The New York State Legislature has adopted a law to provide a subsidy to New York State residents in the entertainment industry whose current income is below a certain threshold. If a member is eligible for COBRA, and is a New York State resident, then you may be eligible for a subsidy to defray 49.45% of the cost of those COBRA premiums. Please be aware that there are certain conditions that MUST be met in order to qualify for this program. Below you will find an application, and listing of instructions from The New York State Insurance Department that explains the conditions of the program and how to apply. Once completed, all applications should be sent to the New York State Insurance Department AS SOON AS POSSIBLE. Once applications have been approved, and accepted, members are eligible to receive up to total of 12 months of premium assistance.
Please also keep in mind that each time members apply for COBRA, and require financial assistance through this program, you must re-apply, and send a new application to the New York State Insurance Department. For example, let's say that you are receiving health coverage through COBRA for 3 months from January 1 through March 31, and qualify for the COBRA Subsidy Program. You then become eligible for health coverage through covered employment effective April 1 for 6 months. You will be covered until September 30, and the program will not be in effect during this period. If you do not re-qualify for coverage when the 6 months expires, then you will be given the option to continue your coverage through COBRA that would begin on October 1. At that point, you will have to send another application to the New York State Insurance Department to see if you would qualify for the assistance program again. The New York State Insurance Department does track the amount of payments that members will receive as reimbursement during each COBRA period.
Once the Fund Office receives notification from the State Insurance Department that your application has been approved, you will be entitled to a refund of 49.45% of the COBRA premium you had paid in full. Therefore, you should submit your application to the State Insurance Department as soon as possible. For any month for which the premium has been paid in full and the Fund then receives 49.45% from the State, you will, of course, receive a refund of the credit. But the State of New York will not approve payments retroactively, so the application should be submitted as early as possible. Effective August 1, 2010, entertainment industry members may receive up to a maximum of 12 months of premium assistance (cumulative), regardless of the number of COBRA eligibility periods you may incur. Basically, the 12 months of assistance will be available to you whether it is applied over one COBRA Qualifying period or multiple COBRA periods.
Please note that in determining whether you are eligible, the State Insurance Department has outlined on the first page of the application the monthly household income limits and has specified that you must submit your income information from not only the current gross monthly income but also that of the previous full calendar month. Therefore, you may be eligible even if your earnings were substantial during the previous year.
Please be aware that members residing within the Tri-State areas of New Jersey, and Connecticut, DO NOT qualify for this program. The Fund will mail New York State residents the required application with the COBRA packets each time that a member's health coverage through covered employment becomes terminated.
If you have any questions about this program you may contact the Consumer Services Bureau of the State Insurance Department at 1-800-342-3736 or the Actors Fund at (212) 221-7301