Entertainment Industry Health Plan Comparison DGA-Producer Health MPI Health Plan SAG-Producers Health Plan Participant only - $0
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1 Earned Coverage Premiums AFTRA Health Individual Participant Only - $381 per quarter Participant +1 Dependent only - $2,446 per quarter ($381 + buyup premium $2,065) Participant +2 or more Dependents - $4,315 ($381 + buy-up premium $3,934) Family Participant Only - $381 per quarter Entertainment Industry Health Comparison DGA-Producer Health MPI Health SAG-Producers Health Participant only - $0 Participant + 1 Dependent - $65/month Participant + 2 or more Dependents - $100/month Rates effective 1/1/11 **EFFECTIVE 1/1/13** Participant only - $0 Participant + 1 Dependent - $25/month Participant + 2 or more Dependents - $50/month **EFFECTIVE 7/1/11** I Single - $273/quarter 2 Party - $315/quarter Family - $342/quarter II Single - $324/quarter 2 Party - $372/quarter Family - $405/quarter WG-Industry Health $600/year to cover all dependents Participant + or Samesex Domestic Partner Only - $668 per quarter II Age & Service Single - $414/quarter Participant with Children Only - $668 per quarter Full Family - $732 per quarter 2 Party - $477/quarter Family - $519/quarter ** Rates effective 1/1/12** 1 P a g e
2 AFTRA Health Entertainment Industry Health Comparison DGA-Producer Health MPI Health SAG-Producers Health WG-Industry Health Network Calendar Year Deductible Individual $200 Family Combined with non-network deductible $325/$975 Hospital TIHN * : $150/$300 I: $250/$500 Regular $300/$900 $400 per family maximum II: $500/$1,000 $750/$2,250 Medical TIHN: I: $250/$500 Non-Network Calendar Year Deductible Individual $400/$800 Combined with network deductible $325/$975 II: $500/$1,000 Hospital Regular $300/$900 Family I: No Coverage $800 per family maximum II: No Coverage $750/$2,250 Medical I: $500/$1,000 II: $750/$1,000 * TIHN: The Industry Health Network 2 P a g e
3 Qualification Threshold(s) AFTRA Health Individual $10,000, but less than $30,000 in four consecutive calendar quarters or less Family $30,000 in four consecutive calendar quarters or less Entertainment Industry Health Comparison DGA-Producer Health MPI Health SAG-Producers Health **EFFECTIVE 1/1/12** DGA Premier Choice $106,000 DGA Choice $34,100 Initial Qualification 600 Hours Continuing Coverage 400 work hours will be needed every six months to maintain health eligibility following initial eligibility **EFFECTIVE 1/1/12** I $30,750 II $15,100 or 76 days II Age & Service: Participants age 40+ with 10+ earned years qualify for II with $10,900 WG-Industry Health ** EFFECTIVE 7/1/11** Qualification 4 Consecutive Quarters 4 Consecutive Quarters 6-Month Period 4 Consecutive Quarters 4 Consecutive Quarters Period Waiting Period 1 Quarter 1 Quarter Approximately 2 months 1 Quarter 1 Quarter Benefit Period 4 Consecutive Quarters 4 Consecutive Quarters 6 Consecutive Months 4 Consecutive Quarters 4 Consecutive Quarters $34,355 Eligible Dependents Legal (SSDP) Dependent children age 26 or Dependent children age 26 or Dependent children up to age 26 for medical only Dependent children age 19 through age 22, if enrolled as a full-time student for dental and vision only **Effective 1/1/11** Dependent children age 26 or Same-sex domestic partner Dependent children age 26 or Disabled children age 26 or 3 P a g e
