Health Care and Cafeteria Benefits

Welcome to the Helena School District #1 Health Plan

The Helena School District #1 Health Plan is a Self-Funded Plan.  Allegiance Benefit Plan Management is our third-party Administrator (TPA) to process claims and other administrative functions of our Plan.  Our Pharmacy benefits are through Cigna Insurance.  As you scroll down through this page you will find more information about the Health Plan and options.  You can access the Welcome Packet by clicking on the link below.  Welcome to our School District!

HSD1 Insurance Welcome Packet

Health Benefits Office

The Health Benefits Office is located at 55 South Rodney St in Helena, MT.  The HR Benefits Manager is Richard Franco and you can contact him through email ( or phone (406-324-2008).

Allegiance Plan Management, Inc. Web-site

Employee/Participants – If you have never logged into the Allegiance web site before, click Register New User to create a login Username (ID). You will then be e-mailed a temporary password. If you have already received your temporary password letter, enter the Username (ID) you created during the registration and the password you have received. Be careful to enter the password EXACTLY as it appears in your e-mail, as this site is case sensitive. If you have accessed this site with a login prior to November 2006, then your Username will be your SSN or Alt ID and your password will be the same, just be sure to type your password in ALL CAPS.

If you have any issues logging in, contact Allegiance at 800-877-1122.

All dependents over 18 years of age will need to register and use their own login. If you have not yet logged into our new website you will need to re-request your PIN by clicking on Register New User.

Secured and encrypted, the Allegiance website allows participants access to up-to-date health and flexible benefits plan information twenty-four hours a day.

1. Go to:

2. Click on “Health/Flex Login”

3. Click on “New User” and proceed accordingly if you do not have an account login setup already.

4. If you already have a username and password, then enter: USERNAME and your PASSWORD (case sensitive). A menu of the available services will be displayed.

Health Insurance Plan Description

For PY 2017-18 each full-time employee receives $733.00 per month for 12 months ($879.60/ for 10 months) in cafeteria dollars to apply to the election of a health insurance plan that best meets their needs. Part-time employees receive a pro-rated cafeteria amount based on their full-time equivalency (FTE) (position hours). A summary of health insurance plans available is attached below. The District’s Cafeteria Plan also allows pre-tax dollars to be set aside for items such as child and/or dependent care costs, other benefit premiums such as Life and Disability Insurance and health care expenses not covered by the District’s health insurance. Please contact the Human Resources Benefits Office with any questions.

HB Table for Plans 2017-2018 for 12 MO EE | HB Table for Plans 2017-2018 for 10 MO EE

Health Plan Document

We recommend that you read the plan document carefully, before incurring any medical expenses. If you have specific questions regarding coverage or benefits, you are urged to refer to the Plan Document.

As a result of the Federal government currently writing rules for the new health care reform laws, there maybe a need for required plan changes during the year. Therefore the Health Benefit Plan Document will be sent to your district e- mail in pdf format. You will receive electronic updates when revisions or amendments are added. The most recent up-to-date Health Benefit Plan Document and Summary Plan Description is available by contacting the Human Resource Benefits Office (see below).

HSD1 Plan Document 17-18

If you wish, you may call or write to Allegiance 1-800-877-1122 – P.O. Box 3018 – Missoula, MT 59806 or the HSD#1 Human Resources Benefits Office (324-2008) – 55 S. Rodney – Helena, MT 59601 regarding any detailed questions you may have concerning the Plan.

HSD1 Health Plan Changes for PY 17-18

The document below explains what the differences for this upcoming Plan Year Benefits are in comparison to last Plan Year.

Changes in Health Benefits for 2017-18 Plan Year

Summary of Benefits and Coverage

As required by Affordable Care Act (ACA), we provide a Summary of Benefits and coverage for the Premium and Standard Plans.  The Summary explains what the the Plan covers, what it costs, examples, and other Questions and Answers.

SBC Helena SD #1 Premium Plan PY 17-18 | SBC Helena SD #1 Standard Plan PY 17-18


The Helena School District has an Appeal Process that each member can follow if they are unsatisfied with their initial claims determination by the Third Party Administrator (TPA).  Please see the PDF link below to view the process.  If you should have any questions please contact Rich Franco @ 324-2008.



As required by ACA law, the HSD1 provides notice to inform employees of possible assistance through Medicaid, CHIP, etc.  Also, to inform employees of possible other coverage options through the Health Insurance Marketplace.  If you should have any questions please contact Rich Franco @ 324-2008.

CHIPRA Notice | Health Insurance Marketplace Notice

Recording a Change During Open Enrollment

Open Enrollment – starts mid-August each year – Information for Open Enrollment is mailed prior to school starting and the Online enrollment needs to be completed by the end of the first full week of September of each year.  Open Enrollment is designed for employees to make changes for the upcoming Plan Year (October 1st through September 30th).

