EARNED ELIGIBILITY

Eligibility Requirements
The Health Plan has two levels of benefits, Plan I and Plan II. The amount of your Covered Earnings in your Base Earnings Period determines the Plan for which you qualify. There is also an Alternative Eligibility Program which allows you to qualify for Plan II benefits based on your covered Days of Employment.

Beginning April 1, 2007, there is a third way to qualify for Plan II based on a lower Covered Earnings amount with age and service requirements. See page 2 for more details.

Covered Earnings and Days of Employment
Covered Earnings are those earnings generated theatrical motion pictures, television motion pictures, television commercials, industrial or educational motion pictures, public television, music videos and interactive media projects in accordance with Collective Bargaining Agreements between the Screen Actors Guild and employers in the industry.

If you do not satisfy the Covered Earnings requirements, you may qualify under the Alternative Eligibility Program based on your Days of Employment. Days of Employment are determined by dividing your total sessional earnings by the SAG minimum daily rate, which is based on the type of production. These services must be performed for producers who have signed Collective Bargaining Agreements with the Screen Actors Guild. Only these producers are required to make contributions to the SAG-Producers Health Plan on your behalf.

Minimum Requirements
The minimum requirements for Earned Eligibility commencing on the first day of any calendar quarter in 2007 are outlined below. Calendar quarters start on January 1st, April 1st, July 1st and October 1st. These minimum requirements may increase each year. The Trustees have set a target increase of 3% per year, although they will determine the actual size of the increase based on an annual review of the Health Plan’s financial condition.

Plan I
You must earn at least $28,120 in Covered Earnings in order to generate Earned Eligibility for Plan I.

Plan II
As of January 1, 2007, there are two ways to generate Earned Eligibility for Plan II. One is based on Covered Earnings and one is based on Days of Employment. You must either:

• Earn at least $13,790 in Covered Earnings; or
• Have at least 74 Days of Employment.

For eligibility commencing on or after April 1, 2007, there is a third way to qualify for Plan II if you do not meet either of the requirements listed above. If you are at least age 40 on the first day of your Benefit Period (see page 3), and have at least 10 years of Earned Health Plan Eligibility, you must earn at least $10,000 in Covered Earnings. All years during which you qualified for Earned health coverage will count toward the 10 years, even those for which you chose not to pay the premium.

Special Note Regarding the Alternative Eligibility Program
As previously outlined, the Alternative Eligibility Program allows you to earn a year of Plan II Health Plan coverage based on Days of Employment if you do not meet the Covered Earnings eligibility requirements. The Alternative Eligibility Program also applies to the Pension Plan; however, a Pension Credit earned under this Program may not be applied toward Senior Performers Health Plan eligibility or eligibility under the Extended Spousal benefit.

Non-Covered Earnings
Non-Covered Earnings are those earnings which do not require contributions to be made to the Health Plan; consequently, they are not counted in determining eligibility for benefits under this plan. Some examples of Non-Covered Earnings are:

• Payments for various penalties and allowances, such as meal penalties, payments for rest period violations, traveling, lodging, or living expenses, interest or liquidated damages (late fees), reimbursements for special hair dress, for wardrobe damage or for the use of personal automobile or other equipment.
• Residual payments for the following:
  • Television motion pictures produced prior to June 1, 1960.
  • Television commercials produced prior to November 16, 1960.
  • Theatrical motion pictures produced prior to January 31, 1966, and released to free television. (Theatrical motion pictures produced after that date and released to television after July 31, 1971 may be counted for eligibility.)
  • Earnings in excess of the theatrical and television contribution limits. For a schedule of the applicable “ceiling” amounts, please call the Plan Office.
  • Payments for work performed for a nonsignatory company.

Base Earnings Period
Your Base Earnings Period is the first consecutive four-quarter period in which you meet the Covered Earnings or Days of Employment requirement for Earned Eligibility. Once you have met the minimum Covered Earnings or Days of Employment requirement in the Base Earnings Period you will be entitled to one year of Earned Eligibility in the Health Plan provided you pay the Health Plan premium described on page 4. This year of Earned Eligibility is referred to as your Benefit Period.

You cannot qualify for Plan I and Plan II simultaneously. You will be eligible for the first Plan for which you meet the requirement. Subsequent Covered Earnings or Days of Employment are not considered until your next Base Earnings Period, which will then be used to determine your continuing eligibility status.

