AMERICAN GUILD
of
VARIETY ARTISTS
National Office:
363 Seventh Avenue
17th Floor
New York, NY 10001-3904
{212}675-1003
(212)633-0097 Fax
agva@agvausa.com
agvany@aol.com
West Coast Office:
11712 Moorpark Street
Suite 110
Studio City, CA 91604
(818)508-9984
(818)508-3029 Fax
agvawest@earthlink.net
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AGVA WELFARE TRUST FUND
363 Seventh Avenue, 17Th Floor
New York, New York 10001-3904
(212) 627-4820

PLAN M – MEDICARE SUPPLEMENT (THE DON GEORGE PLAN)

ELIGIBILITY

If you are a Medicare recipient and have ten (10) years of membership in good standing with AGVA, you may apply for Plan M. The years need not be consecutive, except for the last three (3) years.

All of the benefits and restrictions of Plan B apply except that there is a $200 deductible per calendar year (instead of $300).

Since the plan supplements Medicare for Part A/ Part B, the procedure is as follows:

20% of Approved Medicare benefits
Hospital Deductible benefit
Have your provider submit your bill for his/her services to Medicare
When you receive Medicare’s explanation of benefits, send it, with your original bill, to the AGVA Welfare Trust Fund
As a reminder, please ensure that your dues are paid on time so as not to jeopardize your eligibility for Plan M
If we can be of assistance, please notify us
THE BENEFITS DESCRIBED IN THIS SUMMARY ARE SUBJECT TO THE PLAN OF BENEFITS ADOPTED BY THE BOARD OF TRUSTEES, AS AMENDED FROM TIME TO TIME. WHERE A DISPUTE ARISES REGARDING THIS SUMMARY AND THE PLAN OF BENEFITS, THE DECISION OF THE BOARD OF TRUSTEES SHALL BE FINAL AND BINDING ON ALL PARTIES.
+++COMBINED LIFETIME MAXIMUM OF $10,000 FOR ALL BENEFITS+++