Issue link: http://digital.copcomm.com/i/1325752
34 SAG-AFTRA | Winter 2021 | sagaftra.org covered earnings or 100 days worked under specified contracts under the existing Alternative Days Eligibility rules. For coverage beginning Jan. 1, 2021, retirees (participants age 65 or older and receiving a pension from the SAG-Producers Pension Plan or the AFTRA Retirement Fund) must meet the earnings requirement in all sessional earnings during the 12-month base earnings period ending Sept. 30, 2020. Participants age 65 or older who are not taking a pension need to meet the earnings requirement with earnings during that period that include at least one sessional reporting. Senior Performers do not lose health coverage as a result of the changes to the Health Plan. Those not eligible for the Active Plan continue to be covered primarily under Medicare as they are now, as described below. Quarterly premiums for participants and dependents have been increased to $375 for participant only, $531 for participant plus one dependent and $747 for participant plus two or more dependents. With the increased premiums, participants receive similar benefits to those they had under their previous Plan I or Plan II. The Plan's previous Plan I and Plan II benefits are combined into one plan for Active coverage beginning Jan. 1, 2021, and after. Participants with benefit periods beginning in 2020 on or after April 1, 2020, will run out their current level of coverage (either Plan I or Plan II) into 2021, subject to the changes listed below and the new quarterly premium rates above. SAG-AFTRA Senior Performers Health Reimbursement Account Plan Senior Performers who do not meet the new earnings requirements will be transitioned to Via Benefits with a Health Reimbursement Account allocation and may cover all of their qualified dependents under age 65 in the Active Plan by paying $250 per family per month (which covers all eligible under-age-65 dependents). The SAG-AFTRA Health Fund provides the Health Reimbursement Account (HRA) Plan to eligible Senior Performers and their Medicare-eligible spouses to use in conjunction with the Medicare plan they select on the Via Benefits Medicare marketplace. HRA funds can be used to help pay for eligible healthcare expenses, including premiums for Medicare Part B or Medicare supplement plans. Annual HRA allocations will be either $1,140 or $240, depending on the number of Retiree Health Credits earned. Eligible Senior Performers who have not yet enrolled in a Medicare plan through the Via Benefits marketplace must do so before the end of the grace period on Feb. 28, 2021. Information on how to do this is on the SAG-AFTRA Health Plan website; the Health Plan and Via Benefits are also working to get in contact with Senior Performers to guide them through this process. Call (800) 777-4013 to get in touch with a representative from the SAG-AFTRA Health Plan. Catastrophic Prescription Drug Coverage for Senior Performers The SAG-AFTRA Health Fund has also funded a catastrophic prescription drug benefit through the HRA Plan. Any HRA Plan participant who enrolls in a Medicare plan through the Via Benefits Medicare marketplace is eligible for the catastrophic prescription drug benefit under the HRA Plan, which provides reimbursement for any payments made towards the 5% co-insurance responsibility after they have reached the annual Medicare Part D catastrophic limit of benefits. Working Spouse Rule Beginning Jan. 1, 2021, participants' spouses who DO NOT have access to their own employer-sponsored health plan can still be covered by the SAG-AFTRA Health Plan. If they are covered by their own employer-sponsored health plan, they are also eligible for secondary coverage under the SAG-AFTRA Health Plan. Other Changes to Active Benefits (also applies to Plan II coverage runout) 1. Temporary subsidized COBRA rates are being offered to qualified participants losing coverage Oct. 1, 2020; Jan. 1, 2021; and March 31, 2021. 2. An ongoing 80% subsidy of COBRA rates is being offered to qualified participants through a new Extended Career COBRA option. 3. The Plan combined in-network medical and hospital deductibles. 4. The out-of-pocket maximum benefit for out-of-network providers has been eliminated. 5. Benefits for virtual medical and mental health office visits continue. This article is meant to be a brief summary of changes only. Please visit sagaftraplans.org/health/2021-changes/overview for details and FAQs from the Health Plan.