We have renamed the Benefits Program from “My Flex” to “LAwell” to better demonstrate the ultimate purpose of all of our employee benefits: to support our employees’ and their families’ current and future health and wellbeing.
As a new hire, you will receive your LAwell Benefits Enrollment package 2-4 weeks after your first paycheck IF you are working a minimum number of qualifying hours (at least 40 hours per pay period for Full Time employees) and you are a contributing member to LACERS.
Once an offer is made, you have 60 days to make an election.
Want to learn more? View our New Hire benefit flyer
Form 1095-C provides information about a health insurance offer made to an employee by their employer. All employees who receive LAwell health coverage will get a 1095-C tax form.
For more information about the Affordable Care Act (ACA), please visit the Internal Revenue Service website at https://www.irs.gov/affordable-care-act.
For general assistance with your benefits, contact the LAwell Benefits Request Line at 1-800-778-2133, Monday to Friday 8:00 am to 5:00 pm.
For administrative issues you may contact your Employee Benefits Division Member Services Representative according to your last name:
Mayra Martinez (A-F): (213) 978-1615
Tameekah Ford (G-I, K-M): (213) 978-1600
Vincent Pacheco (N-V): (213) 978-1640
Maria Lopez (J, W-Z): (213) 978-1584
Member Advocates from our Health and Dental providers provide personal, one-on-one assistance out of our office in City Hall, 200 N. Spring Street, Room 867 with the following drop-in schedule:
Anthem Blue Cross
If you are eligible for LAwell benefits, you can also cover:
or a Domestic Partner (DP)
and/or a Child:
Special Situation Child Rule: If your child is also a LAwell eligible City employee, he/she must enroll into his/her own LAwell coverage and cannot be covered as your dependent.
Your dependent child's coverage will end on the last day of the month in which your child turns age 26. A COBRA notice will be provided to your child within 45 days of coverage termination.
Disabled Child coverage: Children with disabilities can remain your covered dependent after turning age 26 only if your LAwell health plan has certified the dependents disability.
Grandchild coverage: Coverage for grandchildren will end when the parent child reaches age 19 or age 26 if a full-time student.
The following are examples of individuals who are not considered eligible dependents:
NOTE: If your eligible dependent becomes ineligible (Example: Divorce, loss of custody, etc), you must drop coverage for the ineligible dependent within 30 days of the date he or she loses eligibility.
Yes. As in previous years, both the online and phone enrollment options will be available. Look out for your Enrollment Kit to provide more information.
Review the materials in your Open Enrollment kit you receive in the mail. You can also review information on the online Enrollment Site by clicking “Enroll” on the Home page of this site.
Be sure to review:
Most of your previously elected 2018 benefit elections will automatically roll over to 2019 unless you make a change during Open Enrollment.
However - Enrollment in Dependent Care Reimbursement and Flexible Spending Accounts does not automatically roll over. Any funds in these accounts for 2018 must be used in 2018. If you wish to participate in one of these accounts for 2019, you will need to enroll again during Open Enrollment.
Employees who enroll in specific levels of Life or Disability insurance may be required to complete a Medical History Statement with the Standard Insurance Company before their elected insurance level can take effect.
Employees required to complete this form can do so online by using this link: www.standard.com/mybenefits/mhs_ho.html
Use GROUP #630363
Not sure if your election requires a Medical History Statement? Check your Confirmation Statement, or review your elections by logging into your account.
A Life Event Change can be marriage, beginning or ending a domestic partnership, birth, adoption, divorce, death, addition or loss of an eligible dependent, or a loss or gain of spouse/domestic partner health coverage. You must report a Life Event Change within 30 days of its occurrence and submit documentation within 60 days in order for the change to take effect.
Adding a Dependent Child
What Benefits You Can Change
When You Can Enroll and Make Benefit Changes
How To Enroll and Make Benefit Changes
• Retired employees and employees who transfer to DWP: Last day of the month
• Terminated/Resigned employees: effective date of termination
• Employees on leave: effective date of leave, unless on direct bill
• Dependent children: the last day of the month in which they turn age 26.
Your benefits may continue while you are on certain leave-from-work statuses, but still employed. However, you will be required to pay for all, or a portion, of the premiums for these benefits. Not all benefits may be eligible to continue. Read pages 50-53 of the 2019 CHOOSEwell guide for more information.
A primary care physician (PCP) is your main doctor. Always try to go to your PCP first for health concerns or questions.
Your PCP coordinates any other care you need, such as a visit to a specialist or a hospital stay. You may need to contact your PCP to get an OK (prior authorization) before you get certain services.
Most PCPs are family or general practitioners, internists or pediatricians. These types of doctors have gone to school to learn about all areas of health. That way, they can get a strong, overall picture of your health.
