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On this page: Initial Eligibility, When Coverage Begins, When Eligibility Terminates, Dependents


Initial Eligibility

To become eligible for benefits provided by this Fund you must have accumulated and had reported to the Fund (by your signatory employer) covered earnings of at least $30,145 (as of January 1, 2006) during a period of four or fewer consecutive calendar quarters. This amount will increase in 2007 to $30,823. This amount of covered earnings is equal to the Writers Guild of America minimum for a one hour network prime-time story and teleplay.

This amount will increase with any increase in the Guild minimum provided by the collective bargaining agreement.

 

When Coverage Begins

Because of the time needed to receive and process earnings reports, there is a three month (one calendar quarter) lag period between your satisfying the earnings requirement and commencement of coverage. Once your coverage begins, it remains in effect for 12 consecutive months (four consecutive calendar quarters).

The following chart shows when coverage will begin based upon when the earnings requirement is satisfied, and the four quarter earnings cycle in which the earnings requirement must be satisfied in order to maintain continued coverage:

If you satisfy the earnings requirement in:
Your coverage period will be:
Earnings period for continued coverage:
4th quarter of 2005
(Oct, Nov, Dec)
Apr 1, 2006–Mar 31, 2007 Jan 1, 2006–Dec 31, 2006
1st quarter of 2006
(Jan, Feb, Mar)
Jul 1, 2006–Jun 30, 2007 Apr 1, 2006–Mar 31, 2007
2nd quarter of 2006
(Apr, May, June)
Oct 1, 2006–Sep 30, 2007 Jul 1, 2006–Jun 30, 2007
3rd quarter of 2006
(Jul, Aug, Sept)
Jan 1, 2007–Dec 31, 2007 Oct 1, 2006–Sep 30, 2007
 
When Eligibility Terminates

If you do not satisfy the earnings requirement within the appropriate four quarter earnings cycle, your coverage will end on the last day of the 12 month period during which you were eligible for coverage.

If your eligibility terminates, you may be able to continue coverage under the Extended Coverage Program, banked coverage as a result of enrollment in the medical HMO or the Continuation Coverage Program (COBRA)

Once your eligibility terminates, you can reestablish eligibility by satisfying the earnings requirements as described in the above section entitled “initial eligibility”.

 
Dependents:

Dependents Who Are Eligible for Coverage from This Fund Include:
  • Your lawful spouse
  • Each unmarried lawful child under the age of 19
  • Each unmarried child between the ages of 19 and 23, who are full-time students
  • Unmarried children over the age of 19 who are incapable of self-sustaining employment.
  • Same Sex Domestic Partners
 
Dependent Premium

Due to ever increasing health care costs, changes have been made to improve the financial security of the Health Fund. One of those changes, effective July 1st, 2003 was a $50 per month dependent premium. Dependent premiums are payable quarterly and must be paid in advance. Dependents are: your spouse or same-sex domestic partner, your children and/or other eligible dependents (please refer to your SPD for a description of eligible dependents under the Health Fund). This premium covers all your dependents regardless of number.

When Will You Receive A Bill?

You will receive an invoice about 30 days prior to the due date. Please review your invoice carefully, only the dependents listed on the invoice will be covered. If your dependent information is incorrect, please contact the Fund immediately. If, in the future, you gain or lose a dependent through birth, adoption, marriage, divorce, age ineligibility, or death, please notify the Fund within 30 days of the event.

Please refer to the chart below for the dependent premium due dates.

Premium Due Date
For Eligibility Quarter
June 20
July 1 through September 30
September 19
October 1 through December 31
December 19
January 1 through March 31
March 20
April 1 through June 30

You may pay premiums for more than one quarter at a time, if you wish. If payments are not received by the due date indicated on your invoice, dependent coverage will be terminated

If You Are A Certified Retiree With Dependents

If you have been deemed a Certified Retiree by the Fund and are between the ages of 60 and 64, you are required to pay the dependent premium regardless of the type of coverage you have (retiree or earned). Once you turn 65 the following rules apply:

If you are on earned coverage - you will be required to pay the dependent premium

If you are on Certified Retiree coverage - you will be exempt from the dependent premium

If You Choose Not To Cover Your Dependents

Should you decide not to continue coverage for your dependents, please let us know by completing and returning the declination form included with your premium invoice. Please note: By declining dependent coverage you will not be able to reinstate your dependent(s) coverage until the Fund's annual open enrollment period in the fall for coverage changes effective January 1st of the following year.

Special Enrollment

If you decline enrollment for your dependents (including your spouse) because of other insurance coverage, you may in the future be able to enroll your dependents in the Health Fund, without waiting until the next Open Enrollment, provided that you request enrollment within 30 days after the other coverage ends. In addition, if you have a new dependent as a result of marriage, birth, adoption, placement for adoption, or guardianship, you may be able to enroll your dependents provided that you request enrollment within 30 days after the marriage, birth, adoption, placement for adoption or guardianship.

Please contact the Health Fund with questions regarding the dependent premium.

 
To enroll dependents please provide the following documentation:
Spouse A certified copy of your marriage certificate.
Divorce or Legal Separation A copy of the final divorce decree or legal separation documents.
Child A copy of the birth certificate.
Step-Child A copy of the birth certificate and the divorce decree, custody information or statement of financial responsibility.
Adoption/Guardianship A copy of the adoption/release or guardianship or placement documents.
Students 19-23 A student verification form completed by the Registrar’s office of the institution of higher learning.
Mental Retardation and Physically Handicapped Dependents Completed attending physicians statement along with any other proof of incapacity including medical records and a statement of financial support.
Same Sex Domestic Partner A signed Affidavit of Domestic Partnership and any additional documents requested by the Administrative Office.
 
DisclaimerNOTE: This is only a brief summary of your benefits. All benefit descriptions contained herein are governed by the limitations and other information contained in your SPD.
 

 

   
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