• Intro

    All Earned and Earned Inactive Participants are required to pay a premium for their Health Plan coverage. Below is information regarding the premium. For more information on the Self-Pay program and premium, click here.

     
  • Health Premium Payment Rules for Earned and Earned Inactive Coverage

    The minimum requirements for Earned Eligibility commencing on the first day of any calendar quarter in 2015 and 2016 are outlined below. Calendar quarters start on January 1st, April 1st, July 1st and October 1st. Minimum requirements for Earned Eligibility may increase each year. The Trustees have set a target increase of 3% per year. However, they will determine the actual size of the increase based on an annual review of the Health Plan's financial condition.

    For Coverage Commencing Jan. 1, 2015 - Mar. 31, 2016 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+ dependents $342
    quarterly
    $405
    quarterly
    $519
    quarterly
    For Coverage Commencing Apr. 1, 2016 - Dec. 31, 2016: Plan I Plan II Plan II Age and Service*
    Participant only $300
    quarterly
    $357
    quarterly
    $456
    quarterly
    Participant plus 1 dependent $348
    quarterly
    $408
    quarterly
    $525
    quarterly
    Participant plus 2+ dependents $375
    quarterly
    $447
    quarterly
    $570
    quarterly

    Participants with Earned Eligibility who meet the requirements for Senior Performers coverage will pay the Senior Performer premium if it is lower than the Earned premium, even if they have not actually retired.

    Quarterly Billing Procedures

    Several weeks before the start of each quarter for which you are eligible, you will receive your billing statement and payment coupon. The billing statement will indicate your total account balance for the remainder of your Eligibility Period as well as the minimum payment that is due for the current quarter. You may pay the premium for more than one quarter at a time. For example, you may pay the premium for your entire current Eligibility Period in one payment. However, you may not pay the premium for any period beyond your current Eligibility Period.

     
  • Open Enrollment

    You will receive a Notice of Qualification and an enrollment form listing your qualified dependents when you qualify for coverage. You can make changes to your enrolled dependents for any reason during your Open Enrollment Period by visiting www.sagph.org or by checking the appropriate box next to their name and returning the enrollment form to the Health Plan. If there are no changes to your dependents' enrollment, simply submit your premium before the premium due date. Please note, changes to your covered dependent(s) may affect your premium rate.

    Important Note: Your dependents may only be covered if the participant is covered under the Plan, unless your dependents are covered under the Extended Spousal benefit. If you cancel enrollment for current dependents due to death, divorce or dissolution of a same-sex domestic partnership, please see the instructions below.

    New dependents can only be added by completing a New Dependent Form and submitting all required documents that verify your dependent(s) as qualified. Examples include: a recorded marriage certificate for a spouse; or a recorded birth certificate for your dependent child. Coverage will be extended to your dependents following processing of your legal documents, enrollment form and premium payment.

    Once your enrollment and premium payment are processed, your Notice of Eligibility will be sent to you within 7-10 business days. You cannot make changes until your next Open Enrollment Period. (Please see below under Special Enrollment Opportunities for exceptions to this rule.)

    Your Open Enrollment Period is based upon your Benefit Period. Please refer to the chart below and your enrollment materials to determine which period applies to you.

    Benefit Period Start Date Open Enrollment Period
    January 1st December 1st through January 15th
    April 1st March 1st through April 15th
    July 1st June 1st through July 15th
    October 1st September 1st through October 15th

    Senior Performers and dependents covered under the Extended Spousal benefit are included in the January 1st Benefit Period and corresponding Open Enrollment Period.

     
  • Payment Options

    Premiums can be paid in advance, regardless of your method of payment, with the exception of Auto Debit. However, you may not pay the premium for any period beyond your current Benefit Period.

    • Pension Deduction (only available to Senior Performers)

      The easiest way to pay your premium is through an automatic deduction from your monthly pension benefit. If you qualify for Extended Spousal coverage, please contact the Health Plan to verify that this option is available to you. Automatic deduction ensures that your health coverage will continue without interruption and eliminates the inconvenience of mailing payments.

    • Pay by Auto Debit

      The Auto Debit Plan deducts your quarterly premium automatically on a recurring basis each quarter from a checking or savings account. Payments are deducted on the 25th of the month prior to the due date (e.g. June 25th for 3rd quarter, July through September premium).

