On page 1 of the March 2015 Health Plan booklet, the Calendar Year Out-of-Pocket Limit (in excess of deductible) for non-network providers should be $3,550 for the DGA Premier Choice Plan and $8,900 for the DGA Choice Plan.
The out-of-pocket limits were increased effective January 1, 2012.
The DGA-Producer Pension and Health Plans office is pleased to announce a new option for meeting one-on-one with Plans’ representatives: Skype video meetings.
As a Pension and Health Plans’ participant, you have several options for face-to-face meetings to discuss your retirement and health benefits:
Now, with the addition of Skype video meetings, you can have a face-to-face meeting from the comfort of your home, or anywhere you have an internet connection.
Appointments are available now to meet via Skype with representatives from the Health and Pension Departments during the Plans’ regular business hours: Monday through Friday, 8:30 a.m. to 5:00 p.m. Pacific Time.
To request a Skype meeting, call us at (877) 866-2200 and press 0 for the reception desk. The receptionist will take down your information and have a Plans representative contact you to finalize your meeting.
To use this service, you will need a Skype account and an internet connection. For specific system requirements for running Skype, click here. Setting up a Skype account and making calls via Skype are free, except for calls made to mobiles and landlines.
For instructions on how to set up your free Skype account, click here.
Legendary director and DGA–Producer Pension and Health Plans Trustee, Larry Auerbach, passed away on Saturday, December 20 in La Jolla, California. He was 91.
Mr. Auerbach, who worked as a director on New York daytime dramas for more than four decades, began his directing career on NBC’s Watch Mister Wizard in 1950. In 1951, Mr. Auerbach began working on Love of Life, where he continued for nearly thirty years until that show completed its run in 1980. Mr. Auerbach then went on to direct several other daytime serials, including One Life to Live, As the World Turns, Another World and All My Children.
Mr. Auerbach was nominated for nine daytime Emmy awards, including a win in 1984 for One Life to Live. In 1991, he was presented the DGA’s Robert B. Aldrich award for extraordinary service to the Guild and its membership. In 2004, the DGA honored Mr. Auerbach with one of its highest honors, Honorary Life Member.
Mr. Auerbach, who joined the DGA–PPHP’s Board of Trustees in 1981, served as the Board Chair in 1988, 1990 and 2000. In addition to his work with DGA–PPHP, Mr. Auerbach also served as trustee on the board of the Directors Guild Foundation, the Guild’s philanthropic arm.
“Larry was an icon in the world of daytime dramas, a dedicated Trustee to these Pension and Health Plans and a loyal family man,” said Jay Roth, Chair of the DGA–PPHP’s Board of Trustees and National Executive Director. “We extend our deepest sympathies to his wife, Gale, and his son, Scott.”
Our Trustees and staff will truly miss this remarkable man. He will be remembered for the intelligence, insight and dedication that he brought to his work with the DGA–PPHP.
Photo by Jennifer S. Altman courtesy DGA
The Board of Trustees of the DGA–Producer Pension Plans is pleased to announce the following changes to the Basic Pension Plan:
To help pay for the expanded benefit, the Board of Trustees adjusted the amount of the delayed Basic Plan benefit increase for future benefits from 12% per year to 9% per year.
The Board of Trustees is pleased to issue the 13th check to retirees, reflecting both their commitment to current and future retirees, as well as the financial strength of the Basic Pension Plan. The Basic Pension Plan remains well funded at over 101%, as measured by the Pension Protection Act.
The 13th check will be mailed in early January. The 13th check payment will be equal to the December 2014 monthly payment.
This additional benefit payment is made on a one-time basis only, and is based entirely on the Trustees’ judgment about the financial condition of the Basic Plan during the relevant time frame. There is no right (vested, accrued or otherwise) to any additional or similar payment in future months or years.
If you choose to delay taking your Basic Plan benefit beyond normal retirement age (generally age 65), you are eligible to receive a benefit increase for each month between your 65th birthday and the time you take a benefit from the Basic Plan (delaying your Basic Plan benefit does not affect your ability to take a benefit from the Supplemental Pension Plan and become eligible for Health Plan Certified Retiree coverage).
Previously, you were not eligible for a delayed Basic Plan benefit increase in months where you worked eight or more days in your DGA capacity. However, someone who works full-time in a non-DGA capacity (as a producer, writer, etc.) would continue to be eligible for the delayed Basic Plan benefit increase. The Board of Trustees recognized that if you continue working in your DGA capacity, you should receive the same increase.
As a result, the Board of Trustees approved that, effective January 1, 2015, the eight-day restriction will be eliminated. This change also allows a participant who has reached the $5,500 Basic Plan maximum monthly benefit and delays taking a Basic Plan benefit beyond age 65 to receive a delayed Basic Plan benefit increase for months where eight or more days are worked in his or her DGA category, beginning in 2015.
To help pay for the expanded delayed Basic Plan benefit, the delayed Basic Plan benefit increase has been reduced to 0.75% per month (9% per year) for benefits accrued on or after January 1, 2015. For benefits accrued before 2015, the delayed Basic Plan benefit increase will continue to be 1% per month for the first 60 months after age 65 and 1.5% per month for subsequent months. The eight-day restriction on DGA work still applies through December 31, 2014. Beginning on January 1, 2015, the applicable increase will be applied regardless of the amount of days worked in your DGA category.
These changes do not affect Basic Plan post-retirement suspension rules. Once you begin receiving a monthly benefit from the Basic Plan, your benefit will still be subject to suspension if you work eight or more days in a calendar month in the same DGA position that you worked in prior to your retirement.
If you have any questions, please contact our Pension Department at (877) 866-2200, extension 404.
Health Plan premiums are due typically on the first of the month. If you do not pay your Health Plan self-pay or dependent premium on time, you are risking the suspension of your Health Plan coverage.
When your coverage is suspended, you will have to pay full price when you seek medical services or try to fill a prescription. If you subsequently pay your premium during your 30-day grace period, you can then submit the claim to us for reimbursement.
While there is a 30-day grace period for Health Plan premium payments (45 days for your initial COBRA premium), that simply means that you have 30 days to pay before your coverage is cancelled. If you miss your premium due date, your coverage will still be suspended until your payment is received. If payment is not received within the 30-day grace period, your coverage will be cancelled.
If you use the E-Bill Express automatic payment option to pay your Health Plan premium, make sure that your payment is scheduled to be made on the first of the month, when your premium is due.
If you schedule your payment for after the first of the month, you are risking the suspension of your health coverage (see the article above for more information).
We would like to extend our warmest thanks to the DGA members and their families who attended our 2014 Health Fair this past Saturday, taking advantage of the free flu shots, neck and shoulder massages, Pension and Health Plans presentations and all our vendor tables.
A special thanks to our vendors and other organizations for their support–Anthem, Expess Scripts, Delta Dental, Vision Service Plan, UCLA-MPTF and the Actors Fund. Finally, we would like to thank the DGA Foundation for covering the cost of flu shots for non-covered members and their families and providing food for all!
Hope to see you at the 2015 fair!
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.