be eligible for enrollment as a dependent.
  • Annual benefits enrollment for the Plan Year is Closed Enrollment for a legal spouse unless there is a qualifying event. 

• Dependent children under age 26. Children include the employee's natural children, step-children, and children placed in your home for adoption before age 18 or for whom you have court-ordered permanent legal custody or court-ordered permanent legal guardianship.
  • Eligible dependent children under the age of 26 may be added to the Plan during the Annual Enrollment period or if there is a qualifying event.
  • Coverage may continue past age 26 for an unmarried dependent child who is mentally or physically disabled, is incapable of self-supporting employment, and is chiefly dependent upon the employee for support and maintenance and is enrolled on the Plan when they turn age 26.  Proof of incapacity must be submitted to the MUS Plan for review within 31 days of the child's 26's birthday.  Eligibility is subject to review each benefit Plan year.  Note:  A disabled dependent child, age 26 or older, cannot be added to the Plan.

IMPORTANT:  The MUS Group Benefits Plan requires you to submit written documentation to verify a qualifying event (documents that provide proof of a change in status) and/or dependent eligibility (documents that provide proof your dependent is an eligible dependent) when enrolling dependents. Qualifying event and dependent verification documents will be reviewed by your campus Human Resources/Benefits office.

Documentation must be received within 31 days of becoming eligible for benefits, or within 63 days (marriage, birth, loss of/gains eligibility for other coverage, etc.) or 30 days (divorce or death) of a qualifying life event, or during the Annual Enrollment period or your dependent’s benefits enrollment change will not be approved.  

FAILURE TO PROVIDE SUFFICIENT WRITTEN DOCUMENTATION OF DEPENDENT ELIGIBILITY WITHIN THE REQUIRED TIMEFRAME WILL RESULT IN YOUR DEPENDENT(S) NOT BEING ENROLLED IN COVERAGE.

If you have questions about dependent eligibility or dependent verification, please contact your campus Human Resources/Benefits office.

"Special Enrollment Period" means a period of time allowed under the Plan, other than the employee’s initial enrollment period or during Annual Enrollment, in which an eligible dependent may request to enroll in or disenroll from coverage under the MUS Plan as a result of a qualifying life event.  To enroll or disenroll eligible dependents from coverage, employees must complete the online enrollment for the specific life event mid-year change and submit the required documented proof of the qualifying event and/or verification of dependent eligibility within 63 days of the event, except for divorce or death, which must be requested within 30 days of the event.

Written documentation is required to verify the qualifying event and dependent eligibility for all life events.

Special Enrollment Periods for adding an eligible dependent

• Birth of a child
• Adoption/Pre-Adoption placement
• Marriage/Common-law Marriage
• Court-ordered legal guardianship
• Court-ordered legal custody
• Qualified Medical Child Support Order
• Loss of eligibility for other coverage

Effective dates for a new eligible dependent
Coverage for newly added eligible dependents will be effective on the first day of the month following the date the online life event mid-year change request is made - except for the following:

• Birth - the date of birth.
• Adoption - the date of the qualifying adoption or placement for adoption.
• Court-ordered legal custody or court-ordered legal guardianship – the date of the court order.
• Qualified Medical Child Support Order – the first day of the month following the date of the order.

Voluntary cancellation of other insurance coverage does not constitute a qualifying event.

Special Enrollment Periods for removing a dependent

• Divorce or legal separation
• Death
• Dissolution of an Adult Dependent 
• Dependent child reaching age 26 

Termination dates for an ineligible dependent
Coverage for an ineligible dependent will terminate as follows:

• Divorce or legal separation - the last day of the month in which the event occurs.
• Death - the last day of the month in which the event occurs.
• Dissolution of an Adult Dependent separation - the last day of the month in which the event occurs.
• Dependent child reaching age 26 separation - the last day of the month in which the event occurs.
• Gains eligibility for other coverage – the last day of the month following the date the online life event mid-year change request is made.

If an eligible dependent is removed from MUS coverage, the dependent can only be re-enrolled in the Plan due to a new qualifying event.

Responsibility To Remove Ineligible Dependents

It is the employee's responsibility to remove any dependents that cease to be eligible for coverage within 30 days of the loss of eligibility.  Failure to notify of a dependent’s loss of dependent status within 60 days will result in the dependent’s loss of COBRA rights.  The employee is responsible for repayment of any claim dollars paid out for an ineligible dependent.  Premiums paid pre-tax for a dependent who is no longer eligible may not be retroactively adjusted more than 30 days or beyond the start of the calendar year, whichever comes first.

FAILURE TO PROVIDE SUFFICIENT WRITTEN PROOF OF A QUALIFYING EVENT AND/OR DEPENDENT ELIGIBILITY WITHIN THE REQUIRED TIMEFRAME WILL RESULT IN YOUR DEPENDENT(S) NOT BEING ENROLLED IN OR DISENROLLED FROM COVERAGE.

If you have questions about dependent eligibility, dependent verification, or proof of a change in status, please contact your campus Human Resources/Benefits office.