Los Angeles County Municipal Code Ch. 5.36 Group Insurance

A.

As used in this chapter, "employee" also shall include judges of the Superior Court and municipal courts and all officers and attaches of said courts whose salaries are paid either in whole or in part by this county from county funds.

B.

Any person who terminates county service and receives pay in accordance with the provisions of Section 5.20.070 D of the code except a retiree. Employees defined in this subsection B shall be treated for purposes of this Chapter 5.36 as persons on an approved leave of absence without pay. This subsection B shall only apply to persons for 24 months following termination.

(Ord. 98-0076 § 17, 1998: Ord. 83-0145 § 2, 1983 [readopted 10/18/83]; Ord. 82-0169 § 1 (part), 1982: Ord. 19023 § 2 (part), 1974: Ord. 4099 Art. 97 § 19056, 1942.)

Pursuant to Article 1 (commencing with section 53200) of Chapter 2, Part 1 of Division 2 of Title 5, of the California Government Code, the County will pay a monthly contribution to each group medical/hospital insurance plan administered by the County, or administered by an employee organization and approved by the County, for each eligible employee who elects to enroll in such plan.

A.

The maximum monthly County contribution rates set forth in the table below will apply with respect to:

Monthly temporary and monthly recurrent employees (designated as "O" or "B" in Section 6.28.020 of this Code) who are (a) employed in classifications specifically approved for said special maximum monthly Contribution rates by the Board of Supervisors, and (b) otherwise entitled to a County contribution toward County- sponsored or County-approved union- sponsored health insurance coverage pursuant to the provisions of this chapter.

Monthly permanent 3/4 time employees (designated as "Y" in Section 6.28.020 of this Code).

Maximum Monthly County Contribution—Coalition of County Unions Represented Employees

Coverage Effective Effective Effective 1-1-26 1-1-27 1-1-28

Employee $1,164.01 $1,257.13 $1,357.70

Employee plus one dependent $2,067.43 $2,232.82 $2,411.45

Employee plus two or more dependents $2,373.19 $2,563.05 $2,768.09

B.

The maximum County contribution for Eligible Employees will not exceed the amount specified in the memorandum of understanding with LACEA Local 721, SEIU.

The contribution provided for in this Chapter will be made only on behalf of each employee who actually enrolls in such plan. Such contribution will be made to only one such medical/hospital plan per employee, which contribution may be applied to the premiums paid for coverage of the employee and the dependents of the employee. No contribution will be made on behalf of any employee who has not been in a pay status at least one (1) day of the prior month.

The provisions of this Section 5.36.025 shall be made operative with respect to County pay warrants issued on or about January 15, 2001.

(Ord. 2025-0056 § 4, 2025; Ord. 2025-0039 § 2, 2025; Ord. 2022-0066 § 2, 2022; Ord. 2022-0046 § 11, 2022; Ord. 2021- 0057 § 2, 2021; Ord. 2019-0034 § 3, 2019; Ord. 2018-0047 § 1, 2018; Ord. 2016-0005 § 3, 2016; Ord. 2015-0063 § 13, 2015; Ord. 2014-0045 § 12, 2014; Ord. 2014-0008 § 22, 2014; Ord. 2012-0036 § 4, 2012; Ord. 2009-0055 § 2, 2009; Ord. 2006- 0084 § 11, 2006; Ord. 2004-0001 § 21, 2004; Ord. 2000-0074 § 5, 2000; Ord. 98-0076 § 19, 1998; Ord. 92-0013 § 3, 1992; Ord. 91-0006 § 3, 1991; Ord. 89-0125 § 2, 1989.)

Effective January 1, 2000, the County shall provide a monthly subsidy towards the health care premium for employees in classes eligible for the Local 660 Cafeteria Program. The amount of such subsidy is to be $6.00 for individuals enrolled in employee-only coverage, $9.00 for individuals enrolled in employee plus one dependent coverage, and $11.00 for individuals enrolled in employee plus two or more dependents coverage.

The subsidy provided for in this section shall be made only on behalf of each employee who actually enrolls in such plan. Such subsidy shall be made to only one such medical/hospital plan per employee, which subsidy may be applied to the premiums paid for coverage of that employee and his dependents. No subsidy shall be made on behalf of any employee if he has not been in a pay status at least one day of the prior month.

The provisions of this Section 5.36.026 shall be made operative with respect to County pay warrants issued on or about January 15, 2000.

(Ord. 98-0076 § 20, 1998.)

Leave Act of 1993.

A.

Notwithstanding any other provision of this Code, the County shall continue to make such contributions, if any, as are necessary to maintain coverage under a County-sponsored or County-approved health plan for any employee designated in subsection B of this section, for the duration of the leave and under the conditions the coverage would have been provided if the employee had continued in employment continuously for the duration of such leave.

B.

The provisions of this section shall apply to any employee receiving leave pursuant to the Family and Medical Leave Act of 1993.

(Ord. 93-0063 § 1, 1993.)

A.

