Eligibility & Adding Dependents

Employee Eligibility &

Adding Dependents

Employee Eligibility:

Adding Dependents:

Additional Resources:

Full-Time Employee Eligibility

Your eligibility for LAwell benefits is evaluated on a biweekly basis with each pay period.

Regular full-time* civilian City employees, Elected Officials of the City, or full-time Members of the Board of Public Works are eligible for LAwell if:

They are paid at least 40 hours per pay period of qualifying hours (such as HW, SK, VC, HO, etc.), or the number of hours of qualifying work time specified by their Memorandum of Understanding (MOU); and
They are contributing members of the Los Angeles City Employees’ Retirement System (LACERS) or are a Port Police Officer (MOU 27 or 38) or Airport Police Officer (MOUs 30, 39, or 40), and are a member of the Fire & Police Pension System; and
Are eligible for membership in one of the employee representation units for which the civilian benefits program (LAwell program) has been negotiated in an MOU; or
Are not represented by an employee representation unit.

Meeting All Three of the requirements above is required to receive LAwell benefits. Not meeting requirement number one (1) above will result in discontinuation of the City subsidy applied to your LAwell benefits. Not meeting requirements number two or three (2 or 3) above will result in the termination of your LAwell benefits.

Employees in part-time/intermittent or similar positions are not eligible for LAwell benefits.

*Full-time, half-time, part-time, and intermittent statuses are determined by the employing department and are recorded on your payroll record. Employees in part-time/intermittent or similar positions are not eligible for LAwell benefits. If you change from regular full-time or regular half-time to part-time/ intermittent status, you may not be eligible for LAwell benefits, even if you continue to be a member of the Los Angeles City Employees’ Retirement System.

Half-Time Employee Eligibility

Regular half-time* civilian employees are eligible for LAwell benefits if:

They are paid at least 20 hours per pay period of qualifying hours (such as HW, SK, VC, HO, etc.), or the number of hours of qualifying work time specified by their Memorandum of Understanding (MOU); and
They are contributing members of the Los Angeles City Employees’ Retirement System (LACERS) or are a Port Police Officer (MOU 27 or 38) or Airport Police Officer (MOUs 30, 39, or 40), and are a member of the Fire & Police Pension System; and
Are eligible for membership in one of the employee representation units for which the civilian benefits program (LAwell program) has been negotiated in an MOU; or
Are not represented by an employee representation unit.

Employees in part-time/intermittent or similar positions are not eligible for LAwell benefits.

Dependent Eligibility

If you are eligible for LAwell benefits, you can also enroll your eligible family members (your eligible dependents). However, not everyone who lives with you is an eligible dependent. Before you request enrollment of a dependent, read pages 59-61 to ensure your dependents meet the eligibility criteria, and see Life Events to read about when you can enroll eligible dependents.

In addition, you must review your dependent elections and verify that each dependent enrolled — and dependents you add — continue to meet the LAwell eligibility criteria at all times. You must drop coverage for your enrolled dependents within 30 days of the date they no longer meet the City’s eligibility requirements. If you fail to remove ineligible dependents, you will be required to pay all costs for any benefits that were paid on their behalf, and you may be subject to disciplinary action. Leaving an ineligible dependent on City coverage may be considered fraud.

Eligible Dependents

Your dependents are eligible if they meet the criteria listed in the table below and you have provided the required documentation to confirm your dependents, as determined by the Employee Benefits Division. Once you have added an eligible dependent, that individual is not entitled to coverage unless the City receives the required documentation of eligibility (e.g., birth certificate, marriage certificate) within 60 days of your election. Restrictions apply to family members who are also City employees. You are also not permitted to be dually covered in LAwell benefits, meaning any City employee is not permitted to be simultaneously covered as both an employee and a dependent under LAwell’s medical, vision, dental, life, or AD&D coverages. Eligibility continues up to the end of the month in which your dependent turns age 26.

