Extended Coverage

Disability Extension

A Disabled Writer:

• After completing and returning all required  disability application forms, including a physician's statement, and being deemed eligible for disability extension of coverage, the totally disabled participant and their covered dependents are entitled to full medical benefits for 6-months from the date coverage ends.
• If at the end of the 6-month extension the participantAn individual or that individual's spouse, dependent children who meet(s) the eligibility requirements established by the Fund. is still disabled, he/she will be entitled an additional 12-months of "comprehensive medical coverage" (out-patient medical and prescription benefits only). Dependents are not eligible for this 12-month extension; however they will be offered COBRAThe acronym for the Consolidated Omnibus Budget Reconciliation Act of 1985 which allows for the purchase of coverage after loss of eligibility due to certain qualifying events. Continuation coverage and the COBRA entitlement will be offset by 6-months (the period they were covered under the writers original disability extension).
• COBRA will be offered to the participant after the 1^st 6-month extension of coverage and if elected, the COBRA entitlement will be offset by the 6-months, however if they apply for the additional 12-month "comprehensive coverage disability extension", COBRA will not be offered after the 18-month extension of coverage (6-months "full coverage" & 6-months "comprehensive coverage").

A Disabled Spouse:

• If at the time coverage ends, the covered spouse is totally disabled, the spouse will be offered 12-months of "comprehensive medical coverage" (out-patient medical and prescription benefits only) or COBRA.
• If the 12-month extension is elected, no COBRA will be offered.

A Disabled Child:

• If at the time coverage ends, a dependent child is totally disabled, the child will be offered 12-months of "comprehensive medical coverage" (out-patient medical and prescription benefits only) or COBRA.
• If the 12-month extension is elected, no COBRA will be offered.

Permanently Disabled Dependent Children

• If a dependent child qualifies as "permanently disabled" by the Fund (as defined in the Your Eligible Dependents section), the dependent child will be entitled to coverage as long as the writer is covered under the Fund, and claims will be based upon the plan of benefits the writer elects. If the writer has a break in plan coverage, and then regains earned coverage at a later date, the permanently disabled child's coverage would resume. Recertification of total disability is required every two years.

* Dependent premium tax payments may still be required.

Extended Coverage Program

Beginning April 1, 2000 Writers were credited with points for each year of regular, employer-paid eligibility commencing on and after January 1, 1990. Writers are able to accumulate up to a maximum of fifty (50) points. Under this program, the Health Plan awards points for a Writer's past and future participation. Since 2014, writers have been able to earn up to three Extended Coverage Points per year, with the first point accrued upon qualifying for coverage, the second and third points different levels of covered compensation.

Starting January 1, 2027, the first Extended Coverage Point will be earned at $200,000 in annual earnings, and the second point will be earned once earnings reach the compensation cap for screen, which will be $325,000 on January 1, 2027, and will increase along with the negotiated increases to screen caps.

If a Writer loses eligibility due to failure to earn sufficient compensation within his or her earnings cycle, or due to non-payment of premium and has accumulated at least 10 points at any time, the Writer will automatically be placed in the Extended Coverage Program and will be notified of such. Please note that a premium is still required if using Extended Coverage points as of January 1, 2027.

After January 1, 2027, Extended Coverage under the Anthem PPO plan will cost 4 points per quarter, while Extended Coverage under the new Centivo plan option will cost 2.5 points per quarter. Writers who do not have enough points for a final quarter of coverage will be provided with a point subsidy up to 1 point. If Anthem PPO is elected, you must have a minimum balance of 3 points to receive the subsidy. If Centivo is elected, you must have a minimum balance of 1.5 points to receive the subsidy. The maximum amount of ECP points that a participant can accrue is 50.

For each quarter that a participant receives benefits under this program, the applicable number of points will be deducted from their point balance. This process will continue until:

1. The participant regains employer-paid eligibility; or,
2. The participant retires under the Producer-Writers Guild of America Pension Plan as a Certified Retiree; or
3. There are an insufficient number of points available for continuation in the program.

Excess Earnings Extension

Health Fund coverage will be provided for an additional year to certain Writers who earn $250,000 or more in gross covered compensation in one earnings cycle, but who would otherwise lose coverage because they did not earn enough compensation in the next earnings cycle to be eligible. To provide this additional eligibility, the earnings of $250,000 in compensation shall be deemed allocated equally between each of two consecutive earnings cycles. This extension of coverage is done systematically and no action is required from the Writer.

Excess Earnings Extension with regards to bona fide two-person writing teams

The benefit described in the above paragraph will be extended to cover bona fide, two-person writing teams that meet the same earnings criteria for eligibility cycles beginning on and after January 1, 2005. Only income earned as part of the team will be considered. This is not an automatic extension. If you feel you qualify for this extension, please contact the Eligibility Department of the Fund office.

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