1. Q: When I retire, how much of my health care premium will be subsidized by the County?
A: The general rule is that if you have 10 years of retirement service credit, the County contributes 40 percent of your health care plan premium or 40 percent of the benchmark plan rate (Anthem Blue Cross Plans I and II), whichever is less. For each year of retirement service credit beyond 10 years, the County contributes an additional 4 percent per year, up to a maximum of 100 percent for a member with 25 years of service credit.

The County contribution can never exceed the premium of the benchmark plan. If the premium for the plan and coverage option you have chosen exceeds the benchmark premium, you are required to pay the difference, even if you have 25 years of service. If you have 25 years of service and your plan premium is less than the benchmark rate, the County contributes 100 percent of your plan premium only, not the benchmark plan rate. (7-18-06)

2. Q: I'm a new retiree. When will my health insurance begin?
A: LACERA coverage is coordinated to begin on the first day of the month after active County health coverage ends. For this to occur, your enrollment form must be received by LACERA within 60 days from the date of your retirement, or within 60 days from the date your name appears on the Board of Retirement agenda. Late enrollment rules apply if LACERA does not receive your enrollment form in a timely manner.

3. Q: I'm a retiree. How do I enroll my new partner on my medical insurance?
A: To add your new spouse or domestic partner you must fill out a Change/Cancellation Form and send it to LACERA within 30 days from your date of marriage or domestic partnership registration. You must also provide an original certified marriage license or Certificate of Registered Domestic Partnership, which will be copied and returned to you. If LACERA receives the required items by the 15th of the month, coverage begins on the first day of the month following the date of the qualifying event. If any dependent is added later than 30 days from the date that he/she becomes an eligible family member, late enrollment rules apply. (6-26-06)

4. Q: How does turning 65 affect my medical insurance?
A: If you're eligible to receive Medicare Part A and B when you turn 65, you may elect a Medicare HMO Plan or a Medicare Supplement Plan. These plans are designed to coordinate payment of insurance claims with Medicare and are less expensive than the standard HMO or fee-for-service plans. LACERA currently offers three Medicare HMO plans: Kaiser Senior Advantage, SCAN Health Plan, Secure Horizons, and one Medicare Supplement Plan - Anthem Blue Cross III.

5. Q: How does the new Medicare Part D prescription drug coverage affect my prescription drug coverage?
A: Your prescription drug coverage through any LACERA-administered medical plan is what Medicare calls “creditable,” meaning it is as good as or better than any individual prescription drug coverage offered by any Medicare Part D plan.

If you want to keep your LACERA-administered coverage, DO NOT ENROLL in an individual Medicare Part D plan. If you do, you may jeopardize your coverage in the LACERA-administered health care benefits program and you may not get it back until later.

You can find the “Creditable Coverage Notice” online on the Brochures & Forms page, in the Retiree Health Care section. If you decide to enroll in an individual Part D plan, you can show this notice to Medicare and avoid a Medicare Part D late enrollment penalty. (2-7-08)

6. Q: I am getting ready to retire. How do I enroll in a LACERA-administered health care plan?
A: If you visit LACERA's Public Counter to apply for retirement, a LACERA Retirement Benefits Specialist will meet with you and assist you in preparing your retirement paperwork.  The specialist will provide you with enrollment forms for LACERA-administered retiree medical and dental insurance and direct deposit.

Once you retire, you will receive an Exploring Your Health Care Benefits Through LACERA package in the mail which contains information describing your retirement health care options. Also enclosed within the mailer will be a postcard to be filled out and returned to us for specific information about any of the plans.

The enrollment process involves two steps.
1. Read your LACERA Exploring Your Health Care Benefits booklet regarding all the various medical options.  Fill out the card enclosed to request specific information and enrollment forms for the plans you have selected.
2. Within ten working days you will receive an envelope containing the information that you requested.  Please note that you must select a health care plan within 60 days of your retirement date.