Dependent Type	Age	Eligibility Definition	Documents Required for Verifying Eligibility
Spouse	N/A	Person of the opposite or same sex to whom you are legally married	Marriage certificate
Domestic Partner	N/A	Meet City’s domestic partner eligibility requirements. See Domestic Partnership Information Sheet and Affidavit form at keepingLAwell.com/dp-forms	City of Los Angeles Affidavit of Domestic Partnership, or Declaration of Partnership filed with the California Secretary of State
Biological Child (Natural child)	Up to age 26	Employee’s married or unmarried child(ren) under age 26	Child’s birth certificate, hospital verification of birth, or court document that verifies your relation to the child (an abstract document is not sufficient in most cases)
Stepchild	Up to age 26	Employee’s spouse’s married or unmarried child(ren) under age 26	Child’s birth certificate and certificate showing spouse/domestic partner as parent
Adopted child or child placed for adoption	Up to age 26	Minor or adult child legally adopted by employee, foster child, or child placed for adoption with employee under age 26 (married or unmarried)	Child’s birth certificate and court documentation
Child of Domestic Partner	Up to age 26	Minor or adult child of employee’s domestic partner under age 26 (married or unmarried)	Child’s birth certificate and City of Los Angeles Domestic Partner Affidavit or Declaration of Partnership filed with the California Secretary of State
Disabled Child	Age 26 and older	Disabled child over the age of 26 who is dependent on you for support and was disabled before age 26. To be eligible, your child must remain unmarried, dependent on you for financial support, and disabled as determined by your health plan.	Birth certificate and disability application from your health plan, completed by your child’s doctor and returned to your health plan for approval each year, or as requested by the insurance company
Child under a legal guardianship	Up to age 26	Child (unmarried) up to age 26 if you show proof of legal custody	Child’s birth certificate and court documentation
Grandchildren	Up to age 26	Your grandchildren can be added to the plan if their parent is your child who • is under age 19, unmarried, and financially dependent on you or •is age 19-26 and meets the full-time student status, is unmarried, and financially dependent on you If coverage for your child ends, coverage for your grandchildren will end.	Child’s and grandchild’s birth certificates; the current or most recent tax document indicating the child as a dependent full-time student certification for your child.

Ineligible Dependents

Examples of individuals who are not considered eligible dependents are:

• Your spouse following a divorce

• Someone else’s child (such as your nieces or nephews), unless you have been awarded legal custody or guardianship

• Your parents, parents-in-law, or grandparents, regardless of their IRS dependent status

The following table illustrates some common examples of individuals who are not considered eligible dependents. However, this is not an exhaustive list.

Dependent Type	What Is an Eligible Termination Life Event?	When Coverage Can Terminate	Documents* Required for Verifying Termination (must be submitted within 60 days of reporting)
Spouse	A final divorce	The date you report, as long as the report date is on or after the event date	Signed divorce judgment
Spouse	Notes • Hiring an attorney to initiate the divorce process does not qualify as a termination life event. • A divorce event will also terminate coverage of any covered stepchild.
Domestic Partner (DP)	•Terminating your relationship •Marrying your DP	The date you report, as long as the report date is on or after the event date	• City of Los Angeles Termination of Domestic Partnership • Marriage certificate
Child	Turning age 26	Coverage will terminate the end of the month that your child turns 26	None
Child	Legal change in custody; disabled child age 26 and older is no longer disabled	The date you report, as long as the report date is on or after the event date	Court order or other official documentation
Grandchildren	Your child (parent of grandchild) turns 26	Coverage will terminate the end of the month that your child turns 26	None

Document Verification for Dependents

Documentation is required to verify any enrolled dependents. If you do not provide the required documentation as verification of dependent status, your dependent will be ineligible for coverage. Contact the Benefits Service Center at 833-4LA-WELL with any questions

     
If You Added Your Dependent During… 
     
Deadline 
     
Important Considerations 
  
New Hire Enrollment

If you enroll your dependent during the year, documents must be received within 60 days of your election.

If you fail to provide the required documentation to the Personnel Department, Employee Benefits Division by the deadline, your dependent coverage will not take effect.

You will not be able to re-enroll your dependent until the next Open Enrollment period or within 30 days of a qualifying life event. 
  
Open Enrollment 

If you enroll your dependent who is not currently covered during Open Enrollment,
documents must be received by the deadline.
     
If you fail to provide the required documentation to the Personnel Department, Employee Benefits Division by the deadline. Your dependent coverage will not take effect on January 1st of the following year, for your added dependent who was enrolled during Open Enrollment.

You will not be able to re-enroll your dropped dependent until the next Open Enrollment period or within 30 days of a qualifying life event. 
  
Outside Open Enrollment

If you enroll your dependent during the year, documents must be received within 60 days of the date on the confirmation statement you receive after enrolling the dependent.
     
If you fail to provide the required documentation to the Personnel Department, Employee Benefits Division by the deadline, your dependent coverage will not take effect.

You will not be able to re-enroll your dependent until the next Open Enrollment period or within 30 days of a qualifying life event.

If You Added Your Dependent During…	Deadline	Important Considerations
New Hire Enrollment	If you enroll your dependent during the year, documents must be received within 60 days of your election.	If you fail to provide the required documentation to the Personnel Department, Employee Benefits Division by the deadline, your dependent coverage will not take effect. You will not be able to re-enroll your dependent until the next Open Enrollment period or within 30 days of a qualifying life event.
Open Enrollment	If you enroll your dependent who is not currently covered during Open Enrollment, documents must be received by the deadline.	If you fail to provide the required documentation to the Personnel Department, Employee Benefits Division by the deadline. Your dependent coverage will not take effect on January 1st of the following year, for your added dependent who was enrolled during Open Enrollment. You will not be able to re-enroll your dropped dependent until the next Open Enrollment period or within 30 days of a qualifying life event.
Outside Open Enrollment	If you enroll your dependent during the year, documents must be received within 60 days of the date on the confirmation statement you receive after enrolling the dependent.	If you fail to provide the required documentation to the Personnel Department, Employee Benefits Division by the deadline, your dependent coverage will not take effect. You will not be able to re-enroll your dependent until the next Open Enrollment period or within 30 days of a qualifying life event.

