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 logging in to your Benefits Manager or by checking the appropriate box next to their name and returning the enrollment form to the Plan. If there are no changes to your dependents' enrollment, simply submit your premium before the payment 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 surviving dependent benefit. If you cancel enrollment for current dependents due to death or divorce, 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. See Life Events for instructions. 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 Coverage, which includes your health care ID cards, will be sent to you within 7-10 business days. You cannot make changes until your next open enrollment period. Please see 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||Open Enrollment Period|
|January 1st||December 1 - January 15|
|April 1st||March 1 - April 15|
|July 1st||June 1 - July 15|
|October 1st||September 1 - October 15|
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 Plan within 60 days of the date of marriage, birth, adoption or placement for adoption. See Life Events for instructions for adding a new dependent.
A new dependent will not be enrolled in the 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 surviving dependent coverage, eligible dependents will have an opportunity to re-enroll in the Plan when the spouse turns 65.
If your Plan coverage is available under the surviving dependent 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 below.
Important Note: If you are covered under the surviving dependent benefit and you remarry, your Plan coverage will terminate as of the date of remarriage.
Removing Dependents: If you are canceling enrollment of a current dependent due to divorce or death, you are required to submit a copy of the final judgment of divorce, or recorded death certificate to the Plan. In the event of divorce, you must notify the Plan within 60 days of the date your divorce in order to preserve individual COBRA rights for the dependent, if they qualify.
- Expenses incurred by your spouse or step-children on or after the date of divorce are not covered by the Plan. You, the Participant, will be billed for expenses paid by the Plan from the date of divorce. It is your responsibility, as the participant, to notify the Plan of any change to your qualified dependents.
- Enrolling and canceling 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 canceling enrollment of a current dependent(s).
You may also wish to consider changing your beneficiaries when life events occur by submitting a new Designation of Beneficiaries form.
Supplementary Health Coverage: If you do not pay the premium due to supplementary group health coverage, you may be allowed to participate in the SAG-AFTRA 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 SAG-AFTRA Health Plan. You must submit a written request for coverage under the Plan within 60 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 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 SAG-AFTRA Health Plan premiums.
If you have any questions about the Plan rules for premium payments, please call the Plan at (800) 777-4013 or log in to your Benefits Manager and use the secure message center.