Articles from Take 2
Summer/Fall 2000
Volume XIII, Number 2

Opening on Thousands of Screens in Early October www.sagph.org


Imagine the entire contents of your Summary Plan Description booklets: the eligibility requirements, the benefits, the charts, the examples; then, imagine being able to point and click on any pension and health topic in any category and have the information you need travel to you at the speed of light. You just imagined www.sagph.org, the new Web site of the Screen Actors Guild-Producers Pension and Health Plans. We’ve planned a world wide opening on thousands and thousands of screens (computer that is) in the first week of October, 2000.

The new site will offer a comprehensive selection of information in an easy to use format which you may access without providing any personal information. Some of the features of our new Web site include:

•Benefit Tabs - Organized like file folders these easy to use tabs contain all the basics of Eligibility and Benefits for both Plans.

•Network Providers - Need a doctor or a dentist? They are easy to locate here.

• Life Event Guide Having a baby? Thinking of retiring? Moving? Use the Life Event Guide to easily and thoroughly find out how these and other changes affect your benefits and what steps you need to take, such as notifying the Plan Office.

• Forms - Need to file a new Master Data Card with the Plan Office? Need to file a medical or dental claim form? Want to add a qualified Domestic Partner to your Health Plan benefits? These are just a few of the many forms available through our new Web site.

• Links - Sites of interest related to health and pension issues and assistance organizations.

• and More - Back issues of our newsletter, Take 2, Pension and Health Plan FAQ’s, complete text of both Pension and Health Plan SPDs and more.


Discounts on Prescription Drugs for Medicare Beneficiaries in California


You might have heard about the Prescription Drug Discount Program for Medicare recipients which became effective February 1, 2000. The new program allows Medicare recipients who reside in California to pay the same discounted rate for their prescription drugs as the State pays for drugs obtained for Medi-Cal patients. The new discount pricing program is available to all Medicare recipients in the State of California, including those people
covered by a prescription drug program like ours.

We are pleased to inform you that our arrangement with Merck-Medco assures that all Plan Participants who qualify for the Health Plan’s Prescription Drug Program will receive discounts equal to or greater than the new law provides. The discount is
provided automatically. There is no change in the way you
currently fill prescriptions.

If you are not covered by the Health Plan’s Prescription Drug Program but you are eligible for Medicare, you need to show your Medicare card at a Medi-Cal pharmacy to ensure you receive the discount.


New Address for Santa Clarita Health Center

The Industry Health Network’s Santa Clarita Health Center has relocated fifty yards south of its former location. You may contact them at:

Santa Clarita Health Center
25751 McBean Parkway, #210
Valencia, CA 91355-3702
(661) 284-3100

Open Monday-Saturday
8:30 a.m. - 5:00 p.m.

The Industry Health Network (TIHN) is a wholly-owned subsidiary of the Motion Picture and Television Fund. The five health centers operated by TIHN are located only in California, but are available to all Participants. Remember, when you use an Industry Health Network provider there are no deductibles and only minor copayments.

Vision Care Network Expands For Plan II


We are pleased to announce that effective, October 1, 2000, Vision Service Plan (VSP) will expand the network of doctors available to Plan II and Lower Cost Self-Pay Participants. These Participants are eligible for VSP’s Access Plan, while Plan I Participants are eligible for VSP’s Exam Plus Plan. The plans provide different
benefits and have used different provider networks. The Access Plan network has been a smaller subset of the Exam Plus network. Beginning in October, the expanded Plan II network will offer access to the larger network of doctors currently available to Plan I.

How to Locate a VSP Provider


•Call the number based on the plan for which you qualify:

Plan I - Exam Plus Members (800) 877-7195

Plan II and Lower Cost Self-Pay-
Access Plan Members..........................(800) 475-9163

•You may request a list of VSP participating doctors and
it will be mailed to you, or you may enter a specific
doctor’s telephone number to verify the office’s
participation in the VSP network.