To make change during Open Enrollment you will need to change your selection in the employee portal Benefits Enrollment. If you are adding or removing a dependent or spouse, you will need to fill out a Request for Enrollment Change form for that year (located above).  Once open enrollment is closed all enrolled employees will not be able to make any changes. Contact the Human Resources Benefits Office at 324-2008 with any questions.

 Mid Year Changes – “Special Enrollment Period” (Qualifying Event)

“Special Enrollment Period” means a period of time allowed under this Plan, other than the eligible person’s initial enrollment period or late enrollment, during which an eligible person can request coverage under this Plan as a result of certain qualifying events.

Coverage will become effective on the date of the event if the Employee makes a Special Enrollment request, verbally or in writing, within sixty (60) days of any special enrollment qualifying event and application for such coverage is made on the Plan’s “Request for Enrollment Change” form within ninety (90) days of the event.

Employees are able to add/delete dependents during the plan year only if they experience a “qualifying event”. The following are considered qualifying events and are allowed a “Special Enrollment Period”:

Marriage – Birth of a child – Adoption/Pre-Adoption placement – Loss of other coverage – Court Order – Qualified Medical Child Support Order – Divorce – Legal Separation – Death

You must print the “Request For Enrollment Change” below, complete, sign and return to the Personnel Benefit Office at the May Butler Center as soon as you are aware of the change but no later than ninety (90) days from the qualifying event. If the Request for Enrollment Change is not completed and submitted to the Human Resources Benefits Office within the time frame allowed, the dependent will not qualify for a Special Enrollment Period. If you are enrolling/adding a dependent and they had prior insurance coverage you will need to request and submit a Certificate of Credible Coverage from the enrollees prior insurance carrier within thirty (30) days of the date of change noted on the Request for Enrollment Change Form. If the change to your coverage is due to a birth you will need to complete the Request for Enrollment Change without the Social Security number. At such time that you receive the child’s social security number you will need to submit it to the Human Resources Benefits Office at 324-2008 as required by law.

As a reminder; the Mid Year enrollment can change affects your cafeteria payroll withholding (Example: adding your spouse would change your payroll withholding from Single to Single + Spouse) you could possibly see a difference of pay in your paychecks.  Contact your Insurance Manager (324-2008) if you have any other questions.

Request For Enrollment Change 2017-2018

Dental Schedule

The link below is the Dental Schedule for the 2017-2018 Plan Year. The Dental Schedule is designed to show you, the Member, the benefit dollars paid for each Dental Code/Description.  If you aren’t sure how much will be covered, you can always have your Dental Office submit a pre-approval for any procedures done or contact Allegiance Customer Service @ 1-800-877-1122.

2017-2018 Dental Schedule


The link below is the 2017-2018 Plan Document page for Vision Benefits.  If you aren’t sure how much will be covered, you can always have your Vision Office submit a pre-approval for any procedures done or contact Allegiance Customer Service @ 1-800-877-1122.

Vision Benefits 17-18


If you use Costco or other retailers who will not submit pharmacy claims you will need to complete a reimbursement form. Attached below is a claim form from CIGNA for you to complete and submit.  You can also vist and register as a new user (if you haven’t done so) to do Pharmacy price comparisons in your area.

If you are are wanting to save money through a Mail-Order Pharmacy, then below is the Mail Order Forms for Cigna and Ridgeway Pharmacies.  If you have any questions or need help filling this out, contact your HR Benefits Manager.

Cigna Prescription Rx Reimbursement | Cigna Mail Order Form | Ridgeway Mail Order Form

Accident/Injury Benefit

Each employee on the HSD1 Health Plan may be eligible for this benefit.  Please see the link below (Accident Injury Benefit) to see if your claim may qualify or contact Allegiance Customer Service @ 1-800-877-1122.  Please note that only services within 90 days of the injury date are payable.  Charges for Physical Therapy, Occupational Therapy, Speech Therapy, and Chiropractic Care services are specifically excluded under this benefit.

Accident Injury Benefit | Accident Injury Form

FLEX Benefits (125 Plan)

The final date for incurring expenses for the 2016-2017 FLEX Medical Spending Account is December 15, 2017. All participants of this plan have until March 15, 2018 to submit their valid claims to Allegiance for reimbursement. Under the “use-it-or-lose-it” rule, any money remaining in your account after this date will be forfeited! We encourage you to not wait until the final day for reimbursement due to possible tech/website complications.  To find out more about Flex please visit the Allegiance site below.



Below are the Medical Expense Reimbursement Form and Dependent Care Reimbursement Form. You may print these forms, complete them and fax them to Allegiance along with legible copies of the medical receipts and/or Dependent Care receipts. All forms relating to FLEX can also be found at the above link.

