Skip to main content

EIEA – July 2026 HR Brief

Question of the Month:

Did you know that your EIEA membership includes access to your own HR Portal at no additional cost?

Answer:

As an EIEA member, you receive full access to the EIEA HR Portal at no additional cost. Designed to simplify HR management, the portal is easy to use, intuitive, and backed by comprehensive training and ongoing support for your team. Contact us at info@eieaonline.org for more information.

Membership has its benefits. Make the most of yours.


2026 Midyear Employee Benefits Market Outlook

As 2026 continues, health care costs define the narrative for employers and benefits leaders alike. Organizations face mounting pressure to balance rising health care costs. Prescription drug spending continues to climb, with glucagonlike peptide-1 (GLP-1) medications emerging as one of the most transformative and closely watched categories, reshaping employer costs, vendor strategies and employee expectations around weight management and chronic disease care. New prescription drug platforms, such as TrumpRx, and direct-to employer (DTE) distribution models are changing the available options and require active monitoring from employers as they make decisions for their 2027 plan design.


6 HR Trends in 2026

The workplace in 2026 is undergoing a transformation, largely driven by technological advancements, regulatory shifts and evolving employee expectations. HR is not a back-office function. More than ever, it’s a strategic partner shaping organizational resilience and competitiveness.

Employers will face a dynamic environment in 2026 that demands agility, foresight and collaboration. This article explores six HR trends that will define the year ahead.

1. AI Redefining Roles and Expectations

Artificial intelligence (AI) is no longer just a productivity tool; it’s a workforce disruptor. According to global consulting firm Korn Ferry, more than 4 in 10 companies plan to replace roles with AI. This trend is most pronounced in positions that involve repetitive tasks or data-heavy processes, such as administrative support.

At the same time, AI is creating new opportunities that demand a different skill set. Research shows that while AI and automation threaten many U.S. jobs, they also accelerate demand for roles in industries such as technology, energy and AI infrastructure, as well as those focused on oversight, ethics and human-AI collaboration. Navigating soft skills, such as adaptability, critical thinking and emotional intelligence, is becoming as important as technical proficiency. Employers are investing heavily in reskilling programs to prepare employees for emerging roles, such as prompt engineering and algorithmic auditing. For both workers and employers, success in 2026 will depend on finding ways to work with AI rather than ignore it.

Furthermore, AI’s impact in the workplace expands beyond work tasks and processes. In 2026, empathetic leadership is on the rise amid the digital era. As AI takes on routine tasks, the value of managers, supervisors and company leadership with emotional intelligence, adaptability and communication skills is more important than ever.

As such, organizations can double down on empathy, trust and purpose-driven leadership. Employers recognize that technology can handle tasks, but it cannot replace the creativity, emotional intelligence and resilience that people bring to the workplace. By prioritizing mental well-being, fostering positive workplace cultures and designing roles that empower autonomy, companies are ensuring that innovation remains human-centered. In 2026, leading with humanity is key to thriving in a digital world where machines amplify, but humans define, the future of work.

2. The Growing Gig Economy

Gig work refers to labor defined by short-term contracts, freelance work and independent contracting, rather than traditional full-time employment. Employers commonly use these services to fill skill gaps, manage project-based workloads or reduce overhead costs. An increasing number of workers are actively embracing gig work. According to Statista, more than 70.4 million Americans are currently involved in freelance work. By 2027, freelancers, gig workers and crowd workers are expected to become the majority of the workforce. For employers, this trend is increasingly unavoidable.

People may be drawn to gig work for a variety of reasons. Some pursue it full-time, embracing the independence and flexibility it offers as a lifestyle choice. Others engage in gig work alongside traditional Form W-2 employment, using it to supplement their income, gain a safety net in case of layoffs or enjoy more control over their schedules. This hybrid approach is especially appealing to students, caregivers and professionals seeking autonomy or a creative outlet. For many, gig work is a strategic way to diversify income and reduce reliance on a single employer, offering both financial and personal empowerment.

