Medical Plan Subsidy Eligibility

Post

Your subsidy eligibility is based on your age and your whole years of Service. To be eligible for a subsidy, you must:

  1. Be at least age 55;
  2. Have a minimum of 10 whole years of Service;
  3. Enroll in a LACERS-sponsored medical plan or be a participant in the Medical Plan Reimbursement Program (MPRP)

Full-time employees receive 4% of the maximum medical subsidy for each year of Service Credit.

Part-time employees who have a minimum of 10 years of Service are eligible to receive 40% of the maximum medical subsidy and can receive an additional 4% for each year of Service Credit above ten years. The LACERS Board determines the maximum monthly subsidy amount annually.

Eligible Dependents

You may enroll eligible dependent(s) in a LACERS health plan. However, dependents do not receive a separate medical plan premium subsidy.

An eligible dependent may be a:

  • Spouse
  • Domestic Partner (your partnership must be registered with LACERS or your state)
  • Dependent child who is under age 26, except in circumstances where the adult child is eligible to enroll in an employee-sponsored plan or unable to engage in gainful employment because of a mental or physical disability (disability must have occurred before age 26). A “dependent child” includes:
    • A child born to you
    • A child legally adopted by you
    • A step-child living with you in a parent-child relationship
    • A child of whom you have legal custody or guardianship and provide principal financial support
    • Your spouse or domestic partner’s child
    • Grandchild under age 26, if you are or your spouse/domestic partner is the legal guardian(s) or have legal custody of the grandchild; or if the grandchild is the child of a dependent child as defined above.

Medicare

In order to qualify for a LACERS medical plan premium subsidy and be eligible for coverage in a LACERS-sponsored medical benefit plan, retired members, eligible surviving spouses/domestic partners and dependents are required, upon turning age 65, to enroll in Medicare Part B. Medicare Part A is only required if it is at no cost to the member. 

If you are enrolled in Medicare Parts A and B, your maximum monthly subsidy amount will be based on your years of Service Credit and the one-party premium of the LACERS Senior Plan in which you are enrolled

SUBSIDY TABLEUnder 65 OR age 65 or Older and Required to Enroll in Medicare Part B Only

Service Credit

% Maximum Subsidy

Subsidy Amount
1-10 40% $716.32
11 44% $787.95
12 48% $859.58
13 52% $931.22
14 56% $1,002.85
15 60% $1,074.48
16 64% $1,146.11
17 68% $1,217.74
18 72% $1,289.38
19 76% $1,361.01
20 80% $1,432.64
21 84% $1,504.27
22 88% $1,575.90
23 92% $1,647.54
24 96% $1,719.17
25+ 100% $1,790.80

SUBSIDY TABLE65 or Older and Required to Enroll in Medicare Part A and B

Service Credit % of Maximum Subsidy
1-14 75% of one-party Monthly Premium
15-19 90% of one-party Monthly Premium
20+ 100% of one-party Monthly Premium

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