Motion Picture Fund Sets Up HMO for the Industry : Health: MCA/Universal is the first studio to offer the product, which gives access to a network of health centers, hospitals and 450 physicians.

The Motion Picture and Television Fund expanded its province as a health care provider last week with the establishment of a health maintenance organization that will service exclusively members of the entertainment industry and their families.

Fund officials said their plan is designed to give employees of the major movie studios, production companies and local industry trade unions an affordable way to use the nonprofit organization’s network of health centers, hospitals and 450 physicians. MCA/Universal, the first studio to offer the fund’s HMO as part of its benefits package, has had more than 150 employees enrolled since last month.

Operated in conjunction with an affiliate of Blue Cross of California, the insurance plan also will eventually be open to unemployed, self-employed and retired show-business workers, officials said.

“This was something our market has been asking us to provide--access to our exclusive network via the HMO model,” said Frank Guarrera, the fund’s executive vice president.

The Motion Picture and Television Fund is one of Hollywood’s best-known charities. Founded in 1921 by Mary Pickford, Charlie Chaplin, Douglas Fairbanks and D.W. Griffith and with current annual revenues of $50 million, it operates four industry-specific health clinics in the San Fernando Valley and West Los Angeles, as well as a retirement community and 256-bed hospital in Woodland Hills.

Anyone employed in motion pictures, radio, television or video is eligible to use those facilities for a fee. But the HMO would reduce the cost of the services, Guarrera said. It is expected to appeal mostly to studio employees and members of the unions that represent carpenters, make-up artists and other industry workers.

The fund made its first foray into the insurance business three years ago by spinning its services into a preferred-provider organization available only through large, self-insured industry unions such as the Writers Guild of America and the Directors Guild of America. Under preferred-provider systems, members may use doctors outside their plan’s network if they pay more out of their own pockets. An HMO, on the other hand, covers visits only to insurer-approved doctors.

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Matthias Erieg, administrator of the Directors Guild-Producers Health Plan, said the Motion Picture Fund’s preferred-provider plan “has been very well received” by guild members because the fund “has gone to great lengths to use the doctors the entertainment industry is already using.” As a result, plan participants feel the quality of care they receive under the plan is superior.

“When health care providers think about the entertainment industry, they think maybe Tom Hanks will be in their waiting rooms some day, so we are getting top-notch physicians and facilities who want to be part of this plan,” Erieg said.

Still, Erieg said, the Directors Guild does not plan to offer the new HMO to its members. The HMO would not be useful to Directors Guild members because the plan requires patients to see the same primary-care doctor for all their medical needs; it would not suit directors, who are often out of town on location.

By also offering an HMO insurance format, the fund hopes to make its services available to more members of the entertainment industry, a population it estimates includes more than 500,000 Californians. Like other large companies, the studios, for instance, have been slowly shifting their employees to HMO plans because they are usually less costly to employers. And self-employed workers are usually drawn to HMOs as well because of their lower premiums.

“If you look at what is happening on the horizon with health care, it is obvious the HMOs will play a major part, and we want . . . to be in the continued position of offering high-quality care,” said William F. Haug, fund president.

Glenn Meister, a principal with Foster Higgins, a Century City benefits consulting group, said the fund’s HMO is unusual in its focus on serving one industry. The narrow focus, Meister said, could enable the charity to secure higher-quality care for its members at a lower price. *

“What makes it possible for them to do it as opposed to some other industries is the fact that they have so many people who reside right here,” he said.

Guarrera said that in hooking up with the Blue Cross affiliate, CaliforniaCare Health Plans, the Motion Picture Fund not only greatly increases the number of doctors and hospitals covered under the HMO, but greatly reduces the fund’s financial risk. Blue Cross is providing the plan’s start-up costs and will cover any initial deficits it generates, he said.

But fund officials are expecting the HMO eventually to be a moneymaker with a percentage of its profits funneled back to philanthropic programs, a fact they expect to emphasize in the plan’s marketing. Guarrera estimated the HMO could be profitable with as few as 5,000 members. He said he expects it to be offered to the workers in all the major studios by the end of the summer.