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Answers to Frequently Asked ELIGIBILITY Questions

  1. How do I initially qualify for benefits?

    If you have never been eligible before, or have been ineligible for 5 (or more) preceding six-month eligibility periods (2.5 years or 30 months), you need to earn a minimum of 600 hours in one (or 2 consecutive) six-month Qualifying Periods.

  2. How do I maintain my current coverage?

    After you initially qualify, you need to earn a minimum of 400 hours during each applicable Qualifying Period.

  3. If I don't earn enough hours, can I use my bank?

    As long as the number of hours in your bank combined with your worked hours equal 400 or more and you are still available for work in the motion picture industry, you will be offered a Bank of Hours extension. You will be sent an extension form approximately two weeks prior to the end of your benefit period. You must sign and return the extension form to the West Coast Plan office in order to receive the Bank of Hours extension.

  4. I've been on disability. What will happen to my benefits?

    If your disability claim date is within 90 days of your last date of covered employment in the industry, MPI will calculate your disability benefits at 40 hours per week during the Qualifying Period. If this adds up to at least 400 hours (within the Qualifying Period), you will be eligible for a 6-month extension of benefits. Please note that disability hours are not banked or combined with hours in the bank. Additionally, you may not have two consecutive, temporary disability extensions; nor may you have two disability extensions based on the same disability claim.

  5. What happens if I still don't qualify after all of my extensions have been used up?

    You will be given the option to continue your coverage by self-payment of premiums through COBRA for a maximum of 18 months, less any temporary disability extensions granted after your initial qualifying event. Once you have exhausted 18 consecutive months of extended coverage, you will be offered a direct conversion policy through the hospital/medical plan in which you are enrolled. You also have the option to enroll directly into the conversion policy, within 31 days of your loss of eligibility and without first paying for COBRA.

  6. How long can I pay for COBRA and how much will it cost?

    The maximum period for extended coverage is 18 months. For example, if you use a temporary disability extension and do not qualify for the next benefit period, you will be entitled to 12 months of COBRA coverage. The cost of these benefits will depend on the number of dependents you wish to cover and whether you elect the Core or Noncore benefits. Noncore benefits include hospital, medical, prescription, dental and vision; Core benefits include hospital, medical and prescription only.

  7. I have a new dependent and need to add him/her to my coverage.

    You need to complete a new beneficiary/enrollment card. Mail this card to the West Coast Plan office with a copy of the marriage/birth certificate (or hospital record), and we will add your dependent as of the date of marriage/date of birth. For non-biological children, a separate application and additional documentation (e.g. placement agreements, legal guardianship documents) will be required.

  8. Can I add my same-sex domestic partner?

    MPI health benefits are available to qualified same-sex domestic partners of Health Plan participants. For Active Participants, refer to “Same-Sex Domestic Partner Coverage,” on page seven of the Active Summary Plan Description. Retirees and Survivors should refer to “Same-Sex Domestic Partner Coverage” on page five of the Retiree Summary Plan Description.

  9. My divorce is final this month and I need to take my ex-spouse off of my coverage. What do I need to do?

    You need to complete a new beneficiary/enrollment card indicating the date of divorce. Mail this card to the West Coast Plan office with a copy of the divorce documents indicating the dissolution of marriage date (full document if there are eligible dependent children). Your ex-spouse will be covered through the end of the month specified on the divorce document. He/she will be given the option to continue coverage by self-payment through COBRA. If a current mailing address for the ex-spouse is not provided to MPI, the COBRA notification will be sent to the last known address.

  10. My child will be 19 next month. What happens to his/her coverage?

    Full-Time Student
    As long as s/he is enrolled in an accredited school or college on a full-time basis, MPI will continue to provide medical, hospital, prescription, dental and vision insurance benefits until age 23 or graduation, whichever comes first. You must certify that s/he is a full-time student by submitting the Full-time Student Certification form. To be considered full-time, the student must complete 12 units per semester or 10 units per quarter (additional information regarding schools is available).

    Dependent Disability extensions
    If s/he is disabled and incapable of self-sustaining employment, MPI will continue to provide medical, hospital, prescription, dental and vision insurance benefits upon receipt of a statement from his/her physician verifying the diagnosis, the date of the commencement of the incapacity and the expected date of recovery (if any).

    Affordable Care Act (For Active Participants Only)
    Under the Affordable Care Act, MPI’s paid health coverage for adult children between the ages of 19 and 26 does not include vision and dental benefits.

    If s/he does not currently meet any of the above eligibility requirements you must notify MPI in writing immediately. If his/her coverage ends and MPI has paid any health claims following the termination of dependent’s coverage, you will be responsible for reimbursing MPI for any overpayments, plus interest.

  11. What if my child withdraws from a class?

    Student eligibility will terminate at the end of the month in which he/she withdrew from class, bringing the course load to below full-time. He/she will be given the option to continue coverage under the provisions of the Affordable Care Act (for dependents in the Active Health Plan) and via COBRA. In both cases, a new Dependent Declaration form will be required.

  12. I have a change of address.

    You must complete and submit the MPI Change of Address form, including your signature and social security number.

  13. How do I transfer from my HMO to the MPI PPO (Anthem Blue Cross) Plan or from my pre-paid dental plan to the Delta Dental PPO?

    To change your medical and/or dental plans to the MPI PPO (Anthem Blue Cross) Plan or the Delta Dental PPO plan, you must submit a Benefit Selection form. Alternatively, you can submit your request in writing, stating that you would like to change from the plan in which you are currently enrolled to the MPI PPO (Anthem Blue Cross) Plan or the Delta Dental plan, as applicable. The letter must be address to the MPI Health Plan, contain the Participants full name, be signed by the Participant and identified by the Participant’s Social Security number or identification number.

  14. When can I enroll into an HMO or prepaid dental plan?

    You can enroll in an HMO or prepaid dental plan during Open Enrollment, which takes places annually in July for an effective date of August 1.