Medical Reimbursement Request | Dependent Care Reimbursement Request | Dependent Care Flex Contract | Joint Processing Form | Direct Deposit Form | Allegiance Flex Reimbursement Login Access

Wellness Health Screening & Skin Education Clinic Information

To make a Fall or Spring appointment for the Wellness Health Screenings please log onto this website: -click the green link to Sign up for a Wellness Screening. Please note; you must complete your Health Risk Assessment (HRA) before a screening to be counted towards your incentive.  Make sure to schedule your screening appointment a minimum of 3 days before the screening you wish to attend. You will receive your confirmation email with the date and time of your screening once signed up. To make an appointment for the Skin Education Clinic log on to

Quick Notes:

  • The Wellness Incentive is reimbursed at $33.33 (effective 10/01/16) per month for 12 check employess and $40 per month for 10 check employees over the period of the year, not in a lump sum.  If you are an Active or Retiree member and will go onto other insurance (i.e. Medicare, Other Job, etc.) during any part of the Plan Year, then you will only receive the Incentive for the month’s you are on the District’s Plan.  Example:  You are on the Plan for 4 months, you only receive a total of $133.32 of the Incentive (4 X $33.33). NO exceptions.
  • New this Year! – You can qualify for $100 of the $400 Premium Health Incentive by attending a Wellness Screening and taking your results to your Primary Physician to review.  Have your Primary Physician complete the PCP Follow-up Form (below) and fax to St. Peter’s WellNow! staff, then you automatically qualify for the $100!  Please note this qualifies you for the following Plan Year.
  • The Stepping Out Program is a 6 week course usually held on Tuesdays. Those who do not pass the BMI/Waist Measurement portion of the Premium Incentive are eligible to take the course. Once you complete all 6 weeks, you will be qualified for the BMI/Waist portion of the Incentive. You will also have the opportunity to purchase a Fitbit for $40 and get reimbursed at the end of the class if you attend all 6 weeks. Once all the qualified participants go through the class, then we will be able to allow everyone else through the class.  Please contact Rich Franco for more details.

Remember, this Wellness website is a secure website through St. Peter’s Hospital that will keep your information confidential. You must complete the Wellness Health Risk Assessment (HRA) along with your Health Screening in order to qualify for the Premium Reduction Incentive.

HSD Incentive Info 2017-18 | Wellness Alternative Schedule Options | Wellness Coordinator List 2017.2018 | 2017-2018 Spring Wellness Screening Calendar | Lab Tests Handout | Additional Screening Tests | Wellness Screening Score Card | 2017-18 Wellness Plan Flowsheet | PCP Follow Up Form

Life Insurance

As an employee, you are required to choose a Life Insurance Plan through the HSD1 group policy.  The rates are on the Enrollment sheet link provided below.  You will only need to fill out the Enrollment form if you are applying for Optional (Additional) Life Insurance.  For those who are not New Hires, you will have to complete the Evidence of Insurability form as well.  Please contact Rich Franco (HR Benefits Manager) by email ( if you should have any questions.

Life Insurance Enrollment form 2017-18 Lincoln | Evidence of Insurability Lincoln Financial | Group Benefits LifeKeys

Voluntary Long Term Disability (LTD)

Each year during Open Enrollment eligible employees may elect Voluntary LTD. The Health Benefits Office will typically send out renewal letters to employees, that are already enrolled, just before Open Enrollment begins. However, New Hires that want to opt for this optional election must complete the form on the link provided below. Should you have any questions please contact Rich Franco in Health Benefits.

Assurant LTD | sun-life-assurant-hippa-notice


As a retiree, you should be able to find any information needed in the links provided in the sections above and below.  However, if you do not find what you are looking for, please contact Rich Franco (HR Benefits Manager) by email ( or by Phone (324-2008).

PERS Deduction Form | TRS Deduction Form

Retirement Plans

As a subsidiary of the State of Montana all of our employees are required to belong to either the Montana Public Employees Retirement System (MPERS) or the Montana Teachers Retirement System (MTRS). More information about these retirement systems is available through the personnel office or you can access the following websites.




Costcare walk-in clinic is located across from Burger King by Walmart


Urgent Care

St. Peter’s Urgent Care is located on Ptarmigan Lane located west of Bob Wards Sporting Goods.  This is the only Urgent Care the $10 co-pay applies to, and the co-pay is for the Office Visit only.

St Peters Urgent Care


The Helena Public School District has very low Discount Rates through AFLAC for multiple “Optional” Benefits such as; Short-Term Disability, Life Insurance, Dental, Vision, Accident, Hospital Confinement Indemnity, and much more!  To find out more, just click on the AFLAC booklet link below.


Employee Gym Discounts

We have a few discounts eligible for employees through the Helena Public School District #1.  Currently we have discounts through Crossroads Gym, Fuel Fitness Gym (All Locations: Billings, Bozeman, Butte, Helena, and Missoula), Broadwater Gym, and FireTower Crossfit.  We are working to try and get discounts at other facilities and will update when there’s a resolution.  If you have any questions please contact your Health Benefits Manager (Rich Franco) 324-2008.

Broadwater Gym | Crossroads Gym | FireTower Crossfit | Fuel Fitness Gym