Winter 2023 Spotlight on Benefits Newsletter Now Available  

IN THIS ISSUE:

• Health Plan Partners with Green Light Cost Management to Obtain Lower Payments for Non-Network Claims for You and the Health Plan. The DGA–Producer Health Plan has partnered with Green Light Cost Management to negotiate lower rates for non-network claims and help eliminate balance billing whenever possible. With Green Light, the Health Plan will be better able to decrease out-of-pocket costs when you use non-network providers and reduce costs to the Health Plan. Read here for more information.
• New Prescription Drug Benefit Enhancement Lowers Out-of-Pocket Costs on Non-Specialty Generic Medications. Beginning January 1, 2024, CVS Caremark, the Health Plan’s prescription drug benefit manager, will compare a participant’s regular generic drug co-payment amount to the GoodRx discounted price and automatically select the lowest of the two. This means you no longer have to shop around for the best prices on non-specialty generic drugs. All you have to do is fill your prescription at a network pharmacy, using your CVS Caremark benefit card.
• CVS Updates Its List of Covered Medications, Effective January 1, 2024. CVS Caremark, the Health Plan’s prescription drug benefit manager, periodically reviews its list of covered medications, called the Advanced Control Formulary, to ensure access to safe, effective treatments in all drug classes. Effective January 1, 2024, CVS Caremark revised its list of covered medications in its formulary. Changes to the formulary affect which medications are covered by the Health Plan and how much you pay out-of-pocket for prescriptions. The complete 2024 list of excluded medications along with preferred alternatives is available at www.dgaplans.org/formulary.
• All-Inclusive Network Out-of-Pocket Limit Increases Effective January 1, 2024 as Established Under the Affordable Care Act. The All-Inclusive Network Out-of-Pocket Limit sets a maximum on the amount you pay out of pocket per calendar year for network benefits, including deductibles, co-insurance and co-payments (such as prescription drug co-payments, the $50 emergency room co-payment and the $10 co-payment for visits to the UCLA/MPTF health centers). The Health Plan indexes this limit annually, in line with the amount established each year under the Affordable Care Act. Accordingly, beginning January 1, 2024, the Health Plan’s All-Inclusive Network Out-of-Pocket Limit will increase from $9,150 individual/$18,200 family to $9,450 individual/$18,900 family.
• Board of Trustees Extends the Availability of Temporary Loans from Your Supplemental Pension Plan Account Through March 31, 2024. To assist participants who experienced financial hardship during the work stoppage resulting from the WGA and SAG-AFTRA strikes, the Board of Trustees of the Directors Guild of America–Producer Pension and Health Plans voted to extend temporary loans from the Supplemental Pension Plan through March 31, 2024. For full loan terms and exclusions, refer to the loan application at www.dgaplans.org/loanterms.
• Health Plan’s Infertility Benefit: Obtaining a Diagnosis – What Is and Is Not Covered. The DGA-Producer Health Plan partnered with Carrot Fertility July 1, 2022 to offer infertility benefits for covered participants and dependent spouses, including same-sex spouses and gender diverse spouses, with a diagnosis from their provider of infertility. This benefit includes infertility diagnoses based on any commonly accepted medical guidelines, including the American Society of Reproductive Medicine guidelines. Eligible participants and dependent spouses can each receive a $30,000 lifetime benefit, provided they are covered under Earned Active, Earned Inactive, Regular Carry-over, or related COBRA Continuation coverage with the Health Plan. To learn more about the Health Plan’s infertility benefits through Carrot, visit www.dgaplans.org/infertilitybenefits.
• Be.Well. Don’t Confuse the Common Cold with RSV. With so many respiratory illnesses to watch for this season, it is easy to get confused about which symptoms are specific to an illness and the necessary steps to treat them. This article in the Plans’ ongoing Be. Well series discusses the symptoms of RSV that distinguish the virus from the common cold along with RSV vaccine recommendations.
• CyberSmart(er): Simple Hacks to Keep Your New Devices Safe. New devices are exciting, especially for cybercriminals looking to exploit your unprotected technology. This article in the Plans’ ongoing CyberSmart(er) series will discuss ways to securely integrate new devices into your home and protect them against cybercriminals when connecting to other devices or the internet.
• Women’s Health and Cancer Rights Notice