MOTION PICTURE WORKERS HEALTH BENEFITS PLAN FREQUENTLY ASKED QUESTIONS

Transcription

1 MOTION PICTURE WORKERS HEALTH BENEFITS PLAN FREQUENTLY ASKED QUESTIONS General Plan Information... 6 What benefits are provided?... 6 Who is our insurance provider?... 6 What is our group number?... 6 Where can I get a Plan Booklet?... 6 Where can I get detailed information about the Plan?... 6 Taxation... 6 Are there payroll or tax deductions for this coverage?... 6 Are Plan benefits taxable?... 6 I self-paid during the year. Do I get a tax credit?... 7 But shouldn t I get a tax receipt?... 7 Hour Bank... 7 Summary... 7 How do I establish coverage in the Plan?... 7 How can I find out when I ll be covered?... 8 What if I don t apply for coverage?... 8 Do I still need to file enrolment cards?... 8 Can I back-date my coverage?... 9 How does my coverage continue?... 9 Can I save my hours to be covered later?... 9 What is an hour bank for?... 9 Why is there an Hour Bank Maximum? Is that fair? But they re MY hours! RESIDENCY Are non-residents of BC covered? Are non-residents of Canada covered? Who is a Canadian resident? Enrolment Can my spouse and I cover each other? ) Medical Services Plan of British Columbia (MSP) ) Extended Health and Dental Why such a strange rule? Submitting Dual Coverage claims... 12

2 How do I add (a) dependent(s) to the Plan? Do the Union and Plan office co-ordinate address changes? Shortage Notices What is a Shortage Notice? What should I do if I get one? How can I pay my shortage notice? What if I don t pay a shortage notice? I m back at work do I still need to pay? It s not my fault No one forwarded my shortage notice! How do I re-qualify if coverage terminates? I m unemployed. Is there a reduced rate? Can t I just sign a declaration? What about contractors? I m a new parent. Is there a reduced rate? What if I can t afford the reduced rate? How long can I self-pay for coverage? What if I return to work? Is that fair? What if I work elsewhere? What if I receive Disability Credits? How does maternity leave affect the self-pay rule? I m on my spouse s MSP why should I self-pay the full rate? Disability I m disabled. Is my HOUR BANK maintained? *What is wage loss? What about longer disabilities? What if I win a WCB Appeal after my coverage ends? I m disabled. Why am I still getting a shortage notice? Do I have to pay it? Is there a reduced rate for disabled members? How long can I do this? Can I claim STD when I m not working? How long is STD paid? What if I m still disabled after 30 weeks? What if I return to work, and become disabled again? Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 2 of 34

3 Is there Long Term Disability (LTD) coverage? Reciprocity Can I maintain coverage while working in another IATSE Local? Will my full hours be credited? Does this work in the US? End of Coverage What can I do when Hour Bank coverage ends? How can I sign up for PBC Individual Coverage? What s a Conversion Plan? Is my coverage affected if I leave the Union? What about Life Insurance coverage? What if I join a different IATSE Local? Retiree Benefits I expect to retire soon. Will my coverage continue? Can I delay enrolment? What if I work over 280 hours after retiring? What happens when I retire again? (*)What is Service? When do Retiree benefits end? Why isn t the Retirees plan better? Why must I pay so much for it? Employee and Family Assistance Program (EFAP) What is the EFAP? What kinds of problems can the EFAP help with? Is the EFAP counselling confidential? How do I access the EFAP? Benefits We re a successful industry, why can t we improve benefits? What is a Drug Card? How does it work? Are all prescription drugs covered? Why does the Plan restrict prescriptions? Can I look up PharmaCare drug coverage myself? What if I need a drug requiring Special Authority? How does PBC know the special request was approved? What if PharmaCare rejects the Special Authority Request? Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 3 of 34

4 What if PharmaCare never pays for a drug I need? Where can my doctor get Special Authority Request forms? Why was my Orthotic claim denied? What s a biomechanical assessement? Are there cheaper alternatives? Why was my reimbursement reduced? How can I find out what is R&C? Why aren t some limits published? What can I do? How do financial limits work? When can I buy new glasses? How often can I buy glasses? How can I find out about my current limits? Is there a deadline for submitting my claims? MEDICAL TRAVEL COVERAGE What is paid for when I travel? What IS an Emergency? What is the pregnancy limitation? What is the retirement limitation? Is this Travel insurance? Are Pre-existing conditions covered? What is Medical Travel Assistance? How do I use it? Are all my medical costs covered when I travel? How can I cover all my medical costs? What about other benefits? How can I buy Travel insurance? How can I access discounted PBC travel coverage? Life Insurance Why does life insurance reduce at age 65? Why should I receive a lesser benefit? Isn t that illegal discrimination? Hasn t forced retirement ended? Shouldn't all covered members be treated equally? Don't members have the same needs regardless of age? Life Insurance Changes - July 1, Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 4 of 34

