SIP & LAwell

If you retire through LACERS using the SIP, your LAwell Program benefits will end on the last calendar day of the
month in which you retire. Your LAwell Program coverage for your final month of employment is maintained in full
provided your City paychecks cover all monthly required benefits deductions. If amounts are owed you will be
separately billed for those costs.

You should contact the Los Angeles City Employees’ Retirement System (LACERS) for all questions regarding your
retiree benefits and when they are available to you.

Federal law under the Consolidated Omnibus Budget Reconciliation Act (COBRA) provides certain rights for continuing
health, dental, and vision coverage after leaving employment. You can continue the LAwell Program medical, dental,
and vision benefits through COBRA. You can also continue life insurance and Accidental Death and Dismemberment
(AD&D) insurance through Portability or Conversion as detailed later. Disability insurance benefits, Support PlusEmployee and Family Assistance Program (EFAP) benefits, and all tax-advantaged spending accounts cannot be
continued after retirement.

Your retirement & LAwell Program benefits termination must both take place before a COBRA offer can be made. This
means you will receive your COBRA offer after your LAwell Program benefits end, typically about two weeks after
coverage ends. Once a COBRA offer is made, you will have 60 days to enroll into coverage and an additional 45 days
from your enrollment to pay your first premium payment. Your COBRA coverage will be retroactive to your termination date as long as you submit your payment by the required deadline

Yes. COBRA continuation coverage applies to any dependent covered at the time of coverage termination. You are not
required to enroll everyone you currently cover

Following are current monthly COBRA rates for 2020, inclusive of fees. However, these monthly rates are subject to
change. (Please note: COBRA premiums must be paid retroactively to the coverage termination date.)

 

 

Plan

Individual

Emp+Spouse

Emp+Child(ren)

Family

Anthem Narrow

685.10

1,508.28

1,301.74

1,781.34

Anthem Full

967.42

2,128.30

1,838.08

2,515.32

Anthem Vivity

575.10

1,265.28

1,092.72

1,495.32

Anthem PPO

1,101.72

2,423.82

2,093.26

2,864.50

Kaiser

622.12

1,366.26

1,242.24

1,614.32

Delta HMO

17.12

31.91

28.62

36.96

Delta PPO

53.51

100.31

104.00

139.52

Delta Prevent Only

7.85

14.40

16.16

23.34

EyeMed

9.55

9.55

9.55

9.55

 

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Portability allows you to continue group coverage at group rates, whereas Conversion allows you to continue
your coverage as an individual policy. To select portable coverage or to convert coverage, you must complete
a form within 60 days from the date your employment or dependent coverage ends.

Deadline: you must apply within 60 days from the effective date of your retirement

For any Healthcare or Dependent Care account held in calendar year 2020, you will have until April 30, 2021
to submit claims for expenses incurred up to the last day of your City employment. Any expense incurred
after the date your employment terminates is not eligible for claim reimbursement.

If you are currently Medicare eligible and did not enroll in Medicare while working, you will need to enroll
in Medicare when you leave City service or you may be charged a late enrollment penalty. When you apply,
the federal Centers for Medicare and Medicaid Services (CMS) will provide you with a Request for
Employment Information form. Your LAwell Program member representative will help you complete this
form. Please contact your City Hall member representative phone number listed below or email
[email protected]:

  • Last names: A - F ⇒ Phone: 978-1615
  • Last names: G - I & K - M ⇒ Phone: 978-1600
  • Last names: N - V ⇒ Phone: 978-1640
  • Last names: J, W - Z ⇒ Phone: 978-1611

In addition, CMS may also ask if you had “creditable coverage,” meaning proof that you were previously
enrolled in a plan that meets Medicare requirements for prescription drug coverage. You can find the
LAwell Program’s Medicare Part D Notice of Creditable Coverage in the Important Legal Notice section of
each annual CHOOSEwell Enrollment Guide. The past 10 years of LAwell Program enrollment guides are
available here.

Contact the LAwell Program Benefits Services Center in one of the following ways: