Summer 2024 Spotlight on Benefits Newsletter Now Available

IN THIS ISSUE:

• Board of Trustees Approves Two Additional Three-Month Extensions of Free Major Medical Plus Plan Coverage for Eligible Participants, Beginning July 1, 2024 and October 1, 2024. To lessen the impact on participants who lost or will lose Health Plan coverage as of June 30, 2024 or September 30, 2024 due to the work stoppage resulting from the WGA and SAG-AFTRA strikes, the Plans’ Board of Trustees approved an additional three-month extension to the free medical plan coverage for eligible participants. The Major Medical Plus Plan offers medical coverage within the Anthem Blue Cross network, including mental health and substance abuse benefits, and prescription drug coverage. For eligibility and coverage details, visit http://www.dgaplans.org/majormedicalplus.
• CVS Caremark Updates List of Covered Medications, Effective July 1, 2024. Periodically, CVS Caremark updates its list of covered medications. Review the current list for changes that may impact maintenance medications you are taking, along with excluded medications and preferred alternatives at http://www.dgaplans.org/formulary.
• Health Plan Announces Changes to the Non-Network Claims Process and Payments. On January 16, 2024, the Health Plan partnered with Green Light Cost Management to negotiate lower rates and eliminate balance billing for non-network claims. However, in certain cases where payment is made upfront or when non-network providers do not negotiate with Green Light, participants may still be balance billed and receive lower reimbursements for claims. The Board of Trustees has approved changes to ensure you are reimbursed at the same rate as prior to the change. Retroactive additional payment and updated Explanation of Benefits will be sent to those impacted. Read the full article here for details.
• Working After Retirement? Be Sure You Know the Basic Plan’s Suspension of Benefit Rules. If you are receiving a monthly pension benefit but return to work for eight or more days in a calendar month in the same industry, trade or craft you worked in before retirement, you are required to notify the Plans office. Working after retirement under these circumstances is referred to as Suspendible Service, and monthly benefits may be temporarily suspended, unless you have reached your Required Beginning Date. If you have reached your Required Beginning Date, your monthly benefit is not subject to suspension. For full Suspension of Benefits Rules, refer to the March 2020 Pension Plans Summary Plan Description and its updates.
• Weight Loss Prescription Coverage Requires Enrollment in the Health Plan’s New Weight Management Benefits Provider, Flyte Medical, Effective July 1, 2024. Beginning July 1, 2024, medications prescribed for weight loss will only be covered if participants and/or adult dependents are enrolled in the Health Plan’s new weight management benefits provider, Flyte Medical. If you are currently taking medications prescribed for weight loss by a non-Flyte provider, the Health Plan continued to cover these prescriptions until July 31, 2024. After this date, weight loss medications for participants and adult dependents will no longer be covered unless prescribed by a Flyte provider. Learn more about this change, eligibility for Flyte and the program’s full benefits here.
• Weight Loss Medications Will Be Reclassified as Lifestyle Drugs Effective October 1, 2024. To manage the cost and coverage of weight loss medications, especially the GLP-1s, effective October 1, 2024, all weight loss drugs will be moved to the Health Plan’s Lifestyle Drugs tier, which will change the co-payment amount for these drugs. GLP-1 medications prescribed for diabetes will not be moved to the Lifestyle Drugs tier. However, GLP-1 medications prescribed solely for weight loss, including those prescribed off-label, will be moved to the Lifestyle Drugs tier. Read the full article to learn more about this tier’s special rules and schedule of benefits.
• Be.Well. How to Better Advocate for Yourself When Visiting the Doctor. Have you ever left a doctor’s appointment feeling frustrated, confused or concerned your doctor wasn’t fully invested? Although it may feel like what happens at an appointment is out of your control, your preparation and advocacy are important factors in the appointment’s success. Read this article to learn steps you can take before, during and after an appointment to advocate for yourself and increase the likelihood of a successful visit.
• Health Fairs and Flu Shot Clinics This Fall in LA & NYC. The DGA-Producer Health Plan will host its annual health fairs this fall on September 21 in Los Angeles and October 19 in New York. The event will feature free flu shots for all DGA members and dependents ages 13 and over, one-on-one time with Plans staff, prizes and free neck and shoulder massages. The Plans are also looking for volunteers to join its first ever blood drive during the event. Reservations are required for flu shots. Reserve your spot here.