Based upon your earnings for work performed under AFTRA-negotiated contracts, you may qualify for individual or family coverage under the AFTRA Health Plan.
Individual coverage
To qualify for individual coverage under the Health Plan, you must have AFTRA-covered earnings of at least $10,000 but less than $30,000 in four consecutive calendar quarters or less.
Family coverage
To qualify for family coverage under the Health Plan, you must have AFTRA-covered earnings of at least $30,000 in four consecutive calendar quarters or less. It is important to note that performers who meet the $10,000 threshold for individual Health Plan coverage in a given quarter during their initial earnings cycle, but do not satisfy the $30,000 threshold for family coverage before that same calendar quarter ends, will only be allowed to pay the required premium and enroll in individual coverage for their first four quarter coverage period. Most commonly, this situation occurs with freelance performers and part-time staff performers.
However, effective with coverage periods that began on and after July 1, 2009, performers who initially qualify for individual coverage may pay the higher premium and enroll instead for family coverage if they reach the $30,000 threshold required for family coverage by the end of their three-month waiting period. (The waiting period is the quarter after the end of a performer’s earnings cycle and before the start of the performers coverage period.)
Different rules apply regarding the initial qualification of full-time staff performers, related employees and covered roster artists. For more information call Participant Services at (800) 562-4690 or see pages 14-16 of the 2005 Health Plan Summary Plan Description and relevant Benefits Updates.
When to enroll
Generally, performers may enroll in the Health Plan on the first day of the second calendar quarter after the quarter in which the minimum covered earnings requirements are met. For example, if you meet earnings requirements in a quarter that ends on Sept. 30, you may enroll on the following Jan. 1.
Note that AFTRA Health Plan coverage does not begin when you qualify. It begins when you enroll and the pay the required premium by the due date (see below).
Note that special rules affect the qualification dates of some individuals who are roster artists or employees of radio or television stations. See p.14 of the 2005 AFTRA Health Plan Summary Plan Description and the August 2008 Benefits Update for additional information and details.
How to enroll
Once you qualify, it’s easy to enroll. Simply complete and submit the Performer Enrollment Form and pay your first quarterly Health Plan premium by the required due date. After that, your AFTRA Health Plan coverage will continue as long as you pay the required quarterly premiums on time and continue to meet the annual earnings requirements outlined above and the other qualification requirements of the Plan. Contact Participant Services at (800) 562-4690 for additional information.
For additional details about earnings requirements, qualification and enrollment rules, refer to the 2005 AFTRA Health Plan Summary Plan Description and the August 2008 Benefits Update. The information provided above is summarized and is not a complete description of the actual terms and provisions of the Health Plan documents. If any conflict arises between this information and the Plan documents, or if any point is not discussed above or is only partially discussed, the Plan documents will govern in all cases.
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