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Contact Info

OFFICE HOURS:

Mon - Fri   9am-5pm CST

PHONE:

800-450-1271

773-427-6875 fax

EMAIL:

CustomerService

POSTAL ADDRESS:

3963 W. Belmont Ave.

Suite 6

Chicago, IL 60618


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SAG-AFTRA has brought you additional Dental and Vision coverage

SAG-AFTRA has arranged for a Supplemental Dental and Vision insurance plan for Union members who are enrolled in the AFTRA Health Plan (not SAG Health) and their eligible dependents.

This benefit provides coverage for you and your eligible dependents for Basic Type II and Major Type III dental services, such as fillings, crowns, root canals, etc. (Orthodontia is not included). In addition, this plan includes a vision benefit program through the Vision Service Plan network of providers.

These programs are only available to SAG-AFTRA Union members in good standing, on honorable withdrawal, and employees of SAG-AFTRA who have coverage under the AFTRA Health Plan.

These programs have been arranged through your Union as part of its continuing efforts to provide members access to additional benefits. They will be administered by Group Benefit Associates and Guardian, not SAG-AFTRA or the AFTRA Health & Retirement Funds.

Eligibility
  • SAG-AFTRA Union members in good standing or on Honorable Withdrawal
  • SAG-AFTRA members that are covered under the AFTRA Health Plan (not SAG Health)
  • Employees of SAG-AFTRA and AFTRA H&R that are covered under the AFTRA Health Plan
  • SAG-AFTRA fee paying non-members/ financial core status are not eligible

In order to participate, the individual must be and remain current with any union dues and AFTRA Health Plan premiums that are required under AFTRA H&R Funds Health Plan rules.

Enrollment and participation is subject to verification of enrollment in dental coverage under the AFTRA Health Plan and primary participant's status as a member of the SAG-AFTRA union, employee of SAG-AFTRA or employee of the AFTRA H&R Funds.

Eligible Dependents:

  • Your legal spouse
  • Qualified Domestic Partners
  • Your Qualified Domestic Partner's children
  • Your dependent children are eligible until age 26
  • Legally adopted children
  • Step-children who depend on you for most of their support and maintenance

THE DENTAL BENEFIT

Some of the dental covered services are:

Bridges Caps
Crowns Dentures
Fillings Gum Treatment
Impactions Oral Surgery
Periodontics Root Canal

This supplemental dental insurance covers Basic Type II and Major Type III services that are not currently covered by the AFTRA Health preventative only benefit.  The Basic Type II services include but are not limited to: fillings, bridge, crown and denture repairs, endodontics, periodontics and oral surgery.  The Major Type III services include: crowns, inlays and certain prosthodontic services. Orthodontia is not an insured benefit. Implants are not an insured benefit.

The plan pays a specific amount for each dental service based upon an established fee schedule. If you go to a Guardian PPO provider, the benefits described below apply. If you go to a non-Guardian provider, the amounts charged over the scheduled fees are the patient's responsibility.

Guardian PPO Providers

NON Guardian Providers

CALENDAR YEAR DEDUCTIBLE

$50.00
3x's Family Deductible

$75.00
3x's Family Deductible

BASIC (TYPE II) SERVICES
Fillings, Bridges, Oral Surgery
Crown & Denture Repair
Endodontics, Periodontics

80% of fee schedule

50% of fee schedule

MAJOR (TYPE III) SERVICES
Crowns, Inlays, Certain Prosthodontic Services

50% of fee schedule

50% of fee schedule

ORTHODONTIA

not an insured benefit

not an insured benefit

CALENDAR YEAR MAXIMUM

$1,500 per person

$1,500 per person

PRE-DETERMINATION:  When a course of treatment is expected to cost $300 or more and is of a non-emergency nature, it is recommended to have your dentist submit a treatment plan before he/she begins.

This is intended only as a brief summary of benefits. It is not an official statement of those benefits. For more specific information, please refer to the Summary Plan Description.

 

THE VISION BENEFIT

Vision benefits are provided through the Vision Service Plan network and include an annual eye exam for a $10 co-pay, in addition to discounted rates on frames, lenses, and other professional services at VSP network providers. This benefit also includes discounts on all covered services such as LASIK.

Our vision plan allows you to visit any eye doctor you wish. However, you save significantly on out-of-pocket costs when network providers are used. There's more, you will receive substantial coverage for annual eye exams and discounts on eyewear and contact lens professional services every 12 months.