      Complete and sign the application. Please be sure to include the complete bank information. Applications must be received in our office 15 days prior to the quarterly premium due date.

      You will be assessed a $25.00 handling charge on a declined Auto Debit transaction. Replacement transactions must be in the form of a cashier's check or money order. If transactions are returned three (3) times, your Auto Debit privileges will be cancelled.

      The Health Plan will continue to deduct your quarterly premiums as long as you remain continuously eligible for Earned coverage, even if there is a change in the premium rate because you move from Plan I to Plan II or the reverse. You will be notified, in advance, of any change in your eligibility status and premium rate.

      Cancellation of the Auto Debit Plan requires a written request from you to withdraw from the program. All requests must be received in our office 15 days prior to the quarterly due date. No verbal requests will be accepted.
    • Pay by Phone

      Pay your premium with a credit card by calling (818) 954-9400 or (800) 777-4013 before the due date, and following the prompts. You will receive instant confirmation that your payment has been received. For your security, a Service Representative will not be able to take your credit card information over the phone.
    • Pay by Web

      You may pay your premium online with a credit card. Simply login to our secure Web site here and enter your credit card information. You can pay for up to four quarters at one time. You will receive instant confirmation that your payment has been received.

      You may also pay your premium here using E-Check.

      For your protection, pay by web and pay by phone payments are non-recurring which means that the Plan will not store your credit card information and will not automatically charge your credit card or use E-Check information every time a payment is due.
    • Pay by Mail

      A quarterly billing statement and payment 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 SAG-PHP Payment Center with your coupon. To ensure proper credit, please include the account number from your billing statement on your check. Your payment must be received by the SAG-PHP Payment Center at P.O. Box 30110, Los Angeles, CA 90030-0110 by the due date to be considered timely. DO NOT SEND YOUR PAYMENT TO THE HEALTH PLAN OR THE SAG-AFTRA UNION OFFICE.

     

     
  • Premium Due Dates

    Payment Due Dates

    Your premium is due by the 1st day of each calendar quarter for Earned Eligibility or by the 1st day of the month for Senior Performers or Extended Spousal benefits. For example, the payment for the 1st quarter of the calendar year (January through March) is due on January 1. There is a 15-day grace period. Health Plan coverage will not be extended until your payment is processed. You are encouraged to submit your premium prior to the due date to allow processing time and avoid any interruption in your coverage. The due date applies even when traveling. The grace period is for unforeseen circumstances.

    Termination of Coverage

    If the Plan does not receive your premium payment by the due date, you will not be entitled to any coverage under the Health Plan until your next Benefit Period. (Please see below under Special Enrollment Opportunities for special exceptions.) You will not be entitled to self-pay coverage, nor will you be entitled to any conversion options if your coverage is terminated due to failure to pay your premium.

    For example: If you make quarterly payments and your Benefit Period is January 1, 2016 through December 31, 2016 and you fail to pay your first quarterly premium by January 15, 2016, you will not be entitled to any Health Plan coverage until January 1, 2017, provided you re-qualify for coverage by either meeting the minimum earnings requirement or meeting the Senior Performer requirements.

    Late Payment Waivers

    If your payment was 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 a payment is due.

    The Health Plan will automatically apply a late payment waiver (if available) when your payment is received after the due date. Your coverage will be automatically and retroactively reinstated.

     

     
  • Special Enrollment Opportunities

    Special enrollment opportunities allow you to make changes to your dependent elections outside of the Open Enrollment Period. Traveling is not considered a special exception.

    Adding New Dependents: If you do not pay the premium and subsequently acquire a new dependent, you can request coverage under the Health Plan within 30 days of the date of marriage, birth, adoption or placement for adoption. You will need to complete a New Dependent Form and submit the appropriate documents as outlined below:

    • Spouse – copy of the recorded marriage certificate
    • Child – copy of the recorded birth certificate, adoption or placement for adoption papers, or guardianship papers

    Exception: While you are obtaining a recorded copy of your natural child's birth certificate, we will accept a copy of the birth certificate from the hospital to add your natural child who is younger than one year of age for a period not to exceed 120 days.

    A new dependent will not be enrolled in the Health Plan until all the necessary documents have been received to verify your relationship to the dependent. Once the new dependent documentation is processed, he/she will not be eligible for coverage unless you, the Participant, are or become eligible and the appropriate premiums have been received.