At a broader level, the gig economy is reshaping the labor market. More workers are prioritizing the autonomy, variety and perceived control that gig work offers, sometimes opting out of conventional employment altogether. This trend presents new challenges for employers, who must adapt their recruitment strategies and workplace policies to remain competitive in attracting talent and meeting operational demands. As the gig economy continues to grow, understanding its dynamics is essential for organizations seeking to build resilient and responsive workforce models.

3. An HR and IT Alliance

In 2026, a partnership between HR and IT will be critical. As organizations deploy AI, advanced analytics and integrated digital platforms, HR leaders need IT expertise to ensure secure, scalable and compliant systems. This alliance goes beyond technology implementation. The goal is to co-create a human-centered digital ecosystem.

Together, HR and IT can design workflows that automate routine tasks, such as onboarding and payroll, while maintaining transparency and fairness through governance frameworks. This team can also collaborate on data privacy, cybersecurity and ethical AI use, ensuring that innovation doesn’t compromise trust. By working together, these functions enable personalized employee experiences, predictive workforce planning and adaptive learning systems, all while safeguarding organizational
integrity.

4. Layoffs Reshaping Talent Pools

Economic uncertainty is reshaping workforce strategies, and layoffs are at the center of this transformation. According to Resume.org, 6 in 10 companies plan to lay off employees in 2026, a stark indicator of how organizations are bracing for slower growth and tighter budgets. These cuts aren’t just about trimming costs; they’re fundamentally altering the labor market. While overall labor reports show that total employment and hiring activity have fluctuated at relatively normal levels, the proportion
of layoffs has been significant and is expected to continue into 2026. This contrast highlights a shift in workforce dynamics: Organizations are maintaining or even expanding hiring in some areas while aggressively reducing headcount in others, signaling a more selective and cautious approach to talent management.

When employers downsize, the impact doesn’t end with job loss. Remaining employees often face heavier workloads, increasing the risk of stress and burnout. At the same time, layoffs expand the talent pool with experienced professionals, creating both opportunities and challenges for hiring and retention. For employers, this means striking a balance between short-term savings and long-term stability. While layoffs can ease financial pressure for employers, they can also erode employee morale and loyalty, making retention more challenging.

5. The Rise of Skills-based Hiring

Skills-based hiring has been gaining traction for years, and this trend is expected to continue in 2026. As such, more employers may focus their hiring efforts on looking for the right skills rather than experience or education. Employers may consider skills-based hiring to help them attract top talent. While specific qualifications may be valuable for some roles or industries, HR professionals may evaluate candidates based on desired skills rather than experience or education. With robust learning and development initiatives in place, employers can hire workers who are an excellent cultural fit and then train them on specific skills or tasks later. AI-powered personalized learning platforms can also deliver adaptive micro-learning pathways tied to real time performance feedback. While the labor market has been shifting to be less worker-friendly, employers are still struggling to find qualified candidates who will be a good fit for the company.

6. Compliance Changes

In 2026, the One Big Beautiful Bill Act (OBBBA) is ushering in wide-ranging compliance changes related to compensation, benefits and payroll operations. Under the OBBBA, qualifying employees can now deduct up to $25,000 in tips and $12,500 in Fair Labor Standards Act (FLSA) overtime pay from federal income taxes, significantly altering how employers calculate, track and report wages. This has prompted HR teams to transform ordinary payroll systems into strategic compliance platforms, such as upgrading their human resource information system (also known as HRIS) to track qualified tips and overtime, redesigning W-2 formats and aligning with new IRS guidance and deadlines.

Meanwhile, the expansions of health savings accounts, telehealth, dependent-care flexible spending accounts, student loan repayment and direct primary care are shifting benefits from compliance necessities to competitive advantages. This could potentially help HR reposition health care access and financial wellness as central pillars of employer value propositions. By turning regulation into opportunity, HR professionals can enhance attraction and retention, employee financial well-being and organizational agility.

