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HERE'S TO YOUR HEALTH - A Guide To PGA Health Care Options

Posted By Harvey Wilson, Tuesday, August 8, 2017

Years before health care became a central topic in the halls of Congress, it was a central issue for PGA members. To this day, its still the number one request from the membership—the Holy Grail of benefits.

In a perfect PGA world, the Guild would be able to offer guaranteed access to affordable health insurance to all of its members. And while we havent yet reached that goal, the Producers Guild has continuously expanded the health care options it does afford its members. Because so much has changed over the past few years, we wanted to offer a brief rundown of the health benefits that members can obtain through the Guild. Obviously the nature and scope of American health care is a moving target these days, and members should be on the lookout for new announcements in addition to relying on the information provided here.

 

EMPLOYER-PAID HEALTH COVERAGE

Its true—a significant number of PGA members qualify for employer-paid health coverage. The parameters for eligibility are narrower than wed like, but we encourage all members who qualify for this benefit to take advantage of it.

First, some history. For a brief period, 1977-1983, the PGA was a bona fide labor union, enjoying collectively negotiated labor agreements at two studios, Paramount and Universal. When the PGA was decertified as a labor union by the National Labor Relations Board, those labor agreements became void. Despite that unfortunate outcome, all parties recognized the importance of maintaining health coverage for producers. The result was something called the Non-Affiliate Agreement, negotiated jointly by IATSE, the AMPTP and the Producers Guild.

The Non-Affiliate Agreement allows some producers to receive coverage through the Motion Picture Industry Plan, as administered by the IA—but only under certain conditions:

  • The individual must be credited as a Producer, Executive Producer or Associate Producer.
  • The individual must work for an AMPTP-signatory company.
  • The individual must be working on a theatrical motion picture, primetime network program, or primetime narrative first-run syndicated program.
  • The individual must work on a production utilizing a west coast IA crew, and
  • The individual must have worked 600 hours (The Non-Affiliate Agreement was negotiated to presume producers work a 60-hour workweek.) over the last six months.

If these conditions are met, that producer is likely eligible for employer-paid coverage under the Non-Affiliate Agreement.

Note that this coverage does not simply begin automatically; the producer must personally request that the production make payments on their behalf. And while productions are not compelled to make those contributions, most of them will. After all, a producer whos not constantly stressed out about being sick is a producer whos going to deliver more value to the production.

Producers request contributions by signing and submitting a participation form (Election to Participate in the Motion Picture Industry Health Plan) within 60 days of starting eligible employment. If the producer does not submit a signed participation form, they may be deemed to have waived their right to contributions with respect to the job. Participation forms should be provided by the employer upon request. If you have difficulty obtaining a form, or if the production seems unwilling to make contributions on your behalf, contact the Guilds National Executive Director/COO Vance Van Petten, and the PGA will seek to assist you in straightening the matter out.

A few notes to bear in mind: First, standard practice has dictated (though not required) that once a production has begun making contributions on behalf of one producer, it will make similar contributions for any eligible producer employed by the production, provided coverage is requested in a timely fashion. Second, employees of non-AMPTP signatory companies are eligible to provide coverage, if the company in question is a signatory to both the IATSE Basic Agreement and the Motion Picture Industry Health Plan. Coverage requests made to such companies can be more difficult to secure. A good way to know if your production has signed on to the IATSE Basic Agreement is to check if the camera, grips, or sound providers are members of the West Coast IA.

 

SELF-PAID HEALTH COVERAGE

For those members who are ineligible for employer-paid coverage, the Guild has developed and tapped into some viable options.

First question: Do you have a company that is a C-corp, an S-corp or an LLC, which is more than a sole proprietorship? Do you pay others, and is your company seen as a separate entity from yourself for tax purposes? (That is, if you have an LLC, do you file a separate tax return for that entity?) Even if you dont run such a company, is it possible that you could form one? All it requires is two employees, one of whom could be yourself.

