Equity-League Benefit Funds FAQ
Health Fund
Eligibility
How do I qualify for coverage, and how long will it last?
The Fund offers two coverage levels, and eligibility is earned for six months at a time. The level of coverage for which you qualify is related to the number of weeks you work in covered employment. Learn more about coverage eligibility.
How are work weeks that span two months (split weeks) handled?
If a week at the end of a calendar month has at least one day in the next month, it will be included in the Accumulation Period for the later month (the month in which the week ended). If you want to apply the week to the Accumulation Period for the earlier month (the month the week started), you must contact the Fund Office and ask. For example, the workweek of Monday, July 29 to Sunday, August 4 will apply to the accumulation period that ends August, unless you contact the Fund Office and ask to apply that week to the Accumulation Period that ends July 31
Will I receive two weeks of eligibility if I work for two different employers during the same week?
Yes, as long as each employer is required to make a weekly Health contribution.
When I reach age 65, am I eligible for Medicare Supplemental coverage?
Yes. You are eligible for the Fund’s Medicare Supplemental coverage if you are eligible for Medicare at the end of your coverage earned through covered employment, COBRA, or the Self-Pay Program After COBRA.
If you choose this coverage, the Fund will coordinate your benefits with Medicare under the Cigna plan. If you choose Medicare self-pay coverage through one of the HMOs that offers this coverage (HIP EmblemHealth or Kaiser in northern or southern California), your coverage will be administered through one of their Medicare Advantage plans. Unless you are covered through employment, Medicare will provide your primary coverage, and the Fund will be secondary. The premium for this coverage is lower than our standard COBRA premium.
Paying for coverage
Will I receive a bill for my health insurance premium?
Yes. You will receive one invoice quarterly. This invoice will also include premiums for any other types of coverage you might already be paying for, such as dental coverage. Each premium invoice will provide you with three months of health coverage (for example, October 1 through December 31) while you are eligible. If you have chosen to receive electronic notifications, you will be notified monthly via text message or email.
How can I pay my health insurance premiums?
You can make your health premium payments by credit card, debit card, or Bank ACH directly on your Equity-League Self-Service Account. You will also be able to view your work history, update mailing and email addresses, and much more.
If you already registered, login into the self-service portal or click on Login in the side bars on any page on this site.
If you are not yet a registered user, you will need to register before you can begin to make your health insurance premium payments.
If you have any questions about registration, you can contact the Benefit Services Department at (212) 869-9380 or toll free at (800) 344-5220 outside the New York Metro area or at health@equityleague.org. Our Benefit Services Department staff will be able to walk you through the registration process on the spot.
Can I pay quarterly premiums in advance?
Yes. You may pay for as much coverage as you have qualified for and accepted.
Appeals
What is the appeals process?
- A one-level appeals process is provided for disputes involving vision, supplemental workers’ compensation (SWC), and eligibility claims. These appeals are reviewed by Health Fund Trustees.
- A two-level appeal process is provided for all Cigna and Optum RX claims. Both levels of appeal are handled by Cigna or Optum RX . A voluntary third-level appeal is available if levels one and two appeals are denied by Cigna or Optum RX. Third-level appeals are reviewed by Health Fund Trustees.
For HMO benefits, please consult the materials from the HMO, since the appeals rules may be different.
For complete details about the Health Fund’s appeals processes, refer to the SPD. If you have further questions about appeals, call the Equity-League Benefit Funds office at (212) 869-9380 (New York City) or (800) 344-5220, and a representative will assist you.
Self-Pay Health Fund Coverage Types
What is self-pay coverage?
“Self-pay” or “self-paid” describes coverage where you pay the full amount of what the Fund charges for that coverage. Examples of self-paid coverage include:
- Dependent Coverage – includes paying for dependent coverage when covered by employment
- COBRA continuation coverage and the Fund’s Self-Pay Program After COBRA
- Dental coverage
- Medicare Supplemental
Is there any aid available to help with the cost of COBRA?
The New York State COBRA Premium Assistance Program helps entertainment industry employees maintain health coverage. Eligible applicants can receive premium assistance equal to 75% of their COBRA premiums for up to 12 months. Download the application, and mail it to the address on the form.
