The Spring 2014 issue of the Pension and Health Plans’ newsletter, Spotlight on Benefits, is coming soon to all participants.
This issue brings important information regarding coordinating health benefits among entertainment industry plans, avoiding excess charges from out-of-network providers and ensuring the availability of your health benefits by making timely premium payments.
Click here to view the newsletter.
Co-Insurance is the percentage of an allowable medical expense that you pay once your annual deductible has been met. For example, the network coinsurance is 90% of the contracted allowable amount, which means you pay 10% of the remaining cost.
If you have earned coverage and visit a network doctor, the Plan pays 90% of your covered charges, regardless of whether you are covered under the DGA Premier Choice Plan or the DGA Choice Plan.
And, since a network doctor is required to charge a set, allowable cost for a covered service, you do not need to worry about excess costs not covered by the Health Plan (see below for a brief discussion of these potential excess costs).
To locate a network hospital or doctor near you, use the Anthem Blue Cross Provider Finder. When you make an appointment with a provider, always double-check that the provider is in our network. The provider will have the most up-to-date information.
If you visit a non-network doctor, the Plan pays 70% of the reasonable and customary (R&C) amount under the DGA Premier Choice Plan and 60% under the DGA Choice Plan.
Since a non-network doctor is not under contract with our network, they can charge you an amount over the R&C amount. For example, if you have a $1,000 non-network charge with an R&C amount of $500, the Health Plan will apply the co-insurance to the $500 R&C amount and you will be responsible for the entire $500 over the R&C amount.
In the example above, under the DGA Premier Choice Plan, the Health Plan would pay $350 (70% of $500 R&C amount) and you would pay $150 (30% of $500) in co-insurance plus the $500 over the R&C amount, or $650.
For the DGA Choice Plan, the Health Plan would pay $300 (60% of $500) and you would pay $200 (40% of $500) in co-insurance plus the $500 over the R&C amount, or $750.
Legendary Assistant Director, Unit Production Manager and DGA–Producer Pension and Health Plans Trustee Abby Singer passed away on March 13, 2014 at the age of 96.
Abby joined the Board of Trustees in 1980, serving these Plans for over 33 years. He was a member of the Board’s Administrative Committee, where he contributed his industry-renowned expertise in managing production budgets to overseeing the Plans’ operations.
Mr. Singer’s entertainment career began in 1945 working for the head of production at Columbia Pictures. He soon after joined the (then) Screen Directors Guild in 1949. During his career he oversaw the budgets and crews for some of TV’s most enduring hit shows, including Rhoda, The Bob Newhart Show, WKRP in Cincinnati, and Hill Street Blues. His work in the Directors Guild of America earned him the Frank Capra Achievement Award in 1985.
But Singer won most of his international notoriety for his namesake shot. “The Abby Singer,” as it came to be known, is the second-to-last shot of the workday. Usually signaled on set by someone calling out “We’re on the Abby Singer” or “This shot and one more,” it warns the crew to prepare to move locations after the next shot. The technique saved valuable production time, earning directors up to an additional hour of shooting, time that was usually spent moving equipment from place to place.
Mr. Singer said about the DGA and the Plans: “The Guild is the best thing that ever happened to me…And the health and welfare have been incredible; it really watches out for its members.”
“Abby will be fondly remembered by the Plans’ Board and its staff as a devoted Trustee, a legendary Guild member, a good friend and a loyal family man. We extend our condolences to Mr. Singer’s wife, Lotte, and his family,” said Jay Roth, Chair of the Plan’s Board of Trustees and DGA National Executive Director.
Mr. Singer served these Plans with the same dedication, wisdom, enthusiasm and generosity that were the hallmarks of his nearly half-century career in Hollywood. He will be greatly missed.
Your deductible is the amount you must pay each year before benefits are payable by the Health Plan. This amount is for each calendar year (January 1 – December 31). If you satisfy, or pay, your deductible by April, the Health Plan will start paying benefits for the remainder of the calendar year.
Under the Health Plan, your deductible is only $325 per individual and $975 per family.
For a family, the individual rate still applies if the family rate has not yet been met. So, if one member of your family reaches $325 in payments, the Health Plan will pay benefits for that individual. However, there will still be $650 applicable to the rest of the family. The deductible is never more than $325 per family member.
The following expenses are included in your deductible:
The following expenses are not included in your deductible:
There is a separate deductible for the Health Plan's dental benefit.