5 Why is J&D Benefits contacting me regarding Life Insurance? Who are they?. 32 Why is life insurance coverage changing? What changes were made? Why wasn't I told about this? What will the trust do with the money saved by paying lower premiums? Do I have to enroll with J&D Benefits? What is the main purpose of registering online? How to do I know the J&D Benefits enrolment process is secure? Could I have a paper package? I didn t get the , can it be re-sent? I can t log in thru the tool, can someone help me? Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 5 of 34

6 We welcome your input on the most important questions to be answered. Please go to Contact Us to send us an message or see other contact information for the Plan Office. GENERAL PLAN INFORMATION What benefits are provided? Who is our insurance provider? What is our group number? For answers to the above 3 questions, please click on Plan Summary on this website for a list of benefits and insurance providers. Group numbers may be found in the Plan booklet. Where can I get a Plan Booklet? The printed booklet is available from your local union or the Plan office. The plan booklet is available in pdf form on this website. The booklet is updated every few years. The most recent one is updated effective January 1, Coverage is modified on an ongoing basis. The most recent changes are posted to the website, provided through mailing to covered members, via the union newsletter and via the union website. Where can I get detailed information about the Plan? Please click on Plan Summary on this website for a list of benefits, group numbers, and insurance providers, or click on Plan Booklet for the current Plan booklet in pdf format. A printed copy of your Plan booklet is also available from the Plan Office (see Contact Us on the Plan s home page). The IATSE Local 891 Union office also provides invaluable support to members, helping them understand the Plan and helping them communicate with the Plan office. Contact Julie Jensen, Health Benefits Representative, IATSE Local 891, 1640 Boundary Road, Burnaby, BC, V5K 4V4 Phone , Fax juliej@iatse.com, Web page: TAXATION Are there payroll or tax deductions for this coverage? No. Your employer contributes to the Plan as required by the collective agreement. This cost is bargained as part of the total compensation package, but it is not deducted from your wages. For the same reason, your employer s contributions to the Plan are NOT a tax deduction for you! Are Plan benefits taxable? YES. You will receive a T4A near the beginning of each year for the premiums paid by the Plan on your behalf for Basic Medical and Group Life insurance in the prior year. Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 6 of 34

7 Beginning in the 2013 tax year (T4As issued in early 2014), Accidental Death & Dismemberment premiums paid by the Plan on your behalf are also a taxable benefit. Also, if you received STD Benefits in the prior year, you will receive a T4A from BC Life for those payments. If you later repay BC Life due to a successful WCB or third party (e.g. ICBC) claim, you will receive an adjustment letter for the repayment. I self-paid during the year. Do I get a tax credit? Your taxable benefit amount is automatically reduced by the amount of your selfpayments. The Trustees consider the overall total hours and funding for the year. Within each coverage year, the Trustees have deemed all self-payments to apply first to taxable premium costs. This means that if you self-paid to continue your coverage at any time during the prior year, we automatically deduct the full amount of your cash payment from your taxable benefits in that year. But shouldn t I get a tax receipt? MAYBE. By using self-payments to reduce the taxable benefit reported on the T4A, taxable income is automatically reduced for ALL members self-paying in the year, without the need for a special receipt. Instead of increasing your income and then giving you a receipt to reduce it, we apply your payment directly to reduce the taxable benefit. BUT, every year, some members make more than enough self-payments to reduce their taxable benefits under the Plan to zero. We know that sometimes a member has high medical expenses in a year when they also make a lot of selfpayments, and may be able to apply the excess amount of self-payments for tax purposes. Starting in 2010 for tax year 2009, the Plan Office automatically advises members of the amount of self-payments in excess of their taxable benefits. This can be applied towards the medical expense tax credit. At the Trustees direction, we also issued retroactive notices for members who were in that situation for the 2007 or 2008 tax years. HOUR BANK Summary Hours to qualify for coverage 280 worked within 12 months Monthly cover charge 140 Hour bank maximum 1,680 Self Pay limit 12 months How do I establish coverage in the Plan? 1) You must be a member in good standing of Local 891. Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 7 of 34

8 2) If you are a new member not yet covered on the Health Benefits Plan, or if your coverage in the Plan lapsed, you must qualify for coverage by working in the bargaining unit and the hours must be reported(*) and paid by your employers. The number of hours you need to be covered is shown in the Hour Bank Summary table. There is a one month time lag after enough hours have been worked. This time lag is for processing by the producer, payroll company, Union office and Plan office. For instance, if you work enough hours in February to April, coverage begins in June: Month Hours Comment February 100 not enough March 150 not enough April 150 enough for coverage May 150 reporting(*) month June 150 Covered June 1 * Note on Reporting: Employers report hours on a pay-period basis. For instance, if a pay period ends on Saturday September 5, and you work some hours on Sunday August 30 and Monday August 31, then for reporting and coverage purposes, those are considered September hours. 3) You should also file completed application forms with the Plan Office, because, until you do so, your premiums for MSP-BC are not paid by the Plan. and your spouse and dependent children are not covered for EHC, Dental, MSP-BC or dependent life insurance. How can I find out when I ll be covered? Call the Plan office or the Union office. They can tell you how many hours have been reported by your employers so far, and whether the Plan office has received your enrolment information. When your coverage starts, you will be notified by letter. What if I don t apply for coverage? You are covered for all benefits except MSP after enough hours are received, but your eligible dependents are not covered. The Trustees are pleased to announce that effective April 1, 2011, members for whom 280 hours are reported in 12 consecutive months will be covered on the first of the month after the hours are processed, even if they have not filed an enrolment. This will ensure that you are covered for Dental and Extended Health care, Short-Term Disability and Accidental Death & Dismemberment, as soon as you have accumulated enough hours. Do I still need to file enrolment cards? YES!! You should still file enrolment cards because, until you do so, - Your premiums for MSP-BC are not paid by the Plan. - Your spouse and dependent children are not covered for EHC, Dental, MSP-BC or dependent life insurance. Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 8 of 34

