PLAN DESCRIPTIONS

Download the 2019 Health Plan Descriptions.

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COSTS TO THE FREELANCER

Sign in for a complete breakdown of all potential enrollment and upgrade costs.

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VERIFY YOUR TIER LEVEL AND HISTORY

Sign in to check your current Tier level based on your last qualification period, as well as your reported work for your current qualification period.

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TRANSITION OF CARE / CONTINUATION OF CARE

Download details on policies and procedures for continuing a current course of treatment, including pregnancy.

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FINDING A DOCTOR AND SELECTING A PRIMARY CARE PHYSICIAN

Download details on how to find an in-network doctor for the PPO and a Primary Case Physician (PCP) for your HMO coverage.

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PARTICIPANT AND DEPENDENT ENROLLMENT / DESIGNATING A PCP

Sign in to enroll you and your dependents, and to assign an HMO Primary Care Physician.

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MEETING THE HEALTH CARE NEEDS OF THE CALIFORNIA COMMERCIAL FREELANCER IN 2019

The health-care marketplace is complicated. Skyrocketing premiums, soaring deductibles and increased out of pocket costs are the new normal.

But at the PHBP we have you covered.

When we launched this plan in 2007 we made a commitment to offer free, high quality insurance for our freelance workforce. Over a decade later, despite rising healthcare costs, we are still keeping that promise.

While your Medical coverage will remain with Anthem Blue Cross, the nation’s largest of providers, in 2019 the PHBP will be providing different types of coverage based on your earnings.

Read below to learn more.

INSURANCE BENEFITS:

All eligible Freelance employees will continue to receive Medical, Pharmaceutical, Dental, Vision, Short Term and Long Term Disability Insurance at no cost on an annual basis. Starting in 2019, eligible Freelancers will also receive a $25,000 Life Insurance policy, also free of charge.

ELIGIBILITY REQUIREMENTS

(Eligibility requirements stay the same.)

  • Work 100 days per year (“day” defined as a minimum of 8 hours, “year” as 12 consecutive months), OR
  • Earn $35,000 per year (as defined above).
  • Only non-union commercial work in a covered job category for PHBP Participating Employers counts towards eligibility.
  • Working for a non-participating production company? Encourage them to join - share this link.
  • Music videos, TV, Features, webisodes, etc. are NOT included.
  • You must re-qualify each year for continued coverage.
  • Click here to check your work history.

NEW FOR 2019 – DISCONTINUATION OF DOMESTIC PARTNER ELIGIBILITY

  • With the nationwide legalization of same sex marriage, the Plan will be phasing out the eligibility and coverage of domestic partners.
  • Effective October 20, 2018, the PHBP will no longer accept enrollment of same-sex or opposite-sex domestic partners as Eligible Family Members.
  • The Plan will “Grandfather” those domestic partners or children of domestic partners currently enrolled, and continue coverage through December 31, 2019.
  • The PHBP continues to cover eligible same-sex and opposite-sex legally married spouses and their children.

NEW FOR 2019 – REPORTED EARNINGS DETERMINE YOUR AVAILABLE COVERAGE

  • Effective January 1, 2019 your comprehensive medical coverage will be based on income tiers as described below.
  • Your income Tier will be determined by your reported earnings in the last qualifying period in which you earned eligibility for your current coverage period.
  • For example: If your current coverage period is June 1, 2018 through May 31, 2019, the qualifying period that made you eligible for that coverage was March 1, 2017 through April 31, 2018.
  • On January 1, 2019, all Participants will migrate to their respective Tier of coverage and continue that coverage for the duration of their current coverage period.
  • Eligibility for renewed coverage will continue as is, with the next year’s coverage determined by the annual income tier at the end of the current qualifying period.
  • “Reported Income” continues to mean the gross income paid on covered jobs, in covered job categories, for work performed for Participating employers.

NEW FOR 2019 – DEFINING THE TIERS

All plans utilize the most extensive networks offered by Anthem Blue Cross and its affiliated Blue Shield networks where available

TIER 1 - Annual Reported Income: Up to $74,999
Available Medical Coverage: PHBP California Classic HMO

TIER 2 - Annual reported Income: $75,000 - $109,999
Available Medical Coverage: PHBP California Classic HMO -OR- ‘Buy Up’ to the PHBP Classic Premier PPO

TIER 3 - Annual reported Income: $110,000 and above
Available Medical Coverage: PHBP California Classic HMO -OR- PHBP Classic Premier PPO

CLICK HERE for coverage description.

*“Salary figures are stated for convenient reference only and eligibility is based on 9% contributions actually received derived from such salary amounts.”

