Terms to Know

To help you understand your benefits and how they work, here are definitions of important terms.


Account Balance means the sum of the balances in your Employer Contribution Account, Rollover Contribution Account, and Salary Deferral Account. This is the total of all contributions to all such accounts, adjusted for investment earnings or losses, less any withdrawals or distributions to you.

Allowable Expenseallowable expenses do not include expenses for services received because of an occupational illness or injury, or expenses for services that are excluded or not covered by the Fund. An “allowable expense” means a necessary, reasonable, and customary health care service or expense (including deductibles, coinsurance, or copays) that is covered in full or in part by the Fund, except as provided. This means that an expense or service (or any portion of an expense or service) not covered by the Fund is not an allowable expense. Examples of expenses or services that are not allowable expenses include, but are not limited to, the following:

  • a) the difference between the cost of a semi-private room in a hospital or other health care facility and a private room, unless the patient’s stay in a private room is medically necessary, and,
  • b) amounts charged by a health care provider that exceed the highest of the MRCs allowed by the Fund.

For those covered by more than one health plan, allowable expenses, for the purpose of Coordination of Benefits (COB), will be determined as follows. If you are covered by one plan that provides services or supplies on the basis of maximum reimbursable charges and one plan that provides services and supplies on the basis of negotiated fees, the primary plan’s fee arrangement will be the allowable expense. When benefits are reduced by a primary plan because a covered person did not comply with its provisions (e.g., provisions related to utilization management), the Fund will not consider the amount of those reductions an allowable expense when it pays second.

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Beneficiary means the person you name to receive any benefits provided by the Plan if you die.

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Canadian Actors means Actors who reside in Canada and whose primary pension plan is the CAEA Register Retirement Savings Plan.

Catch-up Contributions means pre-tax contributions that exceed the limits otherwise applicable to normal pre-tax contributions. To make catch-up contributions, you must be at least age 50 by the end of the calendar year and be eligible to make pre-tax contributions. The amount of catch-up contributions for a year cannot exceed the limit on catch-up contributions for that year. For 2024, the catch-up limit is $7,500. This amount may be adjusted for inflation.

Child(ren) – eligible dependent child(ren), including your biological child, adopted child (including a child placed in your home for whom you have begun adoption procedures), stepchild, the child of your domestic partner, a refugee child for whom you have been appointed the caretaker or sponsor by the U.S. Office of Refugee Resettlement (or successor Federal Agency), or a child living with you for whom you are financially responsible and have been appointed legal guardian by a court.

Coinsurance – the cost sharing amount you pay after meeting your applicable annual deductible.

Collective Bargaining Agreement (CBA) means a negotiated agreement between an employer and the Union. It determines the amount of pension contributions, 401(k) contributions, or salary deferrals required to be made by employers to the Fund for work in covered employment. For non-bargained Fund Office employees, the term “collective bargaining agreement” also includes a written participation agreement requiring contributions to be made to the Fund on behalf of Fund Office employees.

Compensation means your reportable W-2 wages earned through Covered Employment (before any Salary Deferral Contributions are deducted under the Plan). Any W-2 wages in excess of either $7,500 per week or an annual amount indexed for inflation ($345,000 for 2024) is excluded from the definition of “compensation” under the Plan. For employers obligated to contribute an amount equal to a percentage of wages to the Plan, any wages excluded from contributions are also excluded from the Plan’s definition (e.g., weekly wages above $5,500 under the Touring agreement).

Contributing Employer means an employer that has signed a collective bargaining agreement with the Union (and includes the Fund Office with respect to its employees if it signs a written participation agreement obligating it to contribute to the Fund).

Coordination of Benefits (COB) – special benefit rules that apply when you are eligible for more than one health benefit plan.

Copay – a dollar amount payable by the participant at the time a covered service or supply is delivered by a health care provider.

Covered Earnings means earnings for which contributions are owed under a collective bargaining agreement. Covered earnings do not include any earnings for which no contributions are owed (e.g., earnings above a weekly maximum on which contributions are owed).

Covered Employee or Participant – an employee who has qualified for coverage under the Fund through covered employment.

Covered Employment means employment under a collective bargaining agreement.

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Deductible – the amount you must pay out-of-pocket before the Plan begins to pay for eligible expenses.

Defined Contribution Plan means a plan that provides an individual account for each participant, and the benefit due each participant is based solely on the value of the account at the time of payment.

Disabled means you must be eligible for disability benefits under Social Security. Eligibility for this Social Security payment requires that you are unable to perform any substantial gainful work, as determined by the Social Security Administration, and that the disability is expected to last at least a year or to result in your death within a year.

Disabled Child – a child of any age who is incapable of self-sustaining employment because of mental illness, developmental disability, mental retardation, or physical handicap. The handicap must have existed before the child’s 19th birthday and must have begun while the child was covered by the Fund. Written evidence of the handicap must be sent to the Fund Office within 31 days of the age when coverage would usually end, and when requested by the Fund Office thereafter.

