Eligibility to enroll in Plan C health coverage is based on the balance in your CAPP account.

Your first opportunity to enroll will be through Optional Enrollment. If your CAPP account balance meets or exceeds the cost of one month of C-2 single coverage plus a $150 administrative fee (currently $1,165) by the end of the day on January 31, April 30, July 31, or October 31 of any year, you’ll receive a statement from the IATSE National Benefit Funds (the NBF) offering you the option to enroll in a Plan C health coverage option.

If you don’t enroll through Optional Enrollment, your next chance will be Automatic Enrollment. Once your CAPP account balance reaches the cost of one quarter of C-2 single coverage plus a $150 administrative fee (currently $3,195) by the end of the day on January 31, April 30, July 31, or October 31 of any year, you’ll receive a statement from the NBF requiring you to choose a Plan C health coverage option. And please note: If you don’t respond to this statement, you’ll be automatically enrolled in C-2 single coverage.

The primary differences between Plan C health coverage options are cost and the scope of coverage.

Each option has a different premium — the amount you pay to purchase the coverage — and other varying costs such as deductibles, copayments, coinsurance, and out-of-pocket maximums. The scope of coverage also differs: Plans C-1 and C-2 include benefits for hospital and medical care received both in-network and out-of-network, while Plans C-3 and C-4 provide coverage for in-network care only. In addition, the dental, vision, and life insurance benefits offered under each plan may vary, so it’s important to review those differences as well.

You can read the summary of benefits for each coverage option on the IATSE National Benefit Funds website.

Plan C-MRP stands for Plan C Medical Reimbursement Program. It allows plan participants to use funds in their CAPP account to get reimbursed for out-of-pocket money spent on “Qualifying Medical Expenses.” (What counts as a Qualifying Medical Expense is determined by the IRS.)

Participants may enroll in C-MRP as a stand-alone option (meaning without also enrolling in C-1, C-2, C-3, or C-4) if they have other group medical coverage (such as coverage from another union, or from a spouse’s employer) provided that it meets certain criteria. You cannot enroll in C-MRP as a stand-alone option if you have coverage through the ACA exchanges, Medicaid or Tricare. Unfortunately, the law doesn’t allow it.

Additionally, participants enrolled in C-1, C-2, C-3, or C-4 coverage can also use Plan C-MRP to get reimbursed for medical expenses if they have “excess funds” in their CAPP account. Having excess funds means that the balance in your CAPP account is greater than the cost of the next two quarters of coverage in the Plan C option in which you are currently enrolled.

More detailed information about Plan C-MRP can be found in this MRP Guidebook provided by the IATSE National Benefit Funds.

Once you have reached the Automatic Enrollment threshold (at least $3,195 in your CAPP account), you must enroll in a Plan C health coverage option. It’s mandatory. That said, if you have group medical coverage from another source (e.g., another union’s health plan or a spouse’s plan from their employer), you may be able to enroll in Plan C-MRP as a stand-alone option, rather than enrolling in C-1, C-2, C-3, or C-4. However, you cannot enroll in C-MRP as a stand-alone option if you have coverage through the ACA exchanges, Medicaid or Tricare. Unfortunately, the law doesn’t allow it.

If you’re unsure about your options, you can contact Participant Services at the IATSE National Benefit Funds or Benefits & Support Services at USA 829 for more information.

We recommend that members check all their benefit accounts (health, pension, 401(k), and annuity) at least(!) four times per year to make sure all your contributions have shown up. That said, if more than two months have gone by and a contribution hasn’t posted in your CAPP account, you should reach out to Participant Services at the IATSE National Benefit Funds.

If there’s not enough in your CAPP account to cover the full cost of your next quarter’s health coverage, you can often "self-pay" the difference out of pocket. For example, if your premium is $2,232, and you have $1,000 in your CAPP account, you can pay the remaining $1,232 yourself.

However, if your CAPP balance is zero, you can only self-pay if you’ve had at least $3,045 (the current quarterly cost of C-2 single coverage) contributed into your CAPP account over the past 24 months.

If your CAPP balance is low, another option is to downgrade your coverage level at the start of a new coverage quarter (e.g., from C-2 to C-3) to reduce your premium. However, keep in mind that you can only upgrade your coverage level (e.g., from C-3 to C-2) during the annual open enrollment period — the quarter when you’re selecting coverage to begin on January 1 — unless you have a qualifying life event like marriage or the birth of a child.

It’s a complex system, so please don’t hesitate to reach out to Benefits & Support Services for guidance — we’re here to help!

You’re allowed to downgrade to a lower-cost Plan option level (e.g., from C-2 to C-3) at the start of any coverage quarter — your downgrade options will be listed on your quarterly Plan C statement.

However, you can only upgrade to a higher-cost Plan option (e.g., switching from single to family coverage or from C-3 to C-2) during the annual open enrollment period — the quarter when you’re selecting coverage to begin on January 1 — unless you have a qualifying life event like marriage or the birth of a child.

Yes. If you’re eligible to enroll in a Plan C health coverage option, you can cover your dependents by enrolling in a family plan and paying the corresponding CAPP charge. Your dependents must be enrolled in the same plan option as you (with limited exceptions), and you’ll need to provide proof of dependent status — like a marriage certificate or birth certificate — when you enroll them.

Eligible dependents include:

• Your legal spouse

• Your children through the end of the year they turn 26 (including biological, stepchildren, and adopted children)

• Disabled children over 26, if the disability began before age 26 and is supported by Social Security documentation

A newborn is automatically covered for 30 days, but you must submit documentation to continue coverage beyond that. If you're switching from single to family coverage, make sure to submit all documents within 60 days of acquiring the new dependent, or you may have to wait until the next annual open enrollment period.

To name a beneficiary, you’ll need to complete the plan’s beneficiary designation form. This form is specific to the life insurance benefit under Plan C and does not apply to any other fund you may participate in — each fund has its own form and rules. You can name any person or persons you wish, and you may update your beneficiary at any time by submitting a new form. Your designation becomes official once the Fund Office receives your completed form, so it’s a good idea to review and update it regularly to ensure your wishes are current.