NOWPLAYING EQ U I T Y – L E A G U E If It’s News, It’s In This Issue NOVEMBER 2007 • VOLUME 14 • NUMBER 2 IT’S A JUNGLE OUT THERE, especially when it comes to health care provider data. Follow along as we clear a path through the thicket of provider information available to you. We’ll also revisit expiring Health Fund transition rules and check in on our improved online payment system. And if you’re feeling lost among the many pensioner health care alternatives, stick with us as we make our way through them. How to Wade Through the River of Health Care Information Available to You It matters which doctor—or even more important, which facility—you go to when you need care. We understand this on a basic level—we wouldn’t go to a plastic surgeon for heart surgery, for example, or vice versa—but now we can and, in fact, we must become even more sophisticated in our analysis of which providers to use, especially where hospital care is concerned. If, say, Springfield Community Hospital does everything right when it comes to treating a heart attack and Springfield General Hospital follows only 80% of the recommended process of care, Springfield Community will have much lower mortality rates and complication rates. By choosing Springfield Community, you increase your chances of a shorter stay, a better outcome and, ultimately, lower costs. The opposite may be true for knee surgery: if Springfield General gets knees right more often than Springfield Community, that’s the place to be for knee surgery—even though Springfield Community did such a fine job treating your heart problems. With such procedure-by-procedure variations in care, you have to pick your spots. See inside for: ■ ■ ■ ■ ■ ■ ■ The end of the Health Fund transition rules New, shorter grace period for self-pay coverage Website changes Alternatives to pensioner health coverage Self-pay dental coverage enrollment window, rates The new Pension Plan SPD is here Why you should contribute to the 401(k) NOWPLAYING THERE’S A TREMENDOUS AMOUNT OF INFORMATION AVAILABLE to help you make important provider-related decisions, much of it right at your fingertips. The hard part is knowing what to do with it. step for you by admitting only those doctors, hospitals and other providers who have met certain CIGNA-established standards to the CIGNA network. This is known as the “credentialing process.” In order to be accepted into CIGNA’s network a provider must meet the following criteria established by CIGNA: CIGNA also offers helpful tools on its website (www.mycigna.com), such as Select Quality Care: a tool to help members identify the hospital in their area with the highest quality service for a particular procedure. The program automatically selects the hospitals that have treated the most patients with your diagnosis and then considers the following for each hospital: ■ ■ Start with CIGNA. CIGNA takes the first Like CIGNA, HMOs also have processes and resources in place to help their members find and use quality, costeffective providers. If you’re in an HMO, check your HMO’s website or contact their member services function to learn more about their credentialing requirements, web resources, etc. •2 ■ ■ ■ ■ ■ ■ have an unrestricted state medical license have full, unrestricted admitting privileges and be in good standing on the medical staff at a CIGNA-participating hospital be board-certified with the American Board of Medical Specialties (limited exceptions may apply) disclose their malpractice claims history verify their education, training and work history have adequate malpractice insurance pass an on-site inspection by the CIGNA credentialing committee. So when you stay In-Network for your care, you can ensure that you are receiving care from a doctor who has already been pre-screened by CIGNA. Mortality rates: How many people have died at that hospital while undergoing the specific treatment? ■ Complications: Do mistakes happen more or less frequently than at other hospitals? ■ Average length of stay: How long, on average, are patients hospitalized for the specific procedure? ■ Average hospital charge: How much does the hospital charge for the procedure? Once you have the results of your search, bring them to your physician, who can help you decide where to seek care. On the Health Scene CIGNA Case Management is a voluntary program designed to assist Health Fund participants who need special or extended care for serious illness or injuries. Its primary goal is to ensure that you (or your enrolled dependents) receive the appropriate care in the most effective setting (whether that be at home, in a hospital or in a specialized facility). Case management also can help you and the Fund save money in the long run. For more information, see the Health Fund Summary Plan Description or call CIGNA Member Services at the number shown on your ID card. Help yourself. You can go beyond CIGNA’s resources by doing your own research. One item to look for is a “report card” for the hospitals in your area. For example, if you live in New York, the New York State Health Accountability Foundation has made available online a New York Regional Health Care Report Card, which presents access, service and quality data for all hospitals in New York State. Most states have a similar service. One centralized resource for report card data is at www.aarp.org/bulletin/yourhealth/statebystate_guide_ healthcare_provider_performance.html, where you’ll find a page of links to report cards for each state that issues them. You can also go to www.hospitalcompare.hhs.gov, a website established by the U.S. Department of Health