MEETING THE HEALTH CARE NEEDS OF THE CALIFORNIA COMMERCIAL FREELANCER

INSURANCE BENEFITS:

All eligible Freelance employees will receive benefits on an annual basis at no cost. These benefits include:

• Medical (based on tier eligibility): Classic Premier PPO, Classic Plus PPO, CA Classic HMO, High Deductible Health Plan with Health Savings Account (HSA).
• All medical plans utilize the largest network of providers offered by Anthem Blue Cross and its affiliated Blue Shield networks where available.
  
• Vision & Dental (Anthem Blue Cross)
  
• Short and Long-Term Disability Insurance (MetLife)
  
• $25,000 Basic Life and Accidental Death & Dismemberment (MetLife)
  
• Employee Assistance Program (MetLife)
  

MetLife offers Voluntary Benefits that are individually available to all Freelancers and may be purchased separately. These voluntary benefits include:

• Accident
• Critical Illness
• Hospital Indemnity
• Supplemental Life Insurance (Up to $1M in coverage)

ELIGIBILITY REQUIREMENTS

• 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.
• * Note: : All 12 month Qualification Periods Ending March 31, 2020 through February 28, 2021 have been extended to 17 months as part of the PHBP’s COVID-19 Relief Measures.

REPORTED EARNINGS DETERMINE YOUR AVAILABLE COVERAGE

• Your income Tier will be determined by your reported earnings in the Qualifying Period in which you earned eligibility for your current Coverage Period.
• For example: if your current coverage period is November 1, 2022 through October 31, 2023, the qualifying period in which you earned eligibility was September 1, 2021 through August 31, 2022.
• “Reported Income” continues to mean the gross income paid on covered jobs, in covered job categories performed for Participating Employers, on which contributions were received by the Plan.”
• If you are eligible for continued coverage at the same tier level, your current coverage will be the default renewal coverage if no changes are made by you. If you are not not eligible at the same tier level, the HMO will be the default coverage if no eligible medical plan is elected.
  
• Participants will be automatically enrolled in the HMO if no medical plan election is made during initial enrollment.
• All benefits, whether elected or auto-enrolled in default selections, will be terminated if the plan does not the receive the required $300 annual administrative fee by the stated due date.
  

TIER 1 –
Annual reported Income: Up to $49,999

Available No Cost Medical Coverage:

California Classic HMO -OR- High Deductible Health Plan w/ available tax advantaged Health Savings Account (HSA)

TIER 2 – Annual reported Income: $50,000 - $109,999

Available No Cost Medical Coverage:

California Classic HMO -OR- High Deductible Health Plan w/ available tax advantaged Health Savings Account (HSA)

Available ‘Buy up’ Medical Coverage:

Classic Plus PPO -OR- Classic Premier PPO

TIER 3 – Annual reported Income: $110,000 and above

Available No Cost Medical Coverage:

California Classic HMO -OR- High Deductible Health Plan w/ available tax advantaged Health Savings Account (HSA) -OR- Classic Premier PPO

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

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, Compliance Assistant
• Production Assistant, PA
• Covid Compliance Manager
• Covid Compliance Coordinator
• Covid Compliance Assistant
  

YOU’VE QUALIFIED FOR COVERAGE! NOW WHAT?

• Once you qualify for coverage, you will be sent an Enrollment Guide with enrollment instructions. All medical plan elections must be made no later than 30 days after becoming eligible and your annual administrative fee must be paid within 30 days of the effective date of coverage or coverage will be terminated.
  
• 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/register to 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

• If you are eligible for coverage, your insurance is free if you unless you are a Tier Two participant and choose to buy up to a different level of coverage.
  
• All covered Freelancers must pay a $300 annual administrative fee upon enrollment and with each annual policy renewal. Failure to pay will result in the termination of benefits.
  
• The cost of dependent coverage is shown below.

FREELANCE DEPENDENT COVERAGE

Covered Freelancers can add their dependents:

• Dependents (spouse/domestic partner or children, children of spouse/domestic partner, 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.
  
• 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/domestic partner’s current employer provided insurance ceases to exist. In this case, the soon-to-be formerly covered dependent can join PHBP without interruption.
• See the 2019 Summary Plan Description and all Summary of Material Modifications in the Documents and Resources section for more information regarding dependent eligibility.
  
• If you have a potential “life event” that could impact the enrollment period of your dependents, click here to notify the Plan Administrator.
• Proof of termination of prior coverage, marriage certificate, birth certificate, etc. required upon special enrollment.

FREELANCER BANKED DAYS

• To help you reach the 100-day requirement, you can bank days worked in excess of 100 per year for use in the upcoming qualifying year . The number of banked days credited towards eligibility will be capped at 50% of the total number of days needed for eligibility.
  
• Only qualifying work days for Participating Employers can be banked.
• All applicable 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 applicable 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 plus applicable banked days and the 100 days of work needed to re-qualify by making monthly payments equal to $9.68 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 $9.68 per day, for a total of $309.76 per month.
• You may combine your actual work days with any applicable banked days from last year’s qualifying period. The total of banked and worked days must be at least 50 days.
• 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.
• Click here to contact the Plan Administrator to get 2020 costs for COBRA continuation coverage and elect your coverage plan.
• Click here to get more information about COBRA continuation coverage.

QUESTIONS ABOUT PLAN POLICIES OR PROCEDURES

• References to or concerning Plan rules, terms, conditions and documents, including carrier insurance contracts, are intended as general statements for informational purposes only. Official plan documents, policies and certificates of insurance contain the details, conditions, maximum benefit levels and restrictions on benefits and in all cases the text of such documents shall control.
• For complete eligibility rules, see the Summary Plan Description and accompanying amendments in the Summary of Material Modifications found in the Documents and Resources section of this website.
  
• Call BeneSys Administrators at 855-696-2909, ext. 8604 between 8am – 4pm PST.
• Email questions to Staff@phbpbenefits.org