In addition, many new state laws have gone into effect in January 2026, including 19 states raising their minimum wage. With many of the OBBBA’s broad changes to employee benefit plans taking effect in 2026, more employers will be taking a proactive approach to compliance.

Summary

As 2026 unfolds, HR leaders stand at the intersection of technology, compliance and workplace culture. Organizational success may hinge on employers’ ability to embrace innovation while safeguarding trust and fostering partnerships that support sustainable growth. Whether it’s navigating compliance, leveraging AI responsibly or leading with empathy in a digital era, the message is clear: the future of work is both high-tech and deeply human. Savvy organizations will not only weather uncertainty but also design workplaces that strike a balance between performance and purpose.

Reach out today for more workplace guidance.

This HR Insights is not intended to be exhaustive nor should any discussion or opinions be construed as professional advice. © 2026 Zywave, Inc. All rights reserved


What to Know About the Cyclosporiasis Outbreak

Cases of cyclosporiasis are climbing across the country this summer, and health officials are urging extra caution around food and water safety. The Michigan Department of Health and Human Services is tracking the outbreak in real time. As of July 13, the state has recorded almost 3,000 cases and around 50 hospitalizations, though these numbers are expected to continue climbing. Cases have also been reported in Ohio, with additional investigations underway in more than two dozen other states.

This article explains what cyclosporiasis is, how it spreads, and what you can do to protect yourself and your family.

About Cyclosporiasis

According to the Centers for Disease Control and Prevention (CDC), cyclosporiasis is an intestinal illness caused by a microscopic parasite called Cyclospora. Cyclosporiasis is not usually life-threatening, but it can cause weeks of uncomfortable symptoms. Not everyone who is infected will get sick, and person-to-person spread is unlikely, since the parasite needs one to two weeks outside the body before it can infect someone else.

People typically become infected with cyclosporiasis through:

  • Consuming fresh produce, such as lettuce, basil, cilantro, raspberries or snow peas, that has been contaminated with feces
  • Drinking water that is contaminated
  • Swimming or wading in contaminated pools, lakes or other recreational water, since the parasite can survive chlorine treatment

Health officials have not yet identified a single source for the current outbreak, so it’s especially important to understand the symptoms of cyclosporiasis and how to protect the health of you and your family.

Symptoms

Cyclospora infects the small intestine and most commonly causes watery, frequent and sometimes explosive diarrhea. Other common symptoms include:

  • Loss of appetite
  • Weight loss
  • Cramping and bloating
  • Nausea
  • Fatigue
  • Low-grade fever

Symptoms usually begin one to two weeks after exposure, though this can range from two days to two weeks or more. Without treatment, symptoms may last anywhere from a few days to over a month, and they can even improve before returning.

One risk factor for serious complications is dehydration, which can result from frequent bouts of diarrhea.
Symptoms of dehydration include:

  • Decreased urination
  • Dry mouth and throat
  • Dizziness when standing up

Prevention

The CDC recommends practicing safe food and water handling to help lower your risk of cyclosporiasis. Consider taking the following precautions:

  • Buy whole heads of lettuce rather than pre-washed, bagged salad mixes.
  • Separate and thoroughly wash cilantro and basil leaves.
  • Trim the root end and peel the outer layer of green onions.
  • Scrub firm produce, such as melons, cucumbers and snow peas, with a clean brush under running water.
  • Cook produce when possible, since heating food to 158 degrees Fahrenheit or higher kills the parasite.
  • Consider avoiding raw raspberries in areas with active outbreaks, as their bumpy surface makes them especially hard to clean.
  • Wash your hands with soap and water before and after preparing food.

Keep in mind that washing produce can reduce risk but isn’t a guarantee, since Cyclospora can be difficult to rinse away completely. If there is an outbreak in your area, it’s also wise to avoid public swimming areas, since this parasite is resistant to chlorine and can linger in pools, splash pads, lakes and rivers.