and Human Services to help patients learn more about hospital care, specifically which hospitals follow “Process of Care” guidelines for patients being treated for a heart attack, heart failure or pneumonia, or for patients having surgery. Another option to look into is using an independent health care research company, many of which provide important tools and information for a fee. For example, Health Grades, a health care ratings company, provides ratings and profiles of over 5,000 hospitals, 650,000 physicians and 16,000 nursing homes around the country on its website (www.healthgrades.com). They also offer a medical cost calculator to help you estimate the cost of procedures and plan for your future health care expenses. The information is out there; all it takes is a little research. It may be as simple as logging on to CIGNA’s website. Or a Google search. The end result—quality care, shorter stays, fewer complications and lower costs—is well worth it. STUDY FINDS COSTS DRIVEN BY DOCTOR HABITS, NOT PATIENT HEALTH Medical care is as much a function of geography as it is of actual medical circumstances, according to a recent Dartmouth Medical School study published in the Archives of Internal Medicine. The study revealed that the discrepancy in health care spending from one part of the U.S. to another is attributable to physician behavior, not the health of patients. Physicians practicing in regions of the U.S. where health care spending is high are more likely to order tests, referrals and treatments for their patients than those in low spending regions, according to researchers at the VA Outcomes Group (White River Junction, Vermont) and Dartmouth Medical School (DMS). What makes this most alarming is that data indicates that health care spending has little relationship to health outcomes. •3 NOWPLAYING TRANSITIONING NO MORE… The New Rules are Here to Stay Last fall, when we announced the Health Fund’s new eligibility rules as of January 1, 2007, we also introduced special rules for making the transition from a two-month to three-month Waiting Period. These transition rules allowed you to choose an Accrual Period that ended either three months or two months before the effective date of your next Benefit Period, depending on which worked best for you. Effective with coverage starting January 2008, the transition rules will “expire.” All participants must use Accrual Periods with a three-month Waiting Period. (See The Big Picture, on page 5, for more information on how—and when—eligibility for coverage is determined.) Transitioning out of the transition rules. One of the wrinkles in eliminating the transition rules is that some participants (namely those of you who chose to stick with the two-month Waiting Periods in 2007) risk coming up short on benefit credits. For example, those of you who already used benefit credits earned in October 2006 to qualify for 12 months of coverage that started in January 2007 would now have only 11 months (November 2006 to September 2007) in which to earn credits for coverage starting in January 2008. (That is, the Accrual Period for January 2008 coverage—which, with the elimination of the transition rules, runs from October 2006 through September 2007—would really be shortened by a month because you can’t re-use benefit credits earned in October 2006.) To prevent this problem, we’ll allow you to spend the following benefit credits twice (if needed): FOR THE BENEFIT PERIOD THAT STARTS ON… THE ACCRUAL PERIOD IS… THE MONTH YOU MAY SPEND TWICE IS… Benefit credits January 1, 2008 October 2006–September 2007 October 2006 “expire” after April 1, 2008 January 2007–December 2007 January 2007 July 1, 2008 April 2007–March 2008 April 2007 October 1, 2008 July 2007–June 2008 July 2007 one year. To get or keep Health Fund coverage, you can’t This extension of the transition rules ends with the Benefit Period that starts on January 1, 2009. use benefit credits Whether or not you spend benefit credits twice in 2008, you cannot do so in 2009, under any circumstance. that are more than 12 months old. •4 CALENDAR OF KEY DATES FOR ELECTING JANUARY 1 COVERAGE October 15, 2007 Fund Office sends election notices to all participants who qualify for coverage as of January 1, 2008, including participants who are already covered and whose coverage is scheduled to continue after January 1, 2008. December 1, 2007 All Health Fund contributions due. You must submit payment with your completed election form in order for coverage to be in place on January 1, 2008. DON’T MISS THIS DEADLINE; if you do, you risk delayed or denied coverage. December 31, 2007 Last day of Health Fund coverage for any currently-covered participant who does not send payment by December 1. January 1, 2008 Coverage continues (current participants) or begins (new participants) for all participants who submitted their $100 contribution by December 1. On the Health Scene The Big Picture Here’s a handy summary of the Health Fund eligibility rules and how the Fund will determine eligibility for 2008 coverage. (You’ve seen it before but we’re bringing it back for an encore!) Getting coverage. Health Fund eligibility is established by earning enough benefit credits (that is, working the required number of weeks) during a 12-month period, known as the Accrual Period. Benefit credits earned in an Accrual Period are what enable you to qualify for coverage for a corresponding Benefit Period, which begins the next calendar quarter (three months after the Accrual Period ends). There’s a three-month gap between an Accrual Period and a Benefit Period, known as the Waiting