Health Summary Plan Description

Senior Performers Eligibility

For the latest updates to these rules and information, please see the Fall 2015 Take 2.

The Senior Performers Health Plan provides coverage for pensioners who have at least 15 Pension Credits and are age 65 or older and their eligible dependents. Pensioners with less than 15 Pension Credits may be eligible when they turn 65 if they had at least 10 Pension Credits as of December 31, 2001 and were at least age 55 as of December 31, 2002.

Occupational Disability pensioners are eligible for Senior Performers health coverage at any age, provided they have at least 15 Pension Credits. In order to be eligible for an Occupational Disability pension your injury must have occurred while working under a SAG-AFTRA Collective Bargaining Agreement for which contributions were made to the Screen Actors Guild – Producers Pension Plan. For a complete description of the Occupational Disability pension requirements please refer to the Pension Plan SPD.

Senior Performers Health Plan eligibility will begin on the date you meet the eligibility requirements and pay the Health Plan premium. As outlined on page 14 there is one premium structure for participants with at least 20 Pension Credits and another premium structure for participants with 15 through 19 Pension Credits. Eligibility will continue on a calendar-year basis, which is the Benefit Period for Senior Performers. For Occupational Disability pensioners, coverage begins when Medicare Disability coverage begins.

Benefits under the Senior Performers Plan are the same as those provided to participants under Plan I Earned Eligibility except that the life insurance benefit is $5,000 instead of $10,000 and there are no accidental death and dismemberment benefits.

Important: Pension Credits earned under the Alternative Eligibility Program do not count toward eligibility for Senior Performers coverage.

Coordination with Medicare

Senior Performers Health Plan coverage is secondary to Medicare for hospital and medical benefits as long as you do not regain Earned Active Eligibility. You must be enrolled in Medicare Parts A and B to be eligible for full Plan coverage. If your spouse or same-sex domestic partner is age 65 or older, or is eligible for Medicare due to disability, he or she must also be enrolled in Medicare Parts A and B to receive full Plan coverage as a dependent. You and your spouse or partner do not need to enroll in a Medicare Part D Prescription Drug Program. Please refer to pages 80 through 83 for additional information regarding Medicare.

Regaining Earned Active Eligibility

Your Senior Performers eligibility may be replaced with Earned Active Eligibility if you meet the minimum earnings requirement for Earned Eligibility based on sessional earnings or if you meet the minimum Days of Employment requirement. You will receive Earned Plan I coverage and Medicare will become secondary to the Screen Actors Guild– Producers Health Plan. Please refer to "Coordination of Benefits with Medicare", pages 81 and 82, for a description of Earned Active Eligibility.