    Senior Performers also have an opportunity to make changes to their covered dependents in the event their spouse turns 65. In the case of Extended Spousal coverage, eligible dependents will have an opportunity to re-enroll in the Plan when the spouse turns 65.

    If your Health Plan coverage is available under the Extended Spousal provision, you may only re-enroll outside of the Open Enrollment Period if you have other health coverage and your other coverage ends because of a reduction in employment, or if you are eligible for a Children's Health Insurance Program (CHIP) or Medicaid event. This is described on below.

    Important Note: If you are covered under the Extended Spousal benefit and you remarry Health Plan coverage will terminate as of the date of remarriage.

    Removing Dependents: If you are cancelling enrollment of a current dependent due to divorce, dissolution of a qualified same-sex domestic partnership or death, you are required to submit a copy of the final judgment of divorce, termination of domestic partnership form or recorded death certificate to the Health Plan. In the event of divorce or same-sex domestic partnership dissolution, you must notify the Health Plan within 60 days of the date your divorce or dissolution of your domestic partnership in order to preserve individual self-pay rights for the dependent, if they qualify.

    Important Notes:

    • Expenses incurred by your spouse, same-sex domestic partner or step-children on or after the date of divorce or domestic partnership dissolution are not covered by the Health Plan. You, the Participant, will be billed for expenses paid by the Health Plan from the date of divorce or dissolution of your same-sex domestic partnership. It is your responsibility, as the participant, to notify the Health Plan of any change to your qualified dependents.
    • Enrolling and cancelling enrollment of current dependents can affect the amount of your premium. Premium changes will be effective the 1st of the month in which the event occurred if enrolling a new dependent(s) and the 1st of the following month if you are cancelling enrollment of a current dependent(s).

    You may also wish to consider changing your beneficiaries when life events occur. A Designation of Beneficiary form can be obtained by visiting our website at www.sagph.org or contacting the Health Plan.

    Supplementary Health Coverage: If you do not pay the premium due to supplementary group health coverage, you may be allowed to participate in the Screen Actors Guild - Producers Health Plan when your other coverage ends due to a reduction in employment, legal separation, divorce or death. If the supplementary coverage is under a COBRA provision and you exhaust your COBRA coverage, you may also be allowed to participate in the Screen Actors Guild–Producers Health Plan. You must submit a written request for coverage under the Health Plan within 30 days after your other coverage ends.

    CHIP/Medicaid: Special enrollment opportunities are also available to:

    • Participants and their dependents who lose coverage under Medicaid or CHIP;
    • Participants and their dependents who become eligible for a state Medicaid or CHIP premium assistance program

    The CHIP/Medicaid enrollment events require you to submit a written request to the Health Plan within 60 days of their occurrence.

    CHIP is a federal/state program designed to provide health care coverage for uninsured children and some adults although benefits under this program are only provided by certain states. If you think you or any of your dependents might be eligible for Medicare or CHIP, you can call 1-877-KIDS-NOW (1-877-543-7669) or visit www.insurekidsnow.gov to find out how to apply. If you qualify, you can ask your state if it has a program that might help you pay the Screen Actors Guild–Producers Health Plan premiums.

    Questions?
    If you have any questions about the Plan rules for premium payments, please contact the Plan Office. Information about these rules, payment options and all other Health Plan benefits can also be found on the Plan’s Web site: www.sagph.org.

     
  • Sample Billing Statement and Payment Coupon

    To view a sample of the billing statement and billing coupon which will be used for health premium payment, you can click below.
    Sample Billing Statement and Payment Coupon (front)
    Sample Payment Coupon (back)

     
  • Questions & Answers

    1. How did the Trustees determine the premium amounts?

      The Plan's actuary provided the Trustees with the projected savings that would be realized for various premium amounts. These, together with the estimated savings for other benefit changes, had to correct the projected deficit. It was the Trustees' intent to provide a meaningful benefit program to the greatest number of participants with the lowest premium possible.

    2. Why is the premium higher in Plan II even though the benefits are lower?

      Plan II participants must pay a higher health premium because virtually 100% of the cost of their coverage is subsidized - that is, the contribution received by the Plan based on their earnings does not cover the cost of the benefits. In Plan I, while some participants' coverage is subsidized, others fully cover their costs and some pay a portion of the cost for Plan II participants.

