How can SAG-AFTRA's health plan balance comprehensive coverage for members against long-term financial sustainability?

Introduction

Balancing comprehensive coverage for SAG-AFTRA health plan members against long-term financial sustainability presents a critical trade-off. This scenario involves managing the needs of union members while ensuring the plan's viability. I'll analyze this trade-off by examining key stakeholders, metrics, and potential solutions.

Step 1

Clarifying Questions (3 minutes)

• Based on recent industry trends, I'm thinking healthcare costs might be rising faster than contributions. Could you provide insight into the current financial state of the SAG-AFTRA health plan?

Why it matters: Helps understand the urgency and scale of the problem Expected answer: The plan is facing financial pressure due to rising costs Impact on approach: Would influence the aggressiveness of cost-cutting measures

• Considering member demographics, I'm assuming there's a diverse range of healthcare needs. Can you share information about the current membership profile and their most common health concerns?

Why it matters: Allows for targeted solutions that address member needs Expected answer: Aging membership with increasing chronic condition management needs Impact on approach: Would focus on balancing preventive care with treatment options

• Looking at the entertainment industry landscape, I'm thinking there might be fluctuations in contributions due to project-based work. How stable are the contribution inflows to the health plan?

Why it matters: Helps assess the predictability of funding Expected answer: Contributions vary based on industry cycles and individual member work patterns Impact on approach: Would consider more flexible coverage options or contribution models

• Given the union's strong advocacy role, I'm curious about member expectations. What feedback have you received from members about their current coverage and any potential changes?

Why it matters: Ensures solutions align with member priorities Expected answer: Members highly value comprehensive coverage but are concerned about rising costs Impact on approach: Would focus on communicating value and exploring cost-sharing options