Direct Pay: Equity-League Fund

We are pleased to inform you of a change in the New York State (NYS) Continuation Assistance Program. Beginning June 1, 2009, entertainment industry member may receive up to twelve months of premium assistance for each COBRA coverage period. Previously, an entertainment industry member could receive only a maximum of up to 12 months of assistance (cumulative), regardless of the number of COBRA eligibility periods. Going forward, members who previously received assistance may apply for a new 12 month period of premium assistance if he or she becomes eligible for a new COBRA continuation coverage period.

Please note that prior to this change subsidy recipients were automatically terminated from the program when the received twelve months worth of subsidy payments - even if the payments were received during separate COBRA coverage periods. Under the new procedure, anyone who was scheduled to terminate from the program on or after June 1, 2009 due to having received twelve months worth of payments during their lifetime, will not be terminated if: (1) they are in the midst of a new coverage period, and (2) they have not received 12 months worth of payments during this new coverage period.

For example: Sue received 9 months worth of COBRA Subsidy payments for the months of January 1st through September 30th. For the October 1st period, she stopped receiving COBRA coverage due to the fact that she qualified for 6 months of health coverage through covered employment. As of April 1, Sue was back on COBRA and she started receiving the NYS subsidy again. Prior to the program's new procedure, Sue would only have been eligible to receive additional NYS subsidy payments for three months. After receiving subsidy payments for those three months, she would have been ineligible to receive additional subsidy payments because she would have received the maximum amount of payments during her lifetime (9 months from January through September, plus 3 month from April through June, equal the prior maximum amount of 12 months). Under the new procedure, Sue will be able to apply for 12 months of assistance during her new COBRA coverage period beginning as of April 1. The previous 9 months worth of subsidy will no longer be counted.

Additionally, please note that the New York State Insurance Department will be notifying enrollees who have received 12 months of subsidies in the past that they are welcome to re-apply to the NYS COBRA Assistance Program when they become eligible for a new COBRA coverage period in the future. The Fund Office will also mail New York State residents the required application within their COBRA packets each time that a member's health coverage through covered employment becomes terminated.

If you have any questions, you may contact the Consumer Services Bureau of the State Insurance Department at (800) 342-3736, or the Actors Fund at (212) 221-7301. Members may also contact the Health Department within the Fund Office for information regarding this Program as well.
In the meantime, please contact the Fund Office at (212) 869-9380 should you have any questions.