AFTRA vs SAG: A Comparison of Health Plan Benefits

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.

WARNING!
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.

		SAG PH
	AFTRA HR	ONE	TWO	Compared	Value	Points
PREMIUMS
Individual	420	273	324	SAG by a mile	10	20
+1	736	315	372	SAG by a mile
+2 and up	807	342	405	SAG by a mile
Senior	166-552	50-155	NA	UND
Senior & Partner	484	100-155	NA	SAG
HOSPITAL	AFTRA HR	SAG ONE	SAG TWO	Compared	Value	Points
Deductible	0	150	150	AFTRA	5	-5
Deductible Fam	0	300	300	AFTRA
Co-Pay	100	100	200	AFTRA	3	-3
Inpatient	90% first 10,000 then 100%	90%	90%	AFTRA by a hair	3	-0.3
Outpatient	90% first 10,000 then 100%	90%	90%	AFTRA by a hair	5	-0.5
Co-Insurance Out-of-Pocket Limit	10% first 10,000	1,750	1,750	SAG	5	5
Family	10% first 10,000 per person	3,000	3,500	SAG by a hair
Annual Out-of-Pocket Maximum	1,000	6,350 (includes medical)	6,350 (includes medical)	AFTRA by a mile	10	-20
Family	1,000 pp	6,350 pp (12,700 max) (includes medical)	6,350 pp (12,700 max) (includes medical)	AFTRA by a mile
MEDICAL	AFTRA HR	SAG ONE	SAG TWO	Compared	Value	Points
Deductible	200	0	0	SAG by a mile	10	20
Deductible Fam	200 pp (400 max)	0	0	SAG by a mile
Office Visit	90% first 10,000 then 100%	90%	90%	AFTRA by a hair	5	-0.5
Co-Pay	10	15	25	AFTRA	3	-3
Inpatient	90% first 10,000 then 100%	90%	90%	AFTRA by a hair	5	-0.5
Co-Pay	10	100	100	AFTRA by a mile	2	-4
Outpatient	90% first 10,000 then 100%	90%	90%	AFTRA by a hair	5	-0.5
Co-Pay	10	100	100	AFTRA	5	-5
Maternity Care	90% first 10,000 then 100%	100%	100%	SAG by a hair
Exam	80%	100%	100%	SAG	5	5
Deductible	0	0	0	EQUAL	0	0
Co-ins Out-of-Pocket Limit	20%	1,000	1,000	UND
Co-Ins Out-of-Pocket Limit Family	20% pp	2,000	2,000	UND
Out-of-Pocket Maximum	1,000	6,350 (includes hospital)	6,350 (includes hospital)	AFTRA	10	-5
Out-of-Pocket Maximum Family	1,000 pp	6,350 pp (12,700 max) (includes hospital)	6,350 pp (12,700 max) (includes hospital)	AFTRA
MENTAL HEALTH	AFTRA HR	SAG ONE	SAG TWO	Compared	Value	Points
Inpatient	100% after 100 copay for first 30 days	90%	90%	UND
Outpatient	100% after 10 copay pv for first 40 visits	90%	90%	AFTRA	3	-3
Deductible	0	150	150	AFTRA
Deductible Fam	0	300	300	AFTRA
DENTAL	AFTRA HR	SAG ONE	SAG TWO	Compared	Value	Points
Deductible	0	75	100	UND (SAG coverage offset deduct)
Deductible Fam	0	200	100 pp	UND (SAG coverage offset deduct)
Preventive	100%	100%	100%	EQUAL
Basic	NC	75%	60%	SAG	3	3
Major	NC	50%	50%	SAG	3	3
Maximum	1,000	2,500	1,000	SAG
Maximum family	1,000 pp (unlimited for under 19 yo)	Unlimited	Unlimited	SAG
VISION	AFTRA HR	SAG ONE	SAG TWO	Compared	Value	Points
Co-Pay	NC	10	NC	EQUAL
Exam	NC	100%	NC	EQUAL
Glasses	NC	20%	NC	EQUAL
Total					100	5.7

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.

aftra_hr_vs_sag_ph_comparison.numbers
File Size:	181 kb
File Type:	numbers

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aftra_hr_vs_sag_ph_comparison.xlsx
File Size:	494 kb
File Type:	xlsx

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