What You Need to Know About Health Insurance for Artists: Interview with Actra Fraternal Benefit Society’s Jason Saulay

Jason SaulayFor the past 5 years, Jason Saulay has been working with the Actra Fraternal Benefit Society (AFBS) to build their profile through member-oriented programs.

Recently, he has been promoting their health insurance solution (offered through a not-for-profit model) to self-employed people in the arts through the Arts & Entertainment Plan® and the Writers’ Coalition Program.

In the interview below, he explains why Canadian creative professionals need additional health insurance, how to decide what type of coverage you need, and what AFBS is offering to help artists with their insurance needs.

Why do (self-employed) creative professionals need additional health insurance?

As a self-employed person working in the arts, protection against risk is important yet many see insurance as an unnecessary expense – especially health insurance. Additional insurance is needed because the things you need to maintain your health or get you back to healthy are not covered by your provincial plan – prescription drugs, dental, registered specialties (acupuncture, chiropractor, massage etc…) and vision care to name a few – these are the types of things you need to maintain your health.

In Canada we have universal health care and we are very proud of it but provincial plans cover doctor visits, and in-hospital procedures, they don’t cover everyday maintenance of health and health care expenses.

What are some common misconceptions creative professionals have when it comes to health insurance? 

There are many misconceptions regarding health insurance, regardless of profession, but the 3 that come to mind and occur most often with creative folks are: 1) they don’t believe it’s necessary, 2) they think it’s not affordable and 3) they find it all confusing.

Those who don’t think health insurance is necessary are in one of two camps; they are fundamentally opposed to the concept of insurance or they don’t really understand what exactly they’re covered for with their provincial plan. For the latter, it’s easy to illustrate. The things you need to maintain or bring you back to good health are not covered.

For the people who think that insurance isn’t necessary and that they could go through their entire life and make all the payments for their health care at a lower cost than the total insurance premiums they would pay – that’s true. But it’s also true that the opposite can happen. The question these people should then be asking themselves is if they have a medical set-back, could they afford to come up with hundreds or thousands of dollars?

Unfortunately, the same people who oppose insurance generally (in my experience) don’t have a savings account for these types of expenses. Maybe then it makes sense to pay a monthly premium to manage that expense and at the same time leverage the cost of health care with an insurer so when you go to the pharmacist you only have to pay your portion of the expense and insurance covers the rest.

Health insurance is affordable if you consider what you would be using health claim wise year over year and taking into consideration the tax deductibility of the medical premiums if you’re self-employed.

And finally, it doesn’t have to be confusing, once you understand the basics it’s quite simple. It does involve you doing some research but a few minutes of reading can provide clarity. And don’t forget to call the insurer or broker and talk to them, ask questions.

What should creative professionals know about health insurance in Canada? 

To make sure we’re all on the same page let’s talk about where we stand when it comes to health care in Canada. If you have a health card, you’re part of Canada’s national health insurance program. The program is called Medicare.

Each province has their own health plan that follows the guidelines of the Canada Health Act. It’s a national program that’s composed of 13 interlocking provincial and territorial health insurance plans that all share common features and basic standards. It’s designed to ensure that all residents have reasonable access to medically necessary hospital and physician services, on a pre-paid basis.

Although a majority of Canadians hold some form of private health care insurance- most commonly obtained as an employment benefit (of themselves, a spouse or a partner) – private insurance’s role is essentially limited to services not covered by public insurance programs. What’s an important take away of that is, the majority of artists (by way of occupation) don’t factor into having private coverage through employment. The fact is the majority of artists are often  not insured or underinsured.  Because you’re self-employed in order to supplement your primary health coverage (or Medicare), you would need to purchase private health insurance on your own.

When we speak of Private health insurance we are talking about personal health insurance through private insurers, not the government. Everything that’s not covered by your public plan, which is a lot and its growing.

Private health insurance is obtained in 2 ways: 1) By a job through employer-sponsored plans or 2) individual health insurance that you buy personally in the marketplace. Since I’m talking to artists, we’re probably talking about health insurance that you would buy personally from a carrier or insurer as many artists don’t have access to health insurance through employment.

What should creative professionals consider when deciding on health insurance (i.e. when considering whether to get it and what exactly to get)? 

In general terms, insurance is the transfer of risk. It’s a product that addresses an individual’s need for sense of security. It’s part of a bigger picture, which is financial planning.

At the core of all these decisions is that we are trying to protect ourselves should something catastrophic happen. For health insurance we are trying to be proactive in maintaining our health while at the same time protecting our wealth.

The decision to purchase health insurance revolves around finances. Do you have a savings account that can address unexpected medical expenses? For most, they don’t. Maybe it makes sense to manage a monthly premium so you have a fixed-cost that shares the risk with an insurer so you’re not out of pocket the whole amount and at the same time offers protection should the unexpected happen.

We don’t know when some medical expenses will occur but for some expenses we do – if you take a regular medication, go to the dentist, visit the chiropractor or get your eyes checked. If you have an idea of what you spend each year for these things and you know what you use, maybe a health insurance policy makes sense if you factor in how you claim and the protection it offers should something happen.

Not to mention, many policies come with other add-on benefits that could bring down the overall cost if you would buy these things on your own. For example, Travel Emergency Medical premiums range anywhere from $30 – $500 dollars if you were to purchase on your own. Many health plans offer this as part of the offering. This is just one example of the value that could be found in health insurance offerings, there are more.

What you need to know is that all health insurance products offered on the market to individuals generally consist of the following benefits: Prescription Drugs, Dental, Extended Health Care (hospital rooms, devices, vision, massage etc…), Accidental Death & Dismemberment and Travel Emergency Medical. This is the basic structure of all offerings they just differ by limits, exclusions, co-insurance, deductibles or waiting periods in each of the main categories I’ve identified.

As an individual you need to decide what benefits are important to you and look for a product that fits your budget, needs and comfort level. Ask yourself things like:

  • What am I looking for health insurance to do for me?
  • How much do I typically spend on health care or health care expenses yearly?
  • What am I willing to pay?
  • Who am I covering?
  • What benefits are absolutely necessary for me?
  • Do I have access to group coverage?
  • Am I eligible for the plans I’m interested in?

These question will get you thinking and will help you in deciding what you need and/or what you’re looking for.

What is the AFBS and what does it do for creative professionals?

afbs-logoAFBS was created almost 40 years ago by artists in film, television and radio and is the insurance and retirement plan provider for the Canadian artistic community, having acted as the insurance and retirement trustee for all performers and screenwriters since 1976.

We are a not-for-profit, member-owned and governed, federally incorporated insurer – exclusive to the arts. Our organization has been a very successful partnership between performers, writers, musicians, visual artists, composers, producers and broadcasters to name a few – for years.

AFBS is purpose built – to allow us to take care of one another. Although we provide the services of a healthcare insurer and an investment overseer, we do not nor have ever seen these specifics as our sole purpose or identity.

The mandate of AFBS is to strive to provide financial security for members who pursue careers where financial stability is the exception rather than the norm.

We are a network of creative professionals who know the life of “creative people” in all their intricacies and who have pooled their knowledge and resources to financially backstop and inspire their creative existence and provide the safety and security required to be able to do what they do well – enrich people’s lives!

You can find out more about the Actra Fraternal Benefit Society (AFBS) on their website as well as the Arts & Entertainment and Writers’ Coalition Programs or you can reach Jason directly at jsaulay@afbs.ca or 416-967-6600/1-800-387-8897 Ext 256.

* Originally published on Canada Arts Connect Magazine.