Largest Quality Network

Our affiliation with Vision Service Plan (VSP) gives members access to approximately 29,000 provider locations nationwide. All network professionals, includes licensed optometrist or ophthalmologist, are committed to delivering consistent and quality service.

You can find a VSP provider near you by:

  1. Looking up a VSP Provider online at www.vsp.com and selecting the "VSP Signature" network
  2. Requesting a provider directory from VSP by calling (800) 877-7195

 

Covered Services & Value Added Discounts

Eye Exams:

  • $10.00 copay, covered in full thereafter

Glasses:

  • 20% off lenses, frames and the industry's most extensive list of "cosmetic extras", including tints, special lenses (e.g. progressives) and scratch resistant coatings.
  • 20% off the retail price of additional glasses after initial pair is purchased.*

Contact Lenses and Professional Services

  • 15% off of the network doctor's evaluation and fitting services.
  • 20-25% off laser vision correction, or 5% off the laser surgery center's best promotional price, whichever is a better deal!**

You should call the VSP provider to schedule an appointment. When calling to schedule the appointment, identify yourself as a VSP member and give the insured's social security number. Before you go for the appointment, the provider will contact VSP to verify eligibility and coverage. You must go for services and materials within 60 days of VSP authorization.

*The claimant must go within 12 months to the same VSP doctor who provided the exam.
**Laser surgery is not an insured benefit. The surgery is available at a discounted fee. The covered person must pay the entire discounted fee. In addition, the laser surgery discount may not be available in all states. Member's out-of-pocket costs won't exceed $1,800 per eye for LASIK and $1,500 per eye for PRK.

The Supplemental Dental and Vision Plan is offered as a combined package and benefits cannot be separated.

All premiums are billed quarterly and are collected on March 15, June 15, September 15 and December 15. (If the 15th falls on a weekend or holiday, the payment will be collected the following business day.)

Rates are subject to increase from year to year.

Quarterly Premium
2014/2015
Individual
$101.16 / quarter
Individual and Spouse
$208.75 / quarter
Individual and Children
$208.97 / quarter
Family
$215.37 / quarter

Cancellation Requests: Cancellation requests must be received in writing by mail, fax or e-mail. Cancellations will become effective on the last day of the month in which they are received.

Ready to enroll?

Enroll Now

OR

  • DOWNLOAD and print the enrollment form and fax or mail it to us

 

 

SAG-AFTRA

Dear SAG-AFTRA Member:

SAG-AFTRA has arranged for a Supplemental Dental and Vision insurance plan for Union members who are enrolled in the AFTRA Health Plan and their eligible dependents.

This benefit provides coverage for you and your eligible dependents for Basic Type II and Major Type III dental services, such as fillings, crowns, root canals, etc. (Orthodontia is not included). In addition, this package includes a vision benefit program through the Vision Service Plan network of providers.

These programs are only available to SAG-AFTRA Union members in good standing, on honorable withdrawal, and employees of AFTRA who have coverage under the AFTRA Health Plan.

These programs have been arranged through your Union as part of its continuing efforts to provide members access to additional benefits. They will be administered by Group Benefit Associates and Guardian, not SAG-AFTRA or the AFTRA Health & Retirement Funds. Please direct questions to Group Benefit Associates at 800-450-1271.

On behalf of the SAG-AFTRA National Board of Directors, we hope that you will find this coverage a welcome benefit to you and your family.

In Solidarity,


Roberta Reardon
SAG-AFTRA National Co-President

The PDF documents below are provided for your reference:

 

Dental Summary  
Vision Summary
Dental / Vision Summary Plan Description
 

Frequently asked questions:

Q: How can I cancel my policy?

A: We must receive your cancellation request by email, fax or mail.

 

Q: I did not receive a vision id card once I enrolled.

A: There is no vision id card. Simply let your providor know that you are a Vision Service Plan (VSP) member.

 

Q: Can my spouse/child be covered under the Supplemental plan if they do not have AFTRA Health coverage?

A: Yes. Only the member needs to have the AFTRA Health plan. All other eligible dependents may be covered under the Supplemental plan.

 

Q: Can my grandchild be covered under the Supplemental plan?

A: Your grandchild may only be covered under the Supplemental plan if you are their legal guardian and they are dependent upon you for support and maintenance.