Health Benefits Overview

Who is eligible for health coverage?

• A classified or exempt permanent employee of the State of Vermont who is expected to work at least 1,040 hours per year (e.g., .5 FTE, 20 hours/week).
• The spouse of an eligible employee. In the case of a divorce, a spouse must be removed from coverage on the date of the final divorce decree.
• The domestic partner of an eligible employee. See instructions regarding additional documentation required.
• The children of an eligible employee, and/or the children of an eligible employee's domestic partner. Adult children under the age of 26 may remain on the plan regardless of marital or professional status. The last day of coverage is the date of the 26th birthday. Disabled adult children may qualify for a contunuation of benefits. Contact DHR.Benefits@vermont.gov for information.

Declaration of Health Insurance Coverage

All employees should annually submit their declaration, particularly any employee who is not covered by the State of VT employee health insurance, due either to ineligibility or access to alternate coverage. The declaration is located in VTHR . Navigation to the form is as follows:

MAIN MENU > SELF SERVICE > BENEFITS > DECLARATION OF HEALTH COVERAGE
 

Medical/Dental Enrollment form (pdf)

Health Premiums for 2024 (Active Employees) (pdf)

Health Premiums for 2025 (Active Employees) (pdf)

What is the difference between the two medical plans?

How much will my benefits cost me?

There is a bi-weekly premium associated with each plan in addition to your co-pays and deductibles.

When will my benefits start?

How do I enroll as a new employee?

All new employees have up to 60 days from their date of hire to enroll, and must contact the Employee Benefits Unit at DHR.Benefits@vermont.gov with the following information:

• Name
• Employee ID number
• Date of hire
• If seeking a waiver of the 30-day waiting period, attach documentation to your email that confirms the termination date of your current/previous coverage (e.g., a letter from your employer or the insurance company, a COBRA letter, a HIPPA statement)

How do I enroll in benefits if I didn't elect coverage within 60 days of my hire date?

Outside of the November Open Enrollment period, in order to enroll in benefits if you did not elect when you first started you must provide proof of a qualifying event. Examples include: having a baby, getting married, or losing health coverage (through no fault of your own). Employees have up to 60 days from the date of the qualifying event to enroll in benefits and must contact the Employee Benefits Unit at DHR.Benefits@Vermont.gov with the following information:

• Name
• Employee ID number
• Date of qualifying event
• Attach a document certifying the qualifying event , such as a birth certificate, marriage certificate, proof of loss of coverage

How do I find a network provider?

Employees can search in-network providers by going to the following websites. You may also contact your preferred provider's office and ask if they are in the BCBS network.

How do I add a Domestic Partner to my plan?

The State of Vermont offers coverage to Domestic Partners of employees. In order to be eligible to enroll a Domestic Partner, you must certify that the following criteria applies to you and your Domestic Partnership:

1. You are each other’s sole domestic partner and have been in an exclusive and enduring domestic relationship, while sharing a residence, for not less than six consecutive months prior to the submission of this application.
2. You are both eighteen years of age or older.
3. Neither one of you is married to anyone.
4. You are not related by blood closer than would bar marriage under Vermont State law.
5. You are both competent to enter into a legally binding contract.
6. You have agreed between yourselves to be responsible for each other’s welfare.

Note: Outside of the Open Enrollment month of November, there must be a qualifying event within the past 60 days in order to add a domestic partner to coverage (e.g., involuntary loss of coverage, birth, meeting the six-month co-residency requirement, etc.)
Employees must complete the Domestic Partner Application, along with the Medical/Dental enrollment form, and send them to DHR.Benefits@vermont.gov

Domestic Partner Application (pdf)
 

What would be the additional cost for adding a Domestic Partner to my plan?

Along with the additional premium associated with adding an individual to your plan, adding a Domestic Partner also has tax implications. The Domestic Partner tax is known as an imputed income tax. The imputed income tax is calculated by adding your share and the state’s share of the domestic partner's premium to your gross income. Payroll then calculates your tax contribution for federal, state, social security, etc., using the higher imputed gross income rate. Once calculated, the state share amount is removed from your gross earnings resulting in less take home pay. Because there are many factors involved in this calculation such as rate of pay, tax withholdings, etc, the Benefits Unit is unable to provide a figure on the additional imputed income tax fee. However, employees can consult with their tax preparer to get a better idea of the overall impact.

What is an annual Open Enrollment period?

An annual Open Enrollment period is a time when you can switch medical plans and/or add dependents to your plan without a qualifying event (e.g., birth, marriage, loss of health coverage). You may cancel coverage or remove a dependent from your medical plan any time during the year.
The State of Vermont’s annual Open Enrollment period begins Nov 1^st of each year and ends Nov 30^th with changes becoming effective on Jan. 1^st of the new plan year.

How do I find out what plan I am in or who is covered under my plan?

Your plan enrollment information can be viewed through your employee self-service portal in VTHR (the same system used for coding  your timesheet). You can go to Main Menu, Self Service, Benefits Summary. Once there you will be able to see the current plan you are enrolled in or, by adjusting the view date, you can see benefits as of a specific time. If you would like to see who is enrolled on your plan, just click the Medical or Dental hyperlink and you should be able to view your dependents. As always, please feel free to contact Benefits should you have additional questions at 802-828-6700 (option 1, option 3) or email us at DHR.Benefits@Vermont.gov .

As an active employee, do I need to enroll in Medicare Part B when I turn 65?

When you turn 65, you will receive information from Social Security informing you of your automatic enrollment in Medicare Part A. You will also be asked if you wish to enroll in Part B.  Active employees who are enrolled in medical benefits can defer enrollment in Medicare Part B until they retire, Your State of Vermont employee medical plan will continue to be your primary coverage for all medical services. If  a dependent on your active employee medical plan is turning 65, they can also defer enrollment in Medicare Part B until you retire. The exception is domestic partners, who must enroll in Medicare Part B when they become eligible at age 65. 
Once you retire or terminate employment with the state, you and your dependents must apply for Medicare Part B immediately, if you are already eligible (65 and over), or when you become eligible.  Forms can be obtained from Social Security and if needed, the Employee Benefits can complete the sections certifying your employee coverage. All forms can be sent to DHR.Benefits@Vermont.gov

How do my benefits differ as a retired state employee?

2024 Retiree Health Premium Chart (pdf)

2024 Medicare Drug Formulary (pdf)

2025 Medicare Drug Formulary (pdf)

Who do I call if I have questions?

If you have any questions please feel free to contact the Employee Benefits Unit at 802-828-6700 (option 1, option 3) or email us at DHR.Benefits@Vermont.gov. Please also see the below contacts should you want to contact our plan administrators directly.