H&W: Important Changes to 2021 Participant Eligibility Levels & Monthly Co-Premium Payments

Though, as usual, there are some changes to the Plan, the Trustees have made every effort to help our participants retain their coverage for 2021, even as we continue to protect and preserve the financial future of the Trust for the coming years.

Below is a summary of material modifications to the Plan.

2021 ELIGIBILITY LEVELS FOR NEW PARTICIPANTS

For the January 1, 2021, coverage year, the minimum initial eligibility threshold for a newly qualified Participant for enrollment in medical plans sponsored by the Professional Musicians, Local 47 and Employers’ Health & Welfare Fund (the “Fund”) shall remain at the level of $700 in Employer contributions.  Thus, effective with the current Qualifying Period – October 2, 2019 through October 3, 2020 – the amount of Employer contributions necessary for initial qualification for eligibility at the Fund’s “C Level” of coverage/benefits shall be $700 (including any available permissible carry-forwards from the 2018/2019 Qualifying Year).

Thus, and for the Qualifying Period that started on October 2, 2019, and for initial eligibility to enroll in one of the three Levels of the Fund’s medical plans for the coverage year commencing January 1, 2021, the minimum amount of Employer contributions necessary for a new participant/enrollee to qualify will be $700 “Level C” enrollment/coverage, $1,200 for “Level B” enrollment/coverage and $1,500 for “Level A” enrollment/coverage.

2021 ELIGIBILITY RULES FOR CURRENT ENROLLEES

Due to the impact COVID-19 (“CV”) has had on our industry resulting in a significant loss of employment and the consequent impact on Employer contributions on behalf of the Fund’s Participants, the following qualification schedule shall apply for the 2021 Coverage Year:

  1. All Participants who received at least $700 in the 2019-2020 Qualifying Year and who were enrolled for coverage during year 2020, shall be eligible to enroll in the Coverage Level they were enrolled in for the 2020 Coverage Year. Thus, and for example, a Participant who qualified for and enrolled in Level A coverage for year 2020 and on whose behalf the Fund receives at least $700 in Employer Contributions during the 2019-2020 Qualifying Year shall again be able to enroll in Level A coverage for the 2021 Coverage Year.
  2. All Participants who were enrolled in Level A coverage during Coverage Year 2020 and did not re-qualify for Level A coverage based on 2019-2020 Employer contributions, shall automatically qualify for Level B coverage regardless of the amount of Employer contributions below the Level A qualifying amount.
  3. All Participants who were enrolled in Level B or Level C coverage during Coverage Year 2020 and did not re-qualify for Level B or Level C coverage based on 2019-2020 Employer contributions, shall automatically qualify for re-enrollment at the same Level they were enrolled in for Year 2020 regardless of the amount of Employer contributions below the Level C qualifying amount.

INCREASE IN PARTICIPANT AND DEPENDENT CO-PREMIUMS

In addition, and to prudently allow the above qualifying adjustments for Coverage Year 2021, the Trustees have also determined that an increase in the monthly Participant co-premium is necessary. Thus, the applicable Participant monthly co-premium for Coverage Year 2021 shall increase by approximately $25 per month, for all Levels of coverage/benefits offered by the Fund. Also, the Trustees determined that Dependent co-premiums will increase in accordance with the annual carrier increase for Coverage Year 2021, if any.