Health Summary Plan Description

Facts About Your Plan

As of January 1, 2016, ValueOptions is now Beacon Health Options. For more information, please see the Winter 2015 Take 2.

Name and Type of Plan

Screen Actors Guild – Producers Health Plan for Motion Picture Actors.

This Plan is a collectively-bargained, joint-trusteed labor-management trust.

Plan's Identification Numbers

The Employer Identification Number (EIN) assigned to the Plan by the Internal Revenue Service is 95-6024160. The Plan number is 501.

Plan Year

The fiscal year runs from January 1 through December 31.

Administrator

The administrator is the Board of Trustees, made up of an equal number of representatives from the Producers and SAG-AFTRA.

The routine administrative functions are performed by The Screen Actors Guild – Producers Health Plan. The Chief Executive Officer is Christopher S. Dowdell who may be reached at the same address and telephone number as the Board of Trustees (see right).

The Plan is sponsored by various Producers who make contributions on your behalf under SAG-AFTRA Collective Bargaining Agreements. If you want to know whether a particular producer is a sponsor, contact the Plan Office.

Names and Addresses of the Current Board of Trustees

To contact the Board of Trustees, write, call, fax or email:

Screen Actors Guild – Producers Health Plan
P.O. Box 7830
Burbank, California 91510-7830
(818) 954-9400 or (800) 777-4013
Fax: (818) 953-9880
Website: www.sagph.org
Email: email us

As of July 1, 2013 the Trustees of this Plan are:

Union Trustees Producer Trustees
Mr. Daryl Anderson
Ms. Amy Aquino
Ms. Timothy Blake
Mr. Jim Bracchitta
Mr. John Carter Brown
Mr. Duncan Crabtree-Ireland
Ms. Leigh French
Mr. Barry Gordon
Mr. Al Hubbs
Mr. Bob Kaliban
Mr. Richard Masur
Mr. John T. McGuire
Mr. Joseph Ruskin
Mr. John H. Sucke
Ms. Kathryn Swink
Ms. Kim Sykes
Mr. Ned Vaughn
Mr. David P. White
Mr. Jay Barnett
Mr. Ted Bird
Ms. Tracy Cahill
Ms. Eryn Doherty
Ms. Marla Johnson
Mr. Robert W. Johnson
Mr. Sheldon Kasdan
Ms. Shelley Landgraf
Ms. An T. Le
Ms. Carol Lombardini
Ms. Stacy K. Marcus
Ms. Diane P. Mirowski
Mr. Paul Muratore
Mr. Alan H. Raphael
Mr. John E. Rhone
Mr. Robert Todd
Mr. David Weissman
Mr. Samuel P. Wolfson

Agent for Service of Legal Process

Legal process may be served on the Trustees or the Chief Executive Officer at:

Screen Actors Guild – Producers Health Plan

Street Address:
3601 West Olive Avenue
Burbank, CA 91505

Mailing Address:
P.O. Box 7830
Burbank, CA 91510-7830

Collective Bargaining Agreements

Contributions to the Plan are made on behalf of each employee in accordance with Collective Bargaining Agreements between SAG-AFTRA and employers in the industry.

The Collective Bargaining Agreements are available on the SAG-AFTRA website: www.SAG-AFTRA.org. Or, you may request that the Plan Office provide you with a copy of the applicable Collective Bargaining Agreement. You will be charged a reasonable amount for copying. The agreement is available for inspection at the office of the Chief Executive Officer.

Source of Financing

The Collective Bargaining Agreements require contributions by Producers to the Plan based on a percentage of a participant's compensation. In addition, the Plan requires participants to pay a premium for coverage. Participants and dependents whose eligibility under the Plan has terminated may continue coverage by making self-payments in accordance with the rules of the Self-Pay Program.

Powers of the Board of Trustees

The benefits provided under the Plan are not contractual benefits. Therefore, the Board of Trustees reserves the right, in its sole discretion at any time and from time to time:

  • To terminate or amend the amount or condition of any benefits even though such termination or amendment affects claims which have already been incurred.
  • To alter or postpone the method of payment of any benefit.
  • To amend or rescind any other provisions of the Plan.

The Trustees do not promise to continue the benefits and coverage in full or in part in the future, and rights to future benefits and coverages are not vested. In particular, retirement or the completion of the requirements to receive a pension benefit under the SAG– Producers Pension Plan does not give any participant or former participant any vested right to continued
benefits or coverages under the Health Plan. The Board of Trustees are authorized and empowered to:

  • Construe the meaning of any doubtful or ambiguous provision of the Plan.
  • Decide on a participant's entitlement to or application for benefits under the Plan.
  • Execute all such agreements, adopt and promulgate all such reasonable rules and regulations, take all such proceedings and exercise all such rights and privileges as are necessary in the establishment, maintenance and administration of the Plan.

Decisions on doubtful or ambiguous provisions or a participant's entitlement to or application for benefits shall be final and binding upon all affected parties.

Type of Benefits Provided by the Plan

The Plan provides hospital, medical, prescription drug, mental health and substance abuse, dental, vision, life insurance and accidental death and dismemberment benefits. It also provides access to discount eye wear.

Organizations Through Which Benefits are Provided

The carrier listed below provides fully insured benefits under the Plan.

Company Benefits
Metropolitan Life Insurance Company
Group Life Claims
123 Wyoming Avenue
Scranton, PA 18503
Life insurance and accidental death and dismemberment benefits

The Plan is fully self-insured for the benefits obtained through the carriers listed below. These carriers administer at least a portion of the benefits for the Plan, but do not insure or otherwise guarantee any of the benefits of the Plan.

Company Benefits
Anthem Blue Cross
21555 Oxnard Street
Woodland Hills, CA 91367
Administers the hospital and medical benefits and provides access to its network of hospital and medical providers
The Industry Health Network
23388 Mulholland Drive
Woodland Hills, CA
91364-2792
Provides access to its network of medical providers inside California
Express Scripts, Inc.
One Express Way
St. Louis, MO 63121
Administers the prescription drug benefit and provides access to its network of retail and home delivery pharmacies
ValueOptions
10805 Holder Street
Cypress, CA 90630
Administers the mental health and substance abuse benefit and provides access to its network of providers
Delta Dental of California
100 First Street
San Francisco, CA 94105
Administers the dental benefit and provides access to its network of dental providers
VSP
3333 Quality Drive
Rancho Cordova, CA 95670
Administers the vision benefit and provides access to its network of vision providers

Individual hospital and medical conversion policies are provided by Anthem Blue Cross in California or the local Blue Cross Blue Shield plan for states outside of California. Metropolitan Life Insurance Company provides life insurance conversion policies.

Requirements with Respect to Eligibility for Participation and Benefits

The Eligibility requirements are outlined on pages 1 through 15 of this book.

Circumstances Resulting in Disqualification , Ineligibility or Denial or Loss of Benefits

Loss of Earned Eligibility is described on page 16 of this book.

Loss of Self-Pay coverage is described on page 24 of this book.

Audit verification procedures and the recovery and offset of future benefit payments are described on pages 61, 95 and 96 of this book.

Expired Check Limit

Replacement checks will not be issued for any lost or expired checks if more than four years have elapsed from the date of issue.

Procedures to Follow for Filing a Claim

The procedure to be followed in filing a claim for benefits is described on pages 84 through 86 of this book.