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DGA Health PlanUsing your DGA Health Plan for virtual outpatient treatment.
The Directors Guild of America Producer-Directors Health Plan covers directors, assistant directors, unit production managers, stage managers, and associate directors, along with their eligible dependents. Your plan is unique. We verify yours specifically before you commit to anything.
The honest version.
We are out of network with commercial carriers. In-network credentialing is in progress. We verify your out-of-network benefits and tell you the real out-of-pocket number before you start.
What we will and will not tell you about cost.
We do not waive cost-shares. We do not tell you treatment is free. We verify your OON benefits, give you the real number, and if cost is a genuine barrier we will talk about it case by case.
Earnings-based eligibility, dependents, and the behavioral path.
Eligibility on the DGA Health Plan is earnings-based. You qualify by reaching a covered-earnings threshold from work under DGA collective bargaining agreements, which establishes your benefit period. The plan covers comprehensive medical and behavioral health for the member and enrolled dependents. The plan's medical and behavioral benefits are administered through major carrier networks, and where the plan uses Optum or UnitedHealthcare for behavioral health administration, that administrator handles authorization, network status, and claims for mental health and substance use treatment. We confirm your specific administrator and your out-of-network behavioral terms before anything starts.
The pieces of the plan
- An allowed amount for each kind of visit or day of behavioral care.
- A deductible you meet before the plan starts splitting the cost.
- A coinsurance split after the deductible.
- An out-of-pocket maximum for the year, after which the plan covers more or all.
- An authorization step for intensive outpatient and PHP-intensity hour expansion, which we handle through the plan's behavioral administrator.
What we do for you on the benefits side
- Call the DGA Health Plan and its behavioral administrator on your behalf to pull the actual out-of-network behavioral numbers for the level of care you need.
- Translate them into the dollar cost of a week of treatment, so there are no surprises.
- Submit the authorization and stay on the case through review and renewal.
- Bill what the plan considers reasonable, so there is no balance-bill surprise later.
Built for the people who keep the set running.
Assistant directors, unit production managers, stage managers, and associate directors carry the schedule of the production on their shoulders, and the work comes in waves. A virtual program is built for that rhythm. Cohorts run morning, afternoon, or evening, all virtual, so the program holds through prep, a shoot day, or a hiatus. We keep documentation tight and release nothing to a production, a studio, or a network without your written consent.
The standard OON behavioral benefit
Most DGA Health Plan coverage includes an out-of-network behavioral health benefit with a separate OON deductible and a coinsurance split after that, administered through the plan's behavioral administrator. We pull yours before you commit.
Start the benefit check UPMs, stage managers, dependentsEnrolled dependents are covered too
Enrolled dependents on the DGA Health Plan, including a spouse and eligible children, carry the same behavioral health benefit as the member. We verify a dependent's benefits the same way we verify a member's. Send us the front of the card and we will read it together.
Start the benefit checkTreatment that does not pause your career.
Cohorts run morning, afternoon, or evening, all virtual. We can hold the schedule through a prep week, a shoot, or a hiatus, and we keep documentation tight within 42 CFR Part 2 limits and your signed authorization. Nothing about your treatment goes to a production, a studio, a network, or a guild office without your written consent.
Plain-English answers.
Are you in network with the DGA Health Plan?
No. We are out of network with the DGA Health Plan and with commercial carriers generally. In-network credentialing is in progress. Most DGA Health Plan coverage includes an out-of-network behavioral health benefit, and we bill out-of-network. We verify your specific terms before you commit.
Do I need to switch plans to use Shift?
No. We work with your existing DGA Health Plan on an out-of-network basis. There is no plan switch required, and switching off the DGA plan is almost never the right move for a working member because of how earnings-based eligibility accrues. We verify your specific benefits and tell you the real out-of-pocket cost before you commit.
What about a dependent? My spouse or adult child needs help.
Enrolled dependents on the DGA Health Plan, including a spouse and eligible children, have the same behavioral health benefit as the member. We verify the dependent's benefits the same way we verify a member's. The benefit check is the same two-minute path.
How does balance billing work on this plan?
When a provider is out of network, the plan pays its share of an allowed amount, and the difference between the provider's charge and that allowed amount is sometimes balanced to the patient. Our practice is to bill what the plan considers reasonable and to tell you the real number before you start, so there is no balance-bill surprise. The federal No Surprises Act adds protections for certain out-of-network situations; we walk you through how that applies to your case during the benefit check.
What about confidentiality? Production and the studio cannot find out.
Substance use treatment records are protected by 42 CFR Part 2, the federal confidentiality rule that is stricter than HIPAA. We do not share with a production, studio, network, agent, manager, or guild office unless you sign a specific written authorization. Co-occurring mental health records are protected by HIPAA. Both rules combined are designed for exactly this situation.
How fast can you verify my benefits?
Same day in most cases if you send us the member ID and group number on the front of your card during business hours. The benefit check itself is no-cost and no commitment.
Verify your benefits in two minutes.
Send us the member ID and group number on the front of your DGA Health Plan card. We come back with your specific out-of-network deductible, coinsurance, out-of-pocket maximum, and what a typical week of intensive outpatient or partial hospitalization-intensity care would cost you. No commitment until you decide.
If you or someone you are with is in immediate danger, call or text 988 (the Suicide & Crisis Lifeline) or call 911. Shift Support Network is an outpatient program and is not an emergency service. Substance use treatment records are protected by 42 CFR Part 2.