9 - If you die the life insurance is paid to your estate and is subject to delay and probate fees. Make sure you fill out ALL the forms beneficiary designation for life insurance Medical Services Plan (basic medical) application. If you do not need MSP coverage because your spouse covers you, send in the opt-out form instead. If you don t send in your MSP application OR the opt-out form, we consider you opted out of MSP by default. But remember, if you lose coverage through your spouse in the future you must tell the Plan Office immediately (see Can I back-date? below). Pacific Blue Cross application for Dental and Extended Health, including spousal declaration if you are covering a common-law spouse. Can I back-date my coverage? Yes, within limits. If you do not send in your application promptly after the Plan office sends your notice of eligibility, a reminder postcard is sent out every following month. When you submit the completed application forms, the standard is to cover you on the first of the following month. If you request coverage to begin at the first of the current month, that will be accepted. For a longer backdate, you must apply in writing, explaining why your application is late. This Plan has established a practice of never backdating coverage beyond a maximum of 6 months. How does my coverage continue? All the hours your employer contributes go into your hour bank. Each monthend, if you are currently covered, 140 hours is automatically deducted from your hour bank, to pay for your coverage. Can I save my hours to be covered later? NO. The purpose of employment-based benefit plans like this is to cover eligible members while working(*), and at the same time to provide some coverage for their eligible dependents. It is like insurance which covers you for specific events while you are eligible, not like a savings account you can draw on when needed. (*) or while still attached to the bargaining unit, with the size of the hour bank being a roughly fair measure of how attached the member is to the bargaining unit at the time. What is an hour bank for? It s useful to look at why hour banks exist in the first place. Decades ago, only regular full time workers had group benefits. In the same way that a salaried worker receives continuous coverage as long as he or she stays with an employer, hourly workers want to have continuity of coverage. Hour banks were designed to promote continuous coverage for working members in industries which lack continuous work at one employer for a significant percentage of their workforce Consider that when regular full-time workers leave their employment, their benefits come to an end immediately, even if they worked lots of overtime in the Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 9 of 34

10 past. In the same way, once an hourly worker has left an industry for a prolonged period, whether due to their own wishes or due to industry conditions, at some point benefits come to an end. The combination of banking hours up to one full year, followed by subsidized self pay (at 85% of true cost) for up to one year can allow members to ride out some difficult times and remain covered and ready to return to the bargaining unit. Why is there an Hour Bank Maximum? Hour banks are always capped, and for good reason. Hours over-flow when a member accumulates the maximum hours which can be banked (one year for our plan). Is that fair? Yes. In effect, the employer payments associated with these overflow hours are blended with all other income received by the plan to create the average amount per hour used to pay for coverage. In this way, hours lost by an individual help support the benefits for the entire Plan, including the worker who "loses" the hours. The employer contributions for 140 hours do NOT provide enough to pay for the average member's coverage. The difference is made up mostly from overflow and also from write off (members who work too little to qualify for coverage). These funds also serve to even out the variances between earnings levels and hours worked, and to subsidize coverage for disabled and self paying members. But they re MY hours! The nature of group plans is that no one pays for specific benefits. Rather, the employer and self contributions pay for the whole plan, providing important protection to members for health related events. The goal is to make the Plan eligibility rules reasonable, and to provide a good mix of benefits according to the needs of the members over time. If members do accurate accounting of what their employers put in and what they and their families take out over short periods of time, chances are more than half will find they're "paying too much". The only really "fortunate" ones are those who cash in big (Life insurance) by dying and they are unlikely to speak up at the next meeting. The fact that at one time, some members receive more benefits from the plan indicates that their need at that time is greater. RESIDENCY Are non-residents of BC covered? MOSTLY. But Medical Services of British Columbia (MSPBC) coverage ends two months after you move out of BC. By that time, you will be eligible for coverage in the new province of residence. Are non-residents of Canada covered? PARTLY. The following Plan benefits are NOT available to non-residents of Canada: a) Group Life and Optional Life Insurance b) Accidental Death & Dismemberment Insurance Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 10 of 34