If the answer to one or more of those questions is yes, then we recommend the OpenHealth Entertainment Trust MEWA (Multiple Employer Welfare Association). OpenHealth is a relatively new player in the health care sphere, a group whose plans are derived from the health care offerings of the Cast & Crew payroll service. MEWAs are set up so that small companies can benefit from the price breaks afforded to large organizations, and large organizations can benefit from the more stable pricing that comes with an even larger pool of policies. OpenHealth has two different MEWA offerings: one for staff members and the other for projects. The company is an independent operation, which does not require you to payroll through Cast & Crew. If you run your own company, we strongly urge you to check the MEWA options available at www.cc-openhealth.com.

If youre simply an individual or single family looking for coverage, we urge you to do your own research and find the best option for you and your family. One way to see those options is to consult with the Actors Fund (www.actorsfund.org). Dont be put off by the name; its not just for actors. With offices in New York, LA and Chicago, it is the official organization representing the Affordable Care Act to the entertainment industry. If you are looking for medical care, the Friedman Health Center for the Performing Arts has recently opened in their headquarters in New York City. If you have ACA marketplace questions, contact the Actors Fund to make an appointment for them to walk you through the marketplace or join their weekly seminars offered in New York, CA and Burbank on finding the best health care options.

At the Producers Guild, we are hopefully on the doorstep of securing a plan for our individual members (and their families), which will be competitive with the open market as well as state and federal marketplaces. What we are seeking is a guaranteed accessplan that any member would be eligible for as long as they are in good standing (current on dues) with the Guild. The more members we get to sign up for a plan, the more stable the premiums will remain. Our goal is to cover at least 1,000 people including members and their families. With a national membership now exceeding 8,000, this should be within reach.

Whatever you do, do something. Everyone should have some form of health care; nobody is invincible. 95% of Americans spend less than $1,000 per year on health services but one bad day can change all of that. A car accident or even a simple bug bite can send you to an emergency room and amass thousands of dollars in expenses that would eclipse years of paying into the health care system. Dont be that person. As producers, we need to be prepared for any eventuality on set—make sure you bring that level of preparedness to your home and family life as well. 


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UNIONS, PROFESSIONAL ASSOCIATIONS AND ACCESS

The PGA is not a union, but a professional association. That distinction is critical in understanding our limitations with regard to heath care.

A union represents its constituents in collective bargaining agreements and receives pension, health and welfare payments from the employers of the members, as well as a percentage of its members’ salaries. Those funds are pooled to provide benefits for all of the working members of that union.

As an association, the PGA collects a relatively small amount of dues that are voluntarily paid by the membership once a year, but the Guild neither receives money from employers nor takes a percentage of member salaries. As producers are considered a “management” position as defined by the National Labor Relations Board, the PGA is ineligible to become a union. Thus, the Guild cannot engage in collective bargaining that would provide su icient leverage to collect the funds for a Guild-wide guaranteed health plan.

The insurance industry has labeled associations such as the PGA with the ominous designation of having “adverse selection.” In a union or company, all employees are covered regardless of age or health. But among association members, those who are young and healthy are more likely to purchase a low-cost, high-risk plan on the open market. Those who will voluntarily buy a more comprehensive plan through the association are those who are most likely to use it often (i.e., older or sicker mem- bers)—thus costing its underwriters more. That in turn causes the rates to rise among that group, which in turn drives healthier members to look for more cost-e ective options, causing the rates to rise even more, continuing in an upward “death spiral.” (Those who have followed the ongoing health care negotiations in Congress have seen politicians debate the viability of “high-risk pools,” a broader variation on this same dynamic.)

So how do we overcome “adverse selection?” In a word: VOLUME. There must be enough people—healthy and sick, alike—buying into the group plan to overcome market fluctuations and balance out the fraction of members who will become heavier users of the policies. Fortunately, the PGA has continued to grow at a rapid pace. Coupled with the unfortunate collapse of more reasonably-priced options in the individual insurance marketplace, the PGA’s growing membership is gradually making the Guild a desirable market for underwriters. 

 

 

- additional text provided by Chris Green

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