OPEN ENROLLMENT

Open Enrollment is your annual opportunity to make any change to your benefits. Outside of this open enrollment period, benefit changes can only be made if you experience a Qualifying Life Event.

Open Enrollment for 2026 will be from October 1–31, 2025.

Your eligibility for LAwell benefits is evaluated on a biweekly basis, each and every pay period as follows:

• Minimum Compensated Hours – You must have a minimum number of compensated hours (such as HW, SK, VC, etc.) based on your employment status as follows:
  • Full-time employees – at least 40 hours
  • Half-time employees – at least 20 hours
• Retirement Contribution – You must continue to be a contributing member to the Los Angeles City Employee's Retirement System (LACERS) or, if authorized by your Memorandum of Understanding, Los Angeles Fire & Police Pensions (LAFPP)
• Eligible Employment Status – You must remain in a job classification and employment type that is authorized to receive LAwell benefits

If you are eligible for LAwell benefits, you can also cover the following dependents subject to providing sufficient proof of eligibility:

• A Spouse – Your same sex or opposite sex spouse is eligible if you provide a valid marriage certificate.
• or a Domestic Partner (DP) – Your same sex or opposite sex DP is eligible if your City of Los Angeles Domestic Partnership Affidavit is approved or you provide a copy of your Declaration of Partnership filed with the California Secretary of State
• and/or a Child:
  • Your dependent children up to age 26 – including your spouse/domestic partner's children with copies of birth certificates, adoption, or other court papers.
  • Your legal custody and/or foster children up to age 26 – if you provide the Employee Benefits Division with copies of court papers.
  • Your grandchildren – if the parent is your dependent child up to age 19, or up to age 26 for a full-time student with valid proof of student status.
  • Your disabled child of any age – who is dependent on you for support and certified as disabled each year by the insurance company for your health plan.
  • Special Situation Child Rule: If your child is also a LAwell eligible City employee, they must enroll into their own LAwell coverage and cannot be covered as your dependent.

• Review your options on the LAwell Enrollment Guide or at KeepingLAwell.com.
• Review your dependent information and eligibility rules. To verify current, add new, or remove ineligible dependents visit Eligibility FAQ's
• Make your Open Enrollment elections!
• Provide Social Security numbers or taxpayer identification numbers for your dependents in the Benefits Central Portal or by calling 833-4LA-WELL (this is for federal tax reporting purposes).
• Document your dependents by the Deadline! Refer to your Enrollment Guidebook for Submission deadlines.
• Review your confirmation statement when you receive it.
• Review the LAwell Enrollment Guide to understand plan rules and successfully manage your benefits over time.

If you take no action during the Open Enrollment period, most of your current 2025 elections will carry over to 2026.

Current Anthem HMO members will be “mapped” into a new Blue Shield or UnitedHealthcare HMO plan based on their Primary Care Physician—see the Medical Plan Change FAQ for details. The exception is your Flexible Spending Account (FSA) and Dependent Care Reimbursement Account (DCRA) elections. These accounts do not carry over each year.

All employees are strongly encouraged to review their benefits options and make an election during Open Enrollment, especially with the upcoming medical plan changes for 2026.

Starting October 1st
To enroll, make changes, and confirm eligibility for your benefits:

• Log in to your Benefits Central Portal account at keepingLAwell.com, available 24/7, OR
• Call the LAwell Benefits Service Center at 833-4LA-WELL (833-452-9355), Monday – Friday, 8:00 a.m. to 5:00 p.m.
• Extended phone hours are provided on Friday, October 31, from 8:00 a.m. to 7:00 p.m.
• (For TDD or TTY service, call 800-735-2922.)
• For all other benefits questions or support, contact your Member Services Representative at per.empbenefits@lacity.org.

Yes, during a very brief period. At the end of Open Enrollment, you'll receive a letter confirming your 2026 benefit elections. If any changes are needed, the letter will specify a short window in November when a correction is allowed. After that period, no further changes can be made unless you experience a Qualifying Life Event.

Yes. Flexible Spending Account (FSA) and Dependent Care Account (DCA) elections do not roll over and must be re-elected each year.

Throughout Open Enrollment there will be various ways to get support:

• Attend on-site Open Enrollment events.
• Call the LAwell Benefits Service Center at 833-4LA-WELL (833-452-9355), Monday – Friday, 8:00 a.m. to 5:00 p.m.
• Contact a Member Services Representative at per.empbenefits@lacity.org.
• Visit our City Hall office in person. Appointments receive priority and are strongly suggested.

