$100.00 Quarterly Premium for Health Plan

Despite our best efforts to keep spiraling medical costs under control, deficits are still projected for the Fund in the up and coming years. The Board of Trustees faced a very tough set of choices: reduce coverage, further tighten the Fund’s eligibility rules, or require contributions. We chose the latter, because it’s expected to have the least overall impact on members. We resisted making this change as long as we could, but we cannot put it off any longer— not if we want to safeguard the long-term viability of the Fund. Therefore all Health Fund participants covered by employment are to contribute $100 per calendar quarter for their medical/vision coverage.

Please know that the Board of Trustees did not make this decision lightly. We appreciate that most of our members are on tight budgets and cannot easily come up with $400 a year. We analyzed and debated and considered our options, trying to figure out the approach that would get us the biggest budgetary bang for the buck. After thorough deliberation, we determined that adding a contribution requirement made the most impact on the Fund’s finances while making the least impact on yours. It strikes the best balance between the Fund’s budgetary needs and those of our members. (FYI, if we were to change coverage or eligibility rules to have a similar bottom-line impact, we would have had to increase medical copays by 20% or require two extra weeks of covered employment to qualify for coverage.)

Even though you will have to pay the $100.00 per quarter, there will be more options for electing your health coverage. Because you must pay for coverage each quarter, each quarter you get to decide whether or not you want it. Since you will no longer automatically get coverage as soon as you qualify for it, the rules that went along with automatic coverage—such as the one that locked you into six months of coverage as soon as you qualified for it, whether you wanted it or not—will no longer apply. This means you will be able to “save” weeks to get 12 months of coverage, or choose when you want your Health Fund coverage to start—flexibility that you don’t have today. See the current eligibility, for more information about the more relaxed eligibility rules.

About two-and-a-half months before each calendar quarter begins, the Fund Office will send an election notice to every member who qualifies for coverage beginning in the next calendar quarter (members who are already covered and whose coverage is scheduled to continue into the next quarter will simply receive an invoice, not an election form). The election notice will show you how many “benefit credits” (weeks of covered employment) you earned in the prior Accrual Period and, as a result, that you qualify for six or 12 months of coverage starting on the first day of the next quarter. The next step is up to you:

• If you already have coverage and it’s scheduled to continue, simply return your billing invoice with your $100 contribution (along with any self-pay contributions you may make).
• If you’re newly eligible for coverage and want it to start in the next quarter, indicate that you want coverage and return the billing invoice with your $100 contribution (along with any self-pay contributions you may make).
• If you’re newly eligible for coverage and don’t want it to start in the next quarter, do nothing. If you don’t want coverage, don’t send a payment.

To allow time for election processing and administration, your contribution payment will be due a month in advance. The payment for coverage that starts on January 1 is due on the preceding December 1; coverage that starts on April 1 is due on the preceding March 1; and so on. If you do not pay on time, your coverage will terminate as of the last day of the month in which payment is due—even if you originally qualified for coverage beyond that date. For example, to have Health Fund coverage start on April 1, 2010, you must submit your $100 contribution by March 1, 2010. If you don’t, your last day of coverage will be March 31, 2010. Here is a handy table of the due dates for $100 quarterly premium.

Payment Due Date	Benefit Period Start Date
December 1	January 1
March 1	April 1
June 1	July 1
September 1	October 1

You can also pay the full premium all at once when your coverage first begins: $200 for 6 months or $400 for 12 months of coverage. This will guarantee your coverage to be in effect without interruptions throughout the entire Benefit Period.

Please note that the $100 contribution applies only to participant coverage earned through covered employment, and is in addition to contributions required for any dependent coverage you elect. In other words, if you cover yourself only you pay $100 a quarter; if you cover yourself and your eligible dependents you pay $100 a quarter PLUS the cost of dependent coverage. On the other hand, for COBRA coverage, Vested Beyond COBRA coverage, Medicare Supplemental coverage and dental coverage, you pay only the applicable costs for coverage— not the $100 contribution. Also note that as long as you qualify for Health Fund coverage, you may elect self-pay dental coverage even if you don’t elect to pay the quarterly contribution for medical/vision coverage. (In this case, you would pay the applicable costs of dental coverage even though you would not be paying the $100 contribution for medical/vision coverage).

DON’T LOSE YOUR OPPORTUNITY FOR HEALTH COVERAGE!

Tragically, nearly every day we see members lose their health coverage (or fail to take advantage of eligibility for it), because they miss a premium payment or enrollment deadline. Remember that the Fund Office cannot accept late premium payments – late payments cannot be remedied by paying interest or a penalty. If you fail to pay your premiums on a timely basis, the coverage you had will end (or coverage you qualified for will not be activated). To avoid this there are two “drop dead” payment deadlines to remember – end of the quarter for your $100 contribution (March 31, June 30, September 30 and December 31) and the end of the month (e.g. January 31 for a premium due on January 1) for all other premium payments.

We provide payment and eligibility reminders for most coverage via regular mail, e-mail and text messages – if we have your accurate contact information (COBRA coverage is an exception because by law, all notices need to be sent via regular mail). You can assure that we have accurate information via an e-mail to health@equityleague.org, or over the phone at (212) 869-9380 (press 1 for health to speak with a Health Fund representative). If your regular and e-mail information is up-to-date and you would like to receive text messages as well, please e-mail textme@equityleague.org and include your cell phone number and AEA membership number (your standard text messaging rates may apply). Please keep us updated so we can update you!

If you have any questions, please feel free to contact the Fund Office for assistance.