How long can self-pay coverage last?
That depends on whether your coverage is COBRA, Self-Pay After COBRA, or dental-only coverage. Participants may generally remain on COBRA coverage for 18 months. Participants who have received a disability award from the Social Security Administration may remain on COBRA for 29 months. Once COBRA ends, you may be eligible for the Fund’s Self-Pay Program After COBRA. View more information about COBRA and after-COBRA benefits. Dental-only coverage can continue indefinitely, as long as you continue to pay your dental premium on time.
If I fail to pay the required premium for any type of self-paid coverage, can I reinstate coverage at any time?
No. When you miss a premium payment, your coverage will terminate, and you will no longer be eligible for coverage. Once you lose the right to self-paid coverage, you cannot have coverage under the Health Fund again until you qualify under the Fund’s eligibility rules through covered employment.
What is the Self-Pay Program After COBRA (SPAC)?
The Health Fund will establish an extended health coverage “bank” for a participant who accumulates at least 10 years of service across their career. Such participants will have 18 months of extended health coverage eligibility placed in their “bank” accounts.
In addition, for each additional year of vesting service that such participants accumulate across their careers beyond the 10 years required to qualify for the initial 18-month extension, they will have one additional month of extended health coverage added to their “bank” accounts. These added eligibility months can be used as of the first of the month following the completion of a participant’s 18th month COBRA coverage period, but no more than 18 of the bank’s months can be used after any single period of COBRA coverage ends (unused months can be used to extend any subsequent periods of COBRA coverage). Months placed in an account can be used only one time. Once the total number of additional months is exhausted, there are no additional months beyond the 18-month COBRA coverage period.
The table below provides examples of bank account accumulations based on years of service:
Does the Fund offer Medicare Supplemental coverage?
Yes. You are eligible for the Fund’s Medicare Supplemental coverage if you are eligible for Medicare at the end of your coverage earned through covered employment, COBRA, or the Self-Pay Program After COBRA.
If you choose this coverage, the Fund will coordinate your benefits with Medicare under the Cigna plan. If you choose Medicare self-pay coverage through one of the HMOs that offers this coverage (HIP EmblemHealth or Kaiser in northern or southern California), your coverage will be administered through one of their Medicare Advantage plans. Unless you are covered through employment, Medicare will provide your primary coverage, and the Fund will be secondary. The premium for this coverage is lower than our standard COBRA premium.
Dependent Coverage
What kind of coverage can I get for my dependents?
You can choose to add self-paid medical and/or dental coverage for your dependent if you are enrolled in the same coverage.
What does dependent coverage cost?
View current premium rates for all plans.
When can I enroll my dependents?
Participants typically enroll dependents when they first become eligible for coverage, or when they regain eligibility from a prior period through covered employment. In these situations, you may enroll any eligible dependents for medical coverage (including vision) at the same time you enroll yourself.
Additionally, you can add dependents in certain special enrollment situations. Since these situations are triggered by life events, such as a marriage or birth, you may add dependents any time these situations occur. Just remember that after a life event that allows you to add a dependent, you have 31 days to enroll them. After the first 31 days, you will still have an additional 31 days to enroll them, but only if you pay an additional $100 penalty. Coverage can begin either on the first day of the month in which the Fund receives notice of the dependent or it can begin the first day of the following month.
You also have an opportunity to add dependents to your coverage during the Health Fund’s Annual Open Enrollment each November. In these cases, the effective date of coverage will be the following January 1.
How do I add a dependent?
If you choose to add a dependent to your existing coverage, you must submit a completed Dependent Coverage Form (for the Cigna plan) or a new Enrollment Application (different for each HMO plan). Along with the form or application, you must also provide proof of dependent status, which may include one or more of the following:
- Marriage certificate (if adding a spouse)
- Birth certificate (if adding any of your eligible child dependents)
- Domestic Partner Registration – state or municipality you reside in that provides for the registering of Domestic Partners
- Proof of residence
- Proof of financial dependency
Please mail the completed form or application and proof of dependent status to:
Equity-League Benefit Services Department
165 West 46th Street, Suite 812
New York, NY 10036
You can also choose to add your dependent when electing health coverage through the Self-Service Portal in which you will be required to attach proof of dependency as part of the online enrollment process.
