SUMMARY PLAN DESCRIPTION (SPD)  This document provides detailed information about covered services, plan limitations and exclusions, and eligibility for coverage under the MUST benefit plans.

BENEFIT SUMMARY  This is an easy-to-use reference guide to the benefits available in each MUST plan. This document is intended only as a summary and does not supersede the more detailed information provided in the Summary Plan Description.

KALISPELL BENEFIT SUMMARY  This version of the Benefit Summary is specific only to the Kalispell plan. 

The mission of the Montana Unified School Trust is to be the benefits provider of choice for Montana's school-related group health plans. MUST provides multiple benefit plans, excellent customer service, cost-effective management, and a solid financial base. Benefit design options, coupled with multiple deductible selections, enable educational communities to tailor their plans to local needs.

• Revised Major Medical Plan (RM).  This plan is similar to the Comprehensive Major Medical plan, with the addition of “first dollar” coverage (deductible waived) for doctor’s office visits, diagnostic X-ray and lab services, and chiropractic care. A range of deductible options is available.

• Comprehensive Major Medical Plan (CM).  This plan provides broad coverage with a wide range of deductible options.

• Value Major Medical Plan (VM). This plan provides broad coverage with limited deductible options and lower coverage limits. This plan includes pharmacy coverage with a pre-set maximum benefit.

• Basic Medical Plan (BP).  The Basic plan provides reduced benefits and plan maximums for those who desire less coverage at a lower premium. This plan does not include pharmacy or chiropractic benefits.  (No minimum employee participation required.)  

• HSA-Qualified Plans (HM/HE).  These plans satisfy federal requirements for employees who wish to open a Health Savings Account (HSA) and provide broad coverage with a single deductible and out-of-pocket maximum for both medical and pharmacy charges.  (No minimum employee participation required.)

Preventive Benefit

In addition, all plans provide preventive (wellness) benefits with no deductible. This provides a tremendous value to all members, encouraging them to obtain annual checkups, well-child care, and other preventive exams with little or no out-of-pocket expense.

Pharmacy Benefit Plan 

The Comprehensive Major Medical, and Revised Major Medical plans have a separate pharmacy benefit with a $50 deductible per individual, and tiered co-payments for generic, preferred, and non-preferred drugs. The Value Plan has a $350 deductible per individual, no Maximum Out-of-Pocket, and a $5,000 maximum benefit.

Basic and Health Savings Account (HSA)-qualified plans do not have a separate pharmacy benefit. Please note:

• If you are enrolled in the Basic Plan, you pay for your own prescriptions.
• If you are enrolled in the HSA-qualified plan, you pay for your own prescriptions and may apply the cost toward your medical deductible. Once your medical deductible has been met, your prescriptions are eligible for coverage the same as any other medical service.

Dental and Vision Plans

School districts may elect to include Dental and/or Vision coverage with their medical plan.  Beginning with the 2009 renewal, Dental and/or Vision coverage are available to all groups with rates tiered according to internal participation levels.