Update your address in Workday. Contact your departmental HR if you need help.

Your 2026 elections default to your current plan (or your mapped plan if your current one is ending). Changes aren't allowed until the next Open Enrollment unless you have a Qualifying Life Event.

The City’s medical plans are changing for plan year 2026 due to the results of a competitive bidding process for the LAwell Program. The City contracts with medical insurance carriers to provide medical insurance to City employees. The LAwell Program’s insurance benefits are a large expense for the City and are subject to this competitive bidding requirement. For fiscal year 2024-25, the City of Los Angeles spent over $400 million in City-paid subsidies toward employee LAwell medical plans (Anthem & Kaiser). The City’s competitive bidding process is widely used and is intended for the City to get the best services at the best price.

The Los Angeles City Charter and Administrative Code outlines the authority and requirements for competitive bidding of any contracted service. This process is commonly referred to as a Request For Proposal (RFP) process. Under the Administrative Code, the LAwell Program is able to execute contracts with bidders selected from a competitive bidding process for up to five (5) consecutive years.

In early 2025, the City held a competitive bidding process to solicit medical insurance proposals from qualified bidders. Blue Shield, Kaiser, and UnitedHealthcare were the winning bidders selected from the City’s competitive bidding process.

Who made the final determination to select the winning bidders?

The results of the RFP were presented at meetings of the Joint Labor-Management Benefits Committee (JL-MBC) and voted on for recommendation to the Personnel Department to administer as authorized by the City Council. The JL-MBC is a committee comprising City Management (specific departments of the City), and Labor Organizations (specific unions that represent City employees). The JL-MBC reviewed the results of the RFP and recommended the selection of Blue Shield, Kaiser, and United Healthcare. Meetings of the JL-MBC are public. Recordings of those meetings are available at: bit.ly/JLMBClivestream. The reports submitted to the JL-MBC are also public and available at www.keepinglawell.com/jlmbc. The specific reports covering the Medical Plans RFP resulting in the selection of Blue Shield, Kaiser, and UnitedHealthcare are:

• Committee Report 24-33: Adopted recommendation to draft a Medical Plans RFP for plan year 2026
• Committee Report: 24-39: Adoption of draft Medical Plans RFP
• Committee Report 25-25: Report on Medical Request for Proposal (RFP) Findings and Recommendation for Plan Year 2026

This table shows the medical plan changes for 2026 compared to 2025.

This answer is best addressed at the plan level:

Anthem PPO Plan
Employees currently enrolled into the Anthem PPO Plan will be automatically assigned to the Blue Shield PPO Plan which offers the same provider network with reduced premiums.

Kaiser Permanente HMO Plan
Kaiser was selected to continue the same plan offered in 2025. Kaiser members will have no change in seeking services or seeing their current doctors as a result.

Anthem HMO Plans (including Anthem Narrow, Anthem Full, and Anthem Vivity)
The City has identified that the vast majority of doctors which employees and their dependents currently see in an Anthem HMO plan are an in-network provider in a Blue Shield HMO and/or UnitedHealthcare HMO plan. The City is taking extensive steps to reduce the disruption caused by this change; to that end, members currently enrolled in Anthem HMO plans will be automatically moved (“mapped”) to the UnitedHealthcare of Blue Shield HMO plan that continues to include current Primary Care Physician(s) (PCP). Additional information will be provided during Open Enrollment. Check now to see if your current doctor and/or hospital is in network using these provider finder tools.

By October, Anthem HMO subscribers will receive a letter from the LAwell Program detailing which plan they will be automatically moved ("mapped") to if they don’t take action.

Use the Provider Finder search tool.

California has "Continuity of Care" regulations that may allow you to continue seeing your current provider to complete current medical treatment even if they are not in your new plan's network. This applies in situations such as:

• Ongoing treatment for a serious condition
• Pregnancy
• Care for a child under age 3

Please note: If the doctor with whom you are currently seeking treatment is in your new network, 'Continuity of Care' generally would not apply and instead you would seek re-approval for treatment (aka medical 'authorization') from your new insurance company.

You must contact your new health plan to request Continuity of Care. They will review your application and the details of your treatment plan and, if you qualify, make arrangements for you to continue treatment with your non-network provider. The window for Continuity of Care applications to be submitted is anticipated to open beginning December 2025. More details will be released during Open Enrollment (October).