Treatment

Cyclosporiasis is typically treated with a course of antibiotics, along with rest and plenty of fluids to help prevent dehydration. Some infections may resolve without treatment, though this can take longer without medical care. If you experience diarrhea lasting more than 48 hours, especially in an area with a known outbreak, contact your healthcare provider for testing and treatment.

Summary

Cyclosporiasis cases have been climbing across multiple states, with Michigan reporting the highest number so far, and health officials are still working to identify the source of a specific outbreak. Because the situation continues to evolve, it’s important to monitor local and national health updates to stay informed and adjust your precautions as needed. In the meantime, following food safety recommendations, such as thoroughly washing and, when possible, cooking your produce, can help reduce your risk of infection.

For additional information or concerns about cyclosporiasis, contact your primary care provider.

This article is for informational purposes only and is not as medical advice. For further information, please consult a medical professional. © 2026 Zywave, Inc. All intended rights reserved.

The Payroll Data Behind Your Healthcare Compliance

Setting the Scene

A production company, a crew of hundreds, and a compliance clock ticking

Picture a mid-sized entertainment employer — a production company managing multiple overlapping projects. At any given time, dozens of crew members are cycling on and off productions. Some work 60-hour weeks for three months straight. Others are called in for a few days here, a week there. Some hold simultaneous engagements across two or three productions under the same employer umbrella.

This is the everyday reality for EIEA member companies. And woven through all of it — invisibly, critically — is a compliance obligation that hinges entirely on one thing: knowing exactly how many hours each of those workers has logged.

That’s where payroll tracking becomes not just an operational function, but the foundation of healthcare coverage compliance.

Why payroll data drives coverage

Hours aren’t just a paycheck calculation — they’re an eligibility trigger

Under the Affordable Care Act, applicable large employers (ALEs) — those with 101 or more full-time employees and full-time equivalents — must offer minimum essential coverage to employees averaging 30 or more hours per week. Miss that threshold determination, and the consequences range from a coverage gap for the employee to a significant penalty assessment for the employer under IRC Section 4980H.

The only way to make that determination accurately is through disciplined, continuous payroll tracking. Every hour recorded, every pay period closed, every payroll register filed — these are not just accounting entries. They are the raw data from which ACA eligibility is built.

In the entertainment industry, hours can be irregular, production-specific, and spread across multiple payroll companies or signatories. EIEA’s tracking infrastructure is designed precisely to aggregate that fragmented data into a single, defensible compliance picture.

How the Process Works

From timecard to coverage determination: the compliance chain

  • Hours are recorded at the production level
    Every hour worked — whether on a feature film, a commercial shoot, or a streaming series — is captured through the production’s payroll system.
  • Payroll data is transmitted to EIEA
    Member companies transmit payroll registers to EIEA on a recurring basis. This includes each worker’s hours, earnings, job classification, hire date, and termination date.
  • Hours are aggregated and measured
    EIEA consolidates hours across all productions for each individual worker. Using the look-back measurement method, total hours are evaluated over the defined measurement period to determine whether the employee meets the full-time threshold.
  • Eligibility is determined and coverage is offered
    Workers who average 30 or more hours per week during the measurement period are flagged as ACA-eligible an the EIEA automatically offers coverage.
  • Data flows into annual ACA reporting
    The same payroll data that drove eligibility determinations feeds directly into Forms 1094-C and 1095-C — the annual IRS filings that document every offer of coverage made to every full-time employee throughout the year.

The EIEA’s Role

Infrastructure that individual employers can’t build alon

For entertainment industry employers, payroll tracking is not a back-office problem — it’s a front-line compliance function. The hours recorded today determine the coverage offers due in the next stability period. The payroll data submitted this quarter determines the accuracy of the 1095-C filed next January.

EIEA’s model brings together employers under a shared compliance infrastructure: standardized data collection, centralized hour aggregation, measurement period management, and fully coordinated ACA reporting. Members don’t have to build that capability themselves — they access it through EIEA’s platform and expertise.

