Affordable Care Act ("ACA") and how it affects your Flex Plan Participation

If you are covered by any type of group insurance (not just from the Flex Plan), there are no adverse affects of the ACA. If you have or are considering an Exchange or Individual Policy, please review the questions and answers below.

For a comparison of Flex Plan group coverage and an Exchange or Individual Policy please make sure to review: www.flexplan.com/aca-compare

Questions and Answers

Does the ACA affect me as a participant in the Flex Plan?

Only participants who choose to be covered by an individual policy (a policy that you obtain as an individual directly from an insurance company) or participants who elect coverage through one of the exchanges created by the ACA. Participants who are enrolled in "group" coverage under any of the Flex Plan insurance contracts, covered by their spouse, another employer or union's plan will not be affected.

If I am covered under "group" health insurance through the Flex Plan, my spouses employer, another employer or union's plan, will there be any changes for me?

No.

If I am covered by an individual or exchange policy, will I have access to my employer contributions posted PRIOR to 01/01/2014?

Participants may use account balances from employer contributions posted PRIOR TO 01/01/2014 for participant and dependent out-of-pocket medical expenses provided the participant has current insurance information (group, individual or exchange) on file with the Plan (Grandfathered Balance Rule). Individual and Exchange premiums incurred after 01/01/2014 cannot be reimbursed from any employer contributions.

If I am covered by an individual policy (one that I or my spouse purchased directly from an insurance company) will there be any changes to how I can use the Flex Plan?

Yes. The ACA requires that in order to use contributions made by your employer to the Flex Plan you must be enrolled in "group" health coverage. If you are not enrolled in a "group" health insurance plan, you will automatically be "opted-out". Employer contributions (if any) will continue to bank in your account and your account will continue to be subject to administrative fees. You will have access to the employer contributions when you resume "group" coverage. You cannot use employer contributions for reimbursement of premiums or reimbursement of out-of-pocket medical expenses when "opted-out" (not covered by "group" insurance).

If you are covered by an individual policy, effective 1/1/2016 you are no longer eligible to use voluntary pre-tax payroll withholdings for premium reimbursement. You cannot use the contributions made by your employer for premium reimbursement or reimbursement of out-of-pocket medical expenses.

If I enroll for coverage through one of the exchanges made available under the ACA, will there be any changes to how I can use the Flex Plan?

Yes. The ACA requires that in order to use contributions made by your employer to the Flex Plan you must be enrolled in "group" health coverage. If you are not enrolled in a "group" health insurance plan, you will automatically be "opted-out". Employer contributions (if any) will continue to bank in your account and your account will continue to be subject to administrative fees. You will have access to the employer contributions when you resume "group" insurance. You cannot use employer contributions for reimbursement of premiums or reimbursement of out-of-pocket medical expenses when "opted-out" (not covered by "group" insurance). In addition, you cannot use voluntary pre-tax payroll withholdings for reimbursement of premiums for coverage purchased through an exchange.

If I am covered by Medicare, will there be any changes for me?

No. You will still be able to be reimbursed for your Medicare and supplemental Medicare Premiums from your Flex Plan account as well as out-of-pocket medical expenses. Here is a link to the Medicare Q&A page regarding the ACA:

http://www.medicare.gov/about-us/affordable-care-act/affordable-care-act.html

If I am covered by VA (Veterans Administration), will there be any changes for me?

No. You will still be able to be reimbursed for out-of-pocket medical expenses. Here is a link to the Veterans Administrations Q&A page regarding the ACA:

http://www.va.gov/health/aca/FAQ.asp

If I'm covered under a group plan and my spouse and/or children are covered under an individual policy or a policy through an exchange, can I get reimbursed for their out-of-pocket medical expenses?

No. In this case you could get reimbursed for your out-of-pocket expenses, but not theirs. Reimbursement of out-of-pocket expenses is only available to participants and dependents covered by a group insurance plan. (See question below)

If I have an individual policy or an exchange policy, but my children are covered under my spouse's group plan (or they are covered by another group plan), can I get reimbursed for their out-of-pocket medical expenses?

Yes. In this case you could get reimbursed for their out-of-pocket expenses, but not yours. Reimbursement of out-of-pocket expenses is only available to participants and dependents covered by a group insurance plan. (See question above)

What happens to employer contributions if I'm enrolled under an individual or exchange policy?

They may be used for dental, vision or disability premiums (group or individual) or Flex Plan life insurance premiums (group only). Any unused employer contributions will roll-over to the next year, they are not lost.

If I have a balance of less than $500 and satisfy the requirements for reimbursement under the "no-qualify" rules, can I still be reimbursed for premiums and out-of pocket expenses?

No. In order for the Flex Plan to reimburse premiums or out-of-pocket expenses, you must be enrolled under a "group" health insurance plan. If you are not enrolled under a "group" insurance plan, you will be "opted-out". Your account will remain with the Flex Plan and will continue to be subject to administrative fees.

