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Disability Crediting & Waivers

If you become disabled, the Welfare Plan has provisions that may help you by: (1) crediting you with earnings for the purposes of determining future medical coverage eligibility, and (2) waiving your self-pay premium payments. The lifetime maximum for disability crediting and waivers is 104 weeks.

If you are disabled and would like more information regarding these provisions, please contact the Fund Office.

Required Proof of Disability
To qualify for up to 104 weeks of disability crediting and waivers, you must submit proof of your disability to the Fund Office on a monthly basis. Proof of disability means copies of documentation that prove you are receiving benefits from:

  • Social Security Disability,
  • State Disability,
  • Long Term Disability,
  • Workers’ Compensation, or
  • demonstrate that you have spent 21 or more consecutive days as an inpatient in a hospital or other facility for which the Fund provided coverage.

If you have exhausted State Disability benefits but have not yet received a Social Security Disability Award or qualified for Long Term Disability, you may be able to continue receiving disability crediting and waivers if you provide other evidence of your ongoing disability.

Disability Crediting
For every week that you are eligible for disability crediting, we credit you with “covered earnings” (the calendar year earnings amount that is used to determine your eligibility for Welfare coverage in the following Plan year) equal to 1/52nd of the amount necessary to qualify you for the applicable Tier. The applicable Tier is the Tier you would be eligible for based upon your covered earnings in the 52 weeks prior to your date of disability.

Disability Self-Pay Waivers
For any month in which you were eligible for disability crediting, you may also be eligible to have your self-pay premium waived. You must apply and be approved for a self-pay premium waiver; please contact the Fund Office for more information. Please note that if you elected to buy up to Tier III, you are still responsible for paying the applicable buy-up premium even if you are granted a self-pay premium waiver.

Please remember that the Welfare Plan currently provides for a lifetime maximum of 104 weeks of disability credits and waivers. If you do not need the disability earnings credits to qualify for Welfare benefits, you may not want to use up your weeks just to receive self-pay waivers. Disability credits are more important as a means to continue your benefits if you become disabled, than as a way to reduce your self-pay premium. Disability credits are a kind of insurance, and you should use them carefully, and only when you need them.

Exception to the 104-week Maximum Rule

You will not receive disability credits for more than one-hundred four (104) weeks of disability in your lifetime, whether for one disability or multiple disabilities, unless you fall within the following exception:  If you have received 104 weeks of disability credits, but have yet to receive a Social Security Disability Award for which you have applied, and you would have sufficient pension credits to qualify for retiree medical coverage were you to later receive a disability pension from the Pension Fund of Local No. One, IATSE, you will be granted up to an additional one-hundred fifty-six (156) weeks of disability credits, provided you remain totally and permanently disabled (and submit ongoing proof of such disability to the Fund Office in the form and manner required) and continue to timely pay for coverage on the same basis as retirees receiving Plan benefits. Please contact the Fund Office for further information if you are in this situation.

News, Notes and Links

  • Visit aetna.com for health insurance coverage information.
  • Visit express-scripts.com for pharmacy benefit information.
  • ER Alternatives: What are your options?
  • Visit The Actor’s Fund Website for information regarding programs and workshops available to Welfare Fund participants.
  • For a full description of the Plan rules regarding Disability Crediting and Waivers, please see the Summary Plan Description and any applicable Plan Amendments and Clarifications.
  • Please note that nothing on this website is intended to interpret, extend or change in any way the provisions expressed in the Summary Plan Description and any other Plan documents. If you have any questions regarding your particular situation, please contact the Fund Office for more information.

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