AFTRA this year saw a tightening of eligibility requirements for its health plan. Now the union is offering ineligible members an alternate health program that it deems "affordable health coverage."
Called Foundation One SecureChoice Plus, the program "allows noninsured AFTRA members to gain basic health care coverage with access to care by a physician of choice, prescription discounts, inpatient benefits at hospital of choice, as well as vision and hearing services," the union tells members in announcing the program on its Web site.
A link that leads to the Foundation One website says the program "is specifically designed for AFTRA members" who can't join the AFTRA plan.
The Foundation One program has no earnings requirement, as the AFTRA health plan does. "It is a month-by-month program that you can terminate at any time," the company site noted. "Seniors who are working might want to consider this plan for 'medigap' coverage. For others, it may work alongside a 'catastrophic only' plan or your existing insurance if it has a high deductible."
The program offers three separate plans, each containing health discount benefits and prescription drug rates. Costs vary under each plan depending on whether the member wants individual coverage or to include children or the entire family.
For example, Plan A—the lowest priced—offers individual health and drug benefits for $71.40 a month, member, and children coverage for $110.12 a month and member and family for $164.96. Plan B is more expensive, and Plan C is the most expensive, the individual rate rising to $123.70 and the family rate to $282.11.
Each plan has a base policy of a daily hospital confinement benefit, with riders for intensive and coronary care, emergency accident, surgery, anesthesia, outpatient sickness, and more. Money to cover the base policy and riders differs according to the plan. For example, Plan A provides $200 per day for hospital confinement, while Plan B provides $400 and Plan C $500.
The prescription drug benefit calls for a $5 co-pay for covered generic drugs, up to a $5,000 annual maximum, and a $15 co-pay for mail-ordered covered generic drugs. The plans also provide up to a 30 percent discount on brand-name drugs and a $20 co-pay on brand-name oral contraceptives.
The AFTRA health plan's trustees this year issued new eligibility requirements for both its individual and family plans. Earnings requirements for individual-plan eligibility rose from $7,500 to $10,000. Under the family plan, the eligibility rose from $20,000 to $30,000.
According to the trustees, their rationale for raising requirements was based on three factors present nationwide, which also affected the AFTRA plan:
• Health care costs rose last year at a rate eight times faster than general inflation.
• Health care spending reached $1.4 trillion and now accounts for more than 14 percent of the nation's gross domestic product, the largest share on record, according to government statistics.
• Health care costs for private plans have risen 50 percent in the past three years; last year, health care spending averaged $5,035 for every person in the United States.