Division of Risk Management and Insurance Services
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- Los Angeles Unified School District
- Benefits Administration
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District Retirees
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Eligibility -
To ensure health benefit coverage, retirees must have completed the required steps as outlined in the Planning to Retire page.
Employees who take a deferred retirement (leave funds on deposit with the retirement system for withdrawal at a later date) or opt for a lump sum distribution are not eligible for District-sponsored retiree health benefits. -
Dependent Children Eligibility -
Eligible children include:
- children up to age 26;
- dependent disabled children must meet the disability standards of your medical plan and must be enrolled prior to age twenty-six (26);
- children of domestic partners whom the retiree has adopted or has been declared legal guardian (must be registered with the State of California); or
- court-ordered children who are included in the retiree’s tax return.
Retirees Under 65
Retiree Over 65
Dependent coverage terminates on the last day of the birthdate month
Dependent Eligibility
Medical
Dental
Vision
Dependent Eligibility
Medical
Dental
Vision
Dependents up to the age 19
Yes
Yes
Yes
Dependents up to the age 19
Yes
Yes
Yes
Students age 19-25
*student verification required
Yes
*Yes
*Yes
Students age 19-25
*student verification required
*Yes
*Yes
*Yes
Non Students age 19-25
Yes
No
No
Non Students age 19-25
No
No
No
All dependents age 25-26
Yes
No
No
All dependents age 25-26
No
No
No
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Available Medical Plans -
EPO & HMO HMO & Seniority Plus Medicare Preferred PPO HMO & Senior Advantage HI: Big Island, Oahu, Maui NW: Oregon, Washington There is no out-of-country coverage.
The Anthem Blue Cross HMO plan is available to most California residents. The Anthem Blue Cross EPO plan is available in all states.
The Anthem Medicare Preferred (PPO) Medical plan is offered to members who are over the age of 65 with Medicare Parts A and B. This 50 state Medicare plan includes enhanced benefits such as no copays, no coinsurance, no deductiles, and offers the same benefits whether you use an in-network or out-of-network provider that accepts Medicare.
The Kaiser HMO plan is available to most California residents. The Kaiser Senior Advantage plan is available in California, Hawaii, Oregon, and Washington.
The Health Net HMO and Seniority Plus plans are available to most California residents.
All medical plans are available in certain zip codes only. Contact each plan directly for specific coverage area.
Changing Doctors
Retirees may contact their plan directly to receive information on electing a different medical provider.
Contact information for each provider can be found on the Benefit Providers page. -
Available Dental and Vision Plans -
DHMO PPO DHMO & Plan Plus
There is no out-of-country coverage.
Both EyeMed and VSP allow for in-network and out-of-network providers.
Please note that enrolling in a vision plan is a two-year commitment. If a vision plan is elected in 2018 (to take effect January 2019), eligibility to change plans is not available until 2020 (for the plan to take effect January 2021).Changing Dentists and/or Optometrists
Retirees may contact their plan directly to receive information on electing a different dental and/or vision provider.
Contact information for each provider can be found at the Benefit Providers page. -
Changing Health Plans -
Changing health plans is permissible only during the District’s annual Open Enrollment period that typically takes place during the month of November.
Mid-year plan changes can only be made because of a qualifying Major Life Event or if moving out of the provider's service area.If moving out of California, retiree must contact Benefits Administration for benefit plan availability in the new area and must complete the Out of Area Enrollment form found in the Related Documents tab at the end of this page.
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Student Verifications -
Student verifications are required every Spring (typically April) and Fall (typically September) to verify eligibility of dependent children ages 19 to 25.
See the Dependent Children Eligibility tab above for further information. -
COBRA Information -
All dependents who lose health coverage may apply for COBRA.
In the event of a retiree’s death, the District will not pay for the health plan coverage of a surviving spouse or other dependents. Surviving spouses may continue coverage at their own expense under the District’s AB528 Continuation Plan, and may also be eligible for COBRA coverage for a limited time. Other dependents, however, are eligible for COBRA only. The retiree’s surviving spouse or dependent(s) must notify the District of the retiree’s death within 60 days of the event. The notice must be in writing and sent by mail to: Benefits Administration P.O. Box 513307, Los Angeles, CA 90051-1307 or fax to 213-241-4247. Include name, employee number/social security number, and a copy of the death certificate. The District will then notify the COBRA/AB528 Administrator who in turn will mail an enrollment packet to the retiree’s surviving spouse/dependent(s). Failure to notify the District of a retiree’s death may cause the surviving spouse and dependent(s) to forfeit their COBRA/AB528 rights.
Further information can be found on the COBRA Information page. -
Prescription Coverage -
Click here for more information.
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Related Documents -
To view related documents, please visit the "District Retirees" section of the Forms and Publications page.