If you enroll after the 60-day deadline, you must complete a six-month waiting period from the date your enrollment form is received by LACERA.

You should also refer to The Process of Retiring web page which includes a Checklist for Retirement Planning to review all the necessary steps in applying for retirement. See the Pre-Retirement Guide on the Brochures and Forms page for additional information. (5-28-08)         

7. Q: How can I switch my LACERA-administered medical plan?
A: You must complete a Medical and Dental/Vision Change Form. The form is available on the Brochures & Forms page. Or you can call LACERA's Retiree Health Care Division at 1-800-786-6464 and press 1 to request a form or receive more information.

Generally, a one-year waiting period from LACERA’s receipt of your signed Dental/Vision Change form applies when switching LACERA-administered dental/vision plans. Coverage is continuous and no evidence of insurability is required. NOTE: The waiting period is waived if you move out of your HMO's designated service area. See the Out of State Move page for more information. (6-11-08)

8. Q: Are there exceptions to the six-month waiting period?
A: Yes. Exceptions include:

• Moving out of your plan’s service area (you must notify LACERA within 30 days)
• Changing from Anthem Blue Cross Plan I, Anthem Blue Cross Plan II, CIGNA, Anthem Blue Cross Prudent Buyer Plan, or Kaiser Permanente to Kaiser Senior Advantage, Secure Horizons, or SCAN
• Changing from Anthem Blue Cross I to Anthem Blue Cross II
• Changing from Anthem Blue Cross I, II, Prudent Buyer Plan to Anthem Blue Cross III
• Changing from any LACERA-administered medical plan to SCAN (11-19-08)

9. Q: How can I switch my LACERA-administered dental/vision plan?
A: You must complete a Medical and Dental/Vision Change Form. The form is available on the Brochures & Forms page. Or you can call LACERA's Retiree Health Care Division at 1-800-786-6464 and press 1 to request a form or receive more information.

Generally a one-year waiting period from LACERA’s receipt of your signed Dental/Vision Change form applies when switching LACERA-administered dental/vision plans. Coverage is continuous and no evidence of insurability is required. NOTE: The waiting period is waived if you move out of your HMO's designated service area. (6-11-08)

10. Q: Where do I get a Change Form for the LACERA-Administered Health Care Plans?
A: Medical and Dental/Vision Change Forms are available on the Brochures & Forms page . Or call LACERA at 1-800-786-6464 and press 1 to request a form or get more information. (3-19-07)

11. Q: I’m a retiree and I have a question about health care. How can I find the answer?
A: Visit our Retiree Health Care section for enrollment information, plan phone numbers and web sites, and more about the LACERA-administered health care program, including medical and dental/vision plans. Our Brochures & Forms page includes printed materials and forms. If you cannot find the answer to your question by using these online resources, call us at 1-800-786-6464 and press 1 to speak with a Health Care Benefits Specialist. (4-6-07)

12. Q: I am a retiree. If I die, will health care coverage extend to my eligible survivors?
A: If a retired member dies while covered by a LACERA-administered health plan, the eligible survivors may continue coverage. Following are the administrative rules.

• When an eligible survivor notifies LACERA of a member's death, we will mail an information packet to the survivor. LACERA must be notified within 30 days of the event; otherwise Late Enrollment rules apply.
• Late Enrollment rules include a six-month wait for medical and a one-year wait for dental/vision coverage, from the date LACERA receives the enrollment form. Benefits for eligible dependents are continuous, provided they were covered under the deceased member's plan.
• If a survivor is not eligible for continuing health care benefits, but has been continuously covered under your plan, LACERA will mail the survivor a COBRA packet with information on continuing health care coverage.
• If a survivor is eligible for continuing health care benefits, but was not continuously covered under your plan, late enrollment rules will apply.
• If a survivor is covered under a LACERA-administered health care plan and remarries, the survivor's eligible new dependents can be added to the plan, provided LACERA is notified within 30 days of the date of acquisition (i.e. marriage, birth, adoption, etc.). However, when the eligible survivor dies, the dependents will no longer be eligible for continued coverage through LACERA, except for a limited period of time through COBRA.
• If your eligible survivors are required to pay premiums for coverage, they will be notified accordingly.

