A change in employment status – gaining a job, losing a job, a reduction in hours or a change in covered earnings – could affect your current health coverage or other options that may be available to you.

If you lose coverage with another health plan

An involuntary change in employment status that causes you to lose other health coverage, such as the loss of a job or a reduction in hours, allows you to enroll and/or add dependents to AFTRA Health Plan coverage if … 

• you are a performer who qualifies for AFTRA Health Plan coverage, but you previously did not enroll because you were covered under another health plan, or 
• you are an enrolled participant in the AFTRA Health Plan who chose not to pay the premium for Family Health Plan coverage or buy-up from Individual to Family coverage because your dependents had coverage under another health plan.

In either situation, if that other coverage is lost because of an involuntary change in employment status, you may enroll yourself and/or your dependents in the AFTRA Health Plan starting the day after the other coverage ends. But to take advantage of this right, qualified performers must inform AFTRA H&R in writing and provide a certificate or letter of creditable coverage from the other health plan within 30 calendar days of the change in employment status. Otherwise you may be prevented from enrolling yourself and/or your dependents in the AFTRA Health Plan until the start of your next coverage period.

If you lose coverage under the AFTRA Health Plan

Sometimes enrolled participants lose AFTRA Health Plan coverage because their covered earnings fall below the minimum required earnings level ($10,000 for the Individual Health Plan) or previously covered dependents lose coverage because of a change affecting their status (i.e., a divorce, a legal separation, or an adult child who no longer qualifies due to age or a change in full-time student status). In these circumstances, participants and dependents have 60 days after the qualifying event to inform AFTRA H&R in writing if they choose to extend their coverage under the terms of COBRA, or the Consolidated Omnibus Budget Reconciliation Act. The written notice must identify the qualifying event, the date on which it occurred and the names of the individuals who are losing coverage. In the case of divorce or legal separation, a copy of the judgment for “Dissolution of Marriage” or recorded separation agreement must be submitted with the written notice. Otherwise COBRA continuation coverage will not be offered by the Health Plan.

If you qualify for coverage in more than one health plan

If you’re a performer who qualifies for health coverage in more than one plan, before declining or dropping coverage in the AFTRA Health Plan, consider that you may be able to coordinate benefits between both plans (one would provide primary coverage and the other would provide secondary coverage). The rules that govern coordination of benefits are complex, and special rules apply to the coordination of benefits with the Screen Actors Guild – Producers Health Plan. Refer to the 2011 Health Plan SPD and relevant Benefits Updates or call Participant Services at (800) 562-4690 with questions you have about coordination of benefits.

For any life event that could affect your coverage, you must notify AFTRA H&R in writing. Please send this notification, along with supporting documentation , to the address below:

AFTRA Health & Retirement Funds
Attention: Eligibility Department
261 Madison Avenue, 7th floor
New York, NY 10016

For definitions of some of the terms listed on this page, visit the online health and retirement glossaries.

Questions? Call Participant Services at (800) 562-4690.

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