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  Now Showing: Premium Rules
 

Health Premium Payment Rules

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Health Premium Payment Rules for Earned and Earned Inactive Coverage
Earned Premium Payment Options
Sample Billing Statement and Payment Coupon
Questions & Answers

 

Beginning January 1, 2003, all Earned and Earned Inactive Participants are required to pay a monthly premium for their Health Plan coverage. Below is information regarding the premium. For more information on the Self-Pay program and premium, click here.

PREMIUM PAYMENT RULES FOR EARNED AND EARNED INACTIVE COVERAGE

Premium Requirements - All Earned and Earned Inactive Participants who do not meet the requirements for Sr. Performer’s coverage are required to pay a premium for Health Plan coverage. One premium covers you and all of your eligible dependents. The amount of premium depends on the Plan for which you qualify as follows:

Plan I
$150 quarterly
Plan II
$195 quarterly

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. The billing statement will indicate your total account balance for the remainder of your Eligibility Period as well as the minimum payment that is due for the current quarter. You may pay the premium for more than one quarter at a time. For example, you may pay the premium for your entire current Eligibility Period in one payment. However, you may not pay the premium for any period beyond your current Eligibility Period.

Time Limits for Payment - Your payment is due by the first day of each calendar quarter for which you qualify for coverage. For example, the payment for the first quarter of the calendar year (January through March) is due on January 1. There is a 15-day grace period. The due date is the 1st, not the 15th and applies even when traveling. The grace period is for unforeseen circumstances.

Payment Options and Procedures

  • Pay by Phone
    You may pay your premium over the telephone with a credit card. Simply call the Plan office and use 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. If you choose to pay by phone, simply call the AIC before the due date and provide the necessary information. You will receive instant confirmation your payment has been received. For your security, this is an automated system and Participant Service Representatives will not be able to take your credit card information.

  • Pay by Web
    You may pay your premium online with a credit card. Simply login to our secure Web site here and enter your credit card information. You can pay for up to four quarters at one time. You will receive instant confirmation that your payment has been received.

    For your protection, pay by web and pay by phone payments are non-recurring which means that the Plan will not store your credit card information and will not automatically charge your credit card every time a payment is due.

  • Pay by Auto Debit
    The Auto Debit Plan deducts your quarterly premium automatically on a recurring basis each quarter from a checking or savings account. Payments are deducted on the 25 th of the month prior to the due date. The Health Plan will continue to deduct your quarterly premium as long as you remain continuously eligible for Earned coverage, even if there is a change in the premium rate because you moved from Plan I to Plan II or vice versa. Call the Plan Office.

  • Pay by Check
    You may pay your premium by check, money order or cashiers check by mailing your payment, along with the payment coupon to the Plan’s Payment Center in the envelope provided. Your payment must be received at the Payment Center no later than the end of the grace period to be considered timely. DO NOT SEND YOUR PREMIUM PAYMENT TO THE PLAN OFFICES OR TO THE GUILD OFFICE. Checks should be made payable to: “ Screen Actors Guild – Producers Health Plan ”. Be sure to include the account number from the billing statement on your check to ensure proper crediting. Do not send cash or checks from non-US banks.

Termination of Earned or Earned Inactive Coverage - If the Plan does not receive your quarterly premium by the due date, your Earned or Earned Inactive coverage will be terminated. You will not be entitled to any coverage under the Health Plan until your next Eligibility Period, with the exceptions outlined below. You will not be entitled to self-pay coverage under the Health Plan nor will you be entitled to any conversion options if your coverage is terminated due to failure to pay your premium.

For example: If your Eligibility Period is January 1, 2004 through December 31, 2004 and you fail to pay your first quarterly premium by January 15, 2004, your coverage will be terminated effective January 1, 2004. You will not be entitled to any Health Plan coverage until January 1, 2005, provided you re-qualify for coverage by meeting the minimum earnings requirement.

Special Note
If your coverage in this Plan is terminated because you do not pay your premium, your coverage under other plans may be reduced or eliminated. You should contact your other plan for further information.

Special Exceptions

New Dependents : If you do not pay the premium and subsequently acquire a new dependent as a result of marriage, birth, adoption or placement for adoption, you may be eligible to participate in this Health Plan prior to your next Eligibility Period. You must request coverage under this Plan within 30 days of the date of marriage, birth, adoption or placement for adoption.

Other Coverage : If you do not pay the premium because you have other health coverage, you may be allowed to participate in this Health Plan when your other coverage ends because of a reduction in employment, legal separation, divorce or death. If the other coverage is under a COBRA provision and you exhaust your COBRA coverage, you may also be allowed to participate in this Health Plan. You must request coverage under this Plan within 30 days after your other coverage ends.

Traveling is not considered a special exception.

Questions?
If you have any questions about the Plan rules for premium payments, please contact the Plan Office. Information about these rules, payment options and all other Health Plan benefits can also be found on the Plan’s Web site: www.sagph.org.

