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The Industry Health Network

Participants can take advantage of significant savings available to you when you use The Motion Picture & Television Fund (MPTF) Health Centers (TIHN - The Industry Health Network), available only in Southern California. Initially, you must choose a primary care physician (PCP). Then, your PCP will treat you directly, coordinate your care and, if necessary, refer you to a TIHN specialist. Without a Primary Care Physician's referral, your standard Writers' Guild-Industry Health Fund (Fund) benefits will apply, including your deductible and co-insurance. No enrollment is required to use this benefit. You can change your PCP at any time as well as other providers within The Industry Health Network.

  • All TIHN benefits are subject to the maximums and limitations listed in this Summary of Benefits and your Summary Plan Description.
  • All claims from a TIHN specialist must be submitted with the referral number assigned by MPTF.
  • The Preventive Care Services (pages 69-72) rendered under TIHN are not subject to a $10 copay and will not be applied towards your Wellness Benefit maximum.
  • If the health center doctor treating you determines that a behavioral health provider should treat your condition, they will provide you with a medical order36 rather than a referral. At this time, behavioral health services will not be part of the TIHN referral program.
  • Referral from a primary care physician (TIHN) does not guarantee payment. All services are subject to medical necessity. Subject to the maximums and limitations of the plan.

PLAN BENEFITS WHEN YOU USE THE INDUSTRY
HEALTH NETWORK
PCP Office Visit 11 $10 copayA fixed dollar amount you pay for an eligible expense at the time the service is provided.
Specialist Office Visit 33 $10 copay
(Referrals to Specialists who will provide Alternative Medicine services, such as Physical/Occupational Therapy are subject to the Plan's Alternative Medicine $60 allowable per visit limitation)
Periodic Physical Exam 11 34 No copay
Well Child Care/
Pediatric Visit 11   35
$10 copay
Lab Works/X-rays 11, 33 100%
Physical Therapy The provision, by a person acting within the licensed scope of practice, of evaluation and training in muscle strengthening, neuromuscular reeducation, and ambulation training. Services may include ambulation aids, such as walkers, wheelchairs and devices to assist with transferring a patient, such as lifts. Services may also include therapeutic interventions related to strength and mobility; teaching of in-home exercises; use of modalities such as ultrasound, hot packs/cold packs, galvanic stimulation, and TENS units; and assessment of equipment needs. 33 $10 copay
(Subject to the Plan's Alternative Medicine $60 allowable per visit limitation)
Hospitalization 33 100% after $100 copay/admission
Surgery 33 100% after $100 copay
Anesthesiology 33 100%


11. See Preventive Care Benefits Services, page 10. Some or all of the services in this section may be covered under the Preventive Care Service Benefits, payable at 100%, no deductible, when seen by a network provider.

33. Requires a written referral from your PCP. (This only applies to specialist charges.)

34. $200 is applied to your Wellness Benefit. Wellness Benefit for over age 7 only.

35. For children under the age of 13, the participant must call The Industry Health Network Customer Service Department at (800) 876-8320 for a referral to see a pediatric physician.

36. A medical order is a treatment recommendation that requires self-referral to a behavioral physician.