•You may visit the VSP web site at: www.vsp.com to locate a participating provider near you.

•You may contact VSP through the mail at: Vision Service Plan, P.O. Box 997100, Sacramento, CA 95899-7100.

Laser Vision Correction Surgery Discounts Available


The two most commonly performed laser vision correction procedures are now available to Plan I Participants. Although the Health Plan will not be paying the cost of the surgery, you will have access to the procedures at reduced fees through Vision Service Plan’s network of doctors and laser centers.

The two surgical procedures, laser-assisted in-situ
keratomileusis (LASIK) and photorefractive keratectomy (PRK), use an excimer laser to reshape the surface of the eye to match the prescription in your glasses or contact lenses. Potential candidates for laser vision correction surgery include those who are nearsighted, farsighted or who have astigmatism. Your VSP doctor can help you make an informed decision as to which procedure is right for you and coordinate your care with the VSP surgeon.

VSP has arranged for Exam Plus Members (Plan I Participants only) to receive the procedure at a discounted fee. The most you will pay is $1,500 per eye for PRK or $1,800 per eye for LASIK. The fee includes both pre and post-operative care through your VSP doctor.

To schedule a complimentary screening and consultation on the benefits and risks of laser vision correction, call your VSP doctor. Participating doctors can also be located on VSP’s Web site at www.vsp.com or by calling toll free, (800) 877-7195.

Ignoring Audit Request Can Lead to Termination of Benefits


You may be selected for an audit to verify the eligibility of your dependents under the Health Plan. Failure to comply with an audit request can lead to a loss of benefits for your dependents.

When you become eligible for benefits under the Health Plan, we ask you to fill out a Master Data Card. This confidential legal document must be signed by the Participant. If the Participant is under the age of 18, the parent or legal guardian must sign for the child. The Master Data Card is our record of your current mailing address and your current dependents. It also designates a beneficiary for any benefits which may be payable from the Health Plan upon your death.

In order to verify the eligibility of the dependents listed on your Master Data Card, we are
performing routine audits. These audits are for your protection. We want to insure that Plan benefits are reserved for eligible Participants and their eligible dependents.

If you are selected for an audit, the Plan Office will send you an initial inquiry specifying the
documents needed for dependent verification. For example, a copy of a marriage certificate to verify your legal spouse or a birth certificate for a child. If you cannot locate a requested document, contact the Plan Office. We can assist you in contacting the issuing agency.

If we don’t receive a response to our initial request, we will send a follow-up notice. If we do not receive a response to our second request we will send you a Notice of Termination of Benefits for the unverified dependents. Additionally, you may be responsible for paying back any medical expense paid out by the Health Plan on behalf of non-qualified dependents.

If you need to update your Master Data Card, contact
the Plan Office.

Long-Term Care Enrollment Ongoing


Some Participants have been confused about the enrollment
deadline in the Long-Term Care Plan offered by the John Hancock Life Insurance Company. We want to clarify that enrollment in the Long-Term Care Plan is ongoing for all eligible Participants and their qualified dependents.

There is an initial 60-day enrollment period for Earned and Retiree Participants to enroll with modified underwriting. Modified underwriting means you can qualify for coverage by answering only two health related questions.

Outside of this special 60-day enrollment period, all Participants and their qualified dependents may apply for coverage at any time. However, you will be subject to regular underwriting which means you will need to answer more extensive questions about your health.

The Long-Term Care Plan helps protect against the costs associated with extended care brought on by an accident, long-term illness or old age. It is available to all Participants with Earned, Retiree or Self-Pay eligibility, their spouses, surviving spouses and qualified same-sex domestic partners as well as for Participant’s parents and grandparents. Participation in this plan is completely voluntary. The Health Plan does not pay for this benefit.

You may request enrollment information directly from the John Hancock Life Insurance Company by dialing toll free: (888)-828-3823.