How do I pay dependent premiums?
You must pay the required additional premium to add coverage for one or more dependents. Dependent coverage offered by the Health Fund is self-paid. This is why the dependent premium is considerably higher than the premium for participant coverage (which is earned through covered employment).
To pay by credit card, use our Self-Service Portal. Checks for the additional dependent premium must be payable to the Equity-League Health Trust Fund.
After your dependent is enrolled, remember that he or she will lose coverage if you fail to pay the additional premium on time.
When will a dependent lose coverage?
- Dependent child reaches age 26
- Divorce
- Dissolution of a domestic partnership
- Dependent death
You must notify the Health Fund within 60 days of any life event that could cause a loss of coverage. In such cases, the dependent’s coverage will end after the end of the month in which dependent status was lost.
Dependents who lose coverage will have an opportunity to enroll in COBRA continuation coverage and keep that coverage for up to 36 months, but only if the dependent had coverage as a result of a participant’s covered employment.
The Affordable Care Act requires plans that offer dependent coverage for children to make such coverage available to participants’ adult children up to age 26. This is true even if the adult child no longer lives with the parents, is not a dependent on a parent’s tax return, or is no longer a student. However, this extended eligibility does not apply to the adult child’s spouse or children.
HMO Plans
What is an HMO?
An HMO (health maintenance organization) is an insurer that contracts with a comprehensive network of providers to provide health care to a population in a particular geographic area. HMOs generally do not cover services from non-network providers.
How are the HMO plans different from the Cigna plan?
Most HMOs require you to choose a primary care physician (PCP) who assumes responsibility for making all your referrals to specialists. Except for emergency situations, generally, you can only receive services from network health care providers.
Where are the HMOs located?
The Equity-League Health Fund currently has contracts with HMOs only in the following locations:
- Southern California (Kaiser Permanente)
- Northern California (Kaiser Permanente)
- Maryland, Virginia, and Washington D.C. areas (Kaiser Permanente)
When can I enroll in an HMO?
You may enroll in an HMO plan:
- When you first become eligible for Equity-League Benefit Funds health coverage
- If you move permanently into a new area served by one of the HMOs under contract with the Fund, i.e., you plan to live in the new location for nine or more continuous months
- During the Fund’s Annual Open Enrollment every November
I’m covered by an HMO plan now. When can I switch to the Cigna plan?
You may change from an HMO plan to the Cigna plan during the Health Fund’s Annual Open Enrollment in November. You can send in a request either by email—to health@equityleague.org—or by mail before or during the month of November to:
Equity-League Benefit Services Department
165 West 46th Street, Suite 812
New York, NY 10036
The change will take effect the following January 1.
If you move out of your HMO service area permanently or have an extended tour, you may change to the Cigna plan by notifying us in writing of the permanent move at the HMO Coordinator address provided above. The change will take effect on the first day of the month after we receive your notification.
A permanent move is a move in which you plan to live in the new location for nine or more continuous months. An extended tour is a tour which lasts nine months or more.
Should I transfer my benefits to the Cigna plan if I am on an extended tour?
If you are on an extended tour, we strongly advise that you transfer your benefits to the Cigna plan, since the Cigna plan will allow you to seek medical care with any doctor in the country.
You do have the option to remain on the HMO and be covered by the HMO only for emergency treatment, though this is not advised. Each HMO has coverage for emergency care if you are away from your service area. Generally, the care is covered by the HMO if the HMO defines your condition as an emergency, if you have notified the HMO of your condition within the HMO’s required time frame, and if you have received approval by the HMO.
Important: You cannot expect the HMO to cover follow-up care or care for a condition that the HMO does not consider to be an emergency. You will have to pay out-of-pocket for any charges not covered by the HMO as an emergency benefit.
Cigna Medical Plan
Is pre-admission required for inpatient hospital visits under the Cigna plan?
