News

Out-of-Network claims (OON) often result in reams of paperwork and multiple forms that have to be filled out precisely. If an item is inadvertently left blank, or if additional information is needed, letters go back and forth. It can take months to get a single transaction completed. We’ve been working with our providers to improve the process, and you can now handle OON claims electronically.

Out of the country medical claims often result in reams of paperwork and multiple forms that have to be filled out precisely. If an item is inadvertently left blank, or if additional information is needed, letters go back and forth. It can take months to get a single transaction completed. We’ve been working with our providers to improve the process, and you can now handle these claims electronically.

While the PWGA has procedures in place to make sure that companies report contributions in a timely manner, mistakes can occur, and the sooner we discover them the sooner we can rectify them. You are your own best advocate when it comes to your earnings. You know when you are working, when you’ve been paid, and when contributions are due on your behalf for your covered services. And now, we have tools to help you monitor your earnings and make sure...

Beginning Saturday, January 15, 2022 the PWGA Health Plan will cover the cost of up to eight COVID home-test kits a month under a new Federal program. Express Scripts has made arrangements with CVS, Walgreens, and independent drug stores, so you just have to show your insurance ID card anywhere it is currently accepted in order to get the tests. If there is a problem (it’s a new program and ESI is still working out the bugs), you may have to pay out...

The PWGA Health Plan spends almost 50% of its resources on approximately 25 specialty drugs. One of these drugs costs $45,000 per dose. Fortunately, we have found a way to lower our costs, and if you use one of these covered specialty drugs, we have lowered your cost, too – down to $0.

Now you can obtain your pension statement, or generate estimates of what you would receive under various scenarios, in seconds, not days or weeks.

This column began in 2016. We’ve covered a lot of ground since then, discussing the resources available to Health Plan Participants, explaining how to maximize benefits, and making sure Participants are aware of Health Plan changes and how those changes might affect them.

The PWGA Health Plan is rich and variegated, so much so that the Health Plan Summary Plan Description (SPD) runs to more than 200 pages, and the Official Plan Documents are even more detailed. It is not surprising that some benefits and/or requirements go overlooked. If you need help quitting smoking, learn more about what benefits are available.

Most healthcare travel advice falls under the rubric of only drink bottled water, stay away from raw vegetables, and make sure your vaccinations are up to date. But what do you do if you are traveling or living outside the United States and you or a covered dependent becomes ill? The good news is that Writers Guild Health Fund coverage is available, subject to some restrictions.

The Health Plan offers extensive reproductive health coverage benefits.

One of the most common issues that affects Health Plan Participants occurs when they fail to pay Dependent Premiums in a timely manner. The PWGA has added the capability to pay Dependent Premiums online, but even so, timely payment problems arise more often than anyone would like.

The PWGA Health Plan is regulated by federal laws and even the Summary Plan Description (SPD) which describes the Health Plan benefits in relatively simple terms runs to over 240 pages. Sometimes, it can be hard for a Participant to discern how to best maximize the benefits available. One of the circumstances where the best way to take advantage of benefits may not be immediately obvious is in the area of married teams trying to qualify for health...

Prior to the enactment of the Affordable Care Act (ACA), the Health Plan classified breast pumps as an item that would not be covered under the Durable Medical Equipment (DME) provisions because they were not “essential” equipment. However, the Health Plan now provides robust coverage for breast pumps.

The PWGA administrative personnel are not doctors. By law, the PWGA cannot practice medicine or offer medical advice, but the opioid crisis is so widespread, and its consequences are so devastating, that we felt we must have an open discussion about opioids, their potential for abuse, and some things you can do if you or a loved one have opiate-related issues.

Every five years, federal law requires that health plans like ours publish an updated Summary Plan Description (SPD) if there have been any changes to the details, benefits, or health plan requirements. The new SPD is the most easily navigable – and we hope most informative – SPD we have ever created. It is filled with examples, FAQs, and detailed explanations in everyday language. And, for the first time, you can opt-in to receive the SPD...

A visit to the emergency room is seldom planned and often fraught with difficulties. Unfortunately, one of those difficulties may be financial. The good news is, there are ways to protect yourself and your loved ones from unnecessary costs.

You can review all the DID YOU KNOW articles for 2018. Our mission has been to bring you practical information about your health and pension benefits. We hope these columns have been useful, and we look forward to bringing you more useful information in the upcoming year.

The PWGA has worked diligently to modernize its paper and electronic communications. The website, in addition to being more secure, and with vastly improved search and navigation features, has a wealth of information that you may want to take advantage of.

If you are currently without Health Fund coverage, or you are paying for COBRA Continuation Coverage and you are at least 60 years of age and you have at least 68 qualified Health Fund Quarters, the PWGA may be able to provide you with health insurance coverage.

If you use the UCLA Entertainment Industry Medical Group (EIMG) facility in Woodland Hills (Jack Skirball Health Center), you should be aware that effective July 1, 2018, they will transition their evening, Sunday and holidays services to the Toluca Lake Health Center, located in Burbank.

A little over ten years ago the world changed profoundly when Steve Jobs stood on a stage in Cupertino and introduced the iPhone and mobile apps entered our lives for the first time. In the intervening years mobile computing has grown into every area of our lives, and healthcare apps have boomed.

A third of the people age 50 or older develop shingles, a most unpleasant disease whose symptoms are a tingling, burning pain that develops into a red bumpy rash, which then turns into painful blisters. Of the population that gets shingles, about 20% will also develop postherpetic neuralgia (PHN), a searing, long-lasting (months to years), deep nerve pain.