Where to Send Required Documents

There are several ways to submit required documents:

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

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

Email: per.empbenefits@lacity.org

Fax: 213-978-1623

Mail: LAwell Benefits Service Center PO Box 534077 St. Petersburg, FL 33747-4077

In-person*: Deliver to the dropbox outside the Employee Benefits Division at:

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

*Our in-person public counter service currently holds limited available hours Monday to Thursday, subject to change. We strongly recommend making an appointment using the scheduling system. However, our Division is fully operational and employees needing assistance may conduct transactions either telephonically and/or electronically.

Dependent Coverage Rules for Special Situations

Employees who enroll dependents in violation of the rules in this section, or as otherwise listed in this guide, are considered to be making an improper use of their benefits. The LAwell program will have authority to take corrective action to any employee’s coverage, or the employee’s applicable dependent coverage, if the employee is found to have made an improper use of benefits.

Disabled Child Over Age 26

You can continue coverage for a disabled child age 26 or older who is dependent on you for support if that child was disabled before age 26. To be eligible, your child must remain unmarried, dependent on you for financial support, and disabled as determined by your medical plan.

You must request a disability certification package or the required application from your medical plan, ask your dependent’s primary care physician to complete it, and then return it to your medical plan for review. The Employee Benefits Division must be notified of the medical plan’s determination regarding the disabled certification application.

Two LAwell-Eligible City Employees Are Married or Are Domestic Partners

If you are married or domestic partners with another LAwell-eligible City Employee (with or without children):

Medical and vision coverage: You cannot enroll as both an employee and as a dependent of your spouse/ domestic partner. If your spouse/domestic partner chooses family coverage, you must choose Cash-in- Lieu and you can be covered as a dependent of your spouse/domestic partner. Only one spouse/domestic partner can cover dependent children.
Dental coverage: Each employee must enroll in his/her own dental plan. Your spouse/domestic partner cannot cover you as a dependent. Only one spouse/domestic partner can cover dependent children.
Life insurance coverage: Each of you can purchase supplemental life insurance as an employee. For Dependent Life, only one of you can purchase dependent life insurance for your spouse/domestic partner and/or child(ren).
AD&D insurance coverage: Each of you can purchase employee only coverage, or only one of you can purchase family coverage.

Two LAwell-Eligible City Employees Have Dependent Children Together

If you have dependent children with another City employee who is not currently your spouse/domestic partner:

Medical, dental, and vision coverage: Only one parent can purchase coverage for your dependent child(ren).
Life insurance coverage: Only one parent can purchase child life insurance for your child(ren).
AD&D insurance coverage: Only one parent can purchase family coverage, or each of you can purchase employee only coverage.

Children Who Are City Employees

Children who are also benefit-eligible employees of the City cannot be covered as both employees and as dependents under their City employee parents. However, they may be beneficiaries of life insurance.

Domestic Partnership

The City of Los Angeles offers domestic partners of City employees, and domestic partners’ children, equal access to its employee benefit programs, including medical, dental, and vision plans. To obtain these benefits, you must enroll your dependents during the specified times and provide the required dependent eligibility documentation. Click here for more information on enrolling dependents.

Click here for the Domestic Partnership Affidavit and the Statement of Termination of Domestic Partnership.

State Taxes vs. Federal Taxes

Under California state law, pre-tax dollars can be used to purchase health or dental coverage for a domestic partner and/or their dependents, if your domestic partnership meets eligibility requirements and is registered with the State of California. You must provide a copy of the approved State certificate to receive this tax benefit. The amount the City of Los Angeles pays toward coverage cost will be excluded from your reported State income.

Under federal tax law, pre-tax dollars cannot be used to purchase benefits for a domestic partner or their children. Unless your partner and the partner’s children meet an exception, you pay your share of the coverage cost with after-tax dollars. The amount the City pays toward the cost of your domestic partner’s coverage will be taxable as regular income on 24 paychecks per year.

