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Please be sure to enter your Member ID WITHOUT
the NSA prefix—only the numbers, no letters.
Additional benefit enhancements and cost-sharing changes
Your to-do list — take action!
The Plan defines you as a Retiree if you’re:
And you have Senior Performer status if:
We’re making several changes to the criteria we use to establish eligibility for active SAG-AFTRA Health Plan coverage:
We’ll determine your eligibility for Via Benefits or the active Plan by evaluating your covered earnings or alternative days worked from October 1, 2019, through September 30, 2020.
You’ll qualify for active SAG-AFTRA Health Plan coverage if you meet one of the requirements below: |
|
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Covered earnings threshold | $25,950 |
Alternative days threshold | 100 days worked under specified contracts |
You’ll be eligible to move into our new SAG-AFTRA Health Plan / Via Benefits program during 2021.
Only sessional earnings are included in your earnings evaluation for benefits in 2021 and beyond.
Sessional and residual earnings are included in your earnings evaluation for 2021 benefits.
Then, for 2022 and beyond, only sessional earnings will be included.
In addition to changing the eligibility thresholds, we’re transitioning our Retirees into calendar-year benefit periods. This will allow us to align our plan with Medicare’s annual calendar, making it easier for you to work with Medicare. The Medicare Annual Enrollment Period is October 1 to December 15.
Here’s how the timing for the transition works, based on your current status as a SAG-AFTRA Health Plan participant and your current benefit period.
You’ll move into our new SAG-AFTRA Health Plan / Via Benefits program (or you can elect active SAG-AFTRA Health Plan coverage, if you qualify) for the period of January 1 to December 31, 2021.
NOTE: You will continue to receive the SAG-AFTRA Health Plan life insurance benefit.
You qualify for active SAG-AFTRA Health Plan coverage from January 1 to December 31, 2021.
You can enroll in the new SAG-AFTRA Health Plan / Via Benefits program for January 1 to December 31, 2021 coverage, or elect COBRA continuation coverage.
You qualify for active SAG-AFTRA Health Plan coverage through December 31, 2021.
In October 2021, we’ll evaluate your earnings between October 1, 2020, and September 30, 2021. This will establish your eligibility for coverage starting January 1, 2022. At that point, you’ve completed the transition to calendar-year eligibility.
You can continue your current Plan I coverage until the end of your current benefit period (March, June, or September 2021) at the new plan premiums.
When your current coverage runs out in 2021, you can enroll in the new SAG-AFTRA Health Plan / Via Benefits program for coverage through 2021, or elect COBRA continuation coverage.
In October 2021, we’ll evaluate your earnings from October 1, 2020, to September 30, 2021. This will establish your eligibility for coverage starting January 1, 2022. At that point, you’ve completed the transition to calendar-year eligibility.
The Plan’s eligibility rules are complex, and the changes are too! If you have questions or need help, contact Via Benefits and discuss what’s best for you with a Via Benefits advisor.
We’re partnering with Via Benefits to provide more choices and personalized support and service to our Retirees. You can shop around and customize your benefits coverage to meet your personal health needs and use of healthcare services. For example:
Learn more about Via Benefits, and begin your shopping and enrollment process online at my.viabenefits.com/sagaftrahp, or call (833) 981-1280.
This is a new benefit for Senior Performers. When you enroll in a Via Benefits medical plan, you’re eligible for the SAG-AFTRA Health Plan Senior Performers Health Reimbursement Account (HRA).
The SAG-AFTRA Health Fund credits money to your Senior Performers HRA. The amount is based on your Retiree Health Credits and whether you enroll yourself only, or yourself and your Medicare-eligible spouse.
We credit $1,140 per year for you and $1,140 per year for your enrolled Medicare-eligible spouse.
The amounts are prorated ($95 per month) for Senior Performers who retire during 2021.
OR
We credit $240 per year for you and $240 per year for your enrolled Medicare-eligible spouse. The amounts are prorated ($20 per month) for Senior Performers who retire during 2021.
Your Senior Performers HRA helps to cover the cost of eligible healthcare expenses for you and your enrolled Medicare-eligible spouse. You can use it to pay your Via Benefits medical plan premiums, Medicare premiums, copayments, deductibles, coinsurance, and other eligible healthcare expenses as long as you have money in your account.
The federal government does not allow you to contribute to an HRA. However, any unused HRA funds roll over from year to year.
This is a new benefit for Senior Performers. When you enroll in a plan that includes prescription drug benefits with Via Benefits, your plan will cover 95% of prescription drug expenses after you reach the Medicare catastrophic expense amount — and you pay 5%.
For Senior Performers facing very high prescription drug expenses, their share can be difficult to pay. That’s why the SAG-AFTRA Health Fund will offer a catastrophic prescription drug HRA. Through this arrangement, you (and your enrolled Medicare-eligible spouse) may be reimbursed for your share of catastrophic expenses.
You’ll learn more about this program in a mailing from Via Benefits.
You and your Medicare-eligible spouse are eligible for the new SAG-AFTRA Health Plan / Via Benefits program — and Senior Performers are eligible for the new Health Reimbursement Account.
Also, Retirees who enroll themselves through a Via Benefits medical plan can cover eligible dependents under age 65 through the SAG-AFTRA Health Plan. If you do, be sure to take note of a few new rules for 2021.
When shopping for a plan through Via Benefits, you may find low-cost premium options — with $0 premium plans available to many participants.
Your premium cost will be based on the plan and coverage you choose and whether you cover your Medicare-eligible spouse. You pay your premium directly to the plan you choose.
The cost for Senior Performers to enroll dependents under age 65 in the SAG-AFTRA Health Plan is $250 per month. The premium covers all eligible dependents (one or more), and it’s paid directly to the SAG-AFTRA Health Plan. The new premium is effective January 1, 2021.
Note: Premiums can no longer be deducted from your pension benefit.
Your cost is based on the number of family members you enroll, and you’ll start paying the new premium as of January 1, 2021.
If you enroll or remain in the active SAG-AFTRA Health Plan, beginning January 1, 2021, you’ll see a few benefit enhancements and changes to coverage and cost-sharing between you and the plan. Get more details.
Our Plan changes will affect different participants at different times. You’ll receive personalized information, including a confirmation of your benefits and any actions required, starting in August.
Medicare-eligible participants | Participants under age 65 |
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Phone: (833) 981-1280 | Phone: (833) 963-1230 |