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SAG-AFTRA Health PlanUsing your SAG-AFTRA Health Plan for virtual outpatient treatment.
The SAG-AFTRA Health Plan covers working actors, broadcasters, recording artists, voice actors, and their spouses and dependents. Effective January 1, 2026, the plan's behavioral health administration moves to Anthem. 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.
Earner tiers, dependents, and the behavioral path.
Eligibility on the SAG-AFTRA Health Plan is earnings-based. You qualify by hitting an annual covered-earnings threshold across SAG-AFTRA contracts, which puts you in either Earner I or Earner II for the benefit year. Both tiers include comprehensive medical and behavioral health coverage for the member and enrolled dependents. As of January 1, 2026, behavioral health administration on the plan moves to Anthem, which handles authorization, network status, and claims for mental health and substance use treatment.
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 Anthem behavioral.
What we do for you on the benefits side
- Call SAG-AFTRA Health Plan member services and Anthem behavioral 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.
The other phone numbers in your wallet.
If you are a SAG-AFTRA member or a dependent, you probably already know about three other phone numbers. They are not us. We are a treatment provider those resources can route into. Use the one that fits the moment.
Your plan's short-term counseling benefit
The SAG-AFTRA Health Plan provides Employee Assistance Program services through Carelon Wellbeing. The EAP is a no-cost short-term counseling benefit. When the clinical picture warrants a higher level of care, the EAP counselor can refer out to intensive outpatient. Tell them you are considering virtual intensive outpatient or PHP-intensity care, send us the referral, and we take it from there.
Start the benefit check Entertainment Community FundAddiction and Recovery line: 800 221 7303
The Entertainment Community Fund (formerly The Actors Fund) operates an Addiction and Recovery program with a confidential phone line for working entertainment professionals and their families. They are independent of Shift Support Network. They can help you navigate options, including referring out to a treatment provider like us when virtual intensive outpatient is the right level of care.
Start the benefit check SAG-AFTRA Foundation WellnessMember wellness programming
The SAG-AFTRA Foundation runs wellness programming and a confidential support line for members, separate from the Health Plan. They are independent of Shift Support Network. If a member calls them and the clinical picture is intensive outpatient level, they can route to us as one of the treatment providers a member can choose.
Start the benefit checkTreatment that does not pause your work.
Cohorts run morning, afternoon, or evening, all virtual. We can hold the schedule through a callback day, a press week, a session, or a shoot, and we keep documentation tight so the people on your team who need to know stay looped in on the cadence they ask for, within 42 CFR Part 2 limits and your signed authorization. Nothing about your treatment goes to a casting office, an agent, a manager, or a studio HR department without your written consent.
Plain-English answers.
Do I need to switch to a different plan to use Shift?
No. We work with your existing SAG-AFTRA Health Plan on an out-of-network basis. There is no plan switch required, and switching off the SAG-AFTRA plan is almost never the right move for a working member because of how earnings-based eligibility accrues. We verify your specific Earner I or Earner II benefits and tell you the real out-of-pocket cost before you commit.
What is the EAP path and is it required first?
The SAG-AFTRA Health Plan provides Employee Assistance Program counseling through Carelon Wellbeing. Using the EAP is not a required gate to getting intensive outpatient care, but it is a useful starting point if you want a short-term counselor to help frame the conversation. When the clinical picture is intensive outpatient or PHP-intensity, the EAP counselor can refer out, and we take it from there. You can also call us directly and skip the EAP step.
What about a dependent? My spouse or adult child needs help.
Enrolled dependents on the SAG-AFTRA 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? My agent and casting 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 an agent, manager, casting office, studio, network, or production company unless you sign a specific written authorization. We also do not share with the SAG-AFTRA Health Plan beyond what is required to bill the claim and obtain authorization for the level of care. 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 SAG-AFTRA 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.