The table below shows the dollar value of domestic partner coverage paid by the City that will be reported as additional biweekly federal taxable income in 2024:

2024 Domestic Partnership Coverage

2024		Kaiser Permanente HMO		Anthem Plans						Delta Dental
2024		Kaiser Permanente HMO		Narrow Network (Select HMO) Full Network (CACare HMO)		Vivity (LA & Orange Counties HMO)		PPO		Delta Dental
Full-Time Employees
Coverage Level	Dependent Type	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	Preventive DHMO, PPO
Employee + Domestic Partner (DP) OR Employee + Family	Domestic Partner (DP) Only OR DP + Your Children OR DP + Your Children and DP’s Children	$465.56	$419.00	$468.53	$421.67	$393.30	$353.98	$359.64	$323.68	$0.00
Employee + Domestic Partner (DP) OR Employee + Family	DP + DP’s Children	$620.74	$558.67	$618.30	$556.47	$524.39	$471.96	$359.64	$323.68	$0.00
Employee + Child(ren)	DP’s Children Only	$387.97	$349.18	$351.41	$316.27	$294.97	$265.48	$359.64	$323.68	$0.00
Employee + Child(ren)	Your Children + DP’s Children	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00
Half-Time Employees
Coverage Level	Dependent Type	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	Preventive DHMO, PPO
Emp + DP OR Emp + Family	All DP dependent Types	$0.00	$0.00	$0.00	$0.00	$60.23	$54.21	$0.00	$0.00	$0.00
Employee + Child(ren)	DP's Children only	$0.00	$0.00	$0.00	$0.00	$60.23	$54.21	$0.00	$0.00	$0.00
Employee + Child(ren)	Your Children + DP’s Children	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00

The table below shows the dollar value of domestic partner coverage paid by the City that will be reported as additional biweekly federal taxable income in 2023:

2023 Domestic Partnership Coverage

2023		Kaiser Permanente HMO		Anthem Plans						Delta Dental
2023		Kaiser Permanente HMO		Narrow Network (Select HMO) Full Network (CACare HMO)		Vivity (LA & Orange Counties HMO)		PPO		Delta Dental
Full-Time Employees
Coverage Level	Dependent Type	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	Preventive, DHMO, PPO
Employee + Domestic Partner (DP) OR Employee + Family	Domestic Partner (DP) Only OR DP + Your Children OR DP + Your Children and DP’s Children	$421.60	$379.44	$426.33	$383.70	$357.87	$322.09	$322.87	$290.58	$0.00
Employee + Domestic Partner (DP) OR Employee + Family	DP + DP’s Children	$562.13	$505.92	$558.23	$502.41	$477.15	$429.44	$322.87	$290.58	$0.00
Employee + Child(ren)	DP’s Children Only	$351.33	$316.21	$319.76	$287.79	$268.40	$241.57	$322.87	$290.58	$0.00
Employee + Child(ren)	Your Children + DP’s Children	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00
Half-Time Employees
Coverage Level	Dependent Type	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	Preventive, DHMO, PPO
Emp + DP OR Emp + Family	All DP dependent Types	$0.00	$0.00	$0.00	$0.00	$53.12	$47.80	$0.00	$0.00	$0.00
Employee + Child(ren)	DP's Children only	$0.00	$0.00	$0.00	$0.00	$53.12	$47.81	$0.00	$0.00	$0.00
Employee + Child(ren)	Your Children + DP’s Children	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00

The table below shows the dollar value of domestic partner coverage paid by the City that will be reported as additional biweekly federal taxable income in 2022:

2022 Domestic Partnership Coverage

2022		Kaiser Permanente HMO		Anthem Plans						Delta Dental
2022		Kaiser Permanente HMO		Narrow Network (Select HMO) Full Network (CACare HMO)		Vivity (LA & Orange Counties HMO)		PPO		Delta Dental
Full-Time Employees
Coverage Level	Dependent Type	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	Preventive, DHMO, PPO
Employee + Domestic Partner (DP) OR Employee + Family	Domestic Partner (DP) Only OR DP + Your Children OR DP + Your Children and DP’s Children	$380.74	$342.67	$421.17	$379.05	$353.54	$318.19	$260.56	$234.50	$0.00
Employee + Domestic Partner (DP) OR Employee + Family	DP + DP’s Children	$507.65	$456.89	$473.99	$426.591	$471.38	$424.24	$260.56	$234.50	$0.00
Employee + Child(ren)	DP’s Children Only	$317.28	$285.56	$315.89	$284.30	$265.15	$238.64	$260.56	$234.50	$0.00
Employee + Child(ren)	Your Children + DP’s Children	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00
Half-Time Employees
Coverage Level	Dependent Type	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	LAwell Plan	LAwell Pay Plan	Preventive, DHMO, PPO
Emp + DP OR Emp + Family	All DP dependent types	$0.00	$0.00	$0.00	$0.00	$0.00	$22.67	$20.40	$0.00	$0.00
Employee + Child(ren)	DP's Children Only	$0.00	$0.00	$0.00	$0.00	$0.00	$22.67	$20.40	$0.00	$0.00
Employee + Child(ren)	Your Children + DP's Children	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00	$0.00