Health Plan Combined Earnings Eligibility FAQs

  1. If I qualify for Combined Earnings Eligibility and later qualify for AFTRA Earned coverage do I have to take the AFTRA coverage?

    Yes. Your SAG coverage will terminate on the date you qualify for Earned AFTRA coverage.
  2. Will I be able to add my eligible dependents under Combined Earnings Eligibility?

  3. If I qualify for Combined Earnings Eligibility and later qualify for AFTRA Earned "Individual Only" coverage will SAGPH continue to cover my dependents?

    No. As you have qualified for coverage under the AFTRA Health Plan you have the option to buy coverage for your dependents. Combined Earnings Eligibility is for participants with no eligibility in either Plan. Your SAG coverage will terminate on the date you qualify for AFTRA coverage.
  4. Can my spouse or eligible dependents who are also Participants under SAGPH qualify for Combined Earned Eligibility?

  5. If my Combined Earnings Eligibility ends due to lack of earnings will I receive a Self-Pay offer?

  6. If my dependents coverage ends due to divorce or aging out will they receive a Self-Pay offer?

  7. If I qualify for Combined Earnings Eligibility and do not apply until the end of September will a late payment waiver be applied?

    No. If it is your first premium payment for the July 1, 2014 eligibility period, payment must be received by September 30, 2014.
  8. If I qualify for Combined Earnings Eligibility and later qualify for AFTRA Earned coverage will out-of-pocket expenses accrued under SAGPH count towards meeting my AFTRA deductibles and out-of-pocket maximums?

  9. Does this include Dental coverage if I have previously earned 3 years of eligibility under SAGPH?

  10. Does a year of Combined Earnings Eligibility apply towards any of the Health Plan year requirements?

    • 3 years for dental in Plan II? No.
    • 10 years for coverage under Plan II Age and Service? No.
    • 17 years for the Self-Pay extension? No.
  11. Under Combined Earnings Eligibility, will I receive a Pension credit?

  12. I do not have an email address can I still apply online?

    Yes. Participants with no email address will be able to submit application via IWR.
  13. When shall I expect a response to see if I qualified?

    At least 10 business days.
  14. Who can I speak with about my application?

    Contact the Plan Office at 1-800-777-4013, a Service Representative will assist you.