11 c) Medical Services of British Columbia (MSPBC) coverage d) Extended Health Care Who is a Canadian resident? According to the MSPBC website, an individual must be a resident of B.C. in order to qualify for medical coverage under MSP. A resident is a person who meets all of the following conditions: must be a citizen of Canada or be lawfully admitted to Canada for permanent residence; must make his or her home in B.C.; must be physically present in B.C. at least 6 months in a calendar year; and dependents of MSP beneficiaries are eligible for coverage if they are residents of B.C. Certain other individuals are deemed to be residents, for instance those with student or work permits. If you are uncertain about your eligibility status, contact MSP for assistance. You qualify for EHC coverage, if you have MSPBC coverage. For Life and AD&D insurance, you must be a Canadian resident. If you qualify as a BC resident for MSPBC purposes, and/or if you have Canadian resident tax status), you would qualify. ENROLMENT Can my spouse and I cover each other? (Dual Coverage) If your spouse does not have benefits at work, be sure to enroll your family for Extended Health, Dental and MSP under this plan. If your spouse does have benefits at work, you can co-ordinate your coverage. 1) Medical Services Plan of British Columbia (MSP) Make sure your family is not enrolled twice or you will be paying income tax on premiums paid by both group plans. There are two choices: Have one plan pay premiums for your family The simplest choice is to enroll under the spouse who has the most secure employment. Or, minimize income tax by enrolling for MSP under the spouse who has the lowest income. Each spouse enroll on their own plan and enroll your children, if any, under one or the other. Either way, if in the future one of you loses your coverage, make sure to enroll everyone under the other plan. 2) Extended Health and Dental If you and your spouse each have coverage for dental and extended health, you may enroll each other as dependents. The Canadian Life and Health Insurance Association (CLHIA) has established rules for handling this. Claims are submitted to both insurers, according to which plan is "first payer", as follows: Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 11 of 34

12 * your claims: first payer is your plan; * spouse's claims: first payer is spouse's plan; * dependent children's claims: if your birthday falls earlier in the year than your spouse's, your plan is first payer; otherwise, it is your spouse's plan. For instance, if Joe's birthday is February 15, 1958 and his wife Mary's birthday is April 10, 1956, Joe's plan is the first payer for the children's claims even though Mary is 2 years older. Why such a strange rule? The "first birth date" rule for dependant children is arbitrary and was chosen for exactly that reason. In dual coverage situations, it will go to the member's plan half the time and the spouse's plan half the time - but always the same for each couple, so you'll always know where to submit the children's receipts first. Submitting Dual Coverage claims Submit the claim first to the "first payer, which pays the normal benefit amount. Be sure to fill in the information about the other coverage in the section near the bottom of the form. If your dentist automatically submits your Dental claim for you, make sure he or she knows about both coverages. Once the Explanation of Benefits is received, submit the claim to the "second payer" which then pays the remainder to a maximum of 100% reimbursement. If both you and your spouse are covered under the Motion Picture Workers plan, it works the same way, but by filling in the information correctly on the form, Pacific Blue Cross should be able to process both the first payer and second payer claims at the same time. How do I add (a) dependent(s) to the Plan? Ask the Plan office or the Union office for the forms you must complete to add a dependent to the Dental, EHC and Basic Medical coverage. You should do this as soon as possible when you marry or have child. Do the Union and Plan office co-ordinate address changes? YES. Effective December 31, 2003, the Union s current address list will be used to automatically update the Plan s address list every month. BUT, if you want your address to change in your enrolment files with the Medical Services Plan (MSP) or for your Dental and EHC coverage with Pacific Blue Cross, please notify the Plan office as well. SHORTAGE NOTICES What is a Shortage Notice? If you are covered this month, but do not have 140 hours in your bank to pay for coverage next month, the Plan sends a shortage notice telling you how many hours you may be short and the amount you must pay to ensure continuing coverage. What should I do if I get one? Our advice is "pay as billed!" IF enough employer hours come in before month-end, you may be covered anyway without self-paying, BUT why take a Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 12 of 34

13 chance? By paying, you ensure continued coverage, and having a few extra hours in your hour bank will probably come in handy very soon. How can I pay my shortage notice? 1) by MAILING A CHEQUE to the Plan Office. DO NOT send cash in the mail. Cheques should be payable to: Motion Picture Workers Health Benefits Plan. 2) by going to Pacific Blue Cross in person and paying by CHEQUE, DEBIT CARD or CASH. 3) You may pay electronically. When making an electronic payment through your financial institution, please remember the following: - As the Payee, select IATSE 891 Health Benefit Plan (Your bank may show it as I.A.T.S.E. 891 Health Benefit Plan ) - The Account for your payment should be your 6-digit IATSE 891 Union ID number. This number also appears as your ID Number on your PBC EHC and Dental ID card. - The Description (if your financial institution allows you to enter one) should be shortage notice - Online payments are accepted online through o VanCity Credit Union o MOST (not all) other BC Credit Unions o Bank of Montreal o Royal Bank of Canada o TD Canada Trust o Scotia Bank o CIBC 4) Sorry, but at this time the Plan is unable to accept payment by credit card. What if I don t pay a shortage notice? Unless enough employer hours come in, your coverage will be terminated. If you aren't willing to ensure future coverage by paying as billed, there are two alternatives: 1) Call the Plan office or the Union office by the 20th of the month to find out how many employer hours came in. Then, calculate and pay the exact amount still required BEFORE month-end cut-off, which varies but is usually around the 25th of each month. 2) OR, if you don't mind being terminated, take your chances! If not enough hours come in, you will receive notice of termination. I m back at work do I still need to pay? Remember, there s a one month time lag between the month you work and the month the hours are posted to your hour bank. If you ve just started back at work, you ll need to pay until the hours start flowing. Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 13 of 34