NEW FOR 2019 – SELECT YOUR COVERAGE

Tier 1

  • Participants will be automatically enrolled in the PHBP California Classic HMO.
  • All Participants and their covered dependents MUST select an In-Network Primary Care Physician (PCP) or Medical Group prior to receiving care. Click here for instructions. You can also Check to see if your current doctor is in the HMO Network.
  • It is strongly recommended that you enroll with your PCP immediately.
  • Click here to enroll yourself and your dependents.

Tier 2

  • Participants will be automatically enrolled in the California Classic HMO unless an enrollment form electing to ‘Buy Up’ to the PHBP Classic Premier PPO is received by December 15, 2018.
  • All Associated “Buy Up’ fees will be billed and the first payment is due no later than January 15, 2019.
  • All Participants and their covered dependents in the HMO MUST select an In-Network Primary Care Physician(PCP) or Medical Group prior to receiving care. Click here for instructions. You can also check to see if your current doctor is in the HMO Network.
  • It is strongly recommended you choose your PCP immediately.
  • Participants electing the PHBP Classic Plus PPO can find a doctor or check to see if your existing doctor is in the network by clicking here.

Tier 3

  • Participants will be automatically enrolled in your current PHBP Classic Premier PPO unless an enrollment form electing the PHBP California Classic HMO is received by December 15, 2018.
  • You can find a doctor or check to see if your existing doctor is in the PPO network by clicking here.
  • All Participants and their covered dependents in the HMO MUST select an In-Network Primary Care Physician (PCP) or Medical Group prior to receiving care. Click here for instructions. You can also check to see if your current doctor is in the HMO Network.
  • For Participants choosing the HMO - It is strongly recommended you choose your PCP immediately.

    CLICK HERE for a complete breakdown of costs and fees.

    PARTICIPATING EMPLOYERS

    • Only work in a Covered Job Category for a Participating Employer counts towards eligibility.
    • Click here for a current list of Participating Employers.

    COVERED PRODUCTION JOB CATEGORIES

    • Work in the following job categories counts towards PHBP eligibility, and includes all modifiers, adjectives, prefixes, suffixes or descriptive terms that may be added to the job title except “Post” or other modifiers which indicate work done in a Post Production capacity.
    • Producer, Line Producer, Bidder
    • Production Manager, Production Supervisor
    • Production Coordinator, Asst. Production Supervisor, DOT Coordinator
    • Production Assistant, PA

    NEW FOR 2019 – POST PRODUCTION JOB CATEGORIES ARE BEING PHASED OUT

    • Work in Post Production job categories will no longer count towards eligibility.
    • All earned eligibility from work in Post Production job categories prior to Jan. 1, 2019 will be honored and coverage granted for the full 12 month coverage period.
    • COBRA continuation coverage will be provide for an additional 18 months for eligible participants.
    • Those effected job categories include Animator (2D or 3D), CG Supervisor, Designer, Compositor, Effects Artist, Flame Artist, Colorist, Editor, Assistant Editor, Post Production Supervisor, Post Production Producer, Finisher, Render Wrangler, Stitcher, Technical Director, and any other “post” job as commonly understood in the industry.

    YOU’VE QUALIFIED FOR COVERAGE! NOW WHAT?

    • Once you qualify, you will be automatically enrolled. Automatic enrollment will be based on Tier (described above). Tier 1 and Tier 2 will automatically be enrolled in the California Classic HMO and Tier 3 in the Premier PPO. If you are eligible for Tier 2 or Tier 3 medical coverage and would like to select a different option, you must complete a 2019 Benefits Election Form and submit it no later than 30 days after becoming eligible.
    • Upon becoming qualified, PHBP will send you information by regular mail about, including an option to opt out of the Plan.
    • Coverage will begin the First of the month following a 60-day processing period after the qualifying event (the 100th day worked or the 35th thousandth dollar earned). Example: If you earn $35,000 or work the 100th day on April 17, the 60-day processing period is from April 17 – June 17, and coverage starts the 1st of the following month, in this case, July 1.
    • Anthem Blue Cross will mail you a welcome packet and and information about their network of approved doctors and providers. Your ID cards will come separately.
    • It may take the carrier up to 30 days from your coverage start date to send you your ID cards. California residents can log onto https://www.anthem.com/ca/registerto print a temporary ID card. You will need your Member ID from the initial mail correspondence received from Anthem Blue Cross.
    • Anthem Blue Cross can also be reached at 800-759-3030.

