Required Documents

When to Submit Required Documentation

Some open enrollment election actions require you to submit supporting documentation to complete the enrollment. A few common examples are shown in the table below. This is not an exhaustive list and is subject to change.

Open Enrollment Election Action

Adding a spouse to coverage…

Adding a domestic partner to coverage…

Adding a child to coverage…

Electing Cash-in-Lieu…

Enrolling yourself and/or your dependent(s) into certain life insurance coverage levels…

Required Documentation

Marriage Certificate

LAwell Domestic Partner Affidavit

Birth Certificate

Cash-in-Lieu Affidavit

Medical History Statement


How to Submit Required Documentation

There are several ways to submit required documents: Online, Email, Fax, or In-person.

Online: Log in to the Benefits Central Portal and upload your documents. 

Upload your supporting documents directly to your account via the:

  • “To do” section of your Enrollment Confirmation screen.

  • “Upload my documents” tile.

  • “Enrollment Forms Requirements” call to Action that should appear after you successfully complete an applicable enrollment event.

You can also monitor the status of your uploaded documents.

EXAMPLE:

Email or Fax: Write your name and employee ID number on each document and send via: 

Email: per.empbenefits@lacity.org

Fax: 213-978-1623 

Mail: Write your name and employee ID number on each document and mail to:

TELUS Health
PO BOX 9929,
PROVIDENCE RI 02940-4029

In-person*: Write your name and employee ID number on each document and place in the dropbox outside the Employee Benefits Division at: 

Los Angeles City Hall
200 N Spring Street, Room 867
Los Angeles, CA 90012