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 help mitigate the impact of the WGA and SAG-AFTRA strikes on participant eligibility for those whose Earned Active or regular Carry-Over coverage expired June 30, 2024 or will expire September 30, 2024, the Board of Trustees of the DGA-Producer Health Plan unanimously approved an additional extension of the free Major Medical Plus Plan for two additional three-month periods beginning July 1, 2024 and October 1, 2024.
The Board of Trustees previously offered Major Medical Plus Plan coverage to participants and their eligible dependents who lost Earned Active or regular Carry-Over coverage as of June 30, 2023, September 30, 2023, December 31, 2023, and March 31, 2024.Those who previously elected this coverage are also eligible for the extensions, provided that they remained on the Major Medical Plus Plan through June 30, 2024 for the extension on July 1, 2024 and through September 30, 2024 for the extension that begins October 1, 2024.
What the Major Medical Plus Plan Covers
The strike-related Major Medical Plus Plan provides the following benefits:
- Network medical coverage, including mental health and substance abuse benefits.
- In the case of Emergency Services provided at a non-network facility, when you receive emergency or non-emergency services from a non-network provider at certain network facilities, or emergency air ambulance services provided by non-network providers, non-network providers may not balance bill a patient and the patient will pay the same cost sharing that applies to network claims.
- Prescription drug coverage.
Exclusions: Hearing aids, chiropractic, acupuncture, and foot orthotics are excluded from coverage under the Major Medical Plus Plan, as are dental benefits, vision benefits, and special arrangements with UCLA Health/EIMG.
Who Qualifies
To qualify for the Major Medical Plus Plan, you must have worked under the Basic Agreement or the Freelance Live and Tape Television Agreement and satisfy the requirements below. Individuals who previously elected and remained on the Major Medical Plus Plan through June 30, 2024 (Groups 1-4) are also eligible for the most recent extensions beginning on July 1, 2024 and October 1, 2024, provided that they remained on the Major Medical Plus Plan through June 30, 2024 for the extension on July 1, 2024, and through September 30, 2024 for the extension that begins October 1, 2024.
The two new eligibility groups are detailed further below:
- Group 1: You and your eligible dependents lost Earned Active or regular Carry-Over coverage as of June 30, 2023 and did not have sufficient earnings to requalify effective October 1, 2023 for the applicable work period July 1, 2022 to June 30, 2023 and have at least $10,000 in initial compensation during the work period July 1, 2022 to June 30, 2023 and the DGA-Producer Health Plan is your primary plan; OR
- Group 2: You and your eligible dependents lost Earned Active or regular Carry-Over coverage as of September 30, 2023 and did not have sufficient earnings to requalify effective October 1, 2023 for the applicable work period July 1, 2022 to June 30, 2023 and have at least $10,000 in initial compensation during the work period July 1, 2022 to June 30, 2023 and the DGA-Producer Health Plan is your primary plan; OR
- Group 3: You and your eligible dependents lost Earned Active or regular Carry-Over coverage as of December 31, 2023 and did not have sufficient earnings to requalify effective January 1, 2024 for the applicable work period October 1, 2022 to September 30, 2023 and have at least $7,500 in initial compensation during the work period October 1, 2022 to September 30, 2023 and the DGA-Producer Health Plan is your primary plan; OR
- Group 4: You and your eligible dependents lost Earned Active or regular Carry-Over coverage as of March 31, 2024 and did not have sufficient earnings to requalify effective April 1, 2024 for the applicable work period January 1, 2023 to December 31, 2023 and have at least $5,000 in initial compensation during the work period January 1, 2023 to December 31, 2023 and the DGA-Producer Health Plan is your primary plan; OR
- Group 5: You and your eligible dependents lost Earned Active or regular Carry-Over coverage as of June 30, 2024 and did not have sufficient earnings to requalify effective July 1, 2024 for the applicable work period April 1, 2023 to March 31, 2024, and have at least $5,000 in initial compensation during the work period April 1, 2023 to March 31, 2024 and the DGA-Producer Health Plan is your primary plan; OR
- Group 6: You and your eligible dependents will lose Earned Active or regular Carry-Over coverage as of September 30, 2024 and do not have sufficient earnings to requalify effective October 1, 2024 for the work period July 1, 2023 to June 30, 2024 and have at least $5,000 in initial compensation during the work period July 1, 2023 to June 30, 2024 and the DGA-Producer Health Plan is your primary plan.
Eligible participants may also cover their eligible dependents under the Major Medical Plus Plan provided they were included on their Earned Active or regular Carry-Over coverage that ended on June 30, 2023, September 30, 2023, December 31, 2023, March 31, 2024, June 30, 2024, or September 30, 2024 and they do not have other primary coverage.
Eligibility Exclusions
You are ineligible for the free strike-related Major Medical Plus Plan if you fit within any of the following categories:
- You worked under an agreement other than the Basic Agreement or Freelance Live and Tape Television Agreement and lost (or will lose) coverage on either June 30, 2023, September 30, 2023, December 31, 2023, March 31, 2024, June 30, 2024, September 30, 2024; OR
- You have Earned Inactive coverage based on residual compensation; OR
- You have any form of Self-Pay coverage (including COBRA, Extended Self-Pay, Retiree Carry-Over or Certified Retiree); OR
- You are covered by other insurance; OR
- You qualify for Medicare as your primary coverage; OR
- You have available Carry-Over credits or Retiree Carry-Over credits or are eligible to begin Certified Retiree coverage. (You will be required to use your credits or Certified Retiree coverage.)
Eligible Participants Will Be Notified
Participants who qualify for the latest extensions of coverage under the Major Medical Plus Plan will be notified. If you are eligible, you will receive a letter from the Health Plan with further information.
If you believe you should be eligible for the extended Major Medical Plus Plan coverage but do not receive notification from the Health Plan, or for any other questions, please contact a Participant Services Representative at (323) 866-2200, Ext. 401.