    COST TO THE FREELANCER

    • Your insurance is free. However you must pay a $300 annual administrative fee upon enrollment and with each annual policy renewal. The cost of dependent coverage is shown below.
    • If you are eligible for Tier 3 medical coverage and elect the California Classic HMO, the Plan will waive your next annual fee.

    FREELANCE DEPENDENT COVERAGE

    Covered Freelancers can add their dependents:

    • Dependents (spouse or children, children of spouse, children placed with you for adoption, all under age 26 ) can be added for $250 per month for the 1st Dependent, plus $100 per month for each additional dependent. See Cost to the Freelancer for more information.
    • Dependents can be added upon initial enrollment or annual renewals only.
    • * Exceptions are made for special “life events”, i.e. birth, marriage, adoption, involuntary cessation of a dependents’ prior coverage, example, if a spouse’s current employer provided insurance ceases to exist. In this case, the soon-to-be formerly covered dependent can join PHBP without interruption.
    • If you have a potential “life event” that could impact the enrollment period if your dependents, click here to notify the Plan Administrator.
    • Proof of termination of prior coverage, marriage certificate, birth certificate, etc. required upon special enrollment.

    WHAT IF I DON’T REQUALIFY FOR CONTINUED COVERAGE?

    FREELANCER BANKED DAYS

    • To help you reach the 100-day requirement, you can bank your worked days in excess of 100 per year for use in the upcoming qualifying year.
    • Only qualifying work days for Participating Employers can be banked.
    • Any banked days from your immediately preceding 12 month qualification period will be automatically added to your current day count.
    • If the sum of your current qualifying days and your banked days is 100 days worked or more, you qualify for policy renewal.
    • Click here to review your work history and Banked Days.

    FREELANCE BRIDGE PAYMENTS

    • You can “bridge” the gap between your actual days worked and the 100 days of work needed to requalify by making monthly payments equal to $5.71 per each day needed to bridge the gap.
    • Example: You have 20 days banked from your previous qualifying year and worked 48 days in the current qualifying year, for a total of 68 days. That’s 32 days short of the 100 needed to re-qualify. The Bridge Payment would be 32 days x $5.71 per day, for a total of $188.43 per month.
    • You may combine your actual work days with any banked days from last year’s qualifying period. The total of banked and worked days must be at least 50 days.
    • Effective January 1, 2019: While participating in the Bridge program, the Participant will pay the full cost of dependent coverage each month.
    • Bridge payments can be made for up to 12 months, or until you re-qualify by earning $35,000 or working 100 days in a consecutive year.
    • Click here to contact the Plan Administrator to set up bridge payments. Bridge payments must be set-up PRIOR to the termination of your current coverage.

    COBRA

    • If your PHBP coverage is terminated for failure to re-qualify, you will be offered COBRA continuation coverage.
    • You may pay the cost of your insurance premium plus a small administration fee in order to continue your PHBP coverage for up to 18 months. Generally, the PHBP premiums are likely to be much less than a similar policy would cost on the individual market.
    • Those currently on COBRA Continuation coverage may elect the Tier One or Tier Three level coverage plans offered in your State of during the December open enrollment period for coverage effective January 1, 2019.
    • Click here to contact the Plan Administrator to get 2019 costs for COBRA continuation coverage and elect your coverage plan.
    • Click here to get more information about COBRA continuation coverage.

    WHAT IF YOUR EMPLOYMENT CHANGES FROM FREELANCE TO STAFF?

    • Freelance coverage continues through the end of the month in which a Freelancer becomes staff.
    • Staff coverage begins the first of the following month (the day after the last day of Freelance coverage).
    • All unused months of the Freelancer’s current annual coverage period can be ‘banked’ for up to 18 months and can be used immediately to reinstate coverage if the staff employment ends within the 18 month banking period.

    WHAT IF YOUR EMPLOYMENT CHANGES FROM STAFF TO FREELANCE?

    • The former staff employee gets 2 days credit per month worked for a participating employer, for up to 36 total days credit (18 months of staff coverage).
    • The credited days will apply towards the 100 days needed to qualify for freelance coverage.
    • Standard Freelance eligibility rules apply. See “Eligibility Requirements” above.
    • Example: If a staff employee worked for 10 months at a participating employer, s/he would get 20 days credited towards the needed 100 days. The former staff employee would therefore need to either earn $35,000 or work (only) 80 days in the first year in order to qualify for freelance coverage.

    QUESTIONS ABOUT 2019 PLAN POLICIES OR PROCEDURES

    • Call BeneSys Administrators at 855-696-2909, ext. 8604 between 8am – 4pm PST.
    • Email questions to Staff@phbpbenefits.org