Period. ACCRUAL PERIOD WAITING PERIOD BENEFIT PERIOD 3 MONTHS COUNTING FROM: 6 OR 12 MONTHS OF COVERAGE STARTING ON: 12 MONTHS COUNTING FROM: U G A L E ue Y – is Iss h I T In T It’s ME ews, • V O L U 06 t’s N If I B E R 2 0 U 13 • NU SE PT TO LAST SUNDAY IN: October September October December January 1 January December January March April 1 April March April June July 1 July June July September October 1 E MB ER 2 on less ney o the f On gm n: savin ORY o tio NCE of t HIST Edi e SCIE recen u.) olMATH;s thabout isthuep to yo o d ) ch new new ESS FunThing lth o-SFund’s good ke REC Hea ood k-tHealth gs; and you ta the e a G g to uld B BlaancarescthrieptioFun dnrud. (When in om Co NG I Y LA P W NO EQ FIRST SUNDAY IN: EM p pre on on Pensi the ns C rage utio ove trib r C Con g fo rly Payin spiralinge still ar arte Qu d How forts to rokel,epdeficanitsd 2008h. set of (an our best efder contin 2007a very tohtugen the ions. r of ou ose verage ne co d th s an ange ttom-li l ica ch need bo ary were to ilar se med of dget a sim crea eks .) ’s bu , if we have to in we ge to Fund (FYI had o extra covera the bers. y rules have tw for mem gibilit would require alify qu or eli ct, we % or ent to 20 impa ys by ploym copa red em cove s tail de or e f w: sid ne e in t’s Se wha n o ent Four times each year—before each Benefit Period begins—the Fund looks back over the most recently completed 12-month Accrual Period to identify those participants who earned enough benefit credits to qualify for coverage in the next Benefit Period. For example, for January 1, 2008 coverage, the Fund looks at how many benefit credits you earned between the first Sunday in October 2006 and the last Sunday in September 2007. Your benefit credits determine the length of your coverage, as follows: un ut irem sts pite Fund ced er tig ntrib riod” requ Des ical co r the tees fa furth co ed to , ire fo ty Pe ion med ected of Trus verage requ expect rs. ibili ribut “Elig proj Board ce co les, or use it’s membe as we cont ru du aces terly The ces: re bility r, beca ct on as long er— riods repl ng pa quar l Pe choi ’s eligi e latte all im change any lo rm 00 riod” th crua Pe ■ $1 Ac Fund chose st over g this t it off long-te ing al Fund ter riod nn ccru We the lea makin ot pu d the begi lth g Pe alth quar ■ “A ea ar e, d tin He ar ai e n have resiste we cann safegu erefor all H ent lend th W whe onlin We d, but nt to nd. Th asking ploym r for ■ Ca ge mon te oose vera coul if we wa the Fu ’ll be d by em quar reeto ch we r co ■ Th not ility of 2007, covere lendar ility gins y fo d exib ge be viab ary 1, cipants per ca rage. to pa email ■ Fl es di e ra rds a uste eciat s Janu parti e $100 cove cove it ca g vi on ut of Tr e appr budget ed in d Fund ntrib l/visi pay cr e ht ar. s Boar ly. W Play selfto co medica ■ Us the light on tig a ye Plu ow 2007 that ion rs are $400 ed their et N ch ow decis th buy 6 be ider ■ G se kn this r mem e up wi d cons approa 200 ty to e Plea make m d an rtuni 30, n, y t th of ou co not most easily debate ure ou dgetar eratio oppo ber em w of rage: that cannot d and g to fig est bu gh delib ion v do o gg and analyze , tryin the bi thorou ntribut the Win al cove 1– N We options get us . After ng a co ct on impact dent ber pa our would e buck at addi ost im e least tween vem No that for th ed th the m ing th ce be in e ak lan ng rm t mad ile m st ba ba dete we iremen ces wh the be an requ ’s fin strikes It Fund urs. yo on For more detailed information about Health Fund eligibility rules, see the September 2006 issue of Now Playing (Volume 13, No. 2) or log on to www.equityleague.org. BENEFIT CREDITS HEALTH FUND COVERAGE 20 or more 12 months At least 12 but fewer than 20 6 months Fewer than 12 No coverage Electing coverage. The Fund Office will send you a Health Fund election notice after the end of each Accrual Period that lets you know whether you qualify for coverage in the next Benefit Period and, if so, the number of months of coverage for which you qualify. When you receive this notice, you have a choice: enroll for coverage by paying the $100 per-quarter premium or save your benefit credits for the future by taking no action (assuming your benefit credits won’t expire by the end of the next Accrual Period). •5 NOWPLAYING Read Our Lips: No More Late Payments—And a Shorter Grace Period for Self-Pay Coverage Effective for coverage that begins January 1, 2008, the Health Fund will apply the following deadlines and grace periods to contributions for coverage: ■ REMINDER: Credit card payments are not recurring. You must initiate a new transaction each time you want to make a payment via credit card. For your security, the Health Fund will not automatically charge your credit card each time a contribution payment is due. And remember: you can pay for six or 12 months of health care coverage with one transaction. If you have coverage earned through employment, all of your Health Fund contributions are due on the first day of the month prior to the start of the quarter. This applies to your $100 premium payment and to any dental or dependent coverage you self-pay. For example, for coverage that starts on January 1, 2008, your $100 premium payment is due to the Fund Office by December 1, 2007. If you make other payments to the Fund (such as those required for dependent coverage or for self-pay dental coverage), they are all due at the same time, so this deadline would apply to those amounts, as well. If circumstances prevent you from getting your payment in to us by the first of the month, we can accept payments up to the last day of the month prior to the start of the