Employee LAwell Eligibility
Full-Time Employee LAwell Eligibility
Your eligibility to receive the City’s subsidy for your benefits is evaluated on a biweekly basis (every 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 LAwell 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.
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.
Continuing Benefits after Losing Eligibility
Continuing Benefits after Losing Eligibility
Losing eligibility for the City subsidy/Direct Bill
Employees who are eligible for LAwell benefits but lose eligibility for the City subsidy through a reduction of hours or a paid or non-paid leave of absence, may be able to continue certain benefits through Direct Bill by paying the full unsubsidized premium.
Additionally, employees who do not receive enough compensation through City payroll to pay their share of benefit premiums may also continue their benefits through Direct Bill.
The following benefits may be continued through Direct Bill:
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Support Plus: Employee and Family Assistance Program
- Life Insurance (for yourself and your dependents)
- Accidental Death & Dismemberment Disability Insurance
City employees on or off payroll may continue LAwell benefits through Direct Bill for a period not to exceed six months. After a continuous six-month period of Direct Billing, employees may continue benefits through COBRA.
Direct bills will be sent to you by the Personnel Department, Direct Billing Section. Your payment must be received within 15 days of the date of the billing letter or benefits may be terminated back to the last date for which premiums were paid.
Direct Bill allows an employee to continue coverage currently in force under certain conditions. Direct Bill status is not a qualifying life event, and members are not allowed to add coverage or modify covered dependents based on their Direct Bill eligibility status.
LAwell benefits are not on a per-use basis. LAwell members must pay benefit premiums, regardless if they use their benefits or not.
Leave Of Absence
Various types of leaves of absence may allow LAwell benefits and the City subsidy to continue. See the table.
| Type of Leave | What is it? | How can my benefits continue? | Can my City subsidy continue? |
|---|---|---|---|
| Family and Medical Leave | Family and Medical Leave Act (FMLA) is approved protected leave for qualified employees that falls under the provisions of the FMLA. Your department must approve an FMLA absence. |
Your benefits can continue through Direct Bill as long as you are on FMLA status if your approved leave is properly recorded through the City's payroll system. | Yes. City subsidy can continue for any FMLA approved leave, both paid leave and unpaid leave. The maximum duration of City subsidy should not exceed the approved FMLA period, as determined by your department. Generally, this is for a maximum of 9 pay periods** within a 12-month period, regardless of the number of incidents. Please contact your department for further details on your FMLA eligibility. Exception: Maternity leave - up to 9 pay periods for childbirth disability and up to an additional 9 pay periods for purposes of bonding. The aggregate period for parents who both work for the City is limited to the time allowed for one employee |
| Disability Leave | An approved leave for a non-work-related disability or illness. | Yes - most of your benefits can continue through Direct Bill. If you are receiving a disability benefit from Standard Insurance Company, your eligible benefits can continue through the duration of your disability - while you are still employed - through the Benefits Protection Plan (BPP). If you are receiving a disability benefit through another company, your benefits can continue for a maximum of six consecutive months. |
City subsidy can only apply to employees who are part of the Benefits Protection Plan (BPP). For BPP approved employees, the City subsidy will only apply to the employee-only level of coverage, unless there has been no coverage break. Employees who do not qualify for BPP will not be eligible for City subsidy. See page 51 for more information on the BPP in the guidebook, Employees who do not qualify for BPP will not be eligible for city subsidy |
| Workers' Compensation Leave Through IOD | An approved leave for a work- related injury or illness, and you are receiving injury or disability “IOD” pay through the City’s payroll | Your benefits can continue through Direct Bill. | Only if your approved leave is supplemented with the minimum number of compensated hours: - Full-Time: 40 hrs - Half-Time: 20 hrs |
| Workers' Compensation Leave Through State Rate |
An approved leave for a work-related injury or illness, and you are receiving injury or disability pay through State Rate from Workers' Compensation | Your benefits can continue through COBRA. However, if you continue to receive a City payroll paycheck, without any lapse, your benefits can continue through Direct Bill. | Only if your approved leave is supplemented with the minimum number of compensated hours: - Full-Time: 40 hrs - Half-Time: 20 hrs |
| Military Leave | An approved leave to actively serve in a branch of the military. | Your benefits can continue through Direct Bill. | Eligibility for the City subsidy is based on classification of you approved military leave type, as determined by your personnel division. Military leave types vary. Ask your human resources or personnel division for more information. |
| Catastrophic Illness Leave | An approved leave that receives donated hours (see “Catastrophic Illness Leave Donation Program” on page 51). | Your benefits can continue through Direct Bill. | City subsidy will only apply for the time you retain the minimum number of compensated hours: Full-Time: 40 hours Half-Time: 20 hours |
COBRA
COBRA (Consolidated Omnibus Budget Reconciliation Act) is a law that allows employees to continue health coverage after leaving employment, losing eligibility for LAwell benefits, and in other situations. COBRA enrollment requires you to pay the full cost of your benefit, plus any COBRA administrative fees. The following benefits may be continued:
- Medical Insurance
- Dental Insurance
- Vision Insurance
Find more information on our COBRA page, here.