You save time and money. There’s less hassle with paperwork. As you may be aware, beginning January 1, 2018, the PWGA reimburses out-of-network care at 60% of the bill. The maximum out-of-pocket for out-of-network is $20,000 as opposed to 85% and $1,500 for in-network services.

“Huh?” “Could say that again?” “I must be in a bad cell zone.” If you’ve found yourself uttering those phrases all too often, it may be time to get your hearing checked. The good news? Not only does the Health Plan have coverage, but our vision provider, VSP, has arranged significant discounts on top-of-the-line hearing aids through a third-party, TruHearing.

The Summary Plan Description (SPD) is a document that provides a detailed description of the Health Plan's benefits; it is generally required by law to be published every five years. A new SPD is on its way, and for the first time, we are going to have an interactive electronic version that will have better information accessibility than is available on paper.

Using your Preventative Care Benefit is easy: call your (in-network) healthcare provider and make an appointment for your annual checkup. Covered services are available at no cost to you, and you can apply the $500 Wellness Benefit to services and tests that aren’t covered.

Sooner or later, we all have to deal with the impending death of ourselves or a loved one. Few of us are prepared to make thoughtful decisions in such an emotionally fraught circumstance. Both Medicare and the Health Fund now provide resources to assist in making end of life discussions.

VSP is now the Health Fund’s vision care provider. In addition to the regular benefits that a Participant can claim as they go to the provider of their choice, VSP offers an online option.

When a writer performs covered services for a signatory producer, in addition to the monies they earn for writing, the company also makes contributions toward the writer’s pension and health coverage. The contributions determine whether or not a writer will qualify for health coverage in a given year (or years), and also determine retirement options once a writer vests.

One of the most common issues PWGA employees face occurs when a writer calls and wants to know why they don’t have health coverage even though they are current on their dues. It is a common misunderstanding, with an unequivocal, no exceptions response: Dues are paid to the WGA and are based on your income as a writer.

As of May 1, 2017, Participants will have two options for obtaining maintenance medications through Express Scripts (ESI). In addition to the existing mail-order program, writers will now be able to arrange to pick up their medications at a participating Walgreens (Duane Reade or Happy Harry’s on the East Coast) – and at the same low cost.

As of January 1, 1998, a Participant becomes vested in the pension plan once he/she accrues five Qualified Years of covered writing employment. Once a writer is vested in the pension plan his/her retirement benefits cannot be taken away – even if they never work as a writer again.

Once a writer earns the equivalent of a one hour prime time story and teleplay ($38,302 as of 5/1/2017), in any consecutive four quarter period for providing covered writing services with a Signatory Company, he/she garners a year of medical coverage.

If your identity is compromised, your bank may freeze your checking and savings accounts as they attempt to protect you, which could mean you won’t have access to your pension funds. Should you find yourself caught up in this challenging circumstance, the PWGA may be able to help.

We put much effort this year into making the PWGA website relevant to our Participants. DID YOU KNOW was conceived as a monthly column to educate Participants about the Pension and Health Plan resources available to them. In addition, we added a host of underlying technical improvements, a vastly improved search engine, much better security, and the ability to receive electronic forms and notifications.

A writer may go months and months with no income – either because he/she is looking for work, or because the writer is laboring on a piece of material and will not get paid until a draft is delivered. The PWGA designed its health plan with these realities in mind.

When a writer works under the WGA Minimum Basic Agreement (MBA), in addition to the monies paid to them for their writing services, the employer contributes an additional 8.5% toward the writer's pension. So, if you were paid $100,000 to write a script, an additional $8,500 was paid to the PWGA Pension Plan on your behalf.

LiveHealth Online, Anthem Blue Cross' new service available to Guild members starting October 1, 2016, allows you to video chat with a doctor online for only $20. The doctor is licensed in whatever state you are contacting them from, and he/she has the ability to prescribe (subject to some limitations on certain classes of drugs). You just need a phone, tablet or computer equipped with video and an Internet connection.

Blue Cross Blue Shield rates doctors and medical centers throughout the country? If you’re choosing a provider for specialty care or just looking for a second opinion, Blue Cross Blue Shield can help you make the best choice for you and your family.

As a consequence of the passage of the Affordable Care Act, beginning January 1, 2012, the Writers’ Guild-Industry Health Fund began to cover preventative services at no cost to Participants (provided services are rendered in-network).

You may opt to take a second retirement once you reach age 65, or at any time after 65 (up to the federally required minimum distribution age of 70½ when you must begin taking your pension even if you elect not to retire). You are entitled to receive a second retirement benefit if you have earned money for covered writing services at any time after your first retirement.

The Health Plan’s Wellness benefit provides up to $500 to help Participants (and their dependents… up to $1,500 per family) improve their health. You don’t have to first meet the $300 annual deductible before accessing your Wellness Benefits.

Now you can manage your prescriptions by using the Express Scripts website and mobile apps.

The entertainment industry is a Gold Rush industry: it has no ceiling, nor does it have a floor. For writers, healthcare can be an area in which they keenly feel the ups and downs of their careers.

When deciding between Urgent Care or a visit to the Emergency Room, it benefits you and it benefits the Writers Guild Health Plan when you make the best decision for your particular circumstances.

Most participants are either unaware of The Industry Health Network (TIHN), or incorrectly think of it as a collection of low cost “clinics”.