Yes. For nonemergency hospital admissions, you or your physician must contact Cigna at (800) 244-6224 (the phone number on your Cigna ID card). If you don’t pre-certify, you are subject to a $250 penalty, and you won’t know in advance whether Cigna will cover that admission, so please call prior to the admission.
How do I find local Cigna plan network providers when away from home?
Visit cigna.com or call Cigna toll-free at (800) 244-6224. This number is also on your ID card, and you can reach Cigna representatives at this number 24 hours a day, seven days a week.
Does each family member need to meet the annual deductible?
When you and at least one dependent are covered, a family deductible for non-network, or certain in-network services applies – depending on the Tier of coverage you elect to enroll into. At least one family member will have to meet the individual deductible. After this occurs, the balance of the deductible can be combined with other family members to meet the family deductible. For specific plan information as to what deductibles are required for each Tier, refer to the medical plan details for each Cigna Plan.
Once I reach the eligibility age for Medicare, can I continue to be covered under the Cigna plan?
Yes, as long as the Cigna plan—not Medicare—provides primary coverage. Basically, this means that you must remain eligible through covered employment and continue to receive primary coverage from the Cigna plan. In that case, Medicare will provide your secondary coverage.
Can my doctor join the Cigna OAP network?
If Cigna is working to expand its network in a particular area, Cigna may choose to accept physician nominations. For more details, ask your doctor to contact Cigna’s Provider Relations Department at (800) 244-6224.
What if I don’t get my new Cigna ID card by the start of my eligibility period?
You can contact Cigna directly 24 hours a day, seven days a week by calling toll-free at (800) 244-6224. Or you may contact the Fund Office at (212) 869-9380 from the New York City area or toll-free nationwide at (800) 344-5220.
You can also view or download your ID card by logging in to your participant account on your carrier’s website. If you are enrolled in Cigna, you can also view or print your ID card via the myCigna mobile app.
OptumRx Prescription Drug Plan
How are my prescription drugs covered?
Prescription drugs are covered by Optum under a plan separate from the Cigna medical plan. Learn more about prescription drug coverage.
Can I use manufacturer coupons for brand-name medications?
Yes. The Equity-League Health Fund permits the use of manufacturer coupons to assist you with any potential high copay amounts.
For example, suppose your physician tells you that you have ulcerative colitis. They suggest the brand-name drug Apriso as a treatment option. After they tell you about Apriso’s benefits and potential side effects, you mention that your prescription drug plan requires the use of generics wherever possible. Your physician responds that they generally have good results with generics and prescribe a generic alternative to Apriso. After you have taken the generic for some time, you and your doctor are not satisfied with the results, and you receive approval for coverage of Apriso. If the cost of the prescription is $360 under the OptumRx prescription drug plan, your copayment would be 25% of that ($90). However, if the drug’s manufacturer offers a $50 coupon to offset against your copayment, you would only be required to pay $40.
Coupons can be used at retail pharmacy locations. For prescriptions ordered through OptumRx’s mail-order pharmacy, please contact them directly to determine if a manufacturer coupon can be used.
Dental and Vision
When am I eligible for dental coverage?
The Fund offers self-paid dental coverage to participants who qualify for health coverage.
If I qualify for health coverage through covered employment, but I do not pay the $300 premium, can I still choose to self-pay for dental coverage?
Yes. You may choose to take self-paid dental coverage even if you do not pay the $300 premium for medical and vision coverage. However, you must continue to pay your dental premium on time to continue your dental coverage.
If you do not continue to pay the required premium for dental coverage on time, you will lose coverage and will not be eligible for dental coverage again until you:
- Requalify for health benefits through covered employment, or
- Enroll during the Plan’s Annual Open Enrollment period in November (for coverage effective January 1 of the following year).
Also, if you stopped paying for dental coverage during the year (other than if you dropped it the same time that you lost medical coverage through covered employment), you’ll be required to pay the missing premiums for that year before you can enroll again the following year.
Can I continue self-paying for dental coverage after my health coverage runs out?