In the example below, a participant begins working in covered employment in January. By the end of the second quarter, the participant has enough Covered Earnings to satisfy the Plan II requirement. In determining this, the Plan looks back over the four-quarter period that ends June 30th, even though the participant did not actually start working until January. The Base Earnings Period becomes July 1st through June 30th.

In the next example, the participant starts working in January and satisfies the Plan I requirement by September 30th. The Plan looks back at the four-quarter period ending September 30th and the Base Earnings Period becomes October 1st through September 30th.

Benefit Period
Your Benefit Period is the one-year period of Health Plan coverage that you earn by meeting the Covered Earnings or Days of Employment requirement. The Benefit Period begins three months after the close of the Base Earnings
Period. The three-month waiting period is needed for employers to submit reports of your earnings and for the Plan to process these reports.

The following chart illustrates the four Base Earnings Periods and the four corresponding Benefit Periods.

Eligibility Notification
When you commence or renew eligibility in the Health Plan, you will receive notification from the Plan Office at least 15 days in advance. This Notice of Eligibility (NOE) contains your Health Plan identification cards and it lists your Benefit Period, the Plan for which you qualify (Plan I or Plan II), a list of the benefit coverages you are entitled to receive and a list of your eligible dependents.

If you know you have met the Covered Earnings or Days of Employment requirement but do not receive a Notice of Eligibility, call the Plan Office. Earnings are sometimes reported late by production or payroll companies and this delays us in notifying you of your Earned Eligibility. The Plan Office will help you determine if your earnings have been appropriately reported. If the Plan Office verifies that your earnings have not been reported, you will need to provide copies of your pay stubs and/or contracts for review. Once the Plan Office reviews your proof of earnings and verifies with the employer that the earnings are reportable, you will receive written notification.

You may also verify that your earnings have been reported to the Plan by checking our interactive Web site, ww.sagph.org. Information on registering for a user name and password to access your personal information may be found on page 66. Please keep in mind that the Web site will not reflect total earnings for any particular quarter until 60 days after the quarter ends.

If you change your address you must notify the Plan Office in addition to the SAG Office.

Health Plan Premium
Participants with Earned Eligibility must pay a premium for Health Plan benefits. The premium covers you and your eligible dependents and is payable quarterly, in advance.

• The monthly premium for Plan I is $50.
• The monthly premium for Plan II is $65.

Individuals who are covered under the Total Disability Extension described on page 22 must also pay the premium. The Total Disability Extension, and therefore the premium, only covers the disabled person. It does not include family members, who may have the option of enrolling in the Self-Pay Program. Certain participants do not need to pay the Earned premium:

• Senior Performers who are not required to pay the Senior Performers premium and who regain Earned Eligibility through sessional employment.
• Individuals who meet the age and service requirements for free Senior Performers coverage but have not actually retired and begun receiving a pension.
• Individuals who are not required to pay the Senior Performers premium and who regain Earned Eligibility while covered under the Plan’s Extended Spousal benefit.

Senior Performers Health Plan eligibility is described on page 7, while the Extended Spousal benefit is outlined on page 13.

Quarterly Billing Procedures
Several weeks before the start of each quarter for which you are eligible, you will receive your billing statement and payment coupon. Your billing statement indicates your total account balance for the remainder of your Benefit Period, as well as the minimum payment due for the current quarter. You may pay the premium for more than one quarter at a time. For example, you may pay the pre-mium for your entire current Benefit Period at one time. However, you may not pay the premium for any period beyond your current Benefit Period.

All quarterly payments are due by the 1st day of the calendar quarter. For example, the payment for the first quarter of the calendar (January through March) is due on January 1st. There is a 15-day grace period, however it should only be used for unforeseen circumstances. No reminders to pay the premium are sent by the Plan Office.

Please note that the Earned Premium grace period is shorter than the grace period for the Self-Pay Program. The length of the Self-Pay Program grace period is determined in accordance with federal law.

If your premium payment is not received by the end of the grace period, your Health Plan coverage will be terminated and you will not be eligible for coverage until you qualify for your next Benefit Period. Nor will you be able to enroll in the Self-Pay Program or conversion options. Exceptions to this rule are outlined under “Special Exceptions” on page 11.

Premium Payment Procedures
There are several ways to pay your Health Plan premium.

