On This Page: Disability, Full Time Students, Extended Coverage Program, $200,000 Extension, COBRA

If you or a dependent are totally disabled at the time coverage ends, benefits may be extended as set forth below.

• Your life insurance will be continued at no cost to you if your disability occurs before age 60.
  
  
• Medical benefits for the disabling condition only will be continued for the disabled participant for up to 12 months from the date on which the benefits are terminated, provided the person has completed and returned all required health forms, and has been deemed eligible for the disability extension of coverage and the person remains totally disabled. Illnesses other than the disabling condition will only be covered if you purchase COBRA coverage.
  
  
• All other dependents (including the writer) that were covered on the plan when the benefits terminated will be offered COBRA continuation coverage.

Unmarried children who are younger than age 23 who are full-time students in an institution of higher learning and are dependent upon you for full support may continue their coverage as long as verification is provided. The Fund will automatically notify you in writing when the full-time student verification is needed. This request will include a student verification form which must to be completed by the school’s Registrar’s office and COBRA continuation coverage information should your child not meet the criteria for continued coverage as a full-time student.

Beginning April 1, 2000 Writers were credited with points for each year of regular, employer-paid eligibility commencing on and after January 1, 1990. Writers are able to accumulate up to a maximum of fifty (50) points. Under this program, the Health Plan awards points for a Writer’s past and future participation as follows:

In summary, a Writer may earn up to three points for each year of employer paid Health Fund coverage earned, beginning January 1, 1990.

If a Writer loses eligibility due to failure to earn sufficient compensation within his or her earnings cycle, and has accumulated at least 10 points at any time, the Writer will automatically be placed in the Extended Coverage Program and will be notified of such. Although the Writer must have 10 points to be eligible for the Extended Coverage Program, based upon their state of residence, there are up to four different benefit plans available with point values ranging from 2.5 to 1.5 points per quarter.

For each quarter that a participant receives benefits under this program, the applicable number of points will be deducted from their point balance. This process will continue until: 1) the participant regains employer-paid eligibility; or 2) the participant retires under the Producer-Writers Guild of America Pension Plan as a Certified Retiree; or 3) there are an insufficient number of points available for continuation in the program. Note: As long as a participant has at least 1.5 points remaining, he or she will be granted one last quarter of coverage in the plan then in effect. If all points are exhausted and eligibility is not regained, the participant and all eligible dependents will be offered COBRA Continuation Coverage. (Same-Sex Domestic Partners have no independent right to participate in the COBRA program individually but may continue to be covered as a dependent under the Writers’ COBRA entitlement.)

(The Consolidated Omnibus Budget Reconciliation Act of 1985)

COBRA allows you to continue medical/hospital, dental, prescription and vision coverage for you and your eligible dependents beyond the date your employer paid coverage ends by paying monthly premiums for the continued coverage. No life insurance benefits are included with COBRA coverage

When a “Qualifying Event” occurs, and the Administrative Office has been notified, a notice of termination, which includes COBRA information will be sent to you or your eligible dependent (excluding same sex domestic partners). If you or your eligible dependent wishes to elect to pay for COBRA continuation coverage, you must respond within 60 days after the later of:

• The date coverage terminates; or
• The date you were notified by the Administrative Office of your continuation coverage privilege.

Situations called “Qualifying Events” resulting in entitlement to COBRA continuation coverage and the duration of the continued coverage are shown in the chart below:

* 24 months if in the last five years the active participant had at least two years of earned eligibility.
** Proof of eligibility for Social Security disability benefits is required for continuation of the additional 11 months of coverage.

Please note: It is your responsibility to notify the Administrative Office of a divorce, legal separation or child’s loss of dependent status within 60 days after the date the event occurred. Notification includes submission of court documents or any other pertinent information. If notification is received later than 60 days of the event, the spouse or dependent child will be ineligible to purchase COBRA continuation coverage.

COBRA continuation coverage is not available to same sex domestic partners. If the participant elects COBRA continuation coverage for him/herself and chooses to add the same sex domestic partner, then the domestic partner shall continue to be covered. The domestic partner shall not have his/her own COBRA rights and coverage will depend entirely on the participant covering the domestic partner as his/her dependent.