SAG-AFTRA Health Plan Raises Rates, Eligibility Requirements in Response to Projected Pandemic Losses

Guild health plan managers recommend members who may no longer qualify consider options such as COBRA

Last Updated: August 13, 2020 @ 5:19 PM

SAG-AFTRA members were informed Wednesday night of drastic changes to the guild’s health plan in response to projected losses incurred as a result of the coronavirus pandemic, with premium increases and stricter financial eligibility requirements set to take effect Jan. 1.

In a letter to members, managers of the guild’s health plan said the changes are necessary because of projected deficits “of $141 million this year and $83 million in 2021,” and that “by 2024, the Health Plan is projected to run out of reserves.”

Among the changes to the plan:

Members under age 65 must have earned at least $25,950 for the year. Members over 65 who are not receiving a pension must earn $25,950 for the year, with at least some “sessional earnings reported; if so, both sessional and residual earnings are included.”

People only covering themselves will now pay $375 per quarter. If they have one dependent, they will pay a $531 premium per quarter. And if they have two or more dependents, their premium will be $747 per quarter.

If an eligible member’s spouse is employed and their employer offers health coverage, they must now take that coverage in order to be eligible for any additional coverage through the SAG-AFTRA plan. If they do not accept their employer’s plan, they become ineligible for the guild plan.

The new plan also eliminates the maximum out-of-pocket expenses for users getting out-of-network coverage. Guild members will now be forced to pay any balance due for out-of-network coverage.

The Guild’s previous plan covered anyone who made at least $18,040. It is unclear how many guild members will be kicked off the rolls as a result of the change in eligibility on Jan. 1.

Guild representatives directed TheWrap to contact representatives of the SAG-AFTRA health plan, which they said is “a separate organization.” Representatives for that separate organization did not immediately respond to a request for comment from TheWrap.

But in a memo obtained by Variety, the guild told members “We understand that no one welcomes the disruption of changing health coverage – even if similar, less costly alternatives are available – but it’s important to note that those participants who lose Plan coverage may still have good, affordable health insurance options.”

The details of the new plan are online. Read it in full here.