14 It s not my fault No one forwarded my shortage notice! It s YOUR responsibility to make sure the Plan knows your current address. If the Plan sends mail to the last address you gave, and that s not your current address, it s your fault. How do I re-qualify if coverage terminates? 1) If by accident you fail to pay a shortage notice and your coverage is terminated, contact the Plan immediately. You may pay the actual number of hours you were short, plus the full 140 hours to ensure continued coverage for the following month. 2) If you fail to contact the Plan office immediately on termination, you must re-qualify as if you were a new member. See How do I establish coverage in the Plan?. I m unemployed. Is there a reduced rate? MAYBE. You may be able to pay a subsidized rate of $0.92*/hour upon application if you present EI (or Social Assistance) stubs, including Maternity or Parental leave. The revised eligibility rule is effective for cash payments made for coverage on or after February 1, Can t I just sign a declaration? In 2002 the Trustees approved the Union s recommendation to require the completion of the unemployed declaration by all members applying for the subsidized rate. This has led to increasingly detailed and confusing appeals over what constitutes unemployment. At their September 2007 meeting, the Trustees decided to revert to the old rule The Trustees recognize that this may not seem fair to all members, but are making this change in the belief that a simpler system is easier to understand and will result in more consistent administration. What about contractors? Members working as contractors are eligible for EI benefits if they choose to participate in that program. If a contractor s hours run out while he or she is between contracts, then if they qualify for EI benefits they can apply for the reduced rate like any other member. But, if they are not eligible for EI, the full shortage rate must be paid. To determine if as a contractor if you wish to participate in the EI Special Benefits please see: I m a new parent. Is there a reduced rate? MAYBE. You may be able to pay a subsidized rate upon application if you present EI Maternity or Parental benefit stubs. The rate is the same as the reduced rate available to some unemployed members. See I m unemployed. Is there a reduced rate? Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 14 of 34

15 What if I can t afford the reduced rate? You may apply for reduced coverage ( Mini-Plan ). This includes all benefits except Dental and Short Term Disability. For rates, refer to Is there a reduced rate for disabled members further down. You will need to provide your EI Maternity or Parental benefit stubs or other proof of payment. How long can I self-pay for coverage? You may continue your coverage by self-payments for a maximum of 12 consecutive months. If you have already made at least 12 full month payments for coverage you will not be allowed to continue your coverage by selfpayment. What if I return to work? If your employer(s) report 20 or more hours in a month, your self-pay count is reset to zero, and you could then pay up to 12 consecutive full months from that point. If your employer(s) report between 1 and 19 hours in a month, your shortage notice would be reduced for the following month, but it will still count as one month s self payment. Remember the reporting period ( Lag month ) between the time you work and the time the employer hours are posted to your hour bank. For instance, If you make your 11th full self-payment in March (for April coverage), and also work 20 or more hours in March, those employer hours will be received by the Plan in March. By that time, you will be making your 12th full self-payment (for May coverage). Your self-pay count will be reset to zero, and you will receive a shortage notice for May. BUT, if you don t return to work in the bargaining unit until April, when you re making your 12th self-payment, the hours will be received by the Plan too late to reset your self-pay count. Is that fair? YES. The same reporting period worked to your advantage at the beginning. When you last worked in the bargaining unit, your last hours were received by the Plan a month later. For instance, If you last worked at least 20 hours in January, your last hours will be received by the Plan in February (March coverage). The shortage notice you receive for April will be less than 120 hours, so your payment will not be counted as a full self-payment. So, your first full self-payment will be for May, four months after you last worked in the bargaining unit. What if I work elsewhere? Work in the jurisdiction of another IATSE local counts toward your continuing coverage, including re-setting your self-pay count. See the section on Reciprocity. Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 15 of 34

