Losing LAwell Eligibility and Continuing LAwell Benefits
If you lose eligibility for the City subsidy through a reduction of hours or a paid or non-paid leave of absence, or you lose eligibility for LAwell benefits through termination, retirement, or transfer to DWP, you may be able to continue certain benefits through Direct Bill, Portability or Conversion and/or Cobra
When Benefits End
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.
How Benefits Can Continue
How Benefits Can Continue
Direct Bill
Employees who are eligible for LAwell benefits but lose eligibility for the City subsidy may continue their 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:
- 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.
Additional Notes:
- 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.
Portability and Conversion
Basic and supplemental life insurance coverage can only continue through portability or conversion. AD&D insurance can only continue through portability. For more information, see portability and conversion.
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
Leaves Of Absence
Various types of leaves of absence may allow LAwell benefits and the City subsidy to continue. Click to see the table below.
Leave Of Absence Types
| 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 |