Medical, Dental, Vision Benefits and Plans

Medical, Dental, Vision Benefits and Plans

Overview

You are eligible to enroll in LACERS health plans if you are a retired City employee who receives a monthly retirement allowance from LACERS. Your LACERS Health Plan coverage is separate from your Active Employee Benefits coverage. If you are a new retiree, you will need to transition to LACERS Medical, Dental, and Vision coverage during the retirement process.

LACERS provides eligible members with a medical and dental subsidy. This subsidy may or may not cover the total cost of the health plan or dental plan premium. Please refer to the current Health Benefits Guide for more information.  

Note for retired Members subject to the medical subsidy cap: If you retired between July 1, 2011-2018, and did not make the additional 4% Retirement Health Defrayal contribution while still an active employee, see the Health Benefits Guide Supplement for your medical subsidy and medical plan premium deductions.

Enrollment Video

Enrolling in LACERS Retiree Health Benefits Video

LACERS has prepared a video for new retirees to provide them information regarding their health plan options, subsidies, and detailing the enrollment process.  This video provides examples of the forms and documentation required to enroll in each of the LACERS medical and dental plans.

Click to watch ”Enrolling in LACERS Retiree Health Benefits”.

Available Plans

Available Medical/Dental/Vision Plans

You may find more information about each individual plan in the Health Benefits Guide as well as refer to each plan’s Evidence of Coverage.

For Retirees under age 65:

  • Anthem Blue Cross HMO (CA only)
  • Anthem Blue Cross PPO (US and its territories)
  • Kaiser Permanente HMO (CA only)

 For Retirees age 65 or older with Medicare Part B only

  • Anthem Blue Cross HMO (CA only)
  • Anthem Blue Cross PPO (US and its territories)
  • Kaiser Permanente Senior Advantage (CA only)

For Retirees age 65 or older with Medicare Parts A and B

  • Anthem Blue Cross Medicare Preferred (PPO) (US and its territories)
  • Kaiser Permanente Senior Advantage (CA only)
  • SCAN Health Plan (CA only)
  • UnitedHealthcare Medicare Advantage HMO (CA, AZ, & NV)

Dual Care Households (at least one subscriber age 65 or older with Medicare Parts A & B and one subscriber under age 65, or age 65 or older with Medicare Part B only):

  • Anthem Blue Cross PPO + Anthem Blue Cross Medicare Preferred (PPO)
  • Kaiser Permanente HMO + Kaiser Permanente Senior Advantage (CA only)
  • Anthem Blue Cross HMO + SCAN Health Plan (CA only)
  • Anthem Blue Cross HMO + UnitedHealthcare Medicare Advantage HMO (CA only)

For Retirees living outside the U.S. and its territories

Anthem Blue Cross PPO Out-of-Country Plan

For Retirees residing outside LACERS HMO plan zip code service area, or outside of California

Medical Premium Reimbursement Program (MPRP)

Qualifying Events

Qualifying Events for Enrollment Changes

Read more about qualifying events that allow plan enrollment changes outside the annual Open Enrollment period in the Health Benefits Guide.

  • 60 days of the Retiree turning age 55
  • 90 days of the Retiree turning age 65 (based on Medicare eligibility)
  • 30 days of relocation into or out of a LACERS HMO plan zip code service area
  • 30 days of a LACERS HMO plan zip code service area becoming available or unavailable
  • 30 days of being involuntarily terminated from a non-LACERS medical plan (proof of termination required)
  • 30 days from the date of family status change (such as marriage and birth or adoption of a child)

Resources

Health Plan Information and Resources

Each health insurance carrier has provided more resources to help you determine which plan might be best for you.

Health Benefits Guide – Annual guide that summarizes: eligibility for benefits; enrollment period; available medical, dental, and vision plans; Medicare and your LACERS health benefits; and contains premium, subsidy, and deduction charts. 

Evidence of Coverage (EOC) - Documents that describe the coverage offered in LACERS-sponsored medical and dental plans.

Carrier Resources - Connect with your medical plan provider and access discounts, information, and programs to support your wellness journey.

SilverSneakers / Silver&Fit – Fitness programs offered by LACERS-sponsored medical plans for your wellness.

Medicare – Webpage discussing LACERS’ Medicare enrollment requirement for individuals age 65 and over

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