MEETING THE HEALTH CARE NEEDS OF THE COMMERCIAL FREELANCER (NON-CALIFORNIA)

INSURANCE BENEFITS

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

• Medical (based on tier eligibility): PHBP HDHP w HSA, PHBP Classic Premier PPO, PHBP Classic Plus PPO
• Vision & Dental
• Short and Long-Term Disability Insurance
• $25,000 Basic Life and Accidental Death & Dismemberment
• Employee Assistance Program

Voluntary Benefits 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 last qualifying period in

  which you earned eligibility for your current coverage period.

• For example: If your current coverage period is June 1, 2019 through May 31, 2020, the qualifying period that made you eligible for that coverage was March 1, 2018 through April 30, 2019.
• Eligibility for renewed coverage will be determined by the annual income tier at the end of the current qualifying period. 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.
• “Reported Income” continues to mean the gross income paid on covered jobs, in covered job categories, for work performed for Participating employers.
• 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 Classic Plus PPO -OR- HDHP w HSA (available for coverage effective Jan 1, 2020)

• Participants will be automatically enrolled in the HMOif no election is made.

TIER 2 – Annual reported Income: $75,000 - $109,999

Available Medical Coverage:

PHBP Classic Plus PPO -OR- HDHP w HSA (available for coverage effective Jan 1, 2020)

-OR-

‘Buy up’ to the PHBP Classic Premier PPO

• Participants will be automatically enrolled in the HMO if no election is made.
• See your Enrollment Guide for current Buy-Up costs.
  

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

Available Medical Coverage:

PHBP Classic Plus PPO -OR- HDHP w HSA (available for coverage effective Jan 1, 2020)

-OR-

PHBP Classic Premier PPO

• Participants will be automatically enrolled in the PremierPPO if no election is made.

“Salary figures are stated for convenient reference only and eligibility is based on contributions actually received as 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, you will be automatically enrolled. Automatic enrollment will be based on Tier (described above in “Reported Earnings Determine Your Coverage”). All medical plan elections must be made no later than 30 days after becoming eligible.
• Upon becoming qualified, you will receive an Enrollment Guidde with instructions on how to enroll for coverage, 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.
• 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 card.
• Anthem Blue Cross can also be reached at 800-759-3030.

COST TO THE FREELANCER

• Your insurance is free if you earn eligibility during a defined Qualifying Period from work performed for Participating Employers.
  
• There is a $300 annual administrative fee due upon enrollment and with each annual policy renewal.
  
• The current cost of Tier Two Buy-up coverage can be found in your enrollment guide
  
• 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. See Cost to the Freelancer for more information.
• See the 2019 Summary Plan Description and 2020 Summary of Material Modifications for more information regarding domestic partner policy.
• 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.
• Exceptions are made for special ‘life events’, such as, for example, if a spouse/domestic partner’s current employer provided insurance ceases to exist because the employer goes out of business. 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 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 workeddays 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 and 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.

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