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AFTRA vs SAG: A Comparison of Health Plan Benefits

2/15/2015

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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.
Picture




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
Download File

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

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    Luke David Johnson

    I write stuff I think the internet is missing.