AFM MPIHP

Disclaimer: The information in the following FAQs (other than information about enrollment in and doctors participating in the Flex Plan) has not been independently verified by the Flex Plan, and the Flex Plan cannot guarantee its accuracy. In the event of any contradiction between the information below and the governing plan documents of the Motion Picture Industry Health Plan or the Flex Plan, those governing plan documents will be controlling.

What Does the "Transition" from the Motion Picture Industry Health Plan to the Flex Plan Mean?

Employer contributions for all hours worked on or after October 21, 2012 in Los Angeles County under the Theatrical and Television Motion Picture Agreements will be paid to the Flex Plan rather than to the Motion Picture Industry Health Plan (MPIHP). This will not affect your current eligibility under the MPIHP, which is based on employer contributions made to the MPIHP for work prior to October 21, 2012.

When Will I Lose My Eligibility for Coverage Under the MPIHP?

If you have accumulated 400 or more hours during each qualifying period through October 20, 2012, your coverage will continue at least through March 31, 2013. Your coverage may continue after that date depending on the banked hours that are credited to you under the MPIHP.

You can find out exactly when your eligibility for MPIHP coverage will end by calling the MPIHP's Eligibility Department at (818) 769-0007. Wait for the "Other Options" and press "1" (for Participants); then press "2" (for the Eligibility Dept). Tell the representative that your contributions will cease on October 21, 2012 and that you need to know when your eligibility under the MPIHP will end, both with and without taking into account banked hours.

Remember - your bank of hours is not automatic. You must complete and return the Notice of Ineligibility that will be sent to you by the MPIHP within the specified time period. If you do not apply for the Bank of Hours extension for the period in which you become ineligible by the required date, your banked hours will be canceled.

How do I Assure That There is No Lapse in Coverage for My Family and Me Once I Lose Eligibility for Coverage Under the MPIHP?

Once $100 in employer contributions are made to the Flex Plan, you will receive enrollment information from the Flex Plan. At that time, you will be eligible to enroll for the various benefits offered by the Flex Plan (medical, dental, vision, disability [a required benefit] and life insurance). If you are already covered under the MPIHP, you should still complete the enrollment process but need not select medical coverage: just be sure that you select the option "I Am Covered by Another Employer's or Union's Plan". You will need to contact the Flex Plan Member Services Department at 323/993-8888, option 1 about 30 days before your MPIHP coverage expires so that you can arrange for your medical coverage through the Flex Plan to begin when your MPIHP coverage ends.

If I am Currently Receiving COBRA Continuation Coverage Under the MPIHP Coverage, Will I be Affected by the Transition?

The MPIHP has advised that it will continue to provide COBRA coverage for the rest of the period during which you would otherwise be entitled to continue COBRA coverage, so long as you continue to pay the required premium and so long as you do not have a "cut-off event". Becoming eligible for coverage under another employer plan, including the Flex Plan, is a "cut-off event". If you want to stay on COBRA coverage as long as possible, you should go through the Flex Plan enrollment process but be sure to indicate that you are covered under another employer or union's plan.

Will I be Able to See the Same Doctors Once I am Covered Under the Flex Plan?

If your doctor participates in the networks of the Flex Plan group insurance providers, you may continue to use your same doctor. To see if your doctor participates in the contracts offered by the Flex Plan, please go to www.flexplan.com / Member / Insurance Options / I agree / California / Click on the provider you want to review / Provider Search. If you are currently using a Motion Picture & Television Fund Clinic, search for the provider you are seeing at the clinic to verify they are a participating provider. You may also check with the clinic. In most cases, the Prudent Buyer option will be the only option that will allow you to see providers at the Motion Picture Clinics. The Motion Picture & Television Hospital is not a participating provider in any network through the Flex Plan.

If I Have a Full Bank of Hours, Can I Stay on the MPIHP Plan? And for How Long?

You can stay on the MPIHP coverage until your eligibility ends.

If I am Covered Through December of This Year on MPIHP, But I Have Less than 400 Hours in My Bank, What Should I do to Avoid a Lapse in Coverage on January 1, 2013?

If you want to exhaust your MPIHP coverage, make sure that when you receive enrollment materials from the Flex Plan, you enroll and select the option "I am Covered by Another Employer's or Union's Plan". About 30 days before your MPIHP coverage expires, please contact the Flex Plan Member Services Department. You will be asked to submit documentation that your coverage through the MPIHP is terminating beyond your control and if you qualify for benefits through the Flex Plan you will be given the opportunity to enroll. For more information, please review the "How do I Qualify for the Flex Plan?" question in the "New Members" section.

What if I Have More Than 400 Banked Hours at MPIHP?

You could potentially be covered by the MPIHP for up to 12 months.

If I am Currently Paying COBRA for MPIHP Coverage, What Happens on the Date of Transition (October 21)?

You would be eligible to continue your COBRA coverage until it terminates.

How Will the Voluntary Contribution from My Secondary Markets Check Work?

The Secondary Markets Fund and the Flex Plan are working together to implement a program under which individuals can elect to have a portion of their annual distribution, beginning with the annual distribution otherwise payable in July 2013, converted to an additional contribution to the Flex Plan. Voluntary contributions cannot be used for coverage through your spouse's employer or coverage through another employer or union's plan. Further, voluntary contributions may not be used for reimbursement of out-of-pocket medical expenses. We will provide more details about this program in coming months.

