AGMA restructures its medical coverage.

Last September 1, the American Guild of Musical Artists enacted revisions to the coverage guaranteed by its Health Fund Plan A, which serves 750 union members. The co-pay for network physicians' visits increased on Jan. 1 from $15 to $20, and the dental plan was eliminated. Beneficiaries of the plan previously had a co-pay of $10 to $30 for their prescriptions, but they now will pay 20 percent of the cost when buying them in pharmacies, or 15 percent for prescriptions filled by mail order. On Jan. 1, a $50 annual deductible for the prescription plan was added for individuals and $100 for families.

Because of the steep escalation of medical care costs, the AGMA trustees recognized the need to redesign the plan, which had not raised the cost of its coverage for 10 years. "The trustees were faced with several choices. They picked the choice that was least destructive," said AGMA executive director Alan Gordon. One alternative considered was to impose an annual cap on prescription costs, so that after the plan had paid a fixed amount on an individual's prescription costs, it wouldn't pay anything more. Another rejected solution was to require stricter qualifications for the people actually covered. Gordon pointed out that the Actors' Equity health plan has recently reduced the number of members receiving coverage by more than 25 percent. "We want to cover everybody who was previously covered without reducing benefits any more than we have to, while keeping the cost affordable," said Gordon. (AGMA services concert dancers. Actors Equity serves dancers in musicals and industrials.)

For some members, the new plan presents a radical change. Lawrence Pech, ballet master for the San Francisco Opera and an AGMA member for 25 years, expressed his dismay at the revisions. Pech's HIV medications cost over $3000 monthly, so the new plan requires him to pay over $500 monthly for drugs, as opposed to the original total co-pay of $40. "It's made a huge impact for me. That's more than a tenfold increase," said Pech.

Gordon stated that AGMA refers members with overwhelming medical expenses to the Actors' Fund (www.actorsfund.org), a national organization for entertainment professionals that provides resources for health care and social welfare.