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Your Health Plan Options
Every eligible participant has the opportunity to select from
either
OPTION A or OPTION B. |
OPTION A
This option offers a health insurance plan, designed to provide
comprehensive medical and hospital coverage. There is also a
comprehensive dental plan.
If you live in New York, New Jersey, or Connecticut, coverage is
provided through Oxford Health Plans. If you live in California,
coverage is provided through Kaiser Permanente.
If you live outside the Oxford or Kaiser service areas, you may purchase
coverage through an insurance company of your own choosing. The Fund
will then reimburse you for the actual cost of your premiums (not to
exceed the cost of the premiums paid for Oxford or Kaiser participants).
There is a $150 semi-annual enrollment fee for Option A.
The semi-annual enrollment fee for family coverage is $300.
SSDC-League Health Plan
Summary Plan Description |
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OPTION B
This option offers a $2,200 semi-annual ($4,400 annual maximum with
continuing eligibility) medical spending account. This option is
intended primarily for participants who are already covered under
another health insurance plan. It is not intended as a replacement for
basic health insurance, but was created to supplement the health
coverage of eligible participants who may fall into one or more of the
following categories:
• Qualified participant in another multi-employer health plan (DGA, AEA,
SAG, etc.)
• Artistic or staff director covered by a theatre’s health plan
• Faculty member covered by a college’s or
university’s health plan
• Qualified participant covered by a spouse’s
or domestic partner’s health plan
• Free-lance director or choreographer qualified under a non-theatrical
employer’s company health plan
Option B provides reimbursement for expenses typically not covered under
many plans, including dental, chiropractic, optical and mental health.
In addition, any other legitimate medical expense that the IRS qualifies
as deductible on your personal income taxes may be submitted for
reimbursement under Option B. This includes any deductibles or
co-payments you may have under another health plan. A complete listing
of reimbursable expenses is outlined in IRS publication 502 (for a copy,
contact the Fund office: Health@ssdc.org).
If you elect Option B, reimbursements will be paid upon presentation of
a receipt showing the name and address of the provider, the date of
service, the service performed and, when appropriate, documentation of
other insurance coverage.
Option B Claim Form
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