The result is a system where payroll tracking is no longer just about cutting checks. It’s about protecting employees’ access to coverage, protecting employers from penalty exposure, and building the kind of documented compliance record that holds up under scrutiny.

For EIEA members, every payroll register submitted is a compliance action. It’s how hours become eligibility, and eligibility becomes coverage — and coverage becomes the documented, reportable proof of an employer meeting its ACA obligations.

Entertainment Industry Employers Association (EIEA) — serving employers and employees across the entertainment industry.

ACA Eligibility & Tracking: What Employers Need to Know

DEFINING ELIGIBILITY

Who Qualifies Under the ACA?

Under the Affordable Care Act, applicable large employers (ALEs) — those with 50 or more full-time equivalent employees — are required to offer minimum essential coverage to full-time employees or risk penalties. A full-time employee is defined as someone who works an average of 30 or more hours per week, or 130 hours per month. In the entertainment industry, where workers frequently move between productions, projects, and short-term engagements, determining who meets that threshold is rarely straightforward. That’s why systematic tracking is not just best practice — it’s essential.

MEASUREMENT PERIODS

Counting Hours the Right Way

The IRS provides two methods for tracking employee hours to determine ACA eligibility: the monthly measurement method and the look-back measurement method. The look-back method is particularly useful for variable-hour and seasonal workers — a common reality in entertainment. It allows employers to observe an employee’s hours over a defined measurement period (typically 3–12 months) before determining their status for a subsequent coverage period. This gives employers a structured, defensible approach to eligibility determinations when work schedules are unpredictable.

STABILITY PERIOD

Locking in Coverage Status

Once an employee is determined to be full-time during the measurement period, they must be offered coverage for the entirety of the subsequent stability period — regardless of how many hours they actually work during that window. The stability period must be at least six months and no shorter than the measurement period itself. This protects employees from losing coverage mid-year due to fluctuating schedules, and it protects employers who follow the process correctly from inadvertent ACA penalties.

DATA COLLECTION

The Foundation of Compliance

Accurate, consistent data collection is the backbone of ACA compliance. Employers must track hours of service for every employee — including hourly, salaried, and variable-hour workers — and maintain those records with precision. For EIEA members, this means aggregating data across productions, payroll companies, and signatories. Tracking systems must capture hire dates, termination dates, hours worked, and any applicable waiting periods. Without reliable data, measurement periods and eligibility determinations are impossible to defend in an audit.

REPORTING

Forms 1094-C and 1095-C

All of this tracking culminates in annual ACA reporting obligations. Applicable large employers must file two key forms with the IRS each year:

  • Form 1094-C
    Transmittal Form
    Filed with the IRS as a cover sheet summarizing the employer’s offer of coverage and aggregated employee data across the reporting year.
  • Form 1095-C
    Employee Statement
    Issued to each full-time employee, detailing the coverage offered, employee cost, and months of coverage — used when filing personal tax returns.

Deadlines, accuracy, and completeness all matter. Errors or late filings can trigger IRS penalties under Sections 6721 and 6722. For EIEA members, coordinating this reporting across a fragmented workforce makes early data collection and strong administrative infrastructure a year-round priority — not just a January scramble.

ACA compliance in entertainment isn’t a once-a-year task. It’s a continuous process of tracking, measuring, and reporting — and EIEA is here to support members every step of the way.

Entertainment Industry Employers Association (EIEA)  |  ACA Compliance Resources

What Is COBRA Continuation Coverage?

COBRA – the Consolidated Omnibus Budget Reconciliation Act – requires group health plans to offer continuation coverage to covered employees, former employees, spouses, former spouses, and dependent children when group health coverage would otherwise be lost due to certain events. Those events include:

  • A covered employee’s death,
  • A covered employee’s job loss or reduction in hours for reasons other than gross misconduct,
  • A covered employee’s becoming entitled to Medicare,
  • A covered employee’s divorce or legal separation, and
  • A child’s loss of dependent status (and therefore coverage) under the plan.

