If you are a member of SAG-AFTRA (the union that represents actors and other entertainers) you probably find yourself accruing earnings in two separate health and pension plans. If you have eligibility to participate in both or either plan you may wish to compare them. I am annoyed by how hard it was to get information on this subject. I created this page to record what I uncovered. As to cover my own ass I need to tell you to please remember: I offer no warranty or guarantee over the information I provide here.
Before you just dive right in to the comparison of the two plans, you really need to know something about our industry's insurance plans:
You think you have a choice between the two plans, but you pretty much don't.
Please click here to let me do some important explaining before you review the comparison below.
This table is NOT exhaustive of the plans' benefits. It has been compiled from sagph.org & aftrahr.com from their respective plan documents as of Feb 2015. I have listed a majority of commonly covered health plan benefits. I compared the AFTRA HR plan to the SAG PH Two Plan, the one I am interested in, and wrote which plan won that category in the COMPARED column and a little about to which degree it won. This is very subjective and needs to be done for yourself. Don't rely on my opinion of which benefit is better. If it wasn't possible for me to determine a winner I wrote UND. If it was a tie I wrote EQUAL.
Next I assigned values to each of the benefits that are important to me. Benefits such as family maximums are not relevant to me so I did not give them any points. I made judgement on the importance on a scale of 0 to 10 for each that would sum to 100. Then I multiplied by 2 for wins "by a mile" and 1 for wins and then 10% for wins "by a hair." I multiplied by 0 if the win was undetermined or equal. Additionally if the win was for SAG it was a positive multiple, if it was a win for AFTRA it was a negative multiple.
The summation at the very bottom of the POINTS column therefore represents the degree to which one plan beat the other. At 5.7, my analysis for my own situation is that the SAG plan is better for me by 5.7 points in that direction. Its pretty arbitrary but I can see which of my two choices win and by how much. For example a slam dunk in either direction would be 100 points. SAG PH is pretty close to AFTRA HR for me, not a huge win but still significant to me.
NC = not covered pp = per person pv = per visit UND = undetermined
Now as you can expect, everyone is going to look at this comparison and assign different values to each item, making this decision isn't easy. For me, the decision is about 5.7 points in the direction of SAG PH. I hope you find this analysis useful in the approach you decide to take, it did helped me!
Please feel free to download, modify, and share the worksheet; you can download it below.
So you happen to qualify for both plans!
Great, now you think you get to change plans or stay with the plan you have, right? Guess what - you kinda really can't do that. Well, of course you can just pay the premiums of the plan you want and not the other. Problem solved. Nope. The plans determine which is primary and which is secondary (or coinsurance) on their own, regardless of which you have paid premiums for, or which you would like to have as primary or secondary.
Let me explain...
The AFTRA HR and SAG PH plans think that they are somehow related, I have no idea why... but they group themselves as Entertainment Industry Plans. These plans have a very important policy of positioning themselves as PRIMARY or SECONDARY insurance.
This is a BIG deal. If you are paying premiums to a plan that isn't your PRIMARY plan, they will not give you the benefits you see outlined in the plan documents. They will only act as a coinsurance paying out only a fraction of the benefits.
To understand which plan is your primary plan according to the insurance plans themselves, please walk through this:
1. Are you ELIGIBLE(1) for more than one Entertainment Industry Plan?
Your primary insurance is the singular plan that you are eligible for. (why are you even here? ;)
GO TO STEP 3 ►
b) Yes, I am eligible for more than one plan.
2. Regarding the Entertainment Industry Plans that you currently are eligible for, which plan were you eligible for longest without any break in eligibility(2)?
a) I was eligible for AFTRA HR for a longer period without a break in eligibility.
Your primary insurance is the AFTRA HR plan. Any other plans that you became eligible for after becoming continuously eligible for this plan are secondary.
b) I was eligible for SAG PH plan for a longer period without a break in eligibility.
Your primary insurance is the SAG PH plan. Any other plans that you became eligible for after becoming continuously eligible for this plan are secondary.
c) Neither plan was first, I became eligible for both plans over the same exact periods (rare).
Call your plans, make sure that this is truly the case. You get to choose which plan you want to be primary.
GO TO STEP 4 ►
3. So it looks like you have a primary plan already.
Thinking of going with the secondary plan and just not paying or using the primary?
They will pay only around 20% of the benefits they would otherwise pay if they were your primary insurance. And remember your primary plan will only pay its plan benefits if you have paid the premiums for that plan. So if you are only paying premiums for what has been determined to be your secondary plan, you may find yourself with getting only around 20% of the benefits you thought you had. It is important to understand that the PLAN determines its position most of the time, NOT you.
Even if you don't have a choice in which plan is primary, it is always possible to change that.
Just work under contracts that will only contribute to qualification for a plan that you wish to be primary. As a result you will not qualify for the other plan and it will not remain as primary because if you are only eligible for one plan, that plan will be your primary plan. Now if you become eligible for both plans again, your primary plan will be that which you had continuous eligibility for over the longest period of time.
Obviously this takes considerable time and it can be risky to turn down work for contracts that happen to earn eligibility to a plan you don't want. However, everyone's situation is different and if you can choose which contracts to work under you may want information to make that decision.
Your primary plan is likely to be the only plan premiums you pay, unless you want additional coverage from a secondary plan. Which plan is best for you as your primary insurance? Now that you understand primary and secondary positions, you should continue on to the comparison between the plans.
4. AFTRA HR vs SAG PH: A comparison of plan benefits.
I created a table to bring common aspects of each plan along side each other for comparison. This table is NOT exhaustive of the plans' benefits. It has been compiled from sagph.org & aftrahr.com from their respective plan documents as of Feb 2015. Keep this in mind when you are making your own comparisons using the data here.
Luke David Johnson
I write stuff I think the internet is missing.