quarter (in other words, there’s a one-month grace period). However, please note that because we send eligibility feeds to CIGNA only once a week, we cannot guarantee coverage as of the first of the month if a payment is received after the 15th of the month. There is a very good chance your coverage won’t be recognized on time if you don’t get your payment in by the 15th. ■ If you have self-pay coverage only, your Health Fund contributions are due on the first day of the quarter. For example, for self-pay coverage that starts on January 1, 2008, your premium payment is due to the Fund Office by January 1, 2008. This rule applies to all participants whose only coverage is self-pay coverage (Dental only, COBRA, Vested Beyond COBRA or Supplemental Medicare coverage). If circumstances prevent you from getting your payment in to us by the first of the quarter, we can accept payments up to the last day of the month after the quarter begins (in other words, there’s a one-month grace period). However, please note that if you don’t make your payments until after the quarter begins, eligibility will be applied retroactively, which can lead to trouble with any expenses you incur before you’re listed on the eligibility feed. As we told you in the March 2007 issue of Now Playing (Volume 14, No. 1), late payments are bad for the Fund and legally risky. And since we’ve made it even easier to pay online by credit card (see page 7), having contributions in on time should be as easy as pie. So for the good of the Fund—and to guarantee coverage for yourself—please make your payments on time. Thanks for understanding. •6 On the Health Scene Website Improvements: Paying by Credit Card Just Got a Whole Lot Easier Well over 3,000 participants are using the online payment system each quarter, leading us to conclude that you like the flexibility of paying online. So to make using the system even easier, we’ve added these new features: ■ FRIENDS, ROMANS, COUNTRYMEN: SEND US YOUR EMAIL ADDRESS! With many of us away from home for long stretches at a time (in touring productions, for example), we’ve found that email is becoming the preferred way for staying in touch with the Fund Office. So if you’re one of the 34% of participants whose email address is not on file, drop us a line at Pay For More Coverage With a Single Transaction. Effective with payments for January 2008 coverage, you can pay for six or 12 months of health care coverage with one transaction. (Previously, you had to pay for one quarter at a time.) This way you don’t have to worry about missing a future payment and losing coverage for which you’ve already qualified. ■ Online Tutorial. If you’re unsure of how to make payments online, check out the new online tutorial, which provides detailed instructions and helpful tips. As always, if you need additional help or have a question the tutorial doesn’t address, you can always call the Fund Office for more information. Keep in mind that when you pay via the website, you must pay the full amount and you must use either Visa or MasterCard. To finalize any online payment transaction, you must include your Actors’ Equity member number (AEA ID number) and your bill number. Have these numbers handy when you log on to the site. [email protected] and let us know where we may reach you electronically (see “Contacting the Fund Office,” page 14, for a longer list of Fund Office email contacts). Only Copays for Network Doctors Some members have reported that their network doctors are asking them to pay the full cost of eligible services up front and then apply to CIGNA for reimbursement. This is wrong. You are never required to pay a CIGNA network doctor more than the $25 copay (if applicable) for eligible services you receive. That’s one of the benefits of using In-Network providers: no claims to file! It is your doctor’s responsibility to work out payment for his/her services directly with CIGNA. If your doctor asks you to pay anything other than your copay up front, please inform the Fund Office and/or CIGNA as soon as possible. •7 NOWPLAYING When It Comes To COBRA, DON’T Just Say “No” If you lose coverage under the Health Fund, you and your eligible dependents have the right to purchase a temporary extension of health care coverage under the Consolidated Omnibus Budget Reconciliation Act (COBRA). Your COBRA benefits will be the same as the coverage you had under the Health Fund, but you must pay the full cost of coverage plus a 2% administrative fee. Coverage may be available for up to 18, 29 or 36 months, depending on your qualifying event. All COBRA payments after the initial payment are ■ The obvious reason: If you have no other coverage (through your spouse’s plan, for example), turning down COBRA leaves you unprotected. You face catastrophic health care costs should you or a member of your family become ill or injured. ■ Think before you reject COBRA. COBRA continuation coverage is expensive, but it may be money well spent for obvious and not-so-obvious reasons. due on a quarterly The not-so-obvious reason: If you decline COBRA when it’s offered to you and go more than 63 days without health care coverage, you risk having a pre-existing condition exclusion applied when you subsequently become covered by another health plan. (As a reminder, a pre-existing condition exclusion gives a plan the right to not pay benefits for a condition you had before coverage started.) This means that by trying to save a few bucks now, you could wind up paying much more later. basis but can be made on the first day of each month for that month’s coverage (for example, by June 