By Action of the Board of Trustees: DEPENDENT PREMIUM PAYMENTS DUE APRIL 1, 2020 MAY BE DEFERRED UNTIL JULY 1, 2020 (Opt-in required)

In recognition of these unprecedented and challenging times, by action of the Board of Trustees, participants with dependent premiums due April 1, 2020 will have the option to defer the payment of such premiums until July 1, 2020.

To exercise this option, you must elect to defer your premium payment by April 15, 2020, by notifying the Health Plan’s Eligibility Department via email at eligibility@dgaplans.org or by fax at (323) 866-2399. Once your election is received, your dependents will remain covered by the Health Plan during the deferral period. In your election email or fax to the Eligibility Department, please state the following and sign and print your name:

“I elect to defer my dependent premiums until July 1, 2020. I understand that I will be liable to the DGA Health Plan for any claims incurred after April 1, 2020, if the required premiums are not paid by July 1, 2020.”

Please be advised that if the dependent premium payment is not made by July 1, 2020, you will be liable to the Health Plan for any claims incurred on behalf of your dependent(s) after April 1, 2020, and you will not be able to resume dependent coverage until you make up the missed payments and satisfy all applicable Health Plan eligibility requirements.