16 What if I receive Disability Credits? Disability Credits (see DISABILITY section which follows) have the same effect as employer hours - they will reset your self-pay count. How does maternity leave affect the self-pay rule? Self-payments for coverage up to 12 months from the effective date of maternal or parental leave, will not affect the self-pay count if you receive a shortage notice and are on maternity or parental leave, please contact the Plan office. Example: you give birth on May 19, 2005, and your maternity leave period starts on that day. If you are currently self-paying for coverage, then payments made for June 2005 through May 2006 will not be added to the self-pay count. If you have hours in your bank at the time of birth, but start to self-pay when they run out, the self-pay count will still remain at zero until May I m on my spouse s MSP why should I self-pay the full rate? The Plan is funded on average costs for the whole membership. Not all members use all benefits for instance very few use life insurance by dying. By not using a certain benefit, overall costs for the membership are kept down, but not your individual costs. The Plan is similar to insurance in this regard. DISABILITY I m disabled. Is my HOUR BANK maintained? YES. 140 hours per full month, up to 12 months per disability, will be credited to your hour bank ( Disability Credits ) while you are disabled and receiving the Plan s STD, EI sick benefits, WCB wage loss*, or ICBC wage loss*. You must submit stubs for WCB or EI and provide evidence of payment for ICBC. *What is wage loss? WorkSafeBC distinguishes between Permanent Disability Benefits and Wage Loss benefits. For Plan purposes, Wage Loss includes Temporary Wage Loss, Income Continuity, and Rehabilitation benefits. The Plan will NOT grant any further disability credits for periods when you are receiving a permanent award. What about longer disabilities? The purpose of disability credits is to maintain coverage during short term disabilities. For longer term disabilities, see What can I do when Plan coverage ends? What if I win a WCB Appeal after my coverage ends? Your coverage may lapse while you are appealing a WCB denial or termination of claim. If you eventually win their appeal with back-dated benefits, the Plan Office s normal practice is to grant the WCB disability credits in the months the WCB eventually pays for, and restore uninterrupted coverage as if the WCB had paid at the time. The Union has pointed out that you may be more concerned about current coverage. At their meeting held January 20, 2011, the Trustees agreed that upon application, if your coverage has lapsed during a WCB appeal, and that Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 16 of 34

17 appeal is ultimately successful, the credits may be applied to start a new, current period of coverage. Contact the Plan Office or Union Office for details. I m disabled. Why am I still getting a shortage notice? Do I have to pay it? If you are disabled and in receipt of Short Term Disability from the Plan, the Plan will automatically grant you Disability Credits to continue coverage. If you are disabled and in receipt of EI sick benefits, WCB Wage Loss or ICBC wage loss, make sure to submit your stubs to receive Disability Credits. Note on timing - because you must first receive the sick benefits before the Plan office can post the disability credits, there is a reporting lag similar to the lag for employer hours. If your Hour Bank was low before you became disabled, you will have to continue paying your shortage notices until the disability credits start coming in. Is there a reduced rate for disabled members? YES. If you are NOT receiving ANY disability or wage loss benefits including a CPP disability pension, you may apply for a) Full coverage at a reduced rate. The rate is the same as for the reduced rate available to some unemployed members. See I m unemployed. Is there a reduced rate? b) reduced coverage. This includes all benefits except Dental and Short Term Disability, at a subsidized 31 cents an hour ($43.40 a month). To apply for this benefit, have your doctor complete the necessary forms, available from the Plan office or the Union office. NOTE: You may apply at any time, while disabled and self-paying, to change from full coverage to subsidized reduced coverage; however, once you have done so, you cannot go back to full coverage until you start working again. How long can I do this? The overall limit on self-pays (12 months) applies to the either subsidized disabled rate. The subsidized rates are intended as an interim measure for short-term disabled members not eligible for STD, or long-term disabled members unable for some temporary reason to qualify for CPP, or with a CPP application pending. Can I claim STD when I m not working? MAYBE. To qualify for Short Term Disability you must be covered by employer hours at the time of disability. This is interpreted as NOT having being covered by full self-payment at the time you became disabled. If you are covered as the result of full self-payment (140 hours) for the month in which you become disabled, you are NOT eligible for STD unless you have at least 140 current employer hours earned but not yet posted to the hour bank; OR you are able demonstrate to the reasonable satisfaction of the trustees that employment in the bargaining unit covered by IATSE Local 891 is a primary source of income. Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 17 of 34

18 IF IN DOUBT, please contact the Union office. How long is STD paid? 40 WEEKS. No STD benefits are payable after you have received a combined total of40 weeks benefits for a single period of disability from this Plan and other payers. For instance, if you remain disabled after receiving 15 weeks from WCB, this Plan would pay for a maximum of a further 15 weeks. What if I m still disabled after 30 weeks? If you are still disabled after 40 weeks, you can apply for EI Sick Benefits, if eligible. There is also a CPP disability pension available for severe and prolonged disabilities. You should also apply for Life Insurance premium waiver which can continue your life insurance to age 65 without payment of premiums, even if your Union membership ends. What if I return to work, and become disabled again? IF YOU ARE DISABLED FROM THE SAME OR RELATED CAUSE, then it will be considered part of the prior disability if, after receiving STD benefits, you returned to work on a full-time basis and were able to perform all the essential duties of your occupation for less than 2 weeks. Once you have resumed work on a full-time basis and have been at work for 2 consecutive weeks, any subsequent injury or sickness will be considered a new disability. IF YOU ARE DISABLED FROM AN UNRELATED CAUSE, then it will be considered a new disability. Is there Long Term Disability (LTD) coverage? NO. This Plan s disability coverage is limited to 30 weeks with a possible 10- week extension upon application. After that, you may be eligible for EI sick benefits. ALSO, if your disability is severe and likely to be prolonged, after 16 weeks you should apply for Canada Pension Plan Disability Pension. RECIPROCITY Can I maintain coverage while working in another IATSE Local? Yes, you can have your hours transferred to 891 for your H&W coverage. Local 891 has Reciprocal Agreements with many I.A.T.S.E. locals in Canada whereby H&W and/or pension monies and hours can be transferred back to 891 at the end of the show. Procedure - You must: Inform Local 891 that you are working within another jurisdiction and the length of time you expect to be there. Ask the accounting department of the away local to make a notation on your timesheets that you are an 891 member and wish to have monies and straight time equivalent hours transferred back to 891. Send a copy of your timesheets to 891 once a month. Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 18 of 34