Can Employee Additional Contributions to the Flex Plan from My Secondary Markets Check be Used to Pay the Additional Premium a Spouse Pays to Add Their Spouse to Their Plan?

No, contributions from the Secondary Markets Fund are voluntary. Voluntary contributions may only be used for coverage under the Flex Plan Group Insurance Contracts or an Individual Policy (a policy you secure directly from an insurance company). Voluntary contributions cannot be used for coverage through your spouse's employer or coverage through another employer or union's plan. Further, voluntary contributions may not be used for reimbursement of out-of-pocket medical expenses.

When Will We be Getting More Info from the Flex Plan Regarding all of the Important Dates? (When We Must Notify Them of Existing Coverage, When We Can Elect to Have Secondary Markets Additional Contributions to the Flex Account Made, etc)

Answer Pending

Can I Reallocate Contributions Sent to the Local 47 Plan to the Flex Plan?

No, contributions made to the Local 47 Plan may not be re-allocated to the Flex Plan.

Do I Need to Change My Corporate Invoices to Reflect the Change to the Flex Plan?

Yes, you should update all of your invoices to properly reflect the Flex Plan name and address for purposes of payments.

New Members

Why am I receiving information from the Flex Plan?

You worked under a Collective Bargaining Agreement (CBA) which is an agreement between an Employer you worked for and a Union who participates in the Flex Plan. The CBA requires the employer to make payments to the plan on your behalf towards medical benefits whether you are a union member or not. The amounts paid to the Flex Plan are not a deduction from your check but an amount over and above your wage. Also, the payments made to the Flex Plan are not subject to income tax.

How do I qualify for the Flex Plan?

Once you have received approximately $100 (a posted account balance of $62.50 after fees have been collected, see "What fees are assessed against my account?") in contributions through work under Collective Bargaining Agreements (CBAs) that pay in to the Flex Plan you will have the opportunity to enroll.

What fees are assessed against my account?

A one-time (lifetime) enrollment fee of $25.00 is assessed against your account once you qualify for benefits. A quarterly administration fee of $14.50 is assessed against any account with a balance. If there are not sufficient funds to collect the fee, it is not carried forward. Members who elect electronic delivery of their account information receive an administrative fee discount of $2.00 per quarter. For more information on fees, please refer to the "Administration Fees" section of the Flex Plan Summary Plan Description (SPD).

What will the Flex Plan cost me?

Your cost will vary depending on many factors, such as whether you select Single Coverage versus Two-Party, Member Child(ren) or Family Coverage as well as the options you select (medical, dental, vision, life insurance and disability coverage).

Do I have to enroll in the Flex Plan? Even if I have access to better or cheaper health coverage?

Yes, it is important that you go through the enrollment process even if you have coverage from another source such as an individual policy, coverage from your spouse or coverage from another employer or union's plan. If you have coverage from a source other than the Flex Plan, you will be sent verification forms which must be completed to avoid automatic enrollment under the Flex Plan group insurance contract. When you enroll, you may also elect dental, vision, disability (a required benefit) and life insurance. Please note that during your first enrollment in the Plan, if you elect life insurance, you are guaranteed the $20,000 benefit regardless of pre-existing medical conditions. If you do not enroll or waive life insurance coverage during your intitial enrollment, later enrollment will be subject to medical underwriting and approval. You could be declined for coverage at a later date.

How do I go about shopping for health coverage outside of the options provided by the flex plan?

You would go to the open market as you would for any other insurance plan. If you have an insurance agent you are comfortable with, that would be a good place to start. You can also use the internet to do competative comparisons of the providers in your area. It is important, however, to carefully review the benefits offered through the Flex Plan to the benefits offered through an individual plan as well as their costs.

Will my dependents (spouse, partner, children, others) be covered?

Once you qualify to enroll under the Flex Plan you may enroll your dependents(if applicable). You must be enrolled under the group insurance benefits if you would like to add your dependents for insurance coverage. If you are enrolling a domestic partner, please request a copy of the Domestic Partner Policy and Instructions.

How do I maintain coverage?

By either having sufficient employer contributions to cover the cost of your insurance coverage or making self-payments to the Flex Plan for the difference between the cost of your coverage and your account balance.

Can I "Self-Pay" a portion of my Flex Plan Premiums?

Once you qualify for benefits under the plan, you may "Self-Pay" on a monthly basis the difference between your account balance and the cost of your insurance elections. Payments are always due the last day of the month for the upcoming month. To ensure your coverage does not lapse, consider signing up for automatic payments. For more information on "Self-Payments", COBRA and CAL-COBRA, please refer to the Summary Plan Description (SPD).

If I travel, will I be covered under the Flex Plan Internationally?

Call the insurance provider customer service telephone number listed on your ID card or on our website (for Flex Plan Group Insurance Contracts) to find out what coverage may be available to you. Coverage varies by the insurance provider.