Written by a parent, not a doctor. Nothing here is medical advice.

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Montana program

Keep an insured work plan when hours drop

A Montana rule can keep an insured work plan during reduced hours with the employer’s agreement.

What it is

A Montana rule can keep an insured work plan during reduced hours with the employer’s agreement.

Reduced hours need not always end your child’s current plan. Montana offers a continuation rule during employment. A separate conversion rule offers a different individual policy when group coverage ends.

Eligibility rules
  • Reduced-hours continuation requires continued employment and employer or trustee consent.
  • Conversion needs three months of prior group coverage.
  • This is an insurance-policy rule, not a promise for every private self-funded plan or every public plan. A reduced-hours worker must still be employed and have employer or trustee consent for the one-year continuation. Conversion is separate: the statute generally requires three months of prior coverage and a request plus initial premium within 31 days, with exclusions and premium limits. Your social worker can help the benefits office compare the actual conversion offer, group continuation and federal COBRA, including the rules for a public employer.
What you get
  • Up to one year of insured group coverage during reduced hours with consent.
  • Conversion to an individual policy when its conditions are met.
What it covers
  • If hours drop, you can keep the group plan for up to a year at the normal price if the employer agrees. If the plan ends, the insurer must offer you an individual policy within 31 days, at up to double the group price; the benefits and doctors can differ.
If you decide to apply
  1. Ask the benefits office to compare continuation, conversion and federal COBRA in writing.
  2. Bring the planned work change, coverage end date and plan booklet.

The employer or the fund’s trustees, and the insurer · Official page ↗

After you ask
  • The employer and insurer can confirm premiums, consent and coverage dates.
Good to know

Conversion changes the policy. Its application and first payment are due within 31 days after group coverage ends.

Other details
  • The one-year rule is not a general promise after resignation or job loss.
Official sources
Ask your social worker

“Could we keep our plan if I reduce hours? What would each option cost and change about care, and could you help compare the paperwork?”

Why I’m asking: I want to understand how a work change could affect our treatment network.

More background and detailed requirements
Additional program information and published rules

Who does what

The three parts, side by side. The agency decides; nobody on this page does.

You

Ask in writing before the change, and keep the answer.

Your social worker

The social worker compares keeping the plan with Montana Medicaid before you decide.

The care team

Records and letters when the application asks for them.

Who decides
The employer or trustees consent; the insurer issues the conversion policy.
Ask HR
“If I cut my hours to care for my child, will you agree to keep me on the group plan under Montana’s reduced-hours continuation rule? If coverage has to end, what is the conversion option and its deadline?”

How to apply

First step: Email the benefits office this week and ask, in writing, what happens to the plan if your hours drop.

  1. Before hours drop, ask the benefits office in writing to keep the plan running under the reduced-hours rule.
  2. If coverage is ending, diary the 31st day for conversion and compare it with the Marketplace and with Montana Medicaid.

Official application / program page ↗

Where it starts: Ask the benefits office in writing before the change takes effect.

What to gather

  • Your written request and the employer’s answer
  • The plan booklet
  • The date coverage would end

How long: Conversion has a hard 31-day deadline from the end of group coverage.

What a yes looks like

A written confirmation that the plan continues, with the premium named.

What a no looks like, and the next move

A refusal to consent. Then compare federal continuation, the Marketplace within 60 days, and Montana Medicaid on this month’s income.

Watch out

  • The one-year rule needs the employer to agree, so ask before the change, not after.
  • Conversion is a new individual policy, not the same plan, and the window is 31 days.
  • These sections do not settle a self-funded or government plan; ask the administrator.

The numbers and the rules

The arcane layer, kept on purpose. Checked September 11, 2026.

What it is worth

Up to one year of the same insured group plan during reduced hours, with consent; or conversion to an individual policy within 31 days of coverage ending.

  • $1 — Maximum reduced-hours continuation during employment
  • $31 — Days to apply and pay for conversion after group coverage ends
  • $3 — Months of prior group coverage needed for conversion

Legal protection: Reduced hours need not end the group plan when the employer or trustees consent · A conversion policy is available to an insured member or dependent within 31 days

What it costs the family: Reduced-hours continuation uses the normal group-class premium. Statutory conversion premium ceilings are generally 200% of the usual group rate, or 150% after more than three years insured, with separate basic-coverage options. The insurer confirms the applicable exclusions, benefits and actual premium.

The eligibility facts, as published

Plan type
a policy issued to an employer or to the trustees of an employer fund; self-funded and some public plans are not settled by these sections
Continuation
during continued employment on reduced hours, for one year, with employer or trustee consent
Conversion
three months of prior group coverage, application and payment within 31 days of termination

The trap: The one-year reduced-hours rule needs the employer or trustees to consent, so it is a conversation, not a right you can claim after the fact. Conversion is a different, weaker thing: a new individual policy, not the same plan.

Where I read this

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