Earned Premium Checking and Savings Auto Debit Plan

You can enjoy the security of knowing that your quarterly premium is on time with the Screen Actors Guild - Producers Health Plan’s Auto Debit Plan option.

The Auto Debit Plan deducts your quarterly premium automatically on a recurring basis each quarter from a checking or savings account. Payments are deducted on the 25th of the month prior to the due date (e.g. June 25th for 3rd quarter, July through September premium).

Complete and sign the application. Please be sure to include the complete bank information. Applications must be received in our office 10 days prior to the quarterly premium due date.

You will be assessed a $10.00 handling charge on a declined Auto Debit transaction. Replacement transactions must be in the form of a cashier’s check or money order. If transactions are returned three (3) times, your Auto Debit privileges will be cancelled.

The Health Plan will continue to deduct your quarterly premiums as long as you remain continuously eligible for Earned coverage, even if there is a change in the premium rate because you move from Plan I to Plan II or the reverse. You will be notified, in advance, of any change in your eligibility status and premium rate. Cancellation of the Auto Debit Plan requires a written request from you to withdraw from the program. All requests must be received in our office prior to the 10th of the month. No verbal requests will be accepted.

Questions?? Please call the Plan Office and ask to speak to one of our Benefit Premium Analysts at extension 2440.

Earned Premium Payment Options

 

DESCRIPTION

 PAYMENT
SET-UP

 COUPONS  

PARTICIPANT’S
QUARTERLY RESPONSIBILITY

 PAY BY
WEB

 

 

  • Allows you to pay online with a credit card.
  • You can pay for up to four quarters at one time.
  • You receive instant confirmation that your payment has been received.
  • Payments are nonrecurring -Plan does not automatically charge your credit card every time a payment is due.

None. Simply visit www.sagph.org and click on “Pay Health Premium.”

You will continue to receive quarterly coupons in advance.

Visit www.sagph.org before the premium due date, click on “Pay Health Premium” and enter credit card information.

PAY BY PHONE

 

 

  • Allows you to pay over the telephone with a credit card.
  • You can pay for up to four quarters at one time.
  • You receive instant confirmation that your payment has been received.
  • Payments are nonrecurring - Plan does not store your credit card information and charge your card every time payment is due.

None

You will continue to receive quarterly coupons in advance.

 

Call the Plan Office (818) 954-9400 (outside the Los Angeles area (800) 777-4013 before the premium due date to access the Automated Information Center and follow the prompts.

CHECKING AND SAVINGS AUTOMATIC PAYMENT PLAN

  • Automatic recurring deduction from a checking or savings account on a quarterly basis.
  • Payments are deducted on the 25 th of the month before the quarterly premium due date (e.g. June 25 th for 3 rd quarter, July through Sept. premium).
  • Applies to U.S. banks only

Complete Application and return to Plan Office no later than 15 days prior to the quarterly premium due date.

You will not receive quarterly coupons in advance.

None - Payments are automatically deducted from your checking or savings account.

PAY BY CHECK

 

 

  • You mail your quarterly premium check and coupon directly to the Plan’s Payment Center.
  • You can pay for up to four quarters at one time.
  • Your cancelled check is your receipt of payment.
  • Payments must be made from U.S. bank or by cashier’s check or money order in U.S. Dollars.

 

 

None

 

You will continue to receive quarterly coupons in advance.

Mail check far enough before the premium due date to the Plan’s Payment Center.

Premiums must be received by premium due date.

 


Sample Billing Statement
To view a sample of the billing statement and billing coupon which will be used for health premium payment, you can click below.
Sample Billing Statement and Payment Coupon (front)
Sample Payment Coupon (back)


Questions & Answers About the New Premium Rules
How did the Trustees determine the premium amounts?
Why is the premium higher in Plan II even though the benefits are lower?
Why is it the same rate for single and family coverage?
Are the premiums going to change every year?
Why didn't the Trustees decide to charge for dependent coverage like some other plans do?
Can I pay for the whole year in advance?
What happens if I am late with my premium payment?
What if I am traveling when my premium payment is due?
What happens if I cannot afford to pay the health premium?
What if I don't receive payment information in the mail?
Does the premium apply to participants with Senior Performers coverage?
Since I am now paying a portion of the premium, is my coverage treated like self-pay coverage for purposes of coordination of benefits?
Can I pay with my credit card?
How do I submit my health premium payment?



QUESTION: How did the Trustees determine the premium amounts?


ANSWER: The Plan's actuary provided the Trustees with the projected savings that would be realized for various premium amounts. These, together with the estimated savings for other benefit changes, had to correct the projected deficit. It was the Trustees' intent to provide a meaningful benefit program to the greatest number of participants with the lowest premium possible.



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QUESTION: Why is the premium higher in Plan II even though the benefits are lower?


