SAG-AFTRA and the AFL-CIO have teamed as much as present two new reasonably priced well being plan choices to all Medicare-eligible SAG-AFTRA members and their spouses, a lot of whom may need misplaced, or are in peril of shedding, their union well being protection on account of current modifications within the guild’s Well being Plan eligibility guidelines. The Movement Image & Tv Fund and the Actors Fund are administering the appliance course of.
SAG-AFTRA president Gabrielle Carteris and AFL-CIO president Richard Trumka mentioned in a joint assertion that the brand new choices, which is able to develop into out there in early July, are being provided by way of Anthem Blue Cross and Blue Defend, that are group Medicare Benefit plans that embrace prescription drug protection.
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There are two tiers out there for this profit: the Medicare Benefit Premier PPO is accessible for a month-to-month premium of $198.90 with no annual deductible and full pharmacy hole protection, and the Medicare Benefit Worth PPO, which is accessible for a month-to-month premium of $99.30 with an annual deductible of $250 and generic pharmacy hole protection.
Members who qualify for Senior Performer advantages underneath the SAG-AFTRA Well being Plan’s Well being Reimbursement Account (HRA) Plan may even qualify for HRA allocations in the event that they enroll in certainly one of these new Medicare Benefit plans. These HRA accounts have been established final December to assist cowl certified out-of-pocket prices.
Carteris and Trumka cited a number of different advantages contained within the new choices for Medicare-eligible members, together with:
- Nationwide entry to suppliers and care, with the identical advantages in or out of community with out penalty.
- As group plans, there are enhanced advantages in comparison with particular person Medicare plans.
- No copay for some medical companies, resembling routine annual physicals and preventive care.
- Model-name prescription drug advantages and “donut gap” hole protection.
- Broader pharmacy formulary checklist for wanted prescriptions.
- A simplified enrollment expertise and purposefully designed packages for older adults.
- Extra value-added packages and companies that embrace telehealth, SilverSneakers well being membership memberships, and listening to and imaginative and prescient advantages.
For info on signing up for certainly one of these plans in early July, Medicare-eligible SAG-AFTRA members are requested to contact Leisure Well being Insurance coverage Options or Artists Well being Insurance coverage Useful resource Middle.
Well being protection for senior performers has develop into a hot-button political situation at SAG-AFTRA ever because the SAG-AFTRA Well being Plan introduced that modifications to eligibility necessities can be going into impact on Jan. 1, 2021. Dealing with staggering deficits, the Plan has mentioned that with out restructuring, it was a $141 million deficit final 12 months, one other $83 million this 12 months, and that it might have run out of reserves by 2024.
The Plan’s trustees projected that some 3,500 performers and a pair of,800 of their dependents would lose advantages underneath the restructuring, although the overwhelming majority of them are eligible for protection underneath Medicare or Obamacare.
A lawsuit filed in U.S. District Court docket in Los Angeles in December claims that the profit modifications “illegally discriminate based mostly on age and violate the Age Discrimination and Employment Act of 1967,” and are a breach of fiduciary obligation underneath the Worker Retirement Revenue Security Act. The ten named plaintiffs within the swimsuit embrace former SAG president Ed Asner and David Jolliffe, at the moment a vice chairman of the union’s Los Angeles Native – each of whom are leaders of the union’s dissident Membership First faction that spearheaded the lawsuit.
Membership First says that “8,200 seniors misplaced their union medical insurance” because of the brand new eligibility necessities; that “members over 65 taking their pensions is not going to have their residuals rely as earnings to qualify for the SAG-AFTRA Well being Plan,” and that “it’s unlikely that any industrial performer over 65, incomes scale, will qualify for SAG-AFTRA medical insurance once more” as a result of “90% of all industrial earnings come from residuals.”
SAG-AFTRA, nonetheless, has mentioned that members are being “misled” by Membership First. “Listed below are 5 information you want to learn about modifications to the SAG-AFTRA Well being Plan,” the union mentioned in December:
1. “With out vital modifications, the SAG-AFTRA Well being Plan’s reserves would have vanished for ALL members by 2024. Ask your self this: Why would the Well being Plan wish to cut back protection for members if there was every other choice?
2. “Senior Performers will not be shedding their healthcare protection; they may proceed to have Medicare as their main insurance coverage, as they do at present. Plus, they may obtain a stipend underneath the brand new Well being Reimbursement Account Plan to make use of for supplemental protection of their selecting by way of By way of Advantages. For a lot of Senior Performers, this may imply comparable protection at a comparable worth.
3. “Spouses aren’t getting ‘kicked off’ the plan. When you meet eligibility necessities and your partner doesn’t have entry to their very own employer-sponsored well being plan, your partner can nonetheless be lined by the SAG-AFTRA Well being Plan. If they’re lined by their very own employer-sponsored well being plan, they may even be eligible for secondary protection underneath the SAG-AFTRA Well being Plan.
4. “There’s a brand new lowered price COBRA security internet out there particularly designed to assist ease the transition for a lot of members. Those that qualify will likely be eligible to keep up their SAG-AFTRA Well being Plan protection with considerably lowered COBRA premiums — at solely 20% of the common COBRA premium — for 12-18 months after their present eligibility expires. For detailed info, please go to sagaftraplans.org/well being.
5. “The concept premium will increase or larger employer contributions alone might have fastened the Well being Plan is just incorrect. The basis of the issue is the exorbitant price of healthcare — an issue made worse by our trade’s manufacturing shutdown as a result of pandemic disaster. The price of healthcare stays a prime situation for People, and the SAG-AFTRA Well being Plan just isn’t immune from this and different financial forces. Structural modifications have been required to place the Plan on a safe footing now and into the long run.”