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SAG Foundation Presentation 10/10/13. Health Fund. Background. The AFTRA Health and Retirement Funds (“Funds”) was created to provide comprehensive health and retirement benefits for AFTRA members.
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SAG Foundation Presentation 10/10/13 Health Fund
Background • The AFTRA Health and Retirement Funds (“Funds”) was created to provide comprehensive health and retirement benefits for AFTRA members. • It is important to note that the Funds are a separate organization from SAG-AFTRA, the union. The two organizations do not share computer databases and maintain their own information
Qualifications: • Qualification for benefits is predicated on your AFTRA Covered Earnings. • Covered earning are earnings received for work under an AFTRA collective bargaining agreement (CBA) or as a full-time staff member of AFTRA or AFTRA H&R; and that do not exceed Plan maximums • When you work under an AFTRA contract, that calls for an employer to submit a contribution, that employer is required to submit a report detailing the work performed and amount you were paid. • The report and contribution are reviewed for accuracy and you are credited accordingly
Eligibility and Participation Health Plan • To qualify for AFTRA’s Health Plan you must earn at least $10,000 in 4 consecutive quarters or less for Individual Plan coverage, or $30,000 for Family coverage • You will become eligible on the 1st day of the second quarter following the quarter in which you meet the minimum covered earnings • When a member qualifies for coverage a notification is sent along with an enrollment form. • When the enrollment form with supporting documents is received within the time allotted, an invoice is sent. • Once the premium has been received the coverage will be activated beginning the first day of the following quarter
Benefits Health Plan • Major Medical Program which includes professional services such as doctor visits, surgeon, physical or occupational therapists chiropractors, lab testing etc. • Hospital Program • Mental Health and Chemical Dependency Program • Wellness Program • Prescription Drug Program • Dental Program • Group Insurance • Loss of Voice Insurance
Accurate Records and Life Events AFTRA H&R is a non-contributory jointly trusteed benefit fund. • Keep the Fund office advised of any life event changes such as address changes, new spouse/domestic partner, new children, divorces etc. • Keep accurate records of your earnings and review your yearly earning statement sent by the Fund • Health and Pension benefits are based on these earnings. Any incorrect or missing earnings may have an impact on these benefits • Updating Union information will not update the Fund information • Most needed forms are available on the website www.aftrahr.com
Mental Health, Chemical Dependency benefit improvements to be implemented effective Dec. 1, 2013 • Changes include lower copayments and the availability of non-network benefits • Non-network benefits available • Pre Authorization through Value Options is required only for inpatient admissions • Out patient Authorizations from Value Options no longer required • Refer to the September Benefits Update for details. This is available on the website www.aftrahr.com