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Other Possibilities

If you don’t have misreported income, and you’re not entitled to Extended Coverage, you still have health coverage options available to you.

ACTOR’S FUND Even though you’re not an actor, The Actor’s Fund is a great resource (available to all in the entertainment industry) for information about health care services. As per their website:

Our Health Services programs offer both Internet-based and personal health insurance guidance, solutions-based health care counseling, experience-based health referrals and, through our own free clinic, direct medical care for people who are uninsured.

The Actor’s Fund offers seminars, clinics, free health services, and serves as a clearing house for a wide range of available healthcare resources. You can find out more at their website.

TIHN The Industry Health Network (TIHN) is run by the Motion Picture & Television Fund (MPTF). They have health services available at little or no cost so that if you are underinsured or uninsured you can see a doctor for a fee of $25 for an office visit, and if necessary receive basic lab services and x-rays at no extra cost. In addition, they offer low-cost prescriptions through a variety of pharmacies. You can find out more at their website.

ACA The Affordable Care Act (ACA) provides for a Health Insurance Marketplace where you can select the best healthcare coverage for you and your family.

The Health Insurance Marketplace offers “one-stop shopping” to find and compare private health insurance options. In the Marketplace, you could be eligible for a new kind of tax credit that lowers your monthly premiums and cost-sharing reductions (amounts that lower your out-of-pocket costs for deductibles, coinsurance, and copayments) right away, and you can see what your premium, deductibles, and out- of-pocket costs will be before you make a decision to enroll.

Through the Marketplace you’ll also learn if you qualify for free or low-cost coverage from Medicaid or the Children’s Health Insurance Program (CHIP). Coverage through the Marketplace may cost considerably less than COBRA continuation coverage. Being offered COBRA continuation coverage won’t limit your eligibility for coverage or for a tax credit through the Marketplace.

You have 60 days from the time you lose your job-based coverage to enroll in coverage through the Marketplace, because loss of job-based coverage is a “special enrollment” event. After 60 days your special enrollment period will end and you may not be able to enroll, unless there is an “open enrollment” period for Marketplace coverage.

To find out more about enrolling in the Marketplace, such as when the next open enrollment period will be and what you need to know about qualifying events and special enrollment periods, visit: www.HealthCare.gov.

If you reside in California, information is available at: http://www.coveredca.com
If you reside in New York, information is available at: https://nystateofhealth.ny.gov
If you live elsewhere, go to: www.HealthCare.gov

SPOUSE’S PLAN If your spouse’s employer offers healthcare coverage, you may be able to obtain through his/her plan. Depending upon what they charge for dependent premiums, this may be the easiest and least costly option available to you.

COBRA If all else fails, though it is expensive, you have COBRA coverage available to you. The right to COBRA continuation coverage was created by a federal law, the Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA). COBRA continuation coverage can become available to you and other members of your family when group health coverage would otherwise end because of a life event known as a “qualifying event.” More information about qualifying events can be found under the Health Fund tab, or by calling the Eligibility Department at: (818) 846-1015 x605

The costs are as follows below:

Writers’ Guild-Industry Health Fund – Regular COBRA Monthly Rates April 1, 2016 through March 31, 2017
Single Two-Party Family
Plan C – Regular Medical/Hospital, Delta Dental (DPO), Rx, Vision, Wellness $891.44 $1,766.34 $2,398.89
Plan B – Regular Medical/Hospital, Rx, Vision, Wellness (no dental) $838.84 $1,664.59 $2,261.62
Plan CU – Regular Medical, Delta Care Dental (HMO), Rx, Vision, Wellness ** $909.40 $1,702.76 $2,285.32
Plan L – Low Cost Medical/Hospital ONLY – $750 Deductible $508.03 $1,004.30 $1,363.19
COBRA RATES FOR CHILDREN AND EX-SPOUSES OF CERTIFIED RETIREES
Single Two-Party Family
Plan RC – (same as Plan C above) $751.02 $1,484.10 $2,014.04
Plan RB – (same as Plan B above) $685.13 $1,355.64 $1,840.36
Plan RU – (same as Plan CU above) $749.95 $1,393.43 $1,865.86
Plan RL – (same as Plan L above) $547.68 $1,084.00 $1,471.73

** FOR CALIFORNIA RESIDENTS ONLY

LOW OPTION PLAN (PLAN L)* With the cost of health care being what it is, no one should be without coverage if at all possible. To make COBRA Continuation coverage more affordable to Writers who don’t qualify for Health Fund coverage, the Health Fund offers the Low Option Plan (Plan L) which can be purchased at a lesser cost than the current COBRA continuation plan options (which continue to be available, as well).

Before any benefits are payable under Plan L, hospital or otherwise, you must satisfy the annual deductible. The key provisions of Plan L are as follows:

Annual Deductible:

$750 per individual
$2,250 per family

Coinsurance In-Network:

Plan pays 70%
You pay 30%

Coinsurance Out-of-Network:

Plan pays 60%
You pay 40%

Annual Out-of-Pocket Maximum:

$4,500 per individual In-Network
$6,000 Out-of-Network, excluding the deductible

In addition, if your care requires hospitalization or outpatient surgery, you will need to have the hospital stay or surgery pre-certified. If you do not get the required pre-certification, there will be a $500 reduction in benefits in addition to the deductible and coinsurance required on hospital confinements. *Plan L provides medical and hospital coverage only. Life, accidental death and dismemberment insurance, prescription drug benefits, dental benefits, vision, and wellness benefits are not included. For more details on this coverage, you may contact the Participant Services Department at option #1, then option #1 again. You may also visit our website for additional information click here.

Once you’ve exhausted your COBRA continuation coverage and the coverage expires, you’ll be eligible to enroll in Marketplace coverage through a special enrollment period, even if Marketplace open enrollment has ended.

If you sign up for Marketplace coverage instead of COBRA continuation coverage, you cannot switch to COBRA continuation coverage under any circumstance. You can learn more about many of these options at: www.HealthCare.gov

If you reside in California, information is available at: http://www.coveredca.com
If you reside in New York, information is available at: https://nystateofhealth.ny.gov
If you live elsewhere, go to: www.HealthCare.gov

As you can see from the options laid out above, if and when the time comes that you are in jeopardy of losing your Health Fund coverage, there are still many options available to you and your family.