TAKE 2 - Newsletter

Articles from Take 2 Newsletter
Spring 1998
Volume XI, Number 1


EARLY RETIREMENT SUSPENSION RULES MODIFIED

A new suspension of benefit rule will apply to Early Retirement Pensioners who first retire on or after January 1, 1999.

The Early Retirement Pension is designed for Participants who are unable to find meaningful employment after age 55. Accordingly, if you take an Early Retirement Pension and you return to work in the type of employment covered by the Plan, your monthly pension may be suspended. The Board of Trustees continually reviews this rule to determine at any time what constitutes meaningful employment in the industry.

The Board of Trustees has modified this rule over the past several years in an effort to formulate a rule that conforms to the basic purpose of the Early Retirement Pension, complies with federal law and is affordable by the Plan.

Currently, the Plan provides that as an Early Retirement Pensioner your benefit is suspended for any month in which you meet the minimum annual earnings requirement (currently $7,500) in sessional employment. At age 65 you receive an increased monthly benefit amount, based on your additional earnings reported during the months in which your benefit was suspended and paid to you without reduction for age. However, under the $7,500 rule, an actor could earn up to $7,499 every month - $90,000 in a year - and still continue to receive a pension but not receive any benefits for those earnings. The Board of Trustees was concerned that such an individual had not really ceased meaningful employment. Therefore the rule has been changed.

New Rule

If you first retire on an Early Retirement Pension, effective January 1, 1999 or later, your pension will be suspended for any month in which you are younger than age 65 and in which your sessional earnings equal or exceed 7 days multiplied by the minimum day player rate under the TV and Theatrical Agreement, rounded up to the next $100. Under the current TV & Theatrical Agreement, the minimum day player rate is $559. This means your pension will be suspended if you have sessional earnings of $4,000 or more in a month (7 days x $559.00 = $3,913.00, rounded up to $4,000). If the day player rate changes, the suspension amount would also be revised. Upon re-retirement, you will start to receive your pension again in the same amount you were receiving prior to the suspension.

At the end of each calendar year in which you had a suspension, your earnings will be reviewed. If your earnings for the calendar year equal or exceed the minimum earnings required to earn a Pension Credit (currently $7,500), you will be entitled to an increased pension based on those earnings, payable at age 65 without reduction for age. If your earnings for the calendar year are less than the minimum earnings required to earn a Pension Credit, the amount of pension that was suspended will be refunded to you. Only earnings after your retirement are considered in this review.

Example

If you retire on January 1, 1999 and then return to work and earn $5,000 in sessions in June 1999, your pension for the month of June will be suspended. If you have no other earnings during 1999, the amount of pension that was suspended for June will be refunded to you, but you will not receive any accrual for the $5,000.

On the other hand, if you also had other covered earnings totaling $2,500 or more during 1999, your total earnings for 1999 would meet the minimum amount required to earn a Pension Credit ($7,500). Accordingly, you will receive an increase in your benefits at age 65, based on your 1999 earnings and without reduction for age.

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Remember, the suspension rule only applies to pensioners younger than age 65. After age 65 you may be employed in any capacity and still be entitled to your pension and your benefit will be adjusted every January 1st following a year in which you earned a Pension Credit.

The New Rule only applies to Early Retirement pensioners who first retire on or after January 1, 1999. If you retire on an Early Retirement Pension before that date, the current $7,500 rule applies.

 

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QUALIFIED DOMESTIC PARTNER HEALTH COVERAGE INFORMATION PACKETS NOW AVAILABLE

Information packets are now available for Qualified Domestic Partner Health Coverage. A Qualified Domestic Partnership, for purposes of coverage by the Plan, is a committed same-sex relationship which has been in existence for at least 12 months. Coverage is available beginning July 1, 1998.

The information packet includes a Question and Answer section and all the necessary documents needed to establish eligibility for coverage. These documents include an Affidavit of Domestic Partnership that both partners must sign under penalty of perjury in the presence of a Notary Public. You are also required to provide to the Plan specific items that establish financial interdependence.

Health Plan coverage for your domestic partner begins the first day of the month following receipt and approval by the Plan Office of the necessary forms, and tax payments where applicable, as outlined in the information packet.

To request an information packet on Domestic Partner Health Coverage, call the Plan Office and speak with a Participant Services Representative.

 

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EYE CARE BENEFIT ENHANCED

The Health Plan currently offers a discount eye wear benefit through Eye Care Plan of America (ECPA) under both Plan I and Plan II. This benefit allows you and your eligible dependents access to providers who offer substantial discounts on frames, lenses and other eye wear accessories. However the program does not provide benefits for vision care and does not reimburse you for eye examinations, frames, lenses, etc.

The Board of Trustees is pleased to announce that effective January 1, 1999, the Plan’s eye care benefit will be enhanced. The new benefit will continue to offer access to providers who offer discounts on eye wear and accessories to all Participants but will now include an annual eye exam for Plan I Participants and their eligible dependents.

Also effective January 1, 1999 the eye care benefit will be administered by a new company, Vision Service Plan (VSP). The VSP network is one of the largest in the country with almost 22,500 providers. We will have additional information on the new eye care benefit, including how to locate a VSP network provider, in the Fall 1998 issue of TAKE 2.

 

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SUMMARY OF EARNINGS STATEMENTS MAILED

You should have recently received your 1997 Summary of Earnings Statement. This is the only record of your earnings you will receive from the Plan Office for the year. Because your pension will be based on these earnings it is in your best interest to carefully review the accuracy of this statement. Errors, such as earnings not listed on your statement, or discrepancies, such as ver or under reporting, can affect your future benefits.