ANSWER: Plan II participants must pay a higher health premium because virtually 100% of the cost of their coverage is subsidized - that is, the contribution received by the Plan based on their earnings does not cover the cost of the benefits. In Plan I, while some participants' coverage is subsidized, others fully cover their costs and some pay a portion of the cost for Plan II participants.



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QUESTION: Why is it the same rate for single and family coverage?


ANSWER: This is called a composite rate, which means that one premium covers you and all of your eligible dependents. This is the same rate structure adopted under the Self-Pay program and reflects the fact that the Plan's cost for covering dependents is significantly less than the cost for covering participants.



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QUESTION: Are the premiums going to change every year?


ANSWER: Like all of the Plan rules, the amount of the premium is subject to review by the Trustees on an ongoing basis. However, unlike self-pay premiums which are required under federal law to be adjusted every year, the amount of premium for the Earned and Earned Inactive coverage is determined solely by the Trustees, based on the financial condition of the Plan.



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QUESTION: Why didn't the Trustees decide to charge for dependent coverage like some other plans do?


ANSWER: This was considered by the Trustees. However, in order to adequately address the financial deficit, a dependent premium would have had to be much larger than the participant premium. In addition, with a dependent premium, there would have been more benefit reductions along with even higher eligibility requirements. It was the Trustees' decision to charge everyone a modest amount in order to maintain better benefits and lower eligibility requirements.



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QUESTION: Can I pay for the whole year in advance?


ANSWER: Yes. The minimum payment is for one quarter (3 months). You can pay in advance for up to four quarters of your current eligibility period.



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QUESTION: What happens if I am late with my health premium payment?


ANSWER: Your payment is due by the 1st day of each calendar quarter during your eligibility period. This means it must be received by the payment center (or via Pay by Web, Pay by Phone or Auto Debit Plan) on or before the due date.

If your payment is not received by the due date, your Earned coverage will be terminated and you will not be eligible for coverage until your next benefit period, provided you requalify and meet the minimum earnings requirement. You cannot enroll in the self-pay program and you will not be eligible for conversion options.


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QUESTION: What if I am traveling when my health premium payment is due?

ANSWER: Traveling is not considered a special exception to paying the health premium on time. If you know that you will be out of town when the premium is due, please pay prior to leaving on your trip. Remember that you can pay your health premium by Phone, through our interactive Web site or by enrolling in the Auto Debit Plan (See Payment Options section above).

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QUESTION: What happens if I cannot afford to pay the health premium?


ANSWER: You should contact one of the assistance organizations, such as the Actors Fund. A list of these organizations is available from the Plan Office and also is on the Plan's Web site at www.sagph.org.



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QUESTION: What if I don't receive payment information in the mail?


ANSWER: If you are eligible and do not receive payment information in the mail by the 15th of the month before the start of the calendar quarter (for example, by December 15, 2002 for the first calendar quarter in 2003), you should call the Plan Office. You will not receive quarterly payment coupons if you are enrolled in the Auto Debit Plan.

To ensure that you receive all quarterly billing statements and other important Plan information, be sure to keep the Plan Office advised of any change in your mailing address. If you use your business manager or agent's address, you should advise them of the new rules.



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QUESTION: Does the premium apply to participants with Senior Performers coverage?


ANSWER: No. The quarterly premiums ($150 for Plan I and $195 for Plan II) apply only to individuals with Earned or Earned Inactive coverage. If an individual on Senior Performers coverage regains Earned eligibility due to sessional employment, he will not be required to pay this health premium. This premium waiver also applies to participants who are 65 and over and have the required number of Pension Credits for Senior Performers coverage, but are not yet receiving their pension. Senior Performers coverage has its own rules outlined here.



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QUESTION: Since I am now paying a portion of the health premium, is my coverage treated like self-pay coverage for purposes of coordination of benefits?

ANSWER: No. For purposes of coordination of benefits (COB), your Earned coverage is still considered "active" even though you are required to pay a health premium. If you are Earned Inactive, your coverage is secondary to Medicare.


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QUESTION: Can I pay with my credit card?

ANSWER: Yes, you can pay with a credit card online or over the telephone. See here for procedures.

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QUESTION: How do I submit my health premium payment?

ANSWER: You will receive a billing statement and payment coupon, along with a payment envelope, from the Plan Office each quarter, in advance. You should complete the payment coupon and mail it, along with your check, in the envelope provided. Payment must be sent to the payment center shown on the coupon. You should not send your payment to the Plan or Guild Offices. You can also pay with a credit card online or over the telephone. See here for procedures. You can also have the quarterly premium automatically deducted from a Checking or Savings account (in which case you will not receive payment coupons in the mail). See here for information and application.

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More Questions?

If you have any questions about the Plan rules for health premium payments, please contact the Plan Office. Information about these rules and all other Health Plan benefits can also be found elsewhere on this site.

   
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