COBRA sets rules for how and when plan sponsors must offer and provide continuation coverage, how employees and their families may elect continuation coverage, and what circumstances justify terminating continuation coverage.

Employers may require individuals to pay for COBRA continuation coverage. Premiums cannot exceed the full cost of the coverage, plus a 2 percent administration charge.

Group Health Plans Subject to COBRA

COBRA generally applies to all private sector group health plans maintained by employers that had at least 20 employees on more than 50 percent of its typical business days in the previous calendar year. Both full- and part-time employees are counted to determine whether a plan is subject to COBRA. Each part-time employee counts as a fraction of a full-time employee, with the fraction equal to the number of hours worked divided by the hours an employee must work to be considered full time. For example, if full-time employees at Company A work 40 hours per week, a part-time employee who works 20 hours per week counts as half of a full-time employee, and a part-time worker who works 16 hours per week counts as four-tenths of a full-time employee.

COBRA also applies to plans sponsored by state and local governments.(1) The law does not apply, however, to plans sponsored by the federal government or by churches and certain church-related organizations.

What is a group health plan? It is any arrangement that an employer establishes or maintains to provide employees or their families with medical care, whether it is provided through insurance, by a health maintenance organization, out of the employer’s assets, or through any other means. “Medical care” includes for this purpose:

  • Inpatient and outpatient hospital care,
  • Physician care,
  • Surgery and other major medical benefits,
  • Prescription drugs, and
  • Dental and vision care.

Life insurance and disability benefits are not considered “medical care.” COBRA does not cover plans that provide only life insurance or disability benefits.

COBRA-covered group health plans that are sponsored by private-sector employers are generally considered welfare plans under ERISA and therefore subject to ERISA’s other requirements. Under ERISA, group health plans must be administered by a plan administrator, who is usually named in the plan documents. Many group health plans are administered by the employer that sponsors the plan, but group health plans are also frequently administered, in whole or in part, by a separate individual or organization, such as a professional benefits administration firm. Carrying out the requirements of COBRA is the direct responsibility of the plan administrator.

Source –
An Employer’s Guide to Group Health Continuation Coverage Under COBRA

What Is Prior Authorization?

If you’ve ever been told that a medication, test or procedure needs “prior authorization,” you’re not alone. It’s a common part of using health insurance, but it can still be inconvenient to many people. In fact, a 2026 KFF poll found that 1 in 3 insured adults say prior authorizations are a “major burden” for getting health care. An additional 4 in 10 adults say that prior authorization is a “minor burden,” meaning about 7 in 10 adults find the process taxing.  

While prior authorization can feel like an extra hurdle, understanding how it works can help you avoid surprises and get the care you need with less stress. This article explains prior authorization, including why and when the process is needed.

What Is Prior Authorization?

Prior authorization may also be referred to as preauthorization, precertification or prior approval. Prior authorization is a process where your doctor must get approval from your health insurance before your plan will cover certain medications, treatments or services. It acts as a green light confirming that the care you’re about to receive is something your insurance plan considers appropriate and eligible for coverage.

“Step therapy” is another term you may hear when seeking health care. Step therapy is a type of prior authorization in which an insurance company has you try less expensive prescription options before “stepping up” to costlier drugs. Basically, the health plan won’t cover the more expensive drug until the lower-cost medication has failed to treat the condition.  

Here’s a simple breakdown of what usually happens during the prior authorization process:  

  • Your doctor recommends care that may need approval.
  • Your doctor’s office submits paperwork to your insurance plan.
  • The insurer reviews the request, checking it against their clinical guidelines.

You and your doctor receive a decision that’s an approval, a denial or a request for more information.   The process may involve different steps, depending on whether the doctor, the lab or a third-party service handles the request. Regardless, the goal is the same: confirming that the plan will cover the care. If the care you need is urgent, most states’ laws require the insurance company to respond within 1 to 3 days; however, if the care isn’t urgent, the company may take up to a few weeks.  

While the prior authorization process helps control costs and reduce unnecessary care, it can also delay care if information is missing or the insurance company needs more details.  