1 for June coverage). Please note that the Fund Office does not send monthly bills for COBRA. It is your responsibility to make sure your payment is at the Fund Office by the due date. Know the COBRA Clock Ordinarily, the COBRA clock starts ticking on the date your coverage earned through employment ends. At that point you have 60 days to decide if you wish to continue coverage via self-pay, which you do by completing the COBRA election form and submitting it to the Fund Office. After you elect self-pay coverage, you have 45 days from your COBRA election date to submit the premium for your first quarter of self-pay coverage. In total, a maximum of 105 days may elapse from the date you first become eligible for COBRA until the date you must make your first payment. Use this time fully to evaluate your need for COBRA coverage. If you do decide to elect COBRA coverage, you make your first payment when you file your COBRA election form. Your first check will cover the period from the date your group coverage ended (and COBRA coverage began) through the date you make your first payment—that is, your payment may be for more than one month, and as many as three months, of retroactive coverage. Thereafter, payments are due on the first day of each month for that month’s coverage (for example, by June 1 for June coverage). You can make COBRA payments on a quarterly basis, if you prefer. For more information on your COBRA continuation coverage rights or electing COBRA coverage, see the Health Fund Summary Plan Description or contact the Fund Office. •8 On the Health Scene Pensioner Health Coverage: Self-Pay Is Not the Only Way APPLYING FOR MEDICARE You can file your application: ■ ■ over the phone by calling 1-800-772-1213 (TTY: 1-800-325-0778) in person at a Social Security office (visit their website or call their toll-free number to find the Social Security office nearest you). If you are eligible for Medicare—or will be in the near future—and you self-pay for health care coverage through the Health Fund, you may want to research your other coverage options. Depending on your individual circumstances, there may be Medicare supplement programs available to you that meet your coverage needs at a much lower cost than the Health Fund’s self-pay rate (currently $384/month). Here’s how it works now. Once a Medicare-eligible self-pay participant signs up for Medicare, Medicare automatically becomes the primary coverage, and the Health Fund becomes the secondary coverage. That is, Medicare pays covered health care expenses first, and then the Fund covers expenses Medicare either does not pay or pays only partially, within Plan limits. In this case, coverage under the Health Fund is known as supplemental coverage. It’s designed to cover many of the hospital and doctor costs that Medicare does not, thereby supplementing your Medicare benefits. (See the Health Fund Summary Plan Description for more information on coordination of benefits.) While rates—and plans—vary by geographic location, it is very likely that there is a Medicare supplement plan available to you for less than the $384/month the Fund requires. Make sure you consider ALL your options before you elect self-pay coverage from the Fund. In general, there are three types of Medicare supplement plans: ■ Medigaps. Medigap plans typically help cover Medicare deductibles, coinsurance and some additional benefits. There are 12 different Medigap plans—letters “A” to “L”—but not all plans are available in all areas. Each plan pays for a particular set of benefits and is priced accordingly, with Plan A being the cheapest but offering the fewest benefits. The most popular plans are Plan C and Plan F because they cover major expenses and are less expensive than most of the other Medigap plans. (For comparison purposes, Plan F usually costs from $140–$220 a month.) Note that Medigap plans generally do not cover outpatient prescription drugs. However, they can be paired with stand-alone Medicare Part D Prescription Drug Plans, which usually run about $25-$30 a month. ■ Medicare HMOs. Medicare HMOs work like standard HMOs. You may be required to choose a primary care physician (PCP). In most cases, benefits are payable for care coordinated by your PCP and received from physicians and hospitals in the HMO network only. Many Medicare HMOs do not have deductibles or coinsurance; you pay a small copay when you see the doctor. They may also offer additional benefits, such as prescription drugs, dental care, eyeglasses and vision care. ■ Medicare PPOs. Unlike the Medicare HMOs, Medicare PPOs typically do not require you to choose a PCP and will provide coverage for care received from non-network providers. Keep in mind, however, you will pay more out-of-pocket for care received from non-network providers. Most Medicare PPOs require higher monthly premiums than the Medicare HMOs. These are the three most common types of Medicare supplemental plans, but they are not the only ones. There are also stand-alone Medicare Part D Prescription Drug Plans, Private Fee-for-service Plans and State Programs that may be available in your area. Keep in mind, supplemental plan designs and rates vary. Be careful choosing a supplemental plan as some plans have significant gaps in coverage or other important restrictions. For more information on supplemental health care coverage, contact the Fund Office or one of the following resources: ■ Actors Fund Health Insurance Resource Center (HIRC), which offers health care-related seminars and counseling to entertainment industry workers. – Website: www.ahirc.org – Phone: 1-212-221-7300, ext. 