Participating Dentist is a dentist that is within the DentaIGuard Preferred provider network offered by The Guardian Life Insurance Company.

Participating Pharmacy is a pharmacy participating in a preferred provider network of pharmacies maintained by Medco Health Solutions.

Performer is an individual who performs AFTRA-covered work.

Physician means a duly licensed doctor of medicine authorized to perform medical or surgical service within the lawful scope of his or her practice.

Prescription drugs are drugs that are obtainable only by a physician's or dentist's written prescription, dispensed by a licensed pharmacist, and approved for their intended use by the United States Food and Drug Administration.

Qualified performer is a registered performer who becomes qualified for health coverage. Qualified performers may or may not choose to enroll in coverage.

Qualifying year refers to qualification for coverage under the Senior Citizen or Early Retiree Program. It is a Base Year during which an individual had covered earnings equal to the greater of: the amount required as of the last day of such Base Year to qualify for a year of eligibility under the AFTRA Individual Health Plan or $2,000.

Registered performer is a performer who has provided a completed and signed registration form to AFTRA H&R. Registered performers are assigned an H&R Funds Number.  This does not indicate qualification for coverage under the Plan.

Related employee is an employee (other than a temporary employee) of AFTRA or AFTRA H&R.

Scheduled allowance is the maximum dollar amount of a medical provider’s fee for a particular service in a particular geographic area, which will be taken into account (prior to application of any deductible, co-insurance or maximum) in determining benefits under the Plan. In the case of a fee billed by a Network Provider, the scheduled allowance shall be deemed equal to the discount fee. For Major Medical benefits, in the case of a fee billed by a Non-Network Provider, the scheduled allowance will be based on the highest amount charged for the specific service by 70% of medical providers in the geographic area.

Staff performer is a performer who is a full-time employee of a radio or television station or network.