This section describes the premium payment rules for Earned Eligibility, Senior Performers coverage and the Extended Spousal benefit. The premium payment rules for the Self-Pay Program are outlined in the Self-Pay Program section starting on page 21.
All participants are required to pay a premium for their Health Plan coverage. The amount of your premium depends on the plan for which you qualify and the dependents you will be covering.
The premium for participants with Earned Eligibility is due quarterly. This premium also applies to individuals covered under the Total Disability Extension described on pages 26 and 27. The current rates outlined below were effective as of July 1, 2011 and are subject to adjustment in the Trustees' sole discretion.
Certain individuals with Earned Eligibility as listed below will pay the applicable Senior Performers premium (see page 14) instead of the Earned Eligibility premium. The premium must be paid quarterly.
* Also applies to Senior Performers who had at least 10 Pension Credits as of December 31, 2001 and were at least age 55 as of December 31, 2002.
|Earned Eligibility||Plan I||Plan II|| Plan II
Age and Service
|Participant only||$273 quarterly||$324 quarterly||$414 quarterly|
|Participant plus 1 Dependent||$315 quarterly||$372 quarterly||$477 quarterly|
|Participant plus 2 or more Dependents||$342 quarterly||$405 quarterly||$519 quarterly|
Senior Performers/Extended Spousal
The premium for Senior Performers and Extended Spousal coverage is due monthly unless you Pay by Mail (see page 15). In that case the premium is due quarterly. The current rates below were effective as of January 1, 2013 and are subject to adjustment in the Trustees' sole discretion. In the table below, the term spouse also includes same-sex domestic partners.
|Senior Performers and Extended Spousal||With No Spouse or With Spouse Age 65 or Older*||With Spouse Under Age 65*|
|20 or more Pension Credits**||$50 per month||$100 per month|
|15 – 19 Pension Credits||$150 per month||$150 per month|
* Includes coverage for dependent children.
** Also applies to Senior Performers who had at least 10 Pension Credits as of December 31, 2001 and were at least age 55 as of December 31, 2002.
Senior Performers with 20 or more Pension Credits who have a spouse or same-sex domestic partner that is eligible for Medicare but under age 65 will pay the $50 monthly premium rate. This also applies to Extended Spousal eligibility for surviving dependents of Senior Performers who had 20 or more Pension Credits. Contact the Plan Office to be sure you are billed at the correct rate.
The Senior Performers/Extended Spousal premium rate for a participant with at least 20 Pension Credits will automatically adjust to the lower premium rate effective the first of the month in which the spouse or domestic partner turns age 65.
You may pay the premium in advance, regardless of your method of payment (except for auto debit). However, you may not pay the premium for any period beyond your current Benefit Period.
Deduction from Monthly Pension (only available to Senior Performers) – You may elect to have the Health Plan automatically deduct the monthly premium from your monthly pension benefit. This ensures your health coverage will continue and eliminates the inconvenience of sending in payments.
Auto Debit – The auto debit plan deducts your quarterly Earned premium or monthly Senior Performers/Extended Spousal premium automatically on a recurring basis from a U.S. checking or savings account. Payments are deducted on the 25th of the month prior to the due date. The Plan will continue to deduct the premium as long as you remain continuously eligible for coverage, even if there is a change in the premium rate because you experience a change in your eligibility type or benefit plan, or if the Trustees make a change in the premium rate. You can sign up online or download an enrollment form on the Plan's website, www.sagph.org.
Pay by Web – You may pay your premium online with e-check or a credit card. Simply visit the Plan's website, www.sagph.org and enter your checking/savings account or credit card information. You will receive electronic confirmation that your payment has been received.
Pay by Phone – You may pay your premium over the telephone 24/7 with a credit card by calling the Plan Office at (818) 954-9400 or (800) 777-4013 and following the prompts. You will receive a confirmation number indicating that your payment has been received. For your security, this is an automated system and Participant Services Representatives will not be able to take your credit card information.
For your protection, Pay by Web and Pay by Phone payments are non-recurring. This means the Plan will not automatically charge your credit card or debit your account every time a payment is due.
Pay by Mail – A quarterly billing statement and coupon will be sent to you a few weeks before the due date. Make your check, money order or cashier's check from a U.S. bank payable to "Screen Actors Guild – Producers Health Plan" and send it to the Plan's Payment Center with your coupon in the envelope provided. To ensure proper crediting you should include the account number from the billing statement on your check. Your payment must be received at the Payment Center no later than the due date to be considered timely. DO NOT SEND YOUR PAYMENT TO THE PLAN OFFICE OR THE SAG-AFTRA UNION OFFICE.
Any check or debit returned to the Health Plan for any reason will be assessed a handling fee. You may replace the premium payment and pay the fee using any of the payment options outlined above.
Premium Due Dates
Your premium is due on the first day of each calendar quarter for Earned Eligibility or the first day of each month for Senior Performers and Extended Spousal benefits. For example, the quarterly payment for the first quarter of the calendar year (January through March) is due on January 1st. The due date applies even when traveling. There is a 15-day grace period, however it should only be used for unforeseen circumstances. Coverage will not be granted until your premium is processed.
If the Plan does not receive your premium by the due date, you will not be entitled to any coverage under the Health Plan until your next Benefit Period. If your coverage is terminated due to failure to pay your premium, you will not be entitled to self-pay coverage nor will you be entitled to any conversion options.
For example, if you make quarterly payments and your Benefit Period is January 1, 2014 through December 31, 2014 and you fail to pay your first quarterly premium by January 15, 2014, you will not be entitled to any Health Plan coverage until January 1, 2015, provided you re-qualify for coverage by meeting the minimum requirements for Earned or Senior Performers coverage.
Late Payment Waivers
If your payment is not received by the due date you can reinstate your coverage by using a late payment waiver. The Plan allows one late payment waiver per Benefit Period with a maximum of two late payment waivers per lifetime for Earned Eligibility. Senior Performers and dependents covered under the Extended Spousal benefit are eligible for one late payment waiver per Benefit Period. Participants may use a late payment waiver up to the last day of the quarter for which the payment is due.
To use a late payment waiver, simply make your payment:
When your payment is received after the grace period, the Plan will automatically apply one of your late payment waivers (if available) and your coverage will automatically be reinstated retroactively.
Special Note: If your coverage in this Plan is terminated because you do not pay your premium, your coverage under other health plans may be reduced or eliminated due to the EICOB rules (pages 77 and 78). You should contact your other plan for further information.