Every eligible participant has the opportunity to select from either OPTION A or OPTION B.

Every eligible participant has the opportunity to select from either OPTION A or OPTION B.

These descriptions are SUMMARIES ONLY. For more complete information, please consult your Summary Plan Description, or contact the Contract Affairs Funds Liaison at (212) 391-1070 ext. 242 or (800) 317-9373. You may also contact the Fund’s Third Party Administrator, Zenith American Solutions at (201) 947-8000. Email us at Health@SDCweb.org.


OPTION A

This option offers a health insurance plan, designed to provide comprehensive medical and hospital coverage.

Coverage is provided through Aetna Managed Choice in all areas of the country except California. If you live in California, coverage is provided through Kaiser Permanente.

Participant Contributions are charged for participation under Option A.  For individual coverage you will be charged 15% of the actual cost of the underlying premiums.  Family coverage is available for the full cost of the family portion of the premium, plus 15% of the cost of the individual premium.

OPTION B

This option offers a $2,200 semi-annual ($4,400 annual maximum with continuing eligibility) medical spending account. This option is intended for participants who are already covered under another health insurance plan.  Certification of employer-sponsored group health insurance is required.  It is not intended as a replacement for 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, most 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. It does not include premiums you pay for individual coverage purchased on the Affordable Care Act Marketplace or through Medicare. A complete listing of reimbursable expenses is outlined in IRS publication 502 (for a copy, contact the Fund office: Health@SDCweb.org, or go to www.IRS.gov).

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 documentation of other insurance coverage.

Once you are eligible, there is no charge to participate in Option B.