2026 State Plan Rates

HCBD works with an independent actuary each year to set rates for the State of Montana Benefit Plan, which is self-funded. To make sure there is enough money available to cover plan costs, HCBD projects claims expenses, administrative fees, and other costs for the upcoming plan year. Based on these estimates, HCBD determines the amount of contributions needed to cover costs while maintaining an adequate reserve. Since the State Plan is self-funded, third-party administrators, like BlueCross BlueShield of Montana and Navitus Health Solutions, assume no financial risk related to claims expenses. This allows the State to set rates based on historical plan costs.

Montana's 69th legislative session passing of HB13, along with union negotiations that wrapped up in the fall of 2024, secured important financial changes starting January 1, 2026, to the State Plan to help maintain its long-term financial stability.

Changes effective January 1, 2026:

• Employer Contributions increased to $1,080 for the first time since 2017
• Employee/Legislator medical benefit contributions increased for the first time since 2016
• Live Life Well Incentive increased to $60 per month
• Tobacco Surcharge increased to $60 per month

The State Plan is currently negotiating with Montana facilities (hospitals) to ensure the contributions collected from the State of Montana (employer contribution/state share) and employees, legislators, and retirees are used to maintain equitable and sustainable benefits, as well as cover the cost of health care services for all State Plan members.

If some facilities choose not to negotiate fair rates, the State may need to make adjustments to the medical benefit (deductibles, coinsurance, copayments for office or urgent care visits, or the maximum out-of-pocket amount) to help keep the plan affordable and sustainable without adjusting contributions (the bi-weekly amount you pay for benefits from your paycheck).

If your medical benefit will change in 2026, you will receive a 60-day notice from HCBD, and you will be afforded the opportunity to adjust your Medical FSA contribution.