HMO (Health Maintenance Organization) – You choose a Primary Care Physician (PCP) from the plan's network. All non-emergency care must be coordinated through your PCP, and you generally need referrals for specialists. HMOs usually have lower out-of-pocket costs but less flexibility in choosing providers.

PPO (Preferred Provider Organization) – You can see any provider, but you'll pay less when you use in-network doctors and facilities. Referrals are not required for specialists. PPOs offer more flexibility but typically have higher monthly premiums.

HDHP (High Deductible Health Plan) – This is a type of PPO with lower monthly premiums but higher deductibles. The full cost of the deductible must be paid before the plan begins paying for most services. It pairs with a Health Savings Account (HSA), which lets you save pre-tax dollars for medical expenses now or in the future. HDHPs can be cost-effective for people who expect low medical use and want to build long-term HSA savings. Click here to learn more.

For the HMO and PPO plan types, the coverage levels are the same as before — meaning the deductibles, copays, co-insurance rates, and other core benefits are unchanged from the previous carrier. What's changing are the insurance providers, plan names, monthly premiums, and, in some cases, the provider networks.

The High Deductible Health Plan (HDHP) PPO is new for 2026, so its benefit structure is different. It has a higher deductible, high co-pays, and higher out-of-pocket maximum but lower monthly premiums and access to a Health Savings Account (HSA).

The tables below provide an overview of the new plan costs for full-time and half-time employees. Green downward arrows indicate premium reductions and red upward arrows indicate increased premiums compared to the equivalent plan this year.

Medical Plan Costs per Pay Period — 2025 vs 2026

No. However, employees are strongly encouraged to consider all of their options and make an active election.

All LAwell members who are enrolled into benefits in 2025 will continue to be enrolled in the same level of benefits for 2026. If you are in an Anthem HMO medical plan for 2025, you will be “mapped” into a new HMO medical plan with either Blue Shield or UnitedHealthcare based on your current Primary Care Physician designations. You should review your automatic reassignment and take action if you prefer something else.

If you want to contribute to a Flexible Health Spending Account (FHSA) or Dependent Care Reimbursement Account (DCRA) in 2026, you need to make an active election during Open Enrollment. Your current year election will not carry over automatically.

"Mapping" means that if your current medical plan is ending in December 2025, LAwell will automatically place you and any dependent enrolled into your medical plan into a new plan that most closely matches your current Primary Care Physician(s) and plan type—so you will continue to have similar coverage and access to seek medical services in January 2026 without a gap, even if you do not make an active election during Open Enrollment.

If you're in an Anthem HMO, you and your dependents will be mapped to a UnitedHealthcare or Blue Shield HMO that includes your and your dependents current Primary Care Physicians (PCPs) in its network.

If you're in the Anthem PPO, you'll be assigned to the BlueShield PPO, which has the same provider network and lower premiums.

You can keep your mapped plan or choose any other available plan during Open Enrollment.

Yes. Starting with this year's Open Enrollment, the Benefits Central Portal (online) and Benefits Services Center (phone) can record your Primary Care Physician (PCP) designation. You will need to have the National Provider Identifier (NPI) number for your PCP, which is a unique 10-digit number assigned to each PCP. Further instructions on how to identify the NPI will be provided during Open Enrollment.

Both Blue Shield and UnitedHealthcare will have representatives present in-person at Open Enrollment events held in October. Contact information to reach a member advocate virtually (phone/email) will be provided as part of Open Enrollment in October.

If you report a Qualifying Life Event between September 2025 and December 2025 and make changes, you'll need to submit new elections at that time for both the remainder of 2025 and for 2026. Depending on the timing of your life event change, additional actions may be required to ensure your intended coverage elections continue correctly from 2025 to 2026. Additional information on these actions will be provided to anyone who reports a life event in 2025.

Your new medical plan will be effective January 1, 2026.

Yes. Medical authorizations from Anthem will not automatically transfer to Blue Shield or UnitedHealthcare. If your plan or provider changes for 2026, you'll need to work with your new carrier to obtain any required pre-authorizations for care scheduled in 2026.

An HDHP, or High Deductible Health Plan, is a type of PPO medical plan with lower monthly premiums but higher deductibles than traditional PPO plans. You pay the full cost for most services until you meet the deductible, after which the plan begins sharing costs. Enrollment into a HDHP is paired with enrollment to a Health Savings Account (HSA), which lets you set aside pre-tax money to pay for eligible medical expenses, including the expenses required to meet your deductible. Your use of the HSA is optional.

