If you are not currently enrolled in a LACERS health plan or need to change your plan, you must complete a LACERS Medical and/or Dental Plan Enrollment form.
If you are enrolled in a LACERS health plan and do not submit a LACERS Medical and Dental Plan Enrollment form, your current LACERS health plan choices will remain in effect.
Generally, you may enroll in a LACERS-sponsored medical/dental plan or the Medical Premium Reimbursement Program (MPRP) within:
- 60 days of your effective retirement date
- LACERS' annual Open Enrollment period (October 15 - November 15)*
To enroll in a LACERS health plan:
- Review all information on premiums, subsidies, deductions and benefits to understand how the plans work, and any out-of-pocket costs you may have
- Make your medical and/or dental plan selections
- Obtain any needed health plan enrollment forms by clicking here or contacting LACERS
- Complete all applicable sections of the health plan enrollment forms
- Mail or deliver your completed form(s) to:
202 W. First Street, Suite 500
Los Angeles, CA 90012-4401
Your medical and dental coverage begins:
- The first of the month following your retirement effective date – OR –
- January 1 of the year following your enrollment during LACERS' annual Open Enrollment period
Also, you may enroll or change plans within:
- 60 days after turning age 55 as a City Retiree who is eligible for a subsidy
- 60 days after turning age 65 as a City Retiree who enrolls in Medicare
- 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 (LACERS requires proof of termination)
- 30 days of a family status change, such as a marriage, a newly formed domestic partnership, a birth or an adoption
If you have a family status change, such as a marriage, domestic partnership or the birth/adoption of a child, you may make changes to your health plan or enroll in another plan without having to wait until Open Enrollment (October 15 - November 15)* to do so.
You have 30 days from the date of your family status change to add a new dependent to your health plan. You may do so by completing a LACERS Medical/Dental Plan Family Account Change Form. Otherwise, you must wait until the next annual Open Enrollment period (October 15 - November 15).* To obtain the form, please visit the Forms section of this website by clicking here or contacting LACERS.
If your dependent is Medicare-eligible, additional forms will be required to enroll in a LACERS medical plan. Contact LACERS for the forms.
You must complete a Certification of Dependent or Survivor Status for Health Coverage form when adding a dependent. To obtain the form, please visit the Forms section of this website by clicking here or contact LACERS. All completed enrollment forms must be submitted to LACERS. To learn more about the taxability of your medical subsidy, click here.
You may delete a dependent from your LACERS health plan at any time. If you would like to delete a dependent, you must complete and submit to LACERS a LACERS Medical/Dental Plan Family Account Change Form
. To obtain the form, visit the Forms section of this website by clicking here
or contact LACERS. Your dependent’s coverage will be terminated on the first day of the month after your form is received.
Be advised: You must delete a dependent from your LACERS health plan within 60 days of any event that makes your dependent ineligible for LACERS health plan coverage (e.g., divorce). LACERS reserves the right to terminate your dependent’s health plan coverage should LACERS discover your dependent is no longer eligible to participate in a LACERS health plan.
If you do not notify LACERS within 60 days of your dependent becoming ineligible to participate in a LACERS health plan, your deleted dependent may not be offered an opportunity to continue coverage under COBRA (Consolidated Omnibus Budget Reconciliation Act).
For more information:
*Open Enrollment dates may change annually.