When Is Prior Authorization Needed?

You might need prior authorization for:  

  • Prescription drugs, especially newer, higher-risk or more expensive medications
  • Imaging tests like MRI or CT scans
  • Planned surgeries or hospital stays
  • Specialty treatments or durable medical equipment  

Emergency care generally does not require prior authorization, but follow-up treatment sometimes does.

Your benefits documents or your insurer’s drug or procedure list can tell you which services need approval.  

Who Handles the Prior Authorization Process?

In most cases, your health care provider is responsible for submitting the prior authorization request. They’ll explain to your insurance company why you need the treatment and may need to provide medical records or document what other treatments you’ve already tried.  

If you see a provider who is outside your plan’s network, you may need to help with the request yourself by contacting your insurance carrier.  

What if a Prior Authorization Is Denied?  

A denial doesn’t necessarily mean you can’t get the care. You still have options. As such, you and your health care provider can pursue the following actions:  

  • Submit more information if something was missing.
  • Appeal the decision and explain why the treatment is necessary.
  • Explore alternatives that are covered by the plan, such as meeting step therapy requirements.

Appeals are common, and many approvals happen once more detailed medical documentation is provided.  

Why Is Prior Authorization Required?  

Prior authorization isn’t meant to be a barrier to health care. Insurance companies require prior authorization to help ensure that:  

The treatment is medically necessary, meaning it’s the right care for your condition based on medical guidelines and evidence. This review helps ensure that a medication, test or procedure is known to be effective for your situation. Health plans rely on clinical experts, including doctors and pharmacists, to evaluate requests and compare them to current medical research and guidelines.

Safer or more effective options have been considered, especially for medications or procedures with higher risks, stronger side effects or complex alternatives. Prior authorization allows insurers to confirm that the standard, recommended or lower‑cost options were explored first. In addition, insurers may require prior authorization to confirm that these treatments are safe and appropriate for you, especially when there are known risks or contraindications. This extra step helps protect patients from potential harm.

Costs stay manageable, both for you and for the health plan, by checking whether a lower cost but equally effective alternative is available. Health care costs vary widely, even between medications or procedures that achieve the same result. Prior authorization helps prevent unnecessary spending by encouraging the use of treatments that are both effective and cost-efficient. For example, if a generic medication is available and works just as well as a brand‑name drug, the insurer may require prior authorization to steer care toward the more affordable option. This helps keep overall plan costs and, ultimately, premiums more stable.

Care fits your health plan’s coverage rules, to avoid situations where a service isn’t covered and leaves you responsible for a large, unexpected bill. Every health plan has its own list of covered treatments, preferred medications and participating providers. Prior authorization helps verify that the care your doctor orders aligns with your plan’s benefits, network rules and coverage requirements.  

Conclusion  

Prior authorization can feel like an extra layer in your health care journey, but it’s designed to make sure the care you receive is safe, effective and covered under your plan. The more you know about the prior authorization process, the more empowered you’ll be when navigating your benefits.  

If you’re unsure whether something needs prior authorization, you can check your health plan documents or call your insurance company. Talk to your health care provider if you have any general questions about prior authorization.      


This Compliance Overview is not intended to be exhaustive nor should any discussion or opinions be construed as legal advice. Readers should contact legal counsel for legal advice.

©2025 Zywave, Inc. All rights reserved.

CAST & CREW ENTERTAINMENT SERVICES LAUNCHES INNOVATIVE HEALTH INSURANCE SOLUTION FOR INDUSTRY

Open Health Provides Coverage for Non-Union Employees; Simplifies Sign-Up, Budgeting and Ongoing Administrative Burden for Employers

BURBANK, Calif., November, 4, 2014 – Cast & Crew Entertainment Services, the premier provider of payroll and production accounting services to the entertainment industry, today announced the launch of Cast & Crew Open Health (the “Plan”) (www.cc-openhealth.com), a unique Affordable Care Act-compliant health care insurance offering. The Plan brings to the industry several solutions – simplified sign-up, budgeting and administrative responsibility – not available from any other plan.