You may need to contact your Primary Care Physician (PCP) to get an OK (preapproval) before you get certain services. Your PCP will work with you to decide if you need to see a specialist. If so, your PCP will refer you to a specialist in your medical group.
You can go to http://www.anthem.com/ca/cityofla and use our online Find a Doctor tool to find available physicians. If you already know the PCP you want, you can call our Member Services team at the number on your member ID card. Let us know who you want to choose as your new PCP and we’ll take it from there.
Kaiser Permanente members are not required to select a PCP before coverage starts and will not be automatically assigned a PCP. Kaiser members can receive urgent care or emergency care services without choosing a PCP. Kaiser members may elect to choose a PCP before MEDICAL COVERAGE & CASH-IN-LIEU or while making a regular doctor’s appointment.
If it is an emergency, call 9-1-1 or go to the nearest hospital - you don’t need an OK from us or your PCP. But be careful not to use the emergency room unless it really is an emergency.
You can also log into www.anthem.com/ca/cityofla and use the Find a Doctor tool to look for an urgent care center. You can usually walk in without an appointment needed. And they can handle lots of urgent health issues like a flu or cold, allergies, prescribing medication, even small fractures and X-rays.
You can also use LiveHealth Online to access non-emergency after hours care. LiveHealth Online gives you 24/7 video visit access to board-certified physicians using a mobile device or a computer with a webcam. No appointment is necessary, and you pay your regular copayment. To learn more, go to livehealthonline.com or download the LiveHealth Online mobile app from the App Store® or Google PlayTM.
Visit a Kaiser Urgent Care facility, email your doctor, or talk to member services representative. Go to my.kp.org/ca/cityofla
Doctors, hospitals, facilities (such as labs) and other professionals who provide health care services may have a contract with Anthem. If they do, they're in the Anthem network - also called in-network providers. That means they accept Anthem payment rates when Anthem members go to them for care. If they don't have a contract with Anthem, they're outside of the Anthem network - or out of network providers.
When you see network providers, you only have to pay the copays, deductibles and coinsurance required by your plan. If you get treatment from a provider outside the network, you could have to pay much more. Check your benefit summary or Evidence of Coverage for details regarding how out-of-network services are covered.
Additionally, providers in the Anthem network are responsible for getting any needed precertification (approval) for your care. They also file your claim for you and will seek payment from Anthem for covered services.
Please log into www.anthem.com/ca/cityofla and use the Find a Doctor tool to determine if a particular provider is in the network, contact Member Services at the number on your ID card, or talk with the Anthem Member Advocate at City Hall
Before traveling, contact Anthem Blue Cross Customer Service at the number listed on your member ID card for a list of participating hospitals. Always go to the closest emergency facility; request an itemized bill (in English) before leaving to file a claim for reimbursement. The BlueCross Blue Shield Global Core Service Center is available 24 hours a day, seven days a week toll free at 800-815-BLUE or by calling collect at 804-673-1177. An assistant coordinator, along with a medical professional, will arrange doctor or hospitalization needs.
Go to the nearest emergency facility and call 800-225-8883 if you receive treatment. Request an itemized bill (in English) and save your receipt to file a claim for reimbursement.
If you are covered through an HMO plan and your child is going to school outside of our service area, there may be special circumstances under which your child may be eligible for a guest membership in a medical group in the city your dependent lives in while away from home. Before you leave home, call the Member Services number on your ID card for assistance. Even without a guest membership, you can get medically necessary care (urgent care, emergency services, or follow-up care) when you are away from home.
If you are covered through the PPO plan, medically necessary care is covered for your child who is outside of our California service area through our national BlueCard network. Please visit www.anthem.com/ca/cityofla or call the Member Services number on your ID card to find a participating provider in the area your child is in.
Go to any Kaiser facility for covered care. To find a Kaiser facility, visit kp.org or call 800-464-4000. If no Kaiser facility is available, only emergency care is covered.
The DCUSA HMO plan covers braces for adults and children, and the PPO plan covers braces for children to age 26 only. Coverage is as follows:
DCUSA DHMO plan -
Children under 19 - Member copayment is $1,000 plus start up fees of $300 Children 19-26 - Your copay is $1,350 plus start up fees of $300 Adults - Your copay is $1,350 plus start up fees of $300
Delta PPO plan -
Delta pays 50% of the cost up to $1500 per lifetime per child
The maximum is the amount of money that Delta Dental will pay toward services in a calendar year per person. Once Delta has paid $1500 in a calendar year, any other costs would become your responsibility. Please note that preventive services do not apply toward this maximum.
There are many situations. But in general:
Accidental Death and Dismemberment (AD&D) insurance offers additional financial protection for an employee, or a family member, if they die in an accident, are dismembered, or lose their vision, hearing, or ability to speak.