This section will help you determine which forms below are
needed to submit to enroll in the LACERS Health Plan of
your choice, add or delete dependents from your plan, or cancel
your coverage. You must submit the appropriate forms to LACERS to
process your health plan selection. Health plan enrollment and
family account change forms are available on this page as well as
the Forms section, upon request
LACERS.Health@lacers.org or calling LACERS at (800) 779-8328.
Outside of Open Enrollment period: Completed
forms with applicable supporting documents must be received by
the 10th of the month in order for the transaction to be
effective the first of the following month.
If you are not adding/changing plans nor adding/deleting
dependents, no action is needed on your part.