STATE OF VERMONT EMPLOYEE MEDICAL INSURANCE

2025 Medical Plan Premium Rates (Active Employees)

2025 National Prescription Drug Formulary Prescription Drug Plan Document

SelectCare Plan Summary SelectCare Detailed Plan Document
TotalChoice Plan Summary TotalChoice Detailed Plan Document

Vision Benefit

Hearing Aid Benefit

BLUE CROSS/BLUE SHIELD - FINDING NETWORK PROVIDERS

QUALIFYING EVENT: SELF OR DEPENDENT'S LOSS OF COVERAGE

QUALIFYING EVENT: ADDING NEWBORN, NEW SPOUSE TO COVERAGE

CANCELLING COVERAGE/REMOVING DEPENDENTS

To order/reorder subscriber cards for you and dependents, call Blue Cross/Blue Shield customer service at 888-778-5570

HEALTH PLAN FACTS

HOW DO I KNOW IF MY DOCTOR IS IN NETWORK? AM I COVERED OUTSIDE OF VERMONT?

The easiest way to determine if your doctor is in the BCBS network is to phone their office and ask.
You can also use the Find A Doctor tool on the BCBS website.
Nationwide, more than 1.7 million doctors and hospitals contract with Blue Cross Blue Shield. You will be able to find network doctors in every zip code in the country, and you are also covered if traveling out of the country.
Find more information on Coverage While Traveling or Living Abroad.

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.
Eligible State of Vermont retirees. See "Tools for Retiring Employees" for info.

ENROLLMENT PERIODS: WHEN CAN I ENROLL?

New employees have a 60-day open enrollment period that begins on their date of hire (first day of work). There is currently no waiting period for coverage. See "Tools for New Employees" for information.
Existing employees and/or dependents who have experienced a qualifying event (loss of other coverage, birth, marriage, divorce, adoption, etc.) have a 60-day open enrollment period, beginning on the date of the qualifying event, to enroll and/or add dependents.
All other eligible employees have an opportunity to enroll, add dependents and/or change plans once a year during the November Open Enrollment season. Changes made take effect on the following January.

QUALIFYING EVENT: HOW DO I ENROLL MYSELF AND/OR A DEPENDENT
IF THERE'S BEEN A LOSS OF COVERAGE?

Outside of the annual Open Enrollment period, employees may enroll if they experience a loss of coverage within the past 60 days.
They may also add dependents to their existing plan if the dependent lost coverage within the past 60 days.
Email DHR.Benefits@vermont.gov and attach:

A completed Enrollment/Change form; and
Documentation of coverage loss, including dependent name and termination date.

QUALIFYING EVENT: HOW DO I ADD A NEWBORN
AND/OR NEW SPOUSE TO MY PLAN?

For employees with existing coverage, the newborn is automatically covered under the existing level of coverage for the first 60 days after the date of birth. To enroll the baby on your plan as a dependent email DHR.Benefits@vermont.gov and attach:

A completed Enrollment/Change form; and
A copy of the birth certificate and/or marriage certificate.

Enrollment of the newborn must be completed no more than 60 days after the date of birth.

QUALIFYING EVENT: HOW DO I ADD MY DOMESTIC PARTNER TO MY PLAN?

Domestic partners of employees may be added during any of the enrollment periods noted above. Email DHR.Benefits@vermont.gov, attaching:

A completed and notarized Enrollment/Change form with Domestic Partner Affidavit

If outside the annual Open Enrollment period, documentation of coverage loss, including dependent name and termination date; or documentation within 60 days of completing six months of co-residency (copy of lease, utility bills, etc.)

HOW DO I GET A BCBS SUBSCRIBER CARD/REPLACEMENT
FOR MYSELF AND/OR DEPENDENTS?

Subscriber cards are mailed to the employee and all dependents on the plan approximately two weeks after enrollment. Replacement cards can be ordered by emailing DHR.benefits@vermong.gov

CAN MY ADULT CHILD REMAIN ON MY PLAN?

Adult children under the age of 26 may remain on the plan regardless of marital or professional status.
The last day of coverage for a dependent turning 26 is the date of the 26th birthday. Coverage terminates automatically and a COBRA offer will be mailed approximately two weeks later.

Disabled Adult Children turning 26 may qualify for a continuation of benefits. Contact DHR.Benefits@vermont.gov for information.

HOW DO I CANCEL COVERAGE FOR MYSELF AND/OR DEPENDENTS?

Employees can cancel their own medical plan or remove dependents any time during the year for any reason. Simply email DHR.Benefits@vermont.gov with your request, the effective date and your Employee ID#. When removing dependents, specify the dependent to remove and the effective date.

To order/reorder subscriber cards for you and dependents, call Blue Cross/Blue Shield customer service at 888-778-5570

HEALTH PLAN FACTS

HOW DO I KNOW IF MY DOCTOR IS IN NETWORK? AM I COVERED OUTSIDE OF VERMONT?

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.

Eligible State of Vermont retirees. See "Tools for Retiring Employees" for info.

ENROLLMENT PERIODS: WHEN CAN I ENROLL?

New employees have a 60-day open enrollment period that begins on their date of hire (first day of work). There is currently no waiting period for coverage. See "Tools for New Employees" for information.

Existing employees and/or dependents who have experienced a qualifying event (loss of other coverage, birth, marriage, divorce, adoption, etc.) have a 60-day open enrollment period, beginning on the date of the qualifying event, to enroll and/or add dependents.

All other eligible employees have an opportunity to enroll, add dependents and/or change plans once a year during the November Open Enrollment season. Changes made take effect on the following January.

QUALIFYING EVENT: HOW DO I ENROLL MYSELF AND/OR A DEPENDENT IF THERE'S BEEN A LOSS OF COVERAGE?

Outside of the annual Open Enrollment period, employees may enroll if they experience a loss of coverage within the past 60 days. They may also add dependents to their existing plan if the dependent lost coverage within the past 60 days. Email DHR.Benefits@vermont.gov and attach:

A completed Enrollment/Change form; and

Documentation of coverage loss, including dependent name and termination date.

QUALIFYING EVENT: HOW DO I ADD A NEWBORN AND/OR NEW SPOUSE TO MY PLAN?

For employees with existing coverage, the newborn is automatically covered under the existing level of coverage for the first 60 days after the date of birth. To enroll the baby on your plan as a dependent email DHR.Benefits@vermont.gov and attach:

A completed Enrollment/Change form; and

A copy of the birth certificate and/or marriage certificate.

​Enrollment of the newborn must be completed no more than 60 days after the date of birth.

QUALIFYING EVENT: HOW DO I ADD MY DOMESTIC PARTNER TO MY PLAN?

Domestic partners of employees may be added during any of the enrollment periods noted above. Email DHR.Benefits@vermont.gov, attaching:

A completed and notarized Enrollment/Change form with Domestic Partner Affidavit

If outside the annual Open Enrollment period, documentation of coverage loss, including dependent name and termination date; or documentation within 60 days of completing six months of co-residency (copy of lease, utility bills, etc.)

HOW DO I GET A BCBS SUBSCRIBER CARD/REPLACEMENT FOR MYSELF AND/OR DEPENDENTS?