    3. Are the premiums going to change every year?

      Like all of the Plan rules, the amount of the premium is subject to review by the Trustees on an ongoing basis. However, unlike self-pay premiums which are required under federal law to be adjusted every year, the amount of premium for the Earned and Earned Inactive coverage is determined solely by the Trustees, based on the financial condition of the Plan.

    4. Can I pay for the whole year in advance?

      Yes. The minimum payment is for one quarter (3 months). You can pay in advance for up to four quarters of your current eligibility period.

    5. What happens if I am late with my health premium payment?

      Your payment is due by the 1st day of each calendar quarter during your eligibility period. This means it must be received by the payment center (or via Pay by Web, Pay by Phone or Auto Debit Plan) on or before the due date.

      If your payment is not received by the due date, your Earned coverage will be terminated and you will not be eligible for coverage until your next benefit period, provided you requalify and meet the minimum earnings requirement. You cannot enroll in the self-pay program and you will not be eligible for conversion options.

      If your payment was 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 a payment is due.

    6. What if I am traveling when my health premium payment is due?

      Traveling is not considered a special exception to paying the health premium on time. If you know that you will be out of town when the premium is due, please pay prior to leaving on your trip. Remember that you can pay your health premium by Phone, through our interactive Web site or by enrolling in the Auto Debit Plan (See Payment Options section above).

    7. What happens if I cannot afford to pay the health premium?

      You should contact one of the assistance organizations, such as the Actors Fund. A list of these organizations is available from the Plan Office and also is on the Plan's Web site at www.sagph.org.

    8. What if I don't receive payment information in the mail?

      If you are eligible and do not receive payment information in the mail by the 15th of the month before the start of the calendar quarter (for example, by December 15, 2002 for the first calendar quarter in 2003), you should call the Plan Office. You will not receive quarterly payment coupons if you are enrolled in the Auto Debit Plan.

      To ensure that you receive all quarterly billing statements and other important Plan information, be sure to keep the Plan Office advised of any change in your mailing address. If you use your business manager or agent's address, you should advise them of the new rules.

    9. Does the quarterly premium apply to participants with Senior Performers coverage?

      If an individual on Senior Performers coverage with a $25 premium regains Earned Eligibility due to sessional employment, he will pay the $25 monthly premium. This also applies to participants who are 65 and over and have the required number of Pension Credits for Senior Performers coverage with a $25 premium, but are not yet receiving their pension.

      If an individual on Senior Performers coverage paying 25% of the cost of coverage regains Earned Eligibility due to sessional employment, he will pay the Earned quarterly premium.

      Senior Performers coverage has its own rules outlined here.

    10. Since I am now paying a portion of the health premium, is my coverage treated like self-pay coverage for purposes of coordination of benefits?

      No. For purposes of coordination of benefits (COB), your Earned coverage is still considered "active" even though you are required to pay a health premium. If you are Earned Inactive, your coverage is secondary to Medicare.

    11. Can I pay with my credit card?

      Yes, you can pay with a credit card online or over the telephone. Click here or call 800-777-4013.

    12. What is E-Check?

      E-Check works just like a regular check, only no paper is involved. Your bank account information is securely transmitted to the Plan's bank, a withdrawal is made from your account, and your premium amount is transferred to the Plan's bank account. Not all accounts are appropriate for electronic payments. Certain accounts may not be acceptable.

      Examples of Checks Not Accepted for Electronic Transactions:

      • Brokerage Account Checks
      • Cashier's Checks
      • Corporate Checks
      • Credit Card Checks
      • Equity Lines of Credit
      • Money Market Checks
      • Money Orders
      • Third Party Checks
      • Traveler's Checks
      • U.S. Treasury Checks

      If you plan to use an account other than the standard bank checking or savings account, please check with your financial institution before submitting payment.

    13. How do I submit my health premium payment?

      You will receive a billing statement and payment coupon, along with a payment envelope, from the Plan Office each quarter, in advance. You should complete the payment coupon and mail it, along with your check, in the envelope provided. Payment must be sent to the payment center shown on the coupon. You should not send your payment to the Plan or Guild Offices. You can also pay online or over the telephone with a credit card or online with E-Check. Click here or call 800-777-4013. You can also have the quarterly premium automatically deducted from a Checking or Savings account (in which case you will not receive payment coupons in the mail). See here for information and application.

    More Questions?

    If you have any questions about the Plan rules for health premium payments, please contact the Plan Office. Information about these rules and all other Health Plan benefits can also be found elsewhere on this site.