The Equity-League Benefit Funds: critical deadlines for paying your premiums
Be – and remain – conscious of deadlines. Your health coverage depends on it!
From acting classes and dance lessons to auditions, you have worked hard – and sacrificed – to make your way in the industry. Along the way, through covered work, you also gained eligibility for affordable Equity-League Health Fund coverage. Don’t let the valuable benefits you’ve earned slip away by missing a premium payment.
It is critical that you pay your premiums for health coverage on time. To protect the Health Fund on behalf of all participants, the Trustees established strict policies with regard to payment of premiums.
For instance, let’s say you miss the deadline for a $100 quarterly premium payment for medical coverage. You may pay the premium within 30 days of the deadline – plus a $100 penalty ($200 total) – and your coverage will only be delayed. But if you do not pay the premium and penalty within 30 days of the deadline, you will lose coverage altogether.
The payment deadlines that apply to you depend on the nature of the coverage offered and how you qualified for it. The Health Fund’s two general categories of coverage are:
- Health coverage earned through covered work
- Additional types of self-paid coverage (e.g., COBRA, Medicare supplement, dependent or dental coverage)
Private and public insurers (Medicare and Medicaid) have long recognized the importance of timely premium payments and clear enrollment rules. If a plan’s deadlines and rules are lax, the plan’s solvency is threatened.
For example, without firm rules and deadlines, some participants may choose to enroll and pay premiums only when they anticipate significant medical expenses. This places the plan at risk. In a not-for-profit plan like the Equity-League Health Fund, such risk impacts all participants – in the benefits they receive and the cost of their premiums.
Health coverage that you earn through covered work
Health coverage that you earn through covered work is the standard coverage provided by the Health Fund. This coverage is offered only in three month blocks, or “quarters,” which can begin on the first day of any month (Jan. 1 – March 31, or Feb. 1 – April 30, etc.)
The $100 quarterly premium required for coverage is due no later than the 1st day of the coverage period. You must ensure that we receive your payment by the due date, or we will apply a $100 penalty. This fee cannot be waived.
If you miss a payment deadline, you must ensure that we receive the past-due payment – and the late payment penalty – by the 30th day of a quarter (Jan. 31 in the previous example). Otherwise, the plan requires that we terminate your coverage (or not begin your coverage).
If you pay late, your coverage may not be reflected in the eligibility records of our benefit partners – Cigna and the HMOs offered by the Health Fund – at the time coverage begins. This means that a provider’s office may not be able to confirm your coverage through the system. If this happens to you, call the Fund Office at (212) 869-9380 (NYC) or nationwide toll-free at (800) 344-5220.
Additional types of self-paid coverage that may be available to you In addition to the health coverage you can earn for yourself through employment, we offer other types of self-paid coverage listed below. Most are due quarterly (although monthly payments may be an option):
- Coverage for dependents
- Dental coverage
- COBRA and COBRA extension coverage (due monthly)
- Medicare supplement coverage
Premiums for these coverages are due on the first day of a quarter (or month for COBRA). Make sure we receive your payment within 30 days of the first day of the quarter or month. Otherwise, we must terminate your coverage as of the end of the prior month, And you cannot begin coverage again until and unless you earn coverage again through covered work.
Unfortunately, you cannot enroll in coverage more than 30 days after it became available, even with a penalty payment.
For example, maybe you added dental or dependent benefits to your regular coverage. If this applies to you, you should pay for all coverages at the same time. This is because we must apply the $100 penalty separately to each type of coverage paid late, but on a different date. For example:
• Jack becomes eligible for medical coverage Jan. 1, but pays the premium Jan. 5, so there is a $100 penalty, and his health coverage begins Jan. 5.
• Jack then elects to add dental coverage, but doesn’t pay until Jan. 10, so the dental premium payment is subject to an additional $100 penalty, and his dental coverage begins Jan. 10.
Annual premium payment deadlines
All deadline dates listed below are for valid payments to be received by the Equity-League Fund Office by 11:59 pm PT.
|Health Premium Deadlines for Receipt of a Payment|
|Month||For Your Coverage Earned Through Employment||For All Other Health Coverage|
|Month||Last Date for Timely Record of New Coverage (to avoid “at the doctor” eligibility issues)||Last Date to Have Coverage Begin Day One and Avoid the $100 Penalty (for new coverage)||Last Date to Pay Premium for New Coverage with a $100 Penalty||Last Date to Pay Premium to Continue Self-Paid Coverages After the Initial Election (no $100 penalty applies)|
|January||Dec. 15 of previous year||Jan. 1||Jan. 31||Jan. 31|
|February||Jan. 15||Feb. 1||March 3 (March 2 during leap years)||March 3 (March 2 during leap years)|
|March||Feb. 15||March1||March 31||March 31|
|April||March 15||April 1||May 1||May 1|
|May||April 15||May 1||May 31||May 31|
|June||May 15||June 1||July 1||July 1|
|July||June 15||July 1||July 31||July 31|
|August||July 15||Aug. 1||Aug. 31||Aug. 31|
|September||Aug. 15||Sept. 1||Oct. 1||Oct. 1|
|October||Sept. 15||Oct. 1||Oct. 31||Oct. 31|
|November||Oct. 15||Nov. 1||Dec. 1||Dec. 1|
|December||Nov. 15||Dec. 1||Dec. 31||Dec. 31|
The fastest and most convenient way to pay your health premiums is to click on “Pay my Premium” in order to submit a secure payment online using:
• A credit card
• A debit card, or
• An ACH credit (electronic transfer of funds).
However you choose to pay your premiums – online, by mailing a check, or in person – make sure we receive your payments on time.
In addition to the premium payment penalties described on this page, you should learn the rules and penalties we apply in cases of late enrollment.
Sign up for email invoices, reminders or schedule automatic payments to avoid missing deadlines
Unless you specify otherwise, we will mail quarterly (but not monthly) premium invoices to the last known address you have on file with us – not the one with Actors’ Equity. Please note that we have no access to any contact information you have on file with the Actors’ Equity, so notifying them of your address will not update our records.
In lieu of receiving quarterly paper invoices, you can request quarterly or monthly invoices by email instead. This speeds up notice to you and assures that you can receive notices any time you have access to e-mail. Plus you can help us save trees as well!
Additionally, you can also request that text message reminders of premiums due be sent to you.
To specify any of the premium payment preferences as described above and listed below, simply log into our Self Service Portal (“Contact Info” | “Communication Preferences”) and follow the instructions. (If you have not done so previously, you must register for the Self Service Portal before you can log in.) For assistance with selecting your preferences, or to learn more about any of these options, email your request to firstname.lastname@example.org.
- Email invoices
- Text message reminders
- Authorizing the Actors’ Federal Credit Union to:
– Make automatic premium payments on your behalf
– Pre-pay your premiums for the full coverage period
If you have any questions, don’t hesitate to call the Health Fund at (212) 869-9380 in New York City or nationwide toll-free at (800) 344-5220. You may also email us at email@example.com., and we will be happy to assist you.