The Plan, which is eligible for most state tax-incentive programs, provides coverage for all non-union employees working in the entertainment industry. It is portable for the employer irrespective of payroll-service provider. It also is portable for employees who become covered under the Plan.

Under the employer responsibility requirements of the ACA, large employers must provide health insurance for their employees, or pay a penalty. The penalties are scheduled to go into effect on January 1, 2015.

“The ACA presents very specific challenges to our industry, given its transient workforce,” said Eric Belcher, President and Chief Executive Officer. “To ensure we clearly understood employer concerns and objectives before rushing to market with a quick-fix product or one that doesn’t work, we talked with numerous studios and production companies over the past several months so we could develop a comprehensive solution.

“Employers told us they want a simple solution that eliminates the administrative burden, so they can focus on their productions – not the ACA. Cast & Crew Open Health does that. They also told us they want it to address the very specific employee challenges we have as an industry. I am pleased to say Cast & Crew Open Health addresses their objectives: We’ve simplified the process. It’s an industry solution. And employers can ensure they are compliant with the ACA.”

To bring this type of coverage to the industry, Cast & Crew established the Plan as a multiple-employer health plan. The Plan is designed to provide medical coverage that satisfies ACA requirements to all non-union employees who are required to be offered coverage under the ACA. Accordingly, employers can ensure ACA compliance by participating in the Plan. This is the only plan of its kind offering the non-unionproduction employees a guild-like program.

This structure, developed with leading insurance brokers, attorneys and other insurance and entertainment human resources experts, enables Cast & Crew Open Health to provide employers with large-group pricing and benefits that are superior to market-based coverage that can be obtained elsewhere. The Plan’s fee structure is based on a percentage of gross wages, a structure familiar to the industry.

“Cast & Crew Open Health simplifies budgeting and significantly lessens employers’ administrative burdens,” added Shardell Cavaliere, Senior Vice President, Client Relations at Cast & Crew Entertainment Services and a member of the Board of

Trustees of the Plan. “It removes the need to track employee hiring status and terminations, and because it is billed as a fringe there is no need to allocate premiums down to productions. Cast & Crew Open Health provides the entertainment industry with a one-of-a-kind solution not available elsewhere.”

The Plan complies with ERISA, the ACA and other applicable law and is funded through a trust established for the exclusive benefit of the participants. The trust will hold all the insurance contracts and be a conduit for payment of premiums.

Coverage is provided through Anthem Blue Cross and includes HMO/PPO options as well as optional dental, vision and life. Enrolled individuals will have access to the largest national network in the country, with more than 900,000 providers. Anthem members, moreover, have access to more than 90 percent of hospitals and 90 percent of physicians nationwide – more than any other insurer. Cast & Crew Open Health and Anthem Blue Cross provide employer and employee support through various communication methods, including email, a 24×7 phone center and online assistance.

The Plan is part of the company’s Cast & Crew Complete benefits-management suite. Another component is Cast & Crew ACA SureTrack, which is a comprehensive online ACA management system.

The Plan was developed with The Henehan Company and The Miles Organization, which evaluate, design, implement and administer employee benefit plans.

About Cast & Crew

Cast & Crew Entertainment Services, LLC (www.castandcrew.com) is the premier provider of payroll and related services to the entertainment industry. It is owned by an investor group led by ZM Capital, ZelnickMedia’s private equity fund. Cast & Crew is the leading provider of technology-enabled payroll and related business services to film and TV productions. Cast & Crew’s services include payroll processing, residuals, workers’ compensation, labor relations, production incentives, as well as financing production tax credits. Cast & Crew’s PSL production accounting software is the industry-leading accounting application to serve the needs of the film, television and digital media industries. The company, which was founded in 1976, owns and operates each of its offices – eight in the U.S., two in Canada and one in the U.K. Cast & Crew’s corporate headquarters are in Burbank, California.