Tensions Simmer Over SAG-AFTRA Health Care Plans

Jeremy Fuster
·7-min read

The fight over health care for retired members of SAG-AFTRA continues to broil, with tension and confusion mounting over drastic changes underway to cut costs amid the pandemic.

The Actors Fund and the Motion Picture & Television Fund have stepped in to offer aid to those who need help finding a substitute for their guild health care coverage. But many retirees might not even know these programs exist, while others accuse actors guild leadership of misleading members about all the available options, in favor of the Medicare marketplace the guild has partnered with through this process.

The two long-running nonprofit organizations have provided aid to entertainment workers, offering programs that include weekly seminars, individual counseling and, in some cases, direct enrollment into health care plans. For California residents, both organizations are offering these services through the Entertainment Health Insurance Solutions program, while workers in other states can find assistance through the Actors Fund’s Actors Health Insurance Resource Center.

While these programs predate the COVID-19 pandemic, they are finding new attention as thousands of SAG-AFTRA members find themselves at risk of losing coverage on their guild’s health plan due to changes the plan’s trustees made in August in an effort to avoid insolvency. Among those that have found help through these organizations is Michael Bell, an 82-year-old voice actor who worked on multiple classic cartoons, like “The Smurfs,” “G.I. Joe” and “Rugrats.”

“MPTF doesn’t feel like a group of strangers trying to make a commission off of us,” Bell said. “They actually feel like part of the industry, of the community. I found them extremely helpful, and it’s the kind of support that I wish we could have from our union right now.”

Also Read: Hilary Swank Sues SAG-AFTRA Health Plan for Not Covering Ovarian Cyst Treatment

michael bell
michael bell

Michael Bell (All Axxess Entertainment/YouTube)

The Entertainment Health program “is something everyone affected by these coverage changes should know about. They really do care about helping people in the industry make sense of health insurance policies, and every dollar they get from commissions goes back into that mission,” added Frances Fisher, Vice President of SAG-AFTRA’s Los Angeles chapter. “With thousands of actors and retirees suddenly in need of health care because of this blindside the plan trustees put on us, we need to get the word out about them.”

Entertainment Health was created at the start of 2019 as a way for the West Coast MPTF and the East Coast Actors Fund to combine their efforts for providing health care support to entertainment workers in California. With licensed agents, the program can provide California workers with enrollment in Medical, Covered California plans and Medicare programs.

While the Resource Center does not have licensed agents, the Actors Fund has expanded its insurance counseling program in response to the pandemic. In June, the program launched the Every Artist Insured initiative, aimed to help workers find replacement health care if they were unable to meet their guild’s health plan earnings requirement because of production shutdowns.

“My goal is to make everyone into a health care insurance ninja,” Actors Health Insurance Resource Center Director Renata Marinaro joked. “I want everyone to have knowledge of this system and how they fit into it. While we have a lot of older actors call us for help with Medicare, we want to help everyone in the industry regardless of their age.”

SAG-AFTRA has set up its own in-house program to provide replacement coverage for those losing their guild health plan coverage with Via Benefits, a for-profit Medicare marketplace. The Via program has been heavily promoted by the guild, with former SAG presidents like Richard Masur promoting its ease of use.

Also Read: SAG-AFTRA's 'Unconscionable' Health Plan Changes Spurs Petition With Over 11,500 Signatures

richard masur
richard masur

Richard Masur (Getty Images)

“I am surprised to hear that some say they are unable to find comparable Medicare supplemental plans,” Masur, a SAG-AFTRA health plan trustee, said in a statement to TheWrap. “I ended up with a plan that is actually better than the plan I currently have under the SAG-AFTRA Health Plan and as good as — if not better — than the Senior Performer benefit that the Health Plan previously offered.”

Masur says that he was able to take advantage of the health reimbursement account (HRA) that the guild’s health plan is offering to retirees. In the HRA account, guild members receive credits based on how many years they qualified for either the SAG Pension Plan or the AFTRA Retirement Plan prior to 2017. Those with more than 20 credits can receive $1,140 credit towards health care coverage. Thanks to that HRA credit, Masur says his health care expenses are close to what they were before the health plan changes.

“That includes a dental plan identical to the one we currently have and a vision plan that is actually better than the one we currently have,” Masur said. “My part D drug plan will cost me significantly less than our current plan, and I’m still able to cover my wife, who is younger than 65, through the Active Plan for just $250 a month.”

SAG-AFTRA health plan CEO Michael Estrada also heavily promoted the Via Benefits platform when reached out for comment, promising catastrophic prescription drug coverage and coverage to non-Medicare eligible dependents, in addition to the HRA benefits.

“No senior participant is losing their health care. That is simply misinformation. Medicare remains the primary coverage for seniors over age 65, as it has always been with the SAG-AFTRA Health Plan,” he said. “Via Benefits’ marketplace is extremely broad with a multitude of plans offered by all the leading national, regional and local insurance carriers, and it allows senior performers to customize their coverage to better meet their personal health care and financial needs.”

But Jennifer Louisell, director of insurance services for MPTF, says that the Entertainment Health Insurance Solutions program can provide discounts and benefits that Via Benefits cannot. As an example, she suggested that retirees with certain conditions such as HIV can qualify for special programs, particularly in Los Angeles, that provide the same level of coverage.

“Via Benefits is not going to be able to help people through that process, to help them find those programs that will pay for the extra premiums,” she said. “A senior that doesn’t have a lot of income between pension and Social Security, we can help them get on a low-income federal subsidy to help pay for their prescription drugs. There are programs that we can assist them with that, unfortunately, a program like Via Benefits cannot.”

Even offering Entertainment Health and the Resource Center as an option alongside Via Benefits has become a point of contention among those who have protested the health plan changes. Fisher accused the guild leadership of not doing enough to let people know that the two nonprofit programs were available, instead heavily pushing Via Benefits. On the health plan website, links to Entertainment Health and the Resource Center are included on the site’s general resources page, but only mentioned once in the “2021 Changes” section as part of a lengthy FAQ page.

Also Read: SAG-AFTRA Health Plan Raises Rates, Eligibility Requirements in Response to Projected Pandemic Losses

frances fisher
frances fisher

Frances Fisher (Getty Images)

“I’ve sat and listened to all the guild webinars. I’ve heard everything that [SAG-AFTRA executive director] David White has said. They are pushing Via Benefits as the one service they want the members to go to,” Fisher said. “We’ve been on calls asking them ‘What about MPTF?,’ and their response has been ‘If you’re connected to MPTF or Actors Fund, you can go to them.’ It feels like they’re begrudgingly letting people know about those alternatives.”

Marinaro and Louisell confirmed that their organizations’ programs were not initially approved by the health plan trustees to offer their services to senior performers, and that they had to reach out to SAG-AFTRA to request that their programs be included. The trustees approved MPTF and Actors Fund as alternative services to Via Benefits on Sept. 18.

A spokesperson for the SAG-AFTRA health plan said that Via Benefits was selected after a “stringent request for proposal and interview process,” along with its expertise in handling HRA accounts. The plan trustees added Actors Fund and MPTF as enrollment partners for HRA accounts out of recognition that “some participants already have relationships” with those organizations. Members who have health plans through their workplace or other retiree group health plans are also asked to contact the health plan’s office to ensure they still have access to an HRA.

Read original story Tensions Simmer Over SAG-AFTRA Health Care Plans At TheWrap