Domestic Partners – two unmarried* adults of the same or opposite sex who:

  • Have lived with each other for at least six months before the application for benefits and who intend to live continuously with each other indefinitely;
  • If living in a state or municipality providing for the registration of domestic partnerships, have registered as domestic partners;
    Are not related by blood closer than the law would permit by marriage;
  • Are financially dependent on each other;
  • Have a close, and committed relationship with each other; and
  • Have not terminated the domestic partnership.

*You are considered married even if you are legally separated.

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Early Retirement means you elect your pension and receive a reduced benefit. If you are vested under the Pension Plan, you can elect your benefit early when you are at least age 60 but not yet age 65.

Employer Contributions means contributions required by an employer pursuant to a collective bargaining agreement that are not deducted from your salary.

Employer Contribution Account means the individual account to which all Employer Contributions are credited.

ERISA means the Employee Retirement Income Security Act of 1974. This act established certain rights to obtain information and protections for participants in all retirement plans. It also imposes duties on the people who are responsible for administration of retirement plans.

Excessive Trading means a pattern of frequent transfers in and out of investments. Excessive trading is inappropriate when it negatively affects other Fund investors.

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IRA means individual retirement account.

IRS means the Internal Revenue Service.

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League means the Broadway League.

LORT means the League of Resident Theatres.

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Maximum Reimbursable Charge (MRC) – the maximum charge that will be reimbursed for a covered treatment. The MRC for a particular treatment is established by considering one or more factors, including but not limited to the type of treatment, the nature and severity of the illness or injury being treated, the amount charged by other providers in the geographic area in which the treatment is provided, the amount reimbursed by the Centers for Medicare and Medicaid Services (CMS) under Medicare for that treatment, and/or the amount based upon a methodology similar to that utilized by CMS to determine the amount reimbursed under Medicare for the same or similar service. You can find out in advance of treatment whether the charge made by your provider exceeds the MRC by obtaining that charge from your provider and contacting Cigna to see if the charge exceeds the MRC.

Medically Necessary or Medical Necessity – health care services and supplies that are determined by Cigna to be:

  • Required to diagnose or treat an illness, injury, or disease or its symptoms;
  • In accordance with generally accepted standards of medical practice;
  • Clinically appropriate in terms of type, frequency, extent, site, and duration;
  • Not primarily for the convenience of the patient, physician, or other health care provider, and
  • Rendered in the least-intensive setting that is appropriate for the delivery of the services and supplies. Where applicable, Cigna may compare the cost-effectiveness of alternative services, settings, or supplies when determining the least-intensive setting.

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Network Provider or Participating Provider – an institution, facility, agency, or health care professional with a contractual agreement to provide medical services at a predetermined cost.

Normal Retirement means when you can elect your pension and receive an unreduced benefit. This occurs at age 65 or, if later, your age when you reach Normal Retirement Age.

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Participant means someone who has an individual account with the Plan as a result of Covered Employment.

Present Value is the single sum value of a series of payments (pension) to be made over a period of time (lifetime in most cases) taking into account the probability of death, disability, age at retirement, and the time value of money (investment return).

Preventive Care such as checkups – provided for both children and adults, and includes immunizations. For enrolled dependent children through age 18, routine checkups and immunizations are provided in accordance with current guidelines of the American Academy of Pediatrics. The intervals at which these services are provided are spelled out in the Cigna documents and range from every few months for infants to every three years for children ages 12 through 18.

Production Contract means the Production Contract negotiated between Actors’ Equity Association and the Broadway League and certain other employers.

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Qualified Domestic Relations Order (QDRO) means a domestic relations order deemed qualified by the Plan Administrator. A QDRO can force payment of Plan benefits to an alternate payee (e.g., spouse, former spouse, child) even though the Plan normally prohibits distributions earlier than normal retirement date, termination, death, or disability.

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Rollover Contributions means monies “rolled over” from a qualified retirement plan, 403(b) Plan, 457(b) Plan, or individual retirement account (IRA) into the Plan.

Rollover Contribution Account means the individual account to which all your rollover contributions are credited.

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Salary means Compensation under the Plan (see definition of Compensation, above).

Salary Deferral Contributions means amounts deducted from your Compensation on a pre-tax basis by your employer and sent to the Plan pursuant to a salary deferral agreement with you.

Salary Deferral Account means the Individual Account to which your Salary Deferral Contributions are credited.

Spouse is the person to whom you’re married when benefits begin. If you’re married at least one year and die before benefits begin, the person to whom you were married at the time of your death is considered your spouse. The Plan recognizes a same-sex spouse as a Spouse as long as you have a valid marriage certificate, regardless of where you reside or where you married.

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Termination of Employment means not being employed in covered employment that allows for 401(k) Participation for 12 consecutive months.

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Vested means you have earned a non-forfeitable right to receive a future benefit from the Plan, even if you leave covered employment before you are old enough to retire.

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Year(s) of Attachment to Legitimate Theater consists of each calendar year in which you worked in covered employment for two or more weeks (prior to 1963, it includes any year that you were a paid-up member of Actors’ Equity Association).

Year(s) of Vesting Service (YVS) consists of each calendar year beginning with 1945 in which you worked at least two weeks in covered employment.

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