13. Q: I'm a retiree. Who qualifies as a dependent on my retiree health insurance?
A: Eligible dependents include your spouse, eligible Domestic Partner, unmarried children under 19 or up to 23 if enrolled in school, and/or your unmarried dependent children over 19 who are incapable of self-support due to physical or mental handicap. (3-3-08)

14. Q: My wife is a retired LACERA member. Would I still be eligible for health insurance coverage if she pre-deceases me?
A: Yes, an eligible surviving spouse or domestic partner of a retired member qualifies for the same health benefits they received while the member was alive. (3-3-08)

15. Q: I'm going to retire soon, and I would like information about the health care plans available to retired members.
A: For a list of current LACERA-Administered Retiree Health Care information online, visit our Retiree Health Care section. (3-3-08)

16. Q: I am a retiree. How do I apply for the LACERA-sponsored Long-term Care plan underwritten by MetLife?
A: To obtain an application, receive more information, or to make a reservation to attend a long-term care plan seminar, please call 1-800-207-9883. The seminars are held on the second Wednesday of each month at 10:30 a.m. at LACERA - Gateway Plaza. (6-12-08)

17. Q: If I retire and have dependent children, will the LACERA-administered Health Care plans cover my children?
A: Yes. Your eligible dependents include:

• Your spouse (unless legally separated)
• Your registered domestic partner, provided you both filed a California Declaration of Domestic Partnership
• Your unmarried natural or legally adopted children or stepchildren, up to age 19 or 23 if they are enrolled as full-time students in an accredited institution and depend on you for financial support
• Your unmarried dependent children over 19 who are incapable of self-support due to a physical or mental handicap and meet specific requirements. (For details, call Retiree Health Care at 1-800-786-6464 and press 1.) (5-22-08)

18. Q: How can I qualify for the Medicare Part B Reimbursement and when will I receive the reimbursement money?
A: The County may* reimburse members for the amount of their Medicare Part B premiums on a tax-free basis if the following conditions are met:

• You are enrolled in Medicare Part A and Medicare Part B.
• You are enrolled in a LACERA-administered Medicare HMO plan or Medicare supplement plan.
• You are paying for your Medicare Part B premium yourself.
• You are not being reimbursed for your Medicare Part B Premium by another agency, for example: other employer or State.

Each month after you have paid the Medicare Part B Premium, LACERA will include the reimbursement on your monthly retirement check.

*This reimbursement program is subject to annual review by the Board of Supervisors. (5-27-08)

19. Q: Does LACERA still have annual Retiree Health Fairs?
A:No. In lieu of the annual health fair, we now have a retiree health improvement program entitled Staying Healthy Together: Focus on Wellness which provides health information via three sources: 1) Newsletters, 2) Web, and 3) Workshops. With this program, we can provide information on staying healthy to all our retired members. Every six months, the program will focus on a new health-related topic. Your quarterly Spotlight newsletter includes informative Staying Healthy Together articles for you to read. You can also visit the Staying Healthy Together web section on lacera.com to access links to health-related web sites and find information on upcoming workshops. (6-23-08)

20. Q: Do all LACERA plan members qualify for retiree health care benefits?
A: You are eligible to enroll in the LACERA-administered Health Care Benefits Program if you are a member of LACERA and retire from the County of Los Angeles or outside district; including the South Coast Air Quality Management District, the Little Lake Cemetery District, the Local Agency Formation Commission, and the County Superintendent of Schools. Even if you did not have medical coverage under an employee health care program while you were an active County employee, you are eligible to participate in the program. (5-28-09)