LACERA Benefits and the ACA
The federal Patient Protection and Affordable Care Act (ACA) was enacted in 2010. It included significant regulatory overhauls and mandated health insurance coverage for most Americans.
LACERA benefits were not affected by the ACA for a couple of reasons. First, because the ACA made a distinction between healthcare plans covering active employees and retirees, LACERA’s retiree-only group plans were exempt from certain provisions, including the following:
- Coverage of eligible dependent children (whether employed, married, or a full-time student) until their 26th birthday, provided they don't have access to other coverage through their employer(s)
- Elimination of lifetime limits on coverage
In addition, implementation of the above ACA provisions would have violated the terms of a contract between the County of Los Angeles and LACERA. Under a 1982 contract between the County and LACERA, LACERA is obligated to protect and maintain the level of benefits available at the time the contract was signed. This means that unless a benefit change is legislatively mandated or approved by the County Board of Supervisors, LACERA is prohibited from changing (whether reducing or enhancing) plan benefits.
ACA Insurance Exchanges
Mandated health insurance coverage took effect under the ACA on January 1, 2014. Health insurance exchanges (online marketplaces) with various plan types and carriers were created for people to choose and buy individual health insurance plans.
If You Don’t Have Healthcare Coverage
You can enroll for coverage through LACERA or through a state or federal exchange. If you were eligible for LACERA coverage when you retired but declined to enroll, or were previously covered by a LACERA plan and dropped your coverage, you will be eligible for LACERA-administered coverage six months after LACERA receives your enrollment form.
If you are under age 65, you can enroll for medical coverage through a state or federal exchange. For more information, visit www.healthcare.gov, or for information about California’s health benefit exchange, Covered California, visit CoveredCA.com or call 888-975-1142.
Coverage and Subsidies
In most cases, the LACERA-administered Retiree Healthcare Benefits Program provides you with more comprehensive and lower-cost coverage than an exchange. The County healthcare premium subsidy applies only for enrollment in a LACERA-administered group health plan(s).
Depending on their income, some LACERA retirees who are not eligible for Medicare will qualify for a subsidy from the government to pay for coverage purchased from a state or federal exchange. However, while the premium may be lower, the coverage will likely not be as extensive as a LACERA plan.
Please contact us if you have questions about healthcare coverage or costs.