Monday, September 15, 2014

Did you know? - Member insurance

What is my insurance coverage?

Such a simple question: five words. Would that it could be answered in as few. Since it can’t, here is the answer condensed into as few words as I could manage…

For all members in good standing, year-round, off-contract coverage looks like this:

If you worked a minimum of 8 weeks at insurance levels 2-4 in the previous calendar year, off-contract coverage also includes:
  • 50% of eligible medical expenses incurred as a result of sickness

To find out if you reached that threshold, log into your profile online. In the top right section, you will see your off-contract insurance eligibility listed. You can also find this info included on your insurance receipt each year.

When you are on-contract, your coverage bumps up to the appropriate level for the contract and premium you are paying:
  • Levels 1-3: 85% of eligible medical expenses incurred as a result of an accident or illness
  • Level 4: 100% of eligible medical expenses incurred as a result of an accident or illness
  • All levels: disability (income replacement) coverage
Some important things to know:
  • Your on-contract insurance level is determined by the performer minimum scale fee for the contract in question (since that also determines the premium), not the specific fee you may have negotiated. More info can be found on p. 2 here.
  • If you have a contract with level 4 coverage, on-contract coverage for all subsequent contracts in that calendar year is also at Level 4, even though you may only be paying a level 1-3 premium.
  • Treatment that begins on-contract, say massage for an injury, continues at the on-contract rate for the earlier of 3 months following the end of the contract, or 6 visits.
  • No coverage is unlimited; various annual maximums apply.
  • Paramedical claims are covered at the level of reasonable and customary charges, typically established in the fee guides set by regulatory bodies for the practitioners. You should be aware that practitioners offering "specialty" treatments, or working in spas or health clubs, frequently charge more than will be reimbursed.
  • All members in good standing also have access to the Equity dental network at no extra cost.
  • For those needing even more insurance coverage, AFBS offers Equity members preferred rates on their Arts and Entertainment Plan.
So, those are the basics, covering the vast majority of situations, in a (very large) nutshell. 

Now, do yourself a favour and click on this link. Read the insurance brochure. It will only take you about ten minutes. It's time well spent before you need to make a claim.

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