Life After COBRA

The SAG-AFTRA Health Plan is one of the best health plans available, but participants must qualify, and may sometimes lose eligibility. COBRA coverage may be an option for those who lose eligibility, but COBRA may not be affordable to everyone, and it will only provide coverage to participants for up to 18 months (in some cases up to 36 months). Options outside of COBRA include:

SAG-AFTRA Foundation
The SAG-AFTRA Foundation offers financial grants to participants or qualif ed legal dependents of participants who have a catastrophic illness or injury and who, due to financial need, cannot afford the Plan’s COBRA program. Contact SAG-AFTRA Foundation at (323) 549-6773 for more details.

The Actors Fund
Certified application counselors at The Actors Fund’s Artists Health Insurance Resource Center (AHIRC) can identify coverage options both on and off the Marketplace and help members enroll in them. AHIRC offers weekly seminars on Affordable Care Act plans, Medicaid and Medicare. AHIRC’s website includes educational materials and an extensive database of health care and insurance resources. The Actors Fund was part of a successful fight, led by industry unions, for a COBRA subsidy in New York State for entertainment industry workers. The subsidy will pay for half of your COBRA premiums for 12 months if you are deemed eligible. For information on the subsidy, or any other questions about health care options, call (888) 825-0911 west of the Mississippi or (917) 281-5975 if you are east of the Mississippi.

Other Group Health Coverage
You may qualify for a special enrollment opportunity for another group health plan for which you are eligible, such as a spouse’s plan, even if the plan generally does not accept late enrollees. You must request enrollment within 30 days after your Earned Eligibility coverage with the plan ends.

Health Insurance Marketplace
Under the Affordable Care Act, you have the opportunity to purchase coverage through the Health Insurance Marketplace at healthcare.gov. In New York, you can access the Marketplace directly through the state website: nystateofhealth.ny.gov. The Marketplace allows you to shop and compare coverage, provider networks, premiums, deductibles and out-of-pocket costs before you make a decision to enroll. In the Marketplace, you may be eligible for a tax credit that lowers your monthly premiums; eligibility depends on household income. The Marketplace can also determine if you are eligible for Medicaid or the Essential Plan. Medicaid and the Essential Plan are insurance programs that protect and assist low-income individuals and families in need. Being eligible for the plan’s COBRA program does not limit your eligibility for coverage with a tax credit through the Marketplace. As with the plan’s COBRA program, you have 60 days from the last day of your SAG-AFTRA Health Plan coverage to enroll for coverage in the Marketplace.

The best way to find information about what to do when you lose eligibility with the plan is to call (800) 777-4013 or go to sagaftraplans.org/health.