Opponents of the looming SAG-AFTRA Health Plan cuts have hit back at SAG-AFTRA over the leadership’s accusations that the opponents are spreading “misinformation and fear.”
“They insist that the truth is paramount. We agree. Let us guide you through the five misleading points put forth,” the group said.
The conflicting messages came in the wake of a federal class-action suit, with 91-year-old Ed Asner as lead plaintiff. The action, filed Dec. 1, sued the health plan and its trustees, estimating that the plan changes — announced in August to go into effect in January — will eliminate coverage for 11,750 of 32,000 participants, including 8,200 seniors. The suit alleges two counts of breach of fiduciary duty, one count of engaging in a prohibited transaction and one count of failing to disclose information material to plan participants. The SAG-AFTRA Plan has said the suit is without merit.
In its message, the SOS Health Plan disputed the union’s assertion that trustees had no other options except to cut services and eligibility: “There were options: Direct more money into the Health Plan through recent Contract Negotiations. (2019 Commercials, 2019 Netflix and 2020 TV/Theatrical); Change the premium structure; Add a new option with a higher earnings threshold; Use our reserves for their intended purpose: To mitigate the consequences of an emergency, in this case, the Pandemic.”
The opponents also took issue with the union’s assertion that “Senior Performers are not losing their healthcare coverage; they will continue to have Medicare as their primary insurance, as they do today.”
SOS Health Plan said in response, “Seniors absolutely will be losing their SAG-AFTRA Healthcare coverage,” and noted that it was “a decades-old legacy SAG benefit and SAG-AFTRA benefit upon which seniors based their retirement, which assured life-long secondary health coverage for participants and their spouses over 65 with 20 or more pension credits,” which has now been eliminated.
“Despite being provided with a Health Reimbursement Account Stipend, members over 65 with Medicare as their primary insurance will be forced to choose a secondary plan from the marketplace that may not be comparable in coverage or price to the SAG-AFTRA coverage,” SOS Health Plan said. “Senior performers over 65 taking their pension will now be in grave danger of losing their SAG-AFTRA primary Health coverage because their residuals will no longer count as credited earnings. Senior performers will now only be able to use their sessional earnings to qualify. That current qualifying threshold is $25,950.”
SOS Health Plan disputed the union’s assertion that “Spouses aren’t getting “kicked off” the plan: “Spouses are getting ‘kicked off” the plan,” the group said. “If a spouse’s employer offers health insurance, that spouse must take that plan as primary, even if it’s more expensive and has inferior benefits. Spouses of living participants over 65 with 20 or more pension credits will be losing their SAG-AFTRA secondary insurance, along with the actual participant.”
“Members with 20 or more pension credits were promised their widowed spouses would have lifetime SAG-AFTRA secondary health coverage at 65, until remarriage or demise,” SOS Health Plan said. “That promise has been broken. Spouses over 65 also are losing their SAG-AFTRA primary coverage when their participant spouse loses coverage because residuals are no longer credited.”
SOS Health Plan also criticized the reduced cost COBRA safety net available specifically designed to help ease the transition for many participants, saying the coverage costs between 54% (for an individual) and 213% (for a family with two or more dependents) more than the previous Plan II coverage.
The union insisted in its Dec. 4 message that the trustees had no other choice except to make the cuts: “The idea that premium increases or higher employer contributions alone could have fixed the Health Plan is simply wrong. The root of the problem is the exorbitant cost of healthcare — a problem made worse by our industry’s production shutdown due to the pandemic crisis. The cost of healthcare remains a top issue for Americans, and the SAG-AFTRA Health Plan is not immune from this and other economic forces. Structural changes were required to put the Plan on a secure footing now and into the future.”
In response, SOS Health Plan said, “In their email, SAG-AFTRA conflates sound observations with utterly misleading assertions. We agree that healthcare costs and the industry shutdown are massive problems. But, the root of this plan’s problems is poor management.”
Asner’s suit asserts that the SAG-AFTRA Health Plan Trustees knew soon after the SAG and AFTRA health plans merged in 2017 that the health benefit structure was not sustainable.
“What has led to ‘anger and frustration’ are the draconian changes that harmed thousands of Participants,” SOS Health Plan said. “In 2017 SAG and AFTRA Health Plan Participants were assured the new SAG-AFTRA Health Plan would ‘be financially sustainable for all members for years to come’ and merging the Plans would ‘strengthen the overall financial health of the Plan while ensuring comprehensive benefits for ALL Participants.'”