In addition to the eligible employees designated in Section 5.36.025, employees meeting the criteria in subsection B of this section, who are enrolled in a County-sponsored health plan, or a County-approved union-sponsored health plan, shall be entitled to a monthly contribution toward the payment of the premiums for such plan. The amount of the monthly contribution shall be the lesser of the monthly premium or the contribution provided in subsection A of Section 5.36.025.

B.

The provisions of this section shall apply to each daily as-needed, daily recurrent, hourly as-needed, hourly recurrent, monthly permanent 1/2 time, monthly permanent 3/5 time, monthly permanent 5/8 time, and monthly permanent 2/3 time (designated as C, E, F, H, U, V, W, and X, respectively, in Section 6.28.020 of this Code) employee who:

Has been in a pay-status for an average of 20 hours a week for the three consecutive months prior to enrollment in the County sponsored health plan. For purposes of this section, an employee will be deemed to have been in a pay status for an average of 20 hours per week if, in the aggregate, he has been compensated the following number of hours over any three (3) consecutive month period:

a.

244 hours if employed on a daily or hourly basis,

b.

256 hours if employed on a monthly temporary or monthly recurrent basis or on a 1/2 time, 3/5 time, 5/8 time, or 2/3 time monthly permanent basis;

Is not employed in a position compensated pursuant to the Physician Pay Plan, or

Is not employed in any of the following positions:

C.

No contribution shall be made on behalf of any employee if he has not been in a pay status at least eight hours of the prior month.

D.

An employee shall become ineligible for the County contribution effective July 1st, if an employee is in a pay-status for an average of less than 20 hours a week during January, February, and March of the year following the year the employee is first eligible for this County contribution.

E.

In no event shall the County contribute to more than one health plan at one time for each employee. "Health Plan" for this purpose includes a health plan provided by the Los Angeles County Employees Retirement Association.

F.

In no event shall the subsidy provided for in this Section 5.36.029 be payable prior to the pay day occurring on or about the fifteenth day of the month occurring 90 days after the requirements set forth in subsection B have been met. All employees

who qualify for the subsidy shall qualify on the basis of hours worked subsequent to January 1, 2001. No subsidy payment shall be payable prior to the pay day occurring on or about July 13, 2001.

G.

Effective January 1, 2020 through March 31, 2020, the provisions of subsection B.1 (a) and (b) above regarding the hours of pay-status requirements are amended as follows:

156 hours if employed on a daily or hourly basis,

168 hours if employed on a monthly temporary or monthly recurrent basis or on a 1/2 time, 3/5 time, 5/8 time, or 2/3 time monthly permanent basis;

H.

Effective January 1, 2020 through March 31, 2020, the provisions of subsection D above regarding the hours of pay-status requirements are suspended.

I.

Effective April 1, 2020, the provisions of subsection C are suspended during the duration of the local and public health emergency due to the novel Coronavirus.

(Ord. 2020-0016U § 1, 2020; Ord. 2014-0045 § 13, 2014; Ord. 2012-0017 § 6, 2012; Ord. 2011-0046 § 4, 2011; Ord. 2011- 0012 § 5, 2011; Ord. 2009-0055 § 3, 2009; Ord. 2006-0084 § 12, 2006; Ord. 2004-0001 § 23, 2004; Ord. 2000-0074 § 6, 2000.)

A.

Any employee organization which administers a medical/hospital plan approved by the county prior to March 10, 1971, shall request prior reapproval of the board of supervisors when changes in the premium structure or the level of benefits are planned.

B.

Reapproval must be granted before the contribution may be paid on behalf of eligible enrolled subscribers in such plan. If reapproval is not requested or the county does not grant reapproval, the county contribution toward premiums of that plan will be discontinued as of the date the changes are implemented.

(Ord. 82-0169 § 1 (part), 1982: Ord. 11143 § 2 (a), 1975: Ord. 4099 Art. 97 § 19051.1, 1942.)

A.

County contributions to county-administered or county-approved employee health insurance plans shall be paid concurrent with the county paydays that occur on or about the fifteenth of the month following the month in which such county contributions are earned. Except as provided in subsection B below, all such contributions shall be applied toward the purchase of insurance coverage for the month following the month in which such contributions are actually paid (said arrangement hereinafter referred to as "Prepay").

B.

By specific action, the board of supervisors may authorize the purchase of employee health insurance for the same month in which county contributions are actually paid (such arrangement hereinafter referred to as "Current Pay"). In the event the board of supervisors authorizes a conversion from Prepay to Current Pay, there shall be a one-time-only one-month suspension of county contributions in the month of conversion, pursuant to the rules approved by the board of supervisors.

(Ord. 87-0222 § 2(b), 1987.)

A.

Monthly Subsidy.

For employees who are not in an employee representation unit, the county shall provide a monthly subsidy for each employee and covered family members, if any, toward county sponsored health plan coverage, consisting of the difference between the employee contribution rate approved by the board of supervisors and the projected health plan cost per employee, in the event that the projected health plan cost per employee exceeds the employee's contribution rate.

Notwithstanding any other provision of this Code, the County shall provide amnesty from discipline and payment recovery to any employee whose Ineligible Dependent(s) are removed from County-sponsored or County-approved health plan coverage as a consequence of a dependent eligibility verification process authorized by the CEO; provided, however, that no such amnesty shall be extended to any employee who obtains such coverage through willful misrepresentation or other fraudulent means.