265 (N.Y.) 1-323-933-9244, ext. 32 (L.A.) ■ Medicare Rights Center, which provides counseling to individuals with Medicarerelated questions. – Website: www.medicarerights.org – Phone: 1-800-333-4114. •9 NOWPLAYING 2008 Self-Pay Dental Coverage Window: Open Only in November If you’re eligible for self-pay dental coverage, you can enroll November 1–30, 2007 for coverage that starts January 1, 2008. There are two options for self-pay dental coverage: the CIGNA Dental PPO or the CIGNA Dental HMO. Here are the 2008 quarterly premiums for each option: REMINDER! QUARTERLY PREMIUM If you don’t enroll for self-pay dental coverage during the November open enrollment period, you won’t have another opportunity until the November 2008 open enrollment (in which case your coverage would start on January 1, 2009), or the next time you become eligible for health benefits through employer-paid coverage. If You Elect to Cover CIGNA Dental PPO CIGNA Dental Health (DHMO) Yourself $168.30 $77.79 Yourself + 1 dependent $335.04 $125.79 Yourself + 2 or more dependents $498.33 $220.62 Please note that while quarterly contribution rates are changing, the DHMO’s Schedule of Covered Services (a.k.a. the copay schedule) will stay the same. For information on either of these plans, contact the Fund Office in New York or go to our website (www.equityleague.org) and click on CIGNA Self-Pay Dental Plan Information on the home page. Once you’re in the Self-Pay Dental Information section, you can look at (and download) summaries of both dental options. Important Reminder About the Women’s Health and Cancer Rights Act The Women’s Health and Cancer Rights Act is a federal law that provides protection for breast cancer patients who elect breast reconstruction in connection with a mastectomy. All group health plans, including HMOs, that provide medical and surgical benefits in connection with a mastectomy must also provide for reconstructive surgery, in a manner determined in consultation with the patient and attending physician. If you or an enrolled dependent are a breast cancer patient, you should know that in addition to providing medical and surgical benefits in connection with a mastectomy, your Equity-League Health Fund coverage also includes the following: ■ ■ ■ reconstruction of the breast on which the mastectomy was performed; surgery and reconstruction of the other breast to produce a symmetrical appearance; and prostheses and treatment of physical complications at all stages of mastectomy, including lymphedemas. This coverage is subject to applicable copays, referral requirements, annual deductibles and coinsurance provisions. You should review the provision of your plan regarding any such restrictions that may apply. If you have any questions about this coverage, please contact the Fund Office. • 10 On the Pension Scene WE’VE MADE THE LIST BUT YOU NEED TO CHECK IT TWICE READ ALL ABOUT IT: You will soon receive your “Report of Covered Earnings and Pension Accruals for the Year 2006,” otherwise known as the annual earnings statement. It’s a good idea to check it carefully, go out for a cup of coffee, and then check it again. If you discover any discrepancies, be sure to notify the Fund Office ASAP. After all, what’s shown on your statement now will determine the pension you eventually receive, and it’s much easier to clear up earnings questions sooner rather than later. By now, you should have received the new Pension Plan Summary Plan Description (SPD), which reflects Pension Plan improvements made as of January 1, 2007. In it you’ll notice two new forms of payment, available to all pensioners whose pensions begin on or after September 1, 2007: the New Pension SPD is Here ■ 75% Joint and Survivor Benefit. This payment method provides reduced monthly payments for your lifetime. Upon your death, your spouse (or other designated beneficiary) receives 75% of the monthly benefit you were receiving, payable for the rest of his or her life. Please note if you elect the 75% joint and survivor benefit and choose a non-spouse beneficiary, he or she may not be more than 19 years younger or older than you. ■ EQ U I T Y – L E A G U E SPO TLIG HT … Your P ON ensio n Pla n Sum m ar yP la n D es cr ip ti o n 100% Joint and Survivor Benefit. This payment method provides reduced monthly payments for your lifetime. Upon your death, your spouse (or other designated beneficiary) receives 100% of the monthly benefit you were receiving, payable for the rest of his or her life. Please note if you elect the 100% joint and survivor benefit and choose a non-spouse beneficiary, he or she may not be more than 10 years younger or older than you. For more information on these and other payment options, or the Pension Plan in general, see the Pension Plan SPD. Good News! The Pension Application is Online You can now obtain a pension application online at www.equityleague.org. Please note, however, that you must obtain a “relative value” statement before signing or dating your application. Otherwise, the Fund Office cannot accept it. And while we’d love to be able to make the relative value statement available online as well, legal requirements prevent us from doing so. You still must contact the Fund Office in writing to receive your relative value statement. You can, however, request an age-specific relative value statement. • 11 NOWPLAYING 401(k) Who’s Who & What’s What There are two types of Equity-League 401(k) plans: one type offers salary deferral only, while the other offers both salary and employer contributions. The type available to you depends on your contract, as shown in this