Continuing Life Insurance through Portability and Conversion
If your City employment ends, there are two ways you can take your life insurance with you — portability and conversion. Portability allows you to continue group coverage at group rates, whereas conversion allows you to continue your coverage as an individual policy. Different rules apply. Here is an overview:
Portability
For Your Life Insurance Coverage (Basic and Supplemental)
You must be under age 80, able to perform at least one gainful occupation, and on the date your employment terminates, you must have been continuously insured under the Group Policy for 12 consecutive months. Portable coverage lets you choose group term life insurance up to the amount of your basic and supplemental life coverage combined — to a maximum of $1,000,000 — without a Medical History Statement Form. The minimum amount you may port is $10,000.
For Your Dependent Life Coverage (Spouse/Domestic Partner and Child)
If you choose portable coverage for yourself, you may also take any dependent coverage with you if your dependent(s) meet the following age requirements:
Your spouse/DP must meet the same age requirements listed above for your coverage.
Children must be under age 26.
Conversion
If your coverage ends or reduces for any reason except failure to pay the premium or payment of an Accelerated Benefit, you can convert your life insurance, or your dependent’s life insurance, to an individual policy without a Medical History Statement Form. Because group rates will no longer apply, this individual conversion policy will cost substantially more than coverage you have as a City employee through LAwell. Conversion is the only option available if you do not qualify for portability.
To select portability or conversion coverage: You must complete and submit a form — within 60 days from the date your employment or dependent coverage ends. Forms are available here.
Benefits Not Eligible to Continue
The Healthcare Flexible Spending Account (HCFSA), and Dependent Care Reimbursement Account (DCRA) cannot be continued while you are on leave while you are in a non-pay status, or if you lose eligibility for LAwell benefits. The HCFSA and DCRA are tax-advantaged spending accounts that provide for deductions to be taken through City payroll. Your ability to use these accounts will end when you terminate employment. You may only use any remaining balance only toward eligible expenses that were incurred up to the last day of your City employment.
Disability coverage cannot be continued if you lose eligibility for LAwell benefits. Employees who have submitted a claim prior to losing LAwell benefits eligibility may continue to receive disability benefits through the duration of the claim. However, they are not eligible to submit new claims. For more information, see Filing a Disability Claim
When Benefits End after Losing Eligibility
Termination
When you end your employment with the City, voluntarily or through City action, your benefits will end the day your employment ends. You only have one option to continue your benefits — COBRA. COBRA enrollment requires you to pay the full cost of your benefit, plus any COBRA administrative fees.
Transfer to DWP
When you accept and begin employment with the Department of Water and Power (DWP), your LAwell benefits will end the last day of the month in which you transfer to DWP. You only have one option to continue your benefits — COBRA. COBRA enrollment requires you to pay the full cost of your benefit, plus any COBRA administrative fees.
Retirement
When you end your employment with the City, due to the start of your retirement benefits through LACERS, your benefits will end the last day of the month in which you retire. (A non-LACERS retirement is considered a termination.) You only have one option to continue your benefits — COBRA. COBRA enrollment requires you to pay the full cost of your benefit, plus any COBRA administrative fees.