DESCRIPTION OF THE INDIVIDUAL AND
FAMILY HEALTH PLANS
The AFTRA Health Fund provides two health plans: the Individual Health Plan and the Family Health Plan. Both Plans offer Hospital, Major Medical, Prescription Drug, Mental Health and Chemical Dependency, Wellness and Dental Programs. In addition, both Plans will provide you, but not your dependents, with life insurance, accidental death and dismemberment (AD&D) insurance and loss of voice coverage.
NOTE: For purposes of ERISA, the Individual Health Plan and the Family Health Plan are part of a single plan and where there is a reference to “the Plan”, it is intended to be a reference to both.
The Individual Health Plan
The Individual Health Plan provides you with health care coverage once you pay the required premium on a timely basis, but does not cover your dependents. However, once you qualify for coverage under this Plan, in most cases, you may purchase coverage for your dependents under the Family Health Plan.
The Family Health Plan
The Family Health Plan provides health care coverage for you and your dependents once you pay the required premium on a timely basis.
The only difference between the Individual and the Family Health Plans is that the Individual Health Plan provides coverage only for the participant while the Family Health Plan provides coverage for the participant's dependents as well.
The Plan for which you qualify is determined by your AFTRA covered earnings as described in The Minimum Earnings Requirements section.
Eligibility Requirements
You qualify for health care coverage under the Individual Health Plan or the Family Health Plan if you meet one of the minimum covered earnings requirements and you become enrolled in coverage by paying any required premium on a timely basis.
FAMILY HEALTH PLANS
The AFTRA Health Fund provides two health plans: the Individual Health Plan and the Family Health Plan. Both Plans offer Hospital, Major Medical, Prescription Drug, Mental Health and Chemical Dependency, Wellness and Dental Programs. In addition, both Plans will provide you, but not your dependents, with life insurance, accidental death and dismemberment (AD&D) insurance and loss of voice coverage.
NOTE: For purposes of ERISA, the Individual Health Plan and the Family Health Plan are part of a single plan and where there is a reference to “the Plan”, it is intended to be a reference to both.
The Individual Health Plan
The Individual Health Plan provides you with health care coverage once you pay the required premium on a timely basis, but does not cover your dependents. However, once you qualify for coverage under this Plan, in most cases, you may purchase coverage for your dependents under the Family Health Plan.
The Family Health Plan
The Family Health Plan provides health care coverage for you and your dependents once you pay the required premium on a timely basis.
The only difference between the Individual and the Family Health Plans is that the Individual Health Plan provides coverage only for the participant while the Family Health Plan provides coverage for the participant's dependents as well.
The Plan for which you qualify is determined by your AFTRA covered earnings as described in The Minimum Earnings Requirements section.
Eligibility Requirements
You qualify for health care coverage under the Individual Health Plan or the Family Health Plan if you meet one of the minimum covered earnings requirements and you become enrolled in coverage by paying any required premium on a timely basis.