19 If you follow this procedure, the hours should be credited to your H&W bank within a month of the show ending. Of course this is dependent on when the H&W monies & timesheets are received by 891. Will my full hours be credited? It depends: The Local 891 office may adjust your hours downwards if the health benefits dollars we receive are not above the minimum rate for work in Local 891. Does this work in the US? Not at present. The Union and your Trustees have worked hard to establish a procedure for reciprocity for work in the US, but have not been successful. You may be able to arrange for your employer to remit the contributions directly to this Plan under another arrangement, but we do not have a formal process. Note on Shortage Notices: If your Hour Bank was low before you went to work in the other jurisdiction, you may have to continue paying your shortage notices until the hours from the away local start coming in. END OF COVERAGE What can I do when Hour Bank coverage ends? If your benefits under the Motion Picture Workers Health Benefits Plan end, there are some options to continue part of the coverage. 1) All terminating members Make sure premiums are paid for your Basic Medical (MSP of BC) coverage if you are not eligible for coverage under your spouse s plan, contact the Medical Services Plan for details of paying individually. NOTE: All BC residents are covered for MSP. Either a group plan must pay premiums for this coverage, or you must pay yourself. Otherwise, sooner or later the government will come after you for payment in full! 2) All terminating members - Pacific Blue Cross Individual Extended Health and Dental Plans The Individual Plans are separate from the Union Plan. The benefits are less than on the Union plan. How can I sign up for PBC Individual Coverage? Go to and select "Individual Plans". There's quite a bit of information there, but the choices could be summarized as - Extended Health, or Dental, or both - Regular Plan or Conversion Plan You can spend a little time looking at the information on the site, and then call the Individual Plan department at (or toll free ) to make sure you understand what you've selected. Or, you could call them first if you don't easily find what you're looking for. Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 19 of 34

20 What s a Conversion Plan? The Conversion Plan is available ONLY to former group members, within 60 days of group coverage ending. It costs more than a Regular Plan, but the big advantage is that it does NOT exclude "pre-existing conditions" which could be a big difference depending on your circumstances. 3) Terminating members under age 65 - as long as you remain a member in good standing of IATSE Local 891, your Group Life insurance coverage will continue to age 65, even if other coverage under the Plan ends. For information on continuing Group Life insurance when you leave the Union, refer to Is my coverage affected if I leave the Union? below. 4) Long-service retirees Local 891 Retirees Benefit Plan (Dental & EHC) If you are retiring from Local 891 with at least 10 years of membership, and are age 60 or more, you may be eligible for the Local 891 Retirees Benefit Plan. You must apply within 31 days of the end of your active coverage. 5) Disabled members Life Insurance Waiver; Dental and EHC Mini-Plan If you are totally disabled, you may be eligible to have your life insurance continued to age 65 at no cost ( waiver of premium ). If you are receiving CPP disability pension and have at least 10 years of service*, you may be eligible for reduced Dental and EHC coverage to age 65** at no cost. You must apply promptly for either of these options. * See definition of Service under Retiree Benefits. Unfortunately, this benefit continuation is not available to members with less than 10 years of service. ** When you reach age 65, long term disabled coverage ends, but you may convert to the Retired Members Plan. Your payments will be calculated according to the magic number formula in effect when you reach age 65, using your number of years of service with the Union prior to your disability. For further information on the above, please contact the Plan office. Is my coverage affected if I leave the Union? YES. When you take a withdrawal card from the Union or are expelled or suspended from the Union, all Plan coverage will be cancelled on the date of the Union status change and any hour-bank balance will go into the General Fund of the Plan. Withdrawn or expelled members who return to the union must build their hour bank and re-qualify for coverage the same as for a new member. If a suspended member returns to good standing in the union within a year, his or her hours will be reinstated. However, coverage will not be reinstated automatically. For information on reinstating coverage, please contact the Plan office. Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 20 of 34