When reviewing your statement keep in mind that some payments made to you in connection with your employment may not be reportable earnings. These might include such items as meal penalties and rest period violations. Please refer to item C on the reverse side of your summary for a complete list of non-reportable earnings.

If you find an error in your Summary of Earnings Statement you should contact the Plan Office in writing. Your letter should identify the missing or incorrect item(s) and include all necessary documentation, such as:

Send your letter and documentation to:

SAG-Producers Pension and Health Plans
Contribution Compliance Department
P.O. Box 7830,
Burbank, CA 91510-7830

 

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A MESSAGE FROM THE INDUSTRY HEALTH NETWORK PHARMACISTS

We know your time is valuable so we offer some helpful tips to ensure your next trip to a TIHN Pharmacy meets your needs.

Did you know that regulation requires that we get approval from your doctor before dispensing your refill prescription, even if you have been taking the medicine for years? Additionally, responsible physicians want to make sure that the drug they’ve prescribed is still meeting your needs and that you’re taking the right medicine at all times. Often, it may take 24 hours or longer to receive that approval.

How to Get a Refill Prescription Easily:

We recommend that you call us with your refill request at least 48 hours in advance. When calling, please provide us with

This will help us to have your prescription ready for your pick-up and minimize your waiting time. Also, it’s a good idea to call us prior to coming in to ensure your refill is ready.

Sometimes, physicians will allow for additional refills on the initial prescription. Check with your doctor to see if this is possible.

Getting a New Prescription:

We are happy to call your doctor to order a new prescription for you. As with refills, we recommend giving us a contact name at your doctor’s office to expedite this process.

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Thank you for allowing TIHN Pharmacies to serve you. If you have questions or would like additional information, please call our Customer Service Department at 800.876.8320. TIHN Pharmacies are at the following Motion Picture & Television Fund locations:

 

Toluca Lake Health Center

Woodland Hills Health Center

Bob Hope Health Center

Westside Health Center

4323 Riverside Drive

23388 Mulholland Drive

335 N. La Brea Ave.

1950 Sawtelle Ave.

Burbank, CA 91505

Woodland Hills, CA 91364

Los Angeles, CA 90036

Los Angeles, CA 90025

(818) 295-3333

(818) 976-1040

(213) 634-3811

(310) 231-3033

 

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NEW CLAIM OFFICE FOR METLIFE

MetLife, the dental provider for out of California Participants, has a new claim office:

MetLife Group Dental Claims
P.O. Box 8740
Dayton, Ohio 45401

The customer service phone number, (800) 260-1093 and the phone number to obtain a listing of PDP dentists, (800) 474-7371 have not changed.

 

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COVERAGE OF VIAGRA LIMITED TO MEDICAL NECESSITY

There has been a lot of media coverage on the new prescription drug Viagra, which treats erectile dysfunction in men. The Health Plan will cover Viagra, but only in the case of medical necessity. For example, when a medical condition such as diabetes has caused the problem. In addition, the Plan limits the quantity it will allow.

Currently, if SAG-Producers Health Plan is your primary plan and you utilize a PAID Network pharmacy to fill a prescription, you must satisfy the annual deductible and pay a copayment at the time of purchase. To purchase Viagra you will have to pay 100% of the discounted cost of the drug at the pharmacy and submit a paper claim to the Plan Office for reimbursement. This extra step is necessary to verify that a medical necessity exists which warrants treatment with Viagra.

Here’s how it will work:

1. Take your Viagra prescription to a PAID pharmacy. You pay 100% of the discounted price for the prescription at the pharmacy.

2. Send your PAID pharmacy receipt to the Plan Office, along with a completed medical claim form.

3. Submit a letter from your doctor confirming the underlying medical condition you have that warrants treatment with Viagra along with a copy of your medical records for review.

4. If the Plan Office determines that coverage of Viagra is medically necessary, the claim will be sent to PAID for reimbursement at 100%, minus the prescription drug copayment and subject to the prescription drug deductible and the Plan’s limits.

If you do not use a PAID Pharmacy or you are not eligible for the PAID Drug Card program because the SAG-Producers Health Plan is not your primary plan, your prescription for Viagra will be considered for reimbursement under the Major Medical program, subject to Major Medical deductibles and coinsurance.

 

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INFERTILITY BENEFIT ENHANCED

On January 1, 1998, the infertility benefit was increased to a family lifetime maximum of $12,500. All expenses related to the treatment of infertility, including prescription drugs are included in the lifetime maximum.

While the Plan has previously covered such assisted reproductive techniques as in vitro fertilization (IVF), the benefits were limited to medical expenses incurred by the Participant and his or her spouse. Thus, if donor eggs were utilized for the IVF procedure, the donor’s medical expenses were not covered.

Effective retroactive to January 1, 1998, the infertility benefit has been amended to consider the medical expenses of an egg donor. Coverage will be limited only to the actual medical expenses of the donor, such as doctor’s fees, medications, laboratory fees, etc., subject to the Plan’s allowance. It will exclude any administrative, legal or other such fees. The total charges are still subject to the $12,500 family lifetime maximum.

Note: The Infertility Benefit does not include charges for surrogacy.

If you have questions about this enhancement to the infertility benefit, contact the Plan Office and ask for Participant Services.

 

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ADDRESS CHANGE REMINDER

When you move, you must request a new Master Data Card from the Plan Office. Complete the card in its entirety and mail it back as soon as possible. We can only keep you informed about your Pension and Health Plan benefits if we know where to send your mail.

Please remember that if you change your address you must notify both the Plan Office and the Screen Actors Guild. These are two separate entities and maintain separate records.

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