chart. GUIDE TO 401(K) PLAN CONTRIBUTIONS SALARY DEFERRAL AND EMPLOYER CONTRIBUTIONS Reminder: Order the Email Version of Now Playing If you prefer electronic mail over snail mail, just let us know. The Fund can send you PDF copies of our Now Playing newsletter, which are identical to what you normally receive in your mailbox but don’t take up any space on your kitchen counter. If you’d like to receive your newsletters via email, just send your name, member number and email address to the Fund at [email protected] Contract Effective Date Equity/League Production Contract Equity/Disney Theatrical Ventures, Inc. Production Contract June 25, 2001 SALARY DEFERRAL ONLY Contract Effective Date Off–Broadway Contract October 1, 2002 LORT Contract February 1, 2003 COST Contract June 1, 2003 WCLO Contract September 3, 2003 Special Production Contract Menopause Special Agreements Mid-Size Theatres June 28, 2004 February 28, 2005 April 24, 2005 Chanhassen Dinner Theatres–Chanhassen, MN Beef & Boards Dinner Theatre–Indianapolis, IN New Theatre Restaurant–Overland Park, KS Drury Lane Theatre–Oakbrook, IL May 30, 2005 American Heartland Theatre–Kansas City, MO Marriott Theatre–Lincolnshire, IL Casino Contracts (RMTA) Resident Musical Theatre Association Chicago Area Theatres–CAT Contract Musical Stock and Unit Attractions–MSUA Contract June 7, 2005 June 27, 2005 October 31, 2005 Outdoor Drama Contract TYA (Theatre for Young Audiences) Contract December 26, 2005 Business Theatre and Events Contract March 1, 2006 Second City Agreement (Chicago, Detroit, Denver, Las Vegas) April 10, 2006 Children’s Theatre Company June 26, 2006 Bay Area Theatre (BAT) July 24, 2006 Ellis Island Foundations March 19, 2007 Lawrence Welk Resort Dinner Theatre May 21, 2007 Westchester Broadway Dinner Theatre Alhambra Dinner Theatre (Jacksonville, FL) (ANTC) Association of Non-Profit Theatre Companies Walt Disney World–Orlando, FL May 28, 2007 August 6, 2007 October 15, 2007 As you can see, the list of “salary deferral only” contracts is growing all the time. For the latest list, check our website. • 12 On the 401(k) Scene Why You Should Put Money Into the 401(k) Even if Your Employer Doesn’t If you’re in the “salary deferral only” category in the chart on page 12 (as most members are), participating in the 401(k) is still an opportunity you shouldn’t pass up. Here’s why: ■ contribute to the 401(k), your contributions go into your account on a pre-tax basis—that is, before taxes are deducted from your pay. This means that each dollar of your pay that you want to save goes directly into your account, without stopping for an IRS “shave” first. For example, if you’re in a 30% tax bracket and can handle having $200 come out of your pay each month, that translates into a $200 pre-tax contribution to a 401(k) account or a $140 after-tax contribution to a conventional savings account. Assuming your primary objective is to make the most money for the long haul, which would you prefer? 2008 401(k) Deferral Limits Here are the limits on how much of your taxable salary you can defer under the 401(k) Plan in 2008: Weekly: $4,675 For the year: $15,500 Catch-up: $5,000 Where employer contributions are concerned, the maximum amount of annual compensation per employer that can be taken into account for determining contributions in 2008 is $230,000. For more information about limits on 401(k) Plan contributions, refer to the 2008 Safe Harbor Notice For Plan Contributions Under The Equity-League 401(K) Plan at www.equityleague.org/401k/ 401k_safeharbor.html. Lower cost. When you ■ Faster growth. Your money figures to grow faster through the 401(k) than through a regular savings account. That’s because 401(k) savings grow on a tax-deferred basis, so every dollar you save goes to work for you—and keeps working until you withdraw from your account. With a regular savings account, you’re taxed on your earnings each year, resulting in fewer dollars that can grow each year. For example, suppose you contribute $200 a month to a 401(k) account for 20 years, and your account grows by 5% a year. If you’re in a 30% tax bracket, you’ll have $12,833 more than you would have had if you put that money into a conventional savings account that earned 5% interest a year. Over the years, the tax difference really adds up. (And just for the record, over a 20- or 30-year period five percent annual growth is high for a bank account but low for the stock market.) ■ Professionally-managed investments. With 15 investment options to choose from, the 401(k) plan offers something for everyone. Whether you want to be aggressive, conservative or somewhere in between with your money, the plan’s investment lineup can accommodate you. Each fund is managed by professional investors and administered by MassMutual, under the watchful eye of the Board of Trustees. If you’re new to the idea of investing for your future, the 401(k) plan makes it easy to get started. True, MassMutual applies an administrative charge to your 401(k) balance, but you can more than make up for this with sound investment choices (and a little luck in the market). Going forward, the Fund is looking into reducing the monthly administrative charge at some point in the not-so-distant future. For more information on how to get started in the 401(k) plan, go to www.equityleague.org/ 401k/index.html or contact the Fund Office. • 13 NOWPLAYING CONTACTING THE FUND OFFICE Office ■ ■ Walk-in: 9:30 A.M.–5:30 P.M. ET, Monday–Friday Call-in: – Health Fund Member Services: 9:30 A.M.–8 P.M. ET, Monday–Friday – All other: 9:30 A.M.