The chief administrative officer shall establish, and revise from time to time, policies for the determination of projected health plan cost per employee and shall make such determination. Such determination shall include consideration of total projected expenditures under one or more contracts for health care, establishment and maintenance of a reasonable level of contingency funds to meet extraordinary expenditures under one or more contracts for health care, the level of contributions and subsidies to maintain employee choice among types of health care plans, availability of budgeted funds, and any other relevant factor or factors the chief administrative officer determines should be included. The chief administrative officer may retain the services of one or more consultants to assist in the determination of projected health plan cost per employee, and in the establishment and revision of policies.

B.

The provisions of this Section 5.36.060 shall first be reflected on County pay warrants issued on or about January 14, 2000.

(Ord. 2015-0011 § 11, 2015; Ord. 99-0084 § 7, 1999.)

The County will pay the premium for a $5,000.00 group term life-insurance plan. All employees whose status is one of the following are eligible to receive this insurance:

A.

Permanent, full-time (designated as A, L, N, D, or Z in Section 6.28.020 of this code);

B.

Paid by the county on a full-time basis while working for the county in an official training program of at least one year's duration (designated as M in Section 6.28.020 of this code).

(Ord. 2022-0046 § 12, 2022; Ord. 2016-0005 § 4, 2016; Ord. 82-0169 § 1 (part), 1982; Ord. 19023 § 2 (part), 1974; Ord. 4099 Art. 97 § 19058, 1942.)

Effective with the implementation of Retirement Plan E, in addition to the life insurance specified in Section 5.36.070, the County will pay the premium for an $8,000.00 group term life insurance plan for all employees enrolled in Retirement Plan E who are:

A.

Permanent, full-time (designated as A, L, N, D, Z in Section 6.28.020 of this code);

B.

Paid by the county on a full-time basis while working for the county in an official training program of at least one (1) year's duration (designated as M in Section 6.28.020 of this code).

(Ord. 2024-0044 § 1, 2024; Ord. 2022-0046 § 13, 2022; Ord. 2016-0005 § 5, 2016; Ord. 82-0169 § 1 (part), 1982; Ord. 12406 § 2, 1981; Ord. 4099 Art. 97 § 19059, 1942.)

A.

For employees enrolled in the County-sponsored Delta Dental Plan, or any successor County-sponsored indemnity dental plan, the County shall provide a monthly subsidy toward the cost of such coverage for each employee and each employee's covered family members, as set forth in Table A, Table B, or Table C below.

TABLE A

Monthly Employer Contribution Rates Applicable to Participants in the Options Cafeteria Benefit Plan Established Under Chapter 5.37

TABLE B

Monthly Employer Contribution Rates Applicable to Participants in the Choices Cafeteria Benefit Plan Established Under Chapter 5.33

Coverage Effective 1-1-12 Effective 1-1-13

Employee only $20.59 $20.59

Employee plus one dependent 36.02 36.02

Employee plus two or more 56.58 56.58 dependents

TABLE C

Monthly Employer Contribution Rates Applicable to Participants in the Pensionable or Nonpensionable Flexible Benefit Plans Established Under Chapters 5.27 and 5.28, Respectively

B.

No subsidy shall be payable under this Section 5.36.080 if the applicable employee contribution rate set forth in Table A, Table B, or Table C exceeds the premium for the Delta Dental coverage, or successor indemnity dental coverage. In such event, the County shall be entitled to take such excess as an offset against the costs of the subsidy provided to other dental coverage subscribers.

C.

In no event shall the subsidy provided for in this Section 5.36.080 be payable on behalf of any person who is no longer a County employee or who is receiving dental plan coverage by virtue of the federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), or any successor federal law.

D.

The provisions of this Section 5.36.080 shall first be reflected on County pay warrants issued on or about January 15, 2001.

(Ord. 2018-0031 § 9, 2018; Ord. 2012-0036 § 5, 2012: Ord. 2009-0055 § 4, 2009; Ord. 2008-0014 § 14, 2008; Ord. 2006- 0084 § 13, 2006; Ord. 2004-0001 § 24, 2004; Ord. 2000-0074 § 7, 2000.)

Editor's note— Ord. 2012-0036, § 7, adopted Sept. 18, 2012, provides: Pursuant to Government Code Section 25123(f), this ordinance shall take effect on December 16, 2012 to be operative with respect to County pay warrants issued on or about January 15, 2013.

The provisions of this chapter are not intended to and do not create any contract between the county and any county employee.

(Ord. 82-0169 § 1 (part), 1982: Ord. 10923 § 2 (part), 1974: Ord. 4099 Art. 97 § 19057, 1942.)

A County contribution shall be made to the Peace Officers Relief Fund Trust, 828 West Washington Boulevard, in the amount of $30.00 per month for each person employed on a full-time, permanent position in a County classification specifically authorized by the board of supervisors. Such payment shall be made on the first day of the month for each specified employee who works at least eight hours in the preceding month. This payment shall not constitute a base rate.

(Ord. 90-0001 § 2, 1990.)