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| Now Showing: Health Benefits Summary |
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General Description
View SPD
| Starting January 1, 2003, Earned eligibility is based on:
1. the amount you earn from producers who are signatory to collective bargaining agreements with Screen Actors Guild - called covered earnings, AND
2. the timely payment of your premium.
The Health Plan also has an Alternative Eligibility Program in the event you do not meet the minimum covered earnings requirement. You will have Alternative Earned eligibility if you work the required number of days in covered employment and pay the required premium.
Your covered earnings and days of employment for the previous consecutive four quarters are totaled at the end of each calendar quarter until you earn eligibility. The four-quarter period in which you first meet the earnings or days requirement establishes your "base earnings period". Once your base earnings period is established, the same period will be used each year to determine your eligibility for the next period.
Once you meet the eligibility requirement you are eligible for 12 months of Health Plan coverage provided you pay the required premium. Your coverage - "benefit period" - starts three months after the end of your base earnings period as shown on the following chart:
| Base Earnings Period |
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Benefit Eligibility Period |
| Jan 1 - Dec 31 | |
April 1 - March 31 |
| April 1 - March 31 | |
July 1 - June 30 |
| July 1 - June 30 | |
Oct 1 - Sept 30 |
| Oct 1 - Sept 30 | |
Jan 1 - Dec 31 |
Note that there is a 3-month period between the end of the base earnings period and the beginning of the benefit eligibility period. All periods begin and end on calendar quarters.
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| Earned Eligibility and Alternative Eligibility |
Minimum Health Plan Eligibility Requirements |
Eligibility Commencing |
Plan I |
Plan II |
January 1, April 1, July 1, or October 1, 2011 |
$30,150 |
$14,800; or 76 days or 10,700* if you are at least 40 years of age with 10 years of Earned Eligibility. |
January 1, April 1, July 1, or October 1, 2012 |
$30,750 |
$15,100; or 76 days or 10,900* if you are at least 40 years of age with 10 years of Earned Eligibility. |
These minimum requirements may increase each year. The Trustees have set a target increase of 3% per year, however they will determine the actual size of the increase based on an annual review of the Health Plan's financial condition. |
*This eligibility requirement is referred to as the Plan II age and service requirement.
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| Premium |
Participants with Earned, Earned Inactive or Alternative Eligibility are required to pay a quarterly premium. The three-tiered premium structure allows participants to choose a rate based on the number of dependents they elect to cover under the Plan. The quarterly premium rates are outlined below.
| Coverage for: |
Plan I |
Plan II |
Plan II Age and Service* |
| Participant only |
$273 quarterly |
$324 quarterly |
$414 quarterly |
| Participant plus 1 dependent |
$315 quarterly |
$372 quarterly |
$477 quarterly |
| Participant plus 2+ dependents |
$342 quarterly |
$405 quarterly |
$519 quarterly |
* This premium applies to participants who qualify at the lower earnings amount because they are at least age 40 and have at least 10 years of Earned Eligibility.
For more information on enrollment, please click here. |
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| Spouses, Dependents
| Your legal spouse and dependent children up to age 26 may obtain coverage along with you. To include your legal spouse and dependent children you must complete an enrollment process and pay the appropriate premium. You may be required to provide copies of certain legal documents for verification purposes. | | |
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| Domestic Partners | Your same-sex domestic partner and your partner's children may obtain coverage as long as you meet the Plan requirements, complete the enrollment package, and pay the appropriate premium. | | |
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| Loss of Coverage
| You (the participant) lose coverage if:
1. You do not continue to meet the Earned, Earned Inactive or Alternative eligibility requirements during your designated base earnings period, or
2. You do not pay your premium.
In general, your dependent children, spouse, or domestic partner lose coverage when you lose coverage or when they cease to be a dependent child, legal spouse, etc. as defined by the Plan.
When you lose coverage, the Plan Office will send you a notice outlining your available options. If you lose coverage due to failure to pay your premium, you will not be entitled to Health Plan coverage for the remainder of your current eligibility period.
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| Self-Pay | Self pay coverage is available to participants (and their dependents) who lose coverage as outlined above. It is not available if the loss of coverage is due to failure to pay the Earned premium.
Plan I Self-Pay is available to participants covered by Plan I Earned Eligibility. It provides the same coverage as Plan I Earned coverage except for life insurance and AD&D benefits. Dental is automatically included.
Plan II Self-Pay is for participants covered by Plan II Earned or Alternative Eligibility. It is also available as an option to participants covered by Plan I Earned Eligibility. Plan II Self-Pay provides the same coverage as Plan II Earned coverage. Dental is automatically included for participants who had dental coverage under their Earned coverage.
Additional Extensions to Eligibility
Extended Spousal Benefit
Extended Self-Pay Coverage for Military Service
Total Disability Extension
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| Senior Performers Eligibility | You are eligible for Senior Performers coverage if you are receiving a pension from the SAG-Producers Pension Plan based on at least 20 Pension Credits. Effective 1/1/2010, there will be a $25 per month premium for this coverage. The $25 premium will also apply to participants described in the Exception below. If you have at least 15 but less than 20 Pension Credits, you can obtain Senior Performers coverage by paying a premium equal to 25% of the actual cost of the coverage.
Exception: Participants who have at least 10 Pension Credits as of December 31, 2001 and are at least age 55 as of December 31, 2002, are eligible for Senior Performers coverage when they reach age 65 and are receiving a pension.
Important: Pension Credits earned under the Alternative Eligibility Program do not count towards eligibility for Senior Performers coverage.
The benefits provided under Senior Performers coverage are the same as those provided under Plan I Earned Eligibility except that the life insurance amount is $5,000 and there are no accidental death and dismemberment benefits. The Health Plan does not reimburse the Medicare Part B premium.
Senior Performers Health Plan benefits are not vested benefits. They may be amended or discontinued at any time by action of the Board of Trustees. | | |
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| Eligibility Rules Sheet | | |
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