Yes. You may continue to pay for and continue dental coverage. As long as you pay your required premiums on time, your dental coverage continues—even if your eligibility for health benefits does not. If you decide to stop paying for dental coverage, the next time that you will become eligible is when you earn health coverage through covered employment again.
When am I eligible for vision coverage?
Pension
Receiving your pension benefits
What does being vested in the Plan mean?
When you are vested, you have earned a guaranteed right to a pension. You must pass any one of the four vesting tests. There is a 5-year, 10-year, 25-year, and Age and Participation test. Learn more about a vested pension.
What is the normal retirement age, and when can I begin taking my pension?
The normal retirement age is 65. You may begin collecting your pension as early as age 60, but for each month you receive a pension before age 65, your monthly pension benefit is reduced. You may begin your pension as late as age 73. For each month after age 65 that you wait to begin your pension, your monthly pension benefit is increased. View the pension plan details.
How do I apply for my pension?
To apply for your pension, you must complete a pension application and return it to the Retirement Services Department, along with proof of birthdate. For more information about applying for your pension, visit Start Collecting My Pension.
What is the minimum pension?
Does my pension ever increase?
What are the requirements for disability pension?
If the Social Security Administration has determined that you are totally and permanently disabled, the Equity-League Benefit Funds also considers you disabled. Learn more about the disability pension benefit.
I would like to borrow against my pension. Is that allowed?
Can I roll my pension over into another Plan, IRA, money market fund, etc.?
Can I receive more than one Equity-League Benefit Funds pension?
No. You may qualify for more than one Equity-League Benefit Funds pension. However, you may receive only one pension benefit. The most common types of Equity-League Benefit Funds pensions are regular and service pensions. Depending on the length of your career and your covered employment history, you may qualify for both but can only receive one. The other types of Equity-League Benefit Funds pensions are early retirement, disability, and terminal illness pensions. If you qualify for more than one type of Equity-League Benefit Funds pension, you will automatically receive the one with the highest benefit. Learn more about Equity-League Benefit Funds pensions.
Are all my earnings for work under Actors’ Equity contracts applied toward my pension accruals?
If I am a pensioner and I continue to work, how is my increase from covered employment calculated? Also, when does it go into effect?
If you are a pensioner and you continue to work, your pension increase can be effective as early as January 1 of the following year. The annual increase is currently 3% of your pensionable earnings plus $144 if you worked at least two weeks of covered employment during the year. The increase will be reflected in your monthly pension benefit retroactive to January 1.
Survivor benefits and beneficiaries
Is there a survivor benefit payable after I die?
It depends on the amount of service you accumulated, whether you die before or after you retire, what payment option you chose, and if you began taking your pension before your death. Learn more about the survivor benefit.
Can I name anyone as a beneficiary?
If you are married, your spouse is automatically your beneficiary. If you wish to designate someone else, you and your spouse must both consent in writing on forms provided by the Benefit Services Department. If you are not married, you may designate anyone as your beneficiary. Download a beneficiary form.
If my spouse is automatically my beneficiary, what happens if we divorce?
Following a divorce or legal annulment, your ex-spouse will automatically be removed as your beneficiary, unless a qualified domestic relations order (QDRO) stipulates otherwise.
What if I want my ex-spouse to continue as my beneficiary, even after we divorce?
If there is no QDRO preventing you from doing so, you may actively redesignate your ex-spouse as beneficiary through the following steps:
- Download the simplified Redesignation of Former Spouse as Beneficiary Form.
- Complete, sign, and date the form.
- Mail the completed form to:
Equity-League Trust Funds
Attention: Benefit Services Department
165 West 46th Street, Suite 812
New York, NY 10036
Can my spouse or any other beneficiary share in my pension benefit?
My spouse is a member of Actors’ Equity. Can we both collect a pension?
Yes. If you have both earned a pension from Equity-League Benefit Funds, both you and your spouse are entitled to separate pensions.
Can my spouse continue to collect their pension, as well as my survivor pension, after my death?
Can I be a beneficiary if I’m already receiving my pension?
401(k)
401(k) contributions
What are the eligible contract types that are currently participating in the 401(k) Plan?