21 What about Life Insurance coverage? If Union membership ends or changes to Retired Status prior to you 65th birthday, you have the right to convert to an individual life insurance policy through without medical evidence. To exercise this right, you must make proper application to Great West Life within 31 days from the date of termination under the Plan. This can be a very valuable option if you are not in good health. What if I join a different IATSE Local? When you transfer to another Canadian IATSE Local, partial coverage will be extended for as long as your banked hours allow at 140 hours per month. However: Group Life Insurance only applies to members of Local 891; MSP can continue for a maximum of two months after the month in which you leave the province of B.C.; Medical Travel insurance does not apply when you move permanently; and STD does not apply to members not working in Local 891. RETIREE BENEFITS I expect to retire soon. Will my coverage continue? If you are retiring from Local 891, AND are covered on the Active Members Plan (hour bank), AND are at least 60 years of age, AND have at least 10 years of service(*) as a member of IATSE Local 891, Within 30 days of your termination on the Active Members Plan (hour bank), you may enroll on the RETIRED MEMBERS PLAN. See your Plan booklet, the SUMMARY OF BENEFITS on this web site, or contact the Plan office for details. Definition of Retirement: retirement includes semi-retirement, which means working less than 280 hours in any 12-month period. Can I delay enrolment? MAYBE. if you have spousal coverage for Dental and Extended Health Care when your Active Members Plan coverage ends, and do not want to enroll on the Retirees Plan immediately, you may temporarily delay enrolment on the Retired Plan by providing the Plan Office with confirmation of the other coverage. You must do so within 30 days of your Active Members Plan (hour bank) coverage ending (same deadline as for enrolment). What if I work over 280 hours after retiring? If you intended to retire but return to the bargaining unit due to whatever circumstances, you may re-qualify for the full active plan upon working 280 hours in a 12 month period. To do so, you must apply to the Plan office. What happens when I retire again? If you go on the Retiree Plan, then return to full coverage, and then again go on the Retiree Plan, you will have the same percentage subsidy on subsequent Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 21 of 34

22 retirement as at the initial retirement. Service after your initial retirement does not increase your Retiree Plan subsidy. (*)What is Service? A year of service includes any calendar year from 1993 onwards in which 280 hours were reported to your hour bank account in this Plan, including employerreported hours, cash-pay hours, and disability credit hours. Hours count towards the month and year to which they were posted (and were worked, for employerreported hours). For years prior to 1993 (when the hour bank plan was established), years of service as calculated by the IATSE 891 office will be used. This benefit is funded from employer contributions made on behalf of members working in the bargaining unit, and is meant to provide retirement coverage to those members whose employers have made significant contributions to its cost. When do Retiree benefits end? Please see the Termination of Coverage under Retired Members Plan (page 2) in the Summary of Benefits on this web page, or refer to the plan booklet, or request a retiree information package from the union or plan office.. Why isn t the Retirees plan better? Why must I pay so much for it? When the Plan was set up in 1993, a retiree benefit was offered from the start. Post-retirement health benefits are similar to pensions: a fund must be built while members are actively working, to help pay for benefits after retirement. With the average Canadian living to 80 or older, the fund must pay for benefits for many years after retirement. The Trustees have been working with the Union for a number of years to build the needed fund, following the membership decision effective April 1, 2000 to put ½% of gross pay aside for this purpose. The fund is growing, but in recent years, health costs have risen rapidly. Part of this was expected due to aging population and increased use of prescription drugs. However, the introduction of new and expensive prescription drugs has been more than anticipated. An even larger impact came from government costshifting measures, particularly the introduction of income-based Fair PharmaCare in 2003 following the de-listing of paramedical services such as physiotherapists and chiropractors in Dental costs have also begun escalating more rapidly, perhaps due to changing attitudes to dental care of our aging population. As a result, the Trustees found that to ensure the continued viability of the Plan, benefits were reduced as of July 1, 2004 and at the same time the years of service to qualify increased to 10. EMPLOYEE AND FAMILY ASSISTANCE PROGRAM (EFAP) What is the EFAP? The Employee and Family Assistance Program (EFAP) is a benefit that provides IATSE Local members and their families with quick, confidential access to experienced professional counsellors and consultants who can help you resolve a broad range of personal and work related concerns. Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 22 of 34

23 What kinds of problems can the EFAP help with? FSEAP offers a broad range of counselling services and work/life services. For more information, please download the FSEAP Brochure by clicking on the Forms button of this website. Is the EFAP counselling confidential? Yes. Use of the EFAP and any information collected is completely confidential within the full limits of the law. The information FSEAP counsellors collect during the initial call and throughout the service process is used to: Ensure FSEAP can contact you; Understand your service needs; Maintain accountability as a service provider; Ensure that safety, legal and ethical standards are met; and Allow FSEAP to assess the quality of its services. FSEAP counsellors and consultants do not release any information without prior written consent except to protect life and when ordered to do so by a court of law. How do I access the EFAP? Effective September 1, 2012, simply call the toll-free line: Your call will be answered live 24/7 by a Master s level counsellor who will talk with you about your reason for calling and assess the level of intervention that is required to address your issue or need. They can provide immediate crisis support as needed, schedule you for the appropriate counselling or work/life service, or help you find the perfect specialized resource in your community TTY fseap.bc.ca BENEFITS We re a successful industry, why can t we improve benefits? Since the Plan was started, the Plan has improved in many ways as funding has become available longer short term disability period, higher payments for paramedics, payment of MSP premiums, higher payment for orthodontia and hearing aids, and so on. If the Plan had unlimited funding, benefits too would be unlimited. In a world of scarce resources, the Trustees aim, in consultation with the Union and the membership, to provide the best package possible for the whole membership. What is a Drug Card? In October 2007, all covered members received a new Plan ID card. You may use this as a Drug Card when purchasing prescription drugs. The Trustees implemented a Drug Card for your convenience, so that you do not need to pay for your prescriptions, then send in a claim and wait for reimbursement! Motion Picture Workers Health Benefits Plan FAQs Revised Jul. 7, 14; Page 23 of 34