Frequently Asked Questions (FAQs) as of 31 January, 2008

Q. What is the cost/premium/rate?

A. There is no fixed rate or premium for the Montana Chamber Choices program. It is actually a family of various insurance plans (currently nine), with differing deductibles, co-pays, and benefits. We also utilize age-rating, so that may affect rates. An agent can examine your needs and your situation and get you a quote for coverage.

Q. Who is eligible?
A. As a bona fide association health insurance program, any member in good standing of the Montana Chamber of Commerce and/or any of the participating local chambers of commerce (currently 46 of them) can sign up for Montana Chamber Choices. Customers do not have to be a member to get a quote, but must join when accepting coverage.

Q. Are there business size limitations?
A. Any business is eligible, from the self-employed, independent contractor, or sole proprietor, up to businesses employing 99 people. Employers with 100 employees are not currently eligible. Only employees working at least 20 hours per week (or more, if company policy dictates) are eligible.

Q. What constitutes a Sole Proprietor?
A. Sole proprietor is defined as “A form of business organization in which an individual is fully and personally liable for all the obligations (including debts) of the business, and is entitled to all of its profits and exercises complete managerial control.” Coverage is not available for a single employee, unless the owner participates, as well.

Q. What amount of participation is required?
A. Employers are required to pay at least half (50%) of the employee premium. At least 75% of eligible employees must participate.

Q. We usually have 8 to 10 employees on payroll, but only 3 or 4 want or can afford insurance. Is there anyway we could be covered under Chamber Choices?
A. The rule is that at least 75% of eligible employees must participate. However, many factors can be considered in defining “eligible employee”, such as length of service, position or job title. An individual covered elsewhere (through spousal coverage, for example) does not have to be considered an eligible employee. There are legitimate “carve-outs” for employees who want and need coverage. Contact a Blue Cross representative or your agent for complete details.

Q. What about eligibility of/for part-time employees?
A. The minimum work hours required for employee eligibility in the Choices program is 20 hours per week. If the employer’s policy requires higher hours for eligibility, the employer’s policy rules.

Q. Are there any excluded industries under Chamber Choices?
A. No. Any firm that is a member of the Montana State Chamber or a participating local chamber is eligible.

Q. Can anyone be excluded?
A. Choices is “Guaranteed Issue”, meaning that if all other conditions are met, an individual cannot be denied. This only applies to businesses with from 1-50 employees.  Rates can vary based on existing medical conditions.

Q. What about pre-existing conditions, or previous health issues?
A. If you have/had “creditable coverage” (existing coverage that would have paid for the condition) within 63 days of new coverage, that will apply to new coverage. If not, the first $500 of covered services for pre-existing conditions will be covered, subject to deductible and co-payment provisions. After that, benefits for services, supplies, or treatment for any pre-existing condition will not be covered for a period of 12 months from the enrollment date. A pre-existing condition is a condition for which medical advice, diagnosis, care, or treatment was recommended or received within the 6 month period ending on the enrollment date. Time spent on the employer’s waiting period to become eligible for the employer’s group health plan runs concurrently with the preexisting condition exclusion time period. The pre-existing condition exclusion does not apply to:

• Newborn children of any family member;

• Children placed for adoption as described in the definition of family member;

• Pregnancy; or

• Any condition related to genetic information that has not been diagnosed.

Q. What coverage is available under Chamber Choices?
A. Medical, Dental, Vision, and Life.

Q. What are the major advantages of Chamber Choices?
A. Pooled renewal rates provide greater stability.  Also, individual group rates are determined by that group’s medical loss ratio within table parameters set for the block. Through our size, we are also able to provide a better package of benefits and services.

Q. What have renewal increases been under Chamber Choices?
A. The four renewals in the history of Chamber Choices have been 9.9%, 7%, 11%, and 4.2%, all less than the national trend increase each year.

Q. Who owns the Montana Chamber Choices program?
A. Montana Chamber Choices is owned by the Montana Chamber of Commerce. Blue Cross Blue Shield of Montana is the carrier who underwrites this major medical plan.

Q. Why is the plan only offered through Blue Cross and Blue Shield of Montana?
A. The initial Request For Proposal was sent to the two Montana-based health insurance companies. After careful review, Blue Cross was chosen as the provider. Since Montana Chamber Choices involves their existing plans, their agents have the knowledge, expertise, and system to handle those requests.

Q. Am I eligible for tax credits and premium assistance through Insure Montana?
A. Yes, Montana Chamber Choices is approved by the Insurance Commissioner as a qualified association plan. Please ask your agent to specifically request a Choices quote when applying.

Q. What does it cost to join the chamber?
A. The base rate for membership in the Montana Chamber is $250, with additional dues the larger the company. Dues amounts for local chambers will vary considerably. Contact them directly to determine their rate.

Q. What other benefits do I get from chamber membership?
A. The Montana Chamber is the state’s leading business advocate, working with state and federal government on issues important to its 800 members in Montana. The Montana Chamber helps its members make, save, and keep their money. Local chambers of commerce deal with issues on the state and local level and offer networking, tourism, and economic development opportunities. Contact any of the chambers to find out their specific benefits.

For more information, contact:

Montana Chamber of Commerce

888-442-MONT (6668) ext. 107

Blue Cross Blue Shield of Montana

800-447-447-7828