You can participate in the 401(k) Plan if you work under any contract that permits salary deferrals to the 401(k) Plan and/or requires employer contributions. The actual type of contributions that are or can be made to the Plan depends on the contract under which you work. For more information, see the eligible contract types.
What are the minimum and maximum salary deferrals that I can make?
The minimum and maximum contributions can change annually. Visit irs.gov for the most current information.
What are catch-up contributions?
If you are age 50 or older by the end of a calendar year, you may contribute an additional amount above the weekly and annual deferral maximums for that year. The catch-up contribution amount can change annually. Visit irs.gov for the most current information.
Can I roll over funds into my Equity-League Benefit Funds 401(k)?
You may roll over funds into your 401(k) account from any qualified retirement account:
- Plans qualified under Section 401(a) or 403(a) of the Employee Retirement Income Security Act (ERISA), excluding after-tax employee contributions
- Annuity contracts described in ERISA section 403(b)
- Eligible plans under ERISA section 457(b) maintained by a state or a political subdivision of a state
- Individual retirement accounts under ERISA 408(a) or (b)
Distributions you received as a surviving spouse of a participant in another qualified retirement plan may also be eligible for a rollover. Distributions you received as an alternate payee under a qualified domestic relations order (QDRO) under another qualified retirement plan may also be eligible.
The Plan does not accept rollovers of any after-tax contributions made to another retirement plan. Additionally, the Trustees of the 401(k) Plan reserve the right to approve or deny rollovers in their sole and absolute discretion, or by any agency or instrumentality of a state or political subdivision of a state.
Roth IRAs are not eligible for rollover into your Equity-League Benefit Funds 401(k) Plan.
You may want to compare how much your investments could earn under each plan before deciding to proceed with a rollover. Please understand that Equity-League Benefit Funds staff are neither qualified nor legally permitted to provide investment advice, so consider reviewing your options with a financial planner.
To initiate a rollover from another eligible retirement plan to have those assets added to your Equity-League 401(k) Plan, download a 401(k) Rollover Statement. Complete and submit this form as directed by the form’s instructions.
Can I voluntarily contribute to the 401(k) Plan after taxes?
If I am incorporated (employed as a corporation), can I still participate in the 401(k) Plan?
Your 401(k) account
Who maintains the funds in my 401(k) accounts?
John Hancock maintains all the Equity-League Benefit Funds 401(k) Plan accounts. Visit myplan.johnhancock.com to see your account(s) by fund(s) and to access financial planning resources.
What are my investment options, and how do I change them?
You may view all currently available investment options within the John Hancock Retirement Service portal at myplan.johnhancock.com. You may also change your investment allocations at the John Hancock portal. Alternatively, you can call John Hancock at (833) 388-6466.
How can I register with the John Hancock portal?
When you log on to the website or call John Hancock for the first time, they will ask you to provide your Social Security number in order for them to create your unique personal identification number (PIN) and password. You’ll use your PIN and password to access your account in the future.
- To establish your PIN and password online, go to myplan.johnhancock.com and click Register now. Get started with your Plan.
- Create your User Profile, and, if you’d like, provide an email address.
- To establish your PIN and password by phone, call John Hancock at (833) 388-6466, and follow the prompts (press “0” to reach a customer service representative).
You may also contact the Benefit Services Department within the Fund Office at (212) 869-9380 (New York City) or toll free outside of New York City (800) 344-5220.
Will I receive statements from John Hancock?
How do I reset my PIN?
401(k) distributions
When am I vested?
You are 100% vested immediately after becoming a participant.
How do I take my 401(k) account balance when I retire?
How are my 401(k) benefits taxed?
Your 401(k) benefits will be taxed as income when you receive distributions. However, distributions made prior to age 59½ may be subject to a 10% federal excise tax—a tax penalty—in addition to ordinary income taxes.
What happens to my 401(k) account if I die before collecting any funds?
If you die, funds in your account will be paid as a survivor benefit to your designated beneficiary, per the rules of the Plan as described in the Fund’s Summary Plan Description. [Link to 401(k) SPD]
Can I take a loan from my 401(k) account?
Currently, the 401(k) Plan does not permit participant loans.