4 Banked/Extended Eligibility Rules AFTRA Health Entertainment Industry Health Comparison DGA-Producer Health MPI Health Earnings over $120,000 during an earnings period are banked Max Bank: $420,000 If participant fails to qualify for earned, $120,000 is deducted from earnings bank for 1 year of DGA Premier Choice After initial eligibility, hours over 400 in a 6-month period are banked Max Bank: 450 hours If participant fails to qualify for earned, up to 400 hours is deducted from the hours bank for 6 months of earned SAG-Producers Health $200,000 Extension Participants that earn $200,000 or more in an earnings period, and do not qualify during the next earnings period, receive an additional year of earned **EFFECTIVE 7/1/11** Effective July 1, 2011 Extended Coverage The amount of carry-over credit required for one year of increased to $130,000. The carry-over bank max increased to $450,000 Participants earn 1 point for: Each 12 months of Earnings over $132,809 (indexed annually) in a 4- quarter period Earnings over $238,304 in a 4-quarter period Max point balance: 50 Must have at least 10 points to be eligible for extended points are deducted for each quarter of, contingent on plan chosen 4 P a g e
5 Network Hospital Outof-Pocket Maximums AFTRA Health $1,000 DGA Premier Choice Entertainment Industry Health Comparison DGA-Producer MPI Health SAG-Producers Health Health $1,000 **EFFECTIVE 1/1/12** $1,000 I: $1,750/$3,500 DGA Choice II: $1,750/$3,500 Regular $1,000 Network Emergency Room Benefits Network Physician Services Benefits $1,000 90% 90%; $50 co-pay 90% of first $10,000 in covered expenses* after taking deductible; 100% thereafter (*excludes $10 per visit co-payment) Co-Pay waived if admitted to hospital. $100 co-pay + 10% of allowable amount. No network requirement. Co-pay waived if hospitalized directly from ER hospital admission co-pay still applies Patient still responsible for the 10% of allowable. 90% Reside Inside MPTF Service Area TIHN: $5 co-pay, no coinsurance No-TIHN: 90%; $30 co-pay + 10% of contracted amount I: 90%; $100 co-pay II: 90%; $200 co-pay Co-pay waived under s I and II if hospitalized immediately I: 90% + applicable co-pay II: 90% + applicable copay Applicable co-pays: $4,500 Regular 85%; $50 co-pay 70%; $50 co-pay Co-pay waived if admitted Regular 85% 70% Reside Outside MPTF Service Area TIHN: $5 co-pay, no coinsurance No-TIHN: 90%; $15 co-pay + 10% of contracted amount Office visit or surgery in doctor s office ( I): $15 Office visit or surgery in doctor s office ( II): $25 Inpatient surgery: $100 Outpatient surgery: $100 Maternity care: $100 5 P a g e
6 Prescription Drug Benefits Deductible AFTRA Health Retail $75 per individual $150 per family Mail Order Retail Entertainment Industry Health Comparison DGA-Producer MPI Health SAG-Producers Health Health Mail Order $150/$300 Prescription Drug Benefits Retail Network Co-Payments $10 Brand w/o Equivalent 25% of prescription cost Brand w/ Equivalent 25% of prescription cost, plus entire difference in cost between brand and generic. Up to 30-day supply. $10 Brand w/o Equivalent $24 plus brand-generic equivalent cost difference Lifestyle 50% with $40 minimum co-pay Actives: $10 Retirees: $5 Actives: $25 Retirees: $20 Brand (plus brand-generic cost difference) Actives: $40 Retirees: $30 Greater of $10 or 10% Greater of $25 or 25% plus brand-generic cost difference Non- Greater of $40 or 40% plus brand-generic cost difference *up to a 30-day supply $10 $15 Non- $25 plus brand-generic cost difference, even if DAW *up to a 30-day supply 6 P a g e
7 Prescription Drug Benefits Mail Order Co- Payments AFTRA Health $30 Brand w/o Equivalent 25% of prescription cost, $150 maximum co-payment per prescription $25 Entertainment Industry Health Comparison DGA-Producer MPI Health SAG-Producers Health Health Brand w/o Equivalent $60 plus brand-generic cost difference Actives: $25 Retirees: $12 Actives: $65 Greater of $20 or 10%; maximum co-pay is $50/prescription $20 $30 Non- Brand w/ Equivalent 25% of prescription cost, $150 maximum co-payment per prescription, plus entire difference in cost between brand and generic. Up to 90-day supply. Lifestyle 50% with $60 minimum co-pay Retirees: $50 Brand (plus brand-generic cost difference) Actives: $100 Retirees: $75 *up to a 90-day supply Greater of $50 or 25%; maximum co-pay is $125/prescription Non- Greater of $100 or 40%; maximum co-pay is $300/prescription *up to a 90-day supply $36 plus brand-generic cost difference, even if DAW 7 P a g e
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