Both plans use the same BlueShield PPO network. The BlueShield HDHP PPO has lower premiums compared to the traditional BlueShield PPO. But the BlueShield HDHP PPO has a higher deductible, higher annual out-of-pocket maximum, higher co-pays, and differences in co-insurance. In both PPO plans, you must meet your deductible before the full benefits of the insurance plan begin. However, the BlueShield HDHP PPO comes with a Health Savings Account (HSA) to set aside pre-tax funds for eligible expenses.

An HDHP can be a good fit for those who do not expect to have very many medical needs during the calendar year, are considered generally healthy and have a history of good health, and/or are capable and willing to incur large costs if they seek medical care. It may also be a desirable option for those who want to build savings in a Health Savings Account (HSA) or already have HSA funds saved in another account. Unused HSA funds roll over each year and can be used in the future—even after you leave City employment.

An HDHP may not be the best choice for those who expect routine use of medical services, take high-cost prescriptions or take multiple regular routine prescriptions, or who are not prepared to pay a large amount when they seek medical care. Because you must pay the full cost for most services until you meet the deductible, those with ongoing or complex medical needs may prefer a plan with a lower deductible, even if the monthly premium is higher.

In general, no. The Internal Revenue Code does not permit contributions to both a Health Care Flexible Spending Account (HCFSA) and Health Savings Account (HSA) in the same tax year. Individuals who contribute to both a FSA and HSA in the same tax year may be subject to penalties by the Internal Revenue Services (IRS). This is an IRC/IRS restriction, not a City rule. Each employee is responsible for understanding the tax rules and requirements of any tax-advantaged option they elect to enroll into (inclusive of options available through the LAwell Program) and for ensuring they comply with all applicable tax laws. Please consult with your tax advisor before enrolling into any HSA or HCFSA.

You may continue using your 2025 FSA balance for eligible expenses incurred through March 15, 2026. All claims must be submitted by April 30, 2026.

No. An employer match is not being offered for 2026.

If you enroll in the BlueShield HDHP PPO, a Health Savings Account (HSA) will be available for you through Blue Shield’s HSA administrator. Details will be provided to you by Blue Shield after your enrollment into the HDHP is processed. For 2026, you will make any desired HSA contributions directly to the HSA administrator and not through City payroll deduction.

The LAwell Program provides benefits to eligible employees and their eligible dependents. The City will now periodically audit all dependent records to ensure they meet LAwell Program eligibility rules. A dependent may lose eligibility due to events such as divorce, termination of a domestic partnership, reaching the age limit of 26 for child dependents, or other changes.

Once the Dependent Eligibility Verification audit begins, you may be required to provide documents proving that each dependent covered under your benefits meets the LAwell eligibility rules. Common examples include:

• Marriage certificate for a spouse
• Birth certificate or adoption paperwork for a child
• Domestic partnership registration for a domestic partner

Details and instructions will be provided in early 2026. If any of your dependents are found to be ineligible, their coverage will be terminated, and you will be required to repay the cost of their premiums for the time they were deemed to be ineligible.

Keeping ineligible dependents in your coverage is a violation of LAwell Program rules and abuse of public funds. Removing ineligible individuals helps the City control costs and maintain compliance with LAwell Program rules.

Generally, your legal spouse or registered domestic partner, and your children under age 26 (including biological, step, adopted, or foster children) are eligible. Some other dependents may qualify in specific situations. For full rules and required documentation, visit KeepingLAwell.com/dependents.

When you add a dependent to your LAwell coverage, you are attesting that the dependent meets the Program’s eligibility criteria. You must also provide supporting documentation at the time of enrollment. If a dependent subsequently becomes ineligible (e.g., divorce) and you fail to remove them from LAwell coverage, you may be required to repay the cost of the premiums for the period the dependent was ineligible.

During the 2026 Open Enrollment period (October 1–31, 2025), you should remove any ineligible dependents from your coverage. If you do so at that time, no penalties will apply. The Dependent Eligibility Verification audit is anticipated to take place in the first half of 2026. If the audit identifies that an ineligible dependent still exists in your covered benefits, you will be responsible for repaying all premiums associated with that dependent for the period in which the dependent was ineligible and still enrolled into benefits.

Yes. A new/updated Cash-In-Lieu affidavit will be required to be submitted. Employees receiving Cash-In-Lieu in 2026 will receive a notice and further instructions when the Dependent Eligibility Verification audit begins.