OVERVIEW
For every hour worked for a signatory employer, a contribution is paid into a fund to provide direct benefits to you. These payments are a personal benefit on which you do not pay income tax. Each employer pays an hourly amount towards healthcare, a percentage into an retirement annuity, and a daily rate towards a retirement pension.
Membership in the Union is not required to receive these benefits. Employer contributions are made for all technicians on the referral list who work under IATSE 119’s Collective Bargaining Agreement (CBA).
The IATSE oversees these benefits through the National Benefits Fund (NBF). The NBF administers the funds IATSE 119 technicians contribute. All available information can be found at www.iatsenbf.org. All questions or problems concerning these benefits should be directed to the NBF at 1-800-456-FUND (3863).
It is each referent’s responsibility to inform the NBF office of any change in your contact information or family status. If you move, change your marital status, or change your name, you must inform the NBF. Your employer or IATSE 119 cannot do this for you.
The information below is a brief overview of how the health insurance plan works. A much more complete explanation of the provisions can be found at www.iatsenbf.org.
HEALTH INSURANCE
Each hour you work, your employer contributes directly into an account to pay for healthcare premiums. The account into which funds are known as a Contributions Against Premium Payments (CAPP) account. After the first $100, which is retained by the NBF as the administrative costs of setting up your account, the funds are held for your exclusive benefit to pay for health insurance premiums and other health care expenses.
The NBF offers four levels of health care as well as a medical reimbursement plan for those participants who have existing coverage. Each plan has a quarterly cost to participate.
There are four levels of health care coverage as well as a medical reimbursement plan. The four levels coverage are plans C-1, C-2, C-3, C-4, which align with the Affordable Care Act Platinum, Gold, Silver, and Bronze plans. Within each option there is an Individual Plan and a Family Plan. Please refer to the www.iatsenbf.org for more information on these plans.
Health insurance premiums are due quarterly – on the 15th day of the month before the next quarter. Based on the level of your CAPP account, you will have to pay the difference between your CAPP balance and the premium to maintain coverage. If your CAPP account has sufficient funds to cover the premium, you pay nothing.
You will qualify for voluntary participation in the plan when there is an accumulation in your CAPP account great enough to pay the premium for one month of health insurance under NBF Plan C-2 Individual.
AUTOMATIC ENROLLMENT
Once there is an accumulation in your CAPP account great enough to pay the premium for one quarter of health insurance under NBF Plan C-2 Individual plan, you will receive a letter from the NBF. You will be enrolled in the Health Insurance plan automatically if you do not reply to that letter and show that you already have health insurance coverage. Funds will be deducted each quarter from your CAPP account to pay the premium.
Once you are enrolled, if you do not have enough balance in your CAPP account to pay the quarterly premium, you must pay the difference. If you do not pay the premium, coverage will lapse due to non-payment, and you will not have access to the health insurance plan until you meet the criteria for re-enrollment for coverage. Re-enrollment is more difficult than initial qualification.
IF YOU ALREADY HAVE HEALTH CARE INSURANCE
If you already have health insurance, you must reply to the initial enrollment letter and show that you already have health coverage so that you will not be enrolled in the health insurance plan automatically. You must then enroll in the medical reimbursement plan (MRP). Your CAPP account funds can be used to reimburse you for any legitimate healthcare insurance premiums, co-pays for office visits, or prescriptions. Most legitimate medical costs you pay that are not covered by your existing insurance may also be turned in for reimbursement. There are rules to follow and restrictions to observe, as with any plan, so be sure to coordinate with the NBF office.
STAYING QUALIFIED
To remain qualified to stay enrolled in the plan, one must work for a signatory employer frequently enough for the employer to contribute an amount equal to one quarter’s premium under the C-2 Individual Plan over a 24-month period. If you do not work at least this much for a contracted employer, you will become ineligible for the IATSE Health Insurance plan.
PAY PREMIUMS PROMPTLY
The National Benefits Fund’s rules are quite rigid in regard to the timely payment of premiums. Individuals can lose their coverage because of late payments. This is a severe penalty, usually causing a lapse of coverage for which re-enrollment qualification is required. For convenience, the NBF does accept credit card payments. Premium payments can be made online. Enrollment in the online account can take a few days, so plan ahead and please don’t wait until the last day.
RE-ENROLLING AFTER CANCELLATION FOR NON-PAYMENT OF PREMIUMS
If your NBF Health Insurance coverage lapses, you will not be eligible to re-enroll until the balance in your CAPP account equals the monthly charge for C-3 single coverage plus an administrative fee of $150. This is very likely to happen if you don’t respond to mail from the NBF.
IMPORTANT: If YOU IGNORE MAILINGS FROM THE NATIONAL BENEFITS FUND, YOU STAND TO LOSE ACCESS TO GROUP HEALTH INSURANCE AND/OR SOME OR ALL OF THE BALANCE IN YOUR CAPP ACCOUNT. Set calendar reminders online and on your phone so you do not miss these deadlines.
LOSS OF CAPP ACCOUNT FUNDS
Referents who do not participate in the IATSE Health Care Plan can see their CAPP account accumulate, sometimes to a very high balance. For CAPP accounts in which there is no activity, employer contributions more than two years old will be deducted. Failure to act can cost you money.
COBRA COVERAGE
If for any reason you can no longer be enrolled in the IATSE Health Plan, you can continue to have insurance coverage under provisions of COBRA. You can retain coverage under this plan for at least 18 months after you become disqualified and/or dropped for any reason. The premiums will be significantly higher – more than double – and there are other restrictions, but this could be a useful avenue during a time of qualification for re-enrollment or for a time of transition to another health insurance plan altogether. Please visit www.iatsenbf.org for more information.