–5:30 P.M. ET, Monday–Friday Phone 165 West 46th Street 14th Floor New York, NY 10036-2582 1-212-869-9380 or 1-800-344-5220 Fax ■ Health Fund 1-212-869-3323 ■ Pension Fund 1-212-869-1824 ■ 401(k) Fund 1-212-869-1824 ■ For privacy issues or concerns 1-212-869-3323 ■ Employer Contributions and Collections 1-212-398-2826 or 1-212-730-6360 ■ Executive Director 1-212-391-0371 Email ■ Health Fund [email protected] ■ Pension Fund [email protected] ■ 401(k) Fund [email protected] ■ For privacy issues or concerns [email protected] ■ Employer Contributions and Collections [email protected] ■ Problems or Suggestions regarding the Website [email protected] Complaints, Appeals, Suggestions and Praise for the Funds [email protected] ■ • 14 FAQs How does COB with SAG medical coverage work with the new eligibility rules? What do I do to make credit card payments online? Coordination of Benefits (COB) is the process by which we determine which plan pays first when a participant is covered by two or more plans—as is the case for those who are eligible for both Actor’s Equity and Screen Actor’s Guild (SAG) coverage. SAG has been understanding of our rule changes and is working closely with us to make it all work. At last count, 660 participants had coverage under both the Equity-League Health Care Plan and the SAGProducers Health Plan. SAG’s standard procedure for coordination of benefits is as follows: If you are primary in the Equity-League Plan and have secondary coverage under the SAG-Producers Health Plan, but then lose Equity-League coverage by failing to pay the required premiums, the SAG-Producers Plan will maintain its secondary position. That is, the SAG-Producers Plan will not become your primary plan; it will continue to pay no more than 20% of the Allowed Amount on your claims. However, the SAG-Producers Health Plan will not apply its special coordination of benefits rule to those Equity-League participants who don’t pay their premiums because they have chosen to defer their health care coverage until they can qualify for 12 months of coverage. In such cases, SAG will become the primary plan. For more information about coordination of benefits under the Equity-League Health Care Plan, see the Health Fund Summary Plan Description or contact the Fund Office. Log on to www.equityleague.org and click on the “Health Care Payments” link. From there you can pay for any of the following: I enrolled in Medicare but am also eligible for Fund coverage. Which pays first? If you sign up for Medicare but remain eligible for Health Fund benefits through employment (whether or not you pay the required contributions), the Fund will be the primary payer of your medical benefits and Medicare will be secondary. However, if you’re eligible for Medicare and self-pay for Medicare Supplemental coverage, Medicare will be the primary payer of your medical benefits and the Fund will be secondary. For more information, see the Health Fund Summary Plan Description. ■ ■ ■ ■ $100 quarterly Health Fund contributions (individuals) dependent coverage self-pay dental coverage under either the CIGNA Dental HMO or PPO Plans self-pay COBRA, Vested Beyond COBRA or Medicare Supplemental Coverage. To finalize any online payment transaction, you must include your Actor’s Equity member number (AEA ID number) and your bill number. Make sure you have these numbers handy when you log on to the site. (By the way, if you pay by check, these numbers must be written on your check, too.) What happens if I need medical care when I’m out of the country? If you’re enrolled in the CIGNA Medical Plan, your care will be covered the same way as any other Out-of-Network expense. This means that you must pay for care when you receive it and then file a claim for reimbursement. It doesn’t matter what language the claim form is completed in or what currency was used to pay for the service; CIGNA will do all of the necessary translations and/or currency conversions. However, keep in mind that the emergency notification rules still apply: If you are admitted to the hospital after getting emergency treatment, you (or a family member, a friend, or your doctor) must call CIGNA no later than the second business day after you are admitted. If you’re enrolled in an HMO, check with your HMO to find out how it covers care received outside the U.S. Can I get Now Playing electronically? Yes. If you’d like to receive your newsletters via email, just send your name, member number and email address to the Fund at [email protected]. • 15 Equity-League Pension, Health and 401(k) Funds 165 West 46th Street 14th Floor New York, NY 10036-2582 NOWPLAYING This newsletter is a publication of the Board of Trustees of the Equity-League Trust Funds. Additional copies are available upon request, or online at our website (www.equityleague.org). For any questions about the newsletter or your benefits, contact The Fund Office, Equity-League Pension, Health and 401(k) Funds, 165 West 46th Street, Suite 402, New York, NY 10036-2582. To call the Fund Office from the NYC area, phone 1-212-869-9380; if you’re calling from outside the NYC area, call the Fund Office toll-free at 1-800-344-5220. To the extent that any of the information contained in this newsletter is inconsistent with the official Plan documents (which, of course, includes the Trustees’ rights to amend or modify the Plans at any time), the Plan documents will govern in all cases. No official (other than the Trustees) has any authority to interpret the Plans, or other official Plan documents, or to make any promises to you about them. standard indicia goes here
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