Allegro

More Info on “Healthy New York”

Health Benefits Update

Volume C, No. 12December, 2000

The huge demand for affordable health insurance was reflected in a deluge of calls to Local 802’s Health Benefits Plan, after an article describing coverage that will soon become available to entertainment industry workers appeared in last month’s Allegro.

The article outlined amendments to the Healthy New York program that will make it easier for workers in our industry to qualify for coverage. The campaign was coordinated by the Actors’ Fund and involved 13 entertainment industry unions, including Local 802.

The new program will take effect on Jan. 1, said Jim Brown of the Actors’ Fund’s Actors Health Insurance Resource Center. The cost of the monthly premium is still being worked out but should be available soon, he told Allegro.

Brown pointed out that 802 members should be aware of some of the new program’s limitations:

  • Efforts to keep the premium affordable resulted in more limited coverage than the basic package normally mandated by the state. The three most significant differences: the new program does not include an out-patient mental health benefit; there is a $3,000 cap each year on prescription drugs; and there is a $500 co-payment if you are admitted to the hospital.
  • The income limits to qualify for Healthy New York are fairly restrictive. Income can be no more than 250 percent of the federal poverty level – which is $8,270 a year for a single individual.

“The cap for a single person who wants to enroll in Healthy New York is $20,650 a year, and about $35,000 for a family of four,” Brown said. “That’s problematic. We had to explain to the state that many people in these unions earn more than that – but they cannot support a family in New York at that level of income. Our coalition is working to expand income limits.”

While it is heavily subsidized by the state, the program is administered by private insurance companies. Every company that offers HMO coverage in New York State will be required to offer it.

For members who exceed the income limits, or who are looking for more extensive benefits, Brown pointed out that there is another possibility: joining an organization which offers group policies to its members. A listing of organizations available to self-employed workers appears on the Actors’ Fund’s web site: www.actorsfund.org/ahirc.

More information on Healthy New York will appear in Allegro as it becomes available.