Pay by Mail – Send your check, money order or cashiers check, along with the payment coupon to the Plan’s Payment Center in the envelope provided. You should not use an overnight delivery service because many of these services will not deliver to a P.O. Box. Do not send your premium payment to the Plan or Guild Offices. Checks should be made payable to “Screen Actors Guild – Producers Health Plan” and must be made from a U.S. bank in U.S. dollars. Please include your account number from the billing statement on your check to ensure proper crediting.

You will receive a premium payment coupon from the Plan if you choose to pay by mail and you may pay for up to four quarters or through the end of your current Benefit Period at one time.

(Registration no longer required).
Pay by Web – This option allows you to pay online with a credit card – Visa, MasterCard, American Express or Discover. It requires that you first register on our Web site, www.sagph.org, to obtain a user name and a password. For more information on the Plan’s interactive Web site, please refer to page 66. You should register well in advance of your premium payment due date because your password is mailed to you from the Plan Office and may take several days to arrive. Payments made through the Web are nonrecurring, which means that the Plan does not store your credit card information and will not automatically charge your credit card every time a payment is due.

You will continue to receive a premium payment coupon from the Plan. If you choose to pay online, simply log in to the secure site and enter your credit card information. You can pay for up to four quarters or through the end of your current Benefit Period at one time and you will get instant confirmation that your payment has been received.

Pay by Phone – This option allows you to pay over the telephone with a credit card – Visa, MasterCard, American Express or Discover. Simply call the Plan Office, access the Automated Information Center (AIC) and follow the prompts. The phone numbers are (818) 954-9400 or (800) 777-4013, outside the Los Angeles area. Pay by phone payments are non-recurring, which means the Plan does not store your credit card information and will not automatically charge your credit card every time a payment is due. Plan Office staff are not available to take your credit card information.

You will continue to receive a premium payment coupon from the Plan. If you choose to pay by phone, simply call the AIC before the due date and provide the necessary information. You can pay for up to four quarters or through the end of your current Benefit Period at one time and you will get instant confirmation that your payment has been received.

Checking and Savings Auto Debit Plan – This option allows you to pay through an automatic recurring deduction from a checking or savings account on a quarterly basis. To set up these payments, you must complete an application and return it to the Plan Office at least 10 days prior to the premium due date. Applications may be obtained by speaking with a Benefit Premium Analyst in the Managed Care Department at the Plan Office or by visiting our Web site, www.sagph.org. Payments are deducted on the 25th of the month before the quarterly premium due date. For example, a payment due on July 1st is deducted on June 25th. You will not receive quarterly coupons in advance once you have enrolled in the auto debit plan.

Any check or debit returned to the Health Plan for any reason will be assessed a handling fee. A cashiers check or money order will be required to replace the premium payment. If you have two or more returned Health Plan premium payments, you will be required to make all your future premium payments with a cashiers check or money order.

Maintaining Earned Eligibility
In order to maintain your Earned Eligibility without interruption you must continue to meet the minimum Covered Earnings or Days of Employment requirement during your established Base Earnings Period every year. You must also pay the applicable Health Plan premium. Once you have established Earned Eligibility, your Base Earnings Period and Benefit Period will not change unless you have a break in coverage due to failure to meet the minimum requirement.

If you do not meet the minimum requirement in your established Base Earnings Period, you will no longer be eligible for Earned Eligibility in the Health Plan. To requalify for Earned Eligibility, you will have to meet the Earned Eligibility requirements outlined on page 2

Extended Coverage for Military Service
In accordance with the Uniformed Services Employment and Re-Employment Rights Act of 1994 (USERRA), the Plan provides certain benefits for participants who have military service which started on or after October 13, 1994. Your military service must be with the Armed Services as defined in USERRA on a voluntary or involuntary basis. You will have the choice of using your Earned Eligibility prior to enrolling in the Plan’s Self-Pay Program, or immediately enrolling in the Plan’s Self-Pay Program and freezing your Earned Eligibility for up to five years of uniformed service. In either case, the Health Plan Earned or Self-Pay premium will be waived for up to 24 months. Upon your return from military service, you may use any frozen Earned Eligibility, provided you notify the Plan Office of your intent to resume coverage and that coverage is resumed within one year of your return from uniformed service. Please contact the Plan Office for additional information if you are going to serve or have served in the military.