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DEPENDENT COVERAGE ELIGIBILITY

RETIREE HEALTHCARE COVERAGE ELIGIBILITY FOR DEPENDENTS

If you have dependents, it is important to understand the different rules that determine whether your spouse, domestic partner, or child is eligible to be added to your retiree healthcare plan.

ELIGIBLE DEPENDENTS

Your eligible dependents include:

  • Your lawful spouse or eligible domestic partner
  • Your, your spouse’s, or your eligible domestic partner’s natural children, legally adopted children, or stepchildren
  • Your unmarried dependent child age 26 or older who is incapable of self-support due to a physical or mental handicap and meets specific requirements

NEW ELIGIBLE DEPENDENTS

New eligible dependents include:

  • Your new spouse or registered domestic partner
  • Your, your spouse’s, or your eligible domestic partner’s newborn child or newly and legally adopted children or stepchildren

ELIGIBLE SURVIVING DEPENDENTS

  • Your surviving spouse or eligible domestic partner who is eligible to continue receiving retirement benefits
  • Surviving children up to age 26, regardless of marital or student status
    Your surviving natural children, legally adopted children, or stepchildren or those of your spouse or domestic partner
  • Your disabled dependent child who is incapable of self-support due to a physical or mental handicap and meets specific requirements

ELIGIBILITY OF ADULT DISABLED DEPENDENTS

The LACERA-administered healthcare benefits program recognizes disabled adult children of LACERA members, or those of their spouse or eligible domestic partner, as eligible dependents, provided the disabled adult child meets all of the following requirements:

  • Is incapable of self-support due to a physical or mental handicap
  • Became disabled before age 26
  • Is fully dependent on the LACERA member or the member's spouse or eligible domestic partner for financial support
  • Has been continuously covered by a County-sponsored plan and/or proof is provided that the disabled child meets the other above requirements and has been continuously covered by any other group or individual medical insurance plan
  • Medical evidence of total disability, subject to the conditions of both LACERA and your LACERA-administered healthcare plan, is provided

Enrollment and continuation of coverage requirements vary according to the LACERA-administered healthcare carrier. For a complete listing of each carrier's eligibility requirements and required documentation, see Adult Disabled Dependents; or contact Retiree Healthcare by calling 800-786-6464, then press 1.

TO ADD OR REINSTATE YOUR DEPENDENT

If you add a dependent due to birth, marriage, domestic partnership, or adoption, you must enroll them within 30 days of the date they become eligible family members.

In order to add or reinstate a dependent, you must notify LACERA and sign and submit a completed enrollment form, which will be reviewed to ensure eligibility. LACERA requires that you also provide an original certified birth certificate for each eligible child. The original document will be scanned and returned to you.

If you are married or a domestic partner, both you and your dependents must be members of the same plan.

To learn more about the County’s decision to pay for dependent coverage up to age 26, read the timeline of events or visit Eligible Dependent Child Age Limit Increased to Age 26.

Contact LACERA to request a medical and/or dental/vision enrollment form, or access and download the forms from the RHC Brochures & Forms page.

4/9/15