• Eligibility Requirements



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    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 qualify for Alternative Earned eligibility if you work the required number of days in covered employment and pay the required premium.

    Your Benefit Period is determined when you meet the minimum earnings or days worked requirements for four consecutive quarters. 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 continuing coverage.

    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 Benefit 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 Period. All periods begin and end on calendar quarters.

     
  • 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 $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.

     
  • Premium

    All participants are required to pay a 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. If you have Earned or Earned Inactive Eligibility and you also meet the requirements for Senior Performer coverage (with at least 20 pension credits), you will pay the $50 monthly Senior Performer premium for participants with no spouse or with a spouse or same-sex domestic partner age 65 and over or the $100 monthly Senior Performer premium for participants with a spouse or same-sex domestic partner under age 65. You will also pay the $50/$100 monthly premium if you meet the Senior Performer requirements but are not yet receiving your pension.

    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 premium information, click here.

     
  • Spouses, Dependents, and Domestic Partners

    Your legal spouse and dependent children can be enrolled in the Health Plan. You may be required to provide a copy of certain documents for verification.

    Your same-sex domestic partner may be covered as long as you meet the rules and complete the enrollment package.

    It is your responsibility to notify the Plan Office when there is a change in your dependents.

     
  • Loss of Coverage

    You (the participant) lose coverage if:

    1. You do not continue to meet the minimum earnings or days worked 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.

     
  • 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
     
  • 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. There is a $50 per month premium for this coverage for participants with no spouse or with a spouse or same-sex domestic partner age 65 and over. There is a $100 per month premium for Senior Performers coverage for participants with a spouse or same-sex domestic partner under age 65. These premium amounts 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 secondary to Medicare. They 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.