Los Angeles Municipal Code Ch. 11.5 Health Insurance and Other Benefits for Fire and Police Pension Plans

(Title Amended by Ord. No. 173,028, Eff. 1-17-00; Reference to Article 10 Deleted and Chapter Amended by Ord. No. 179,538, Eff. 3-2-08.)

Section

• 4.1150 Health Care Coverage Account.

• 4.1150.1 Los Angeles Fire and Police Pensions Retiree Health Care Fund.

• 4.1151 Purpose of the Program.

• 4.1152 Administration.

• 4.1153 Subsidies to Be Provided for Approved Plans Only.

• 4.1154 Eligibility for a Health Insurance Premium Subsidy.

• 4.1155 Verification of Health Insurance Coverage.

4.1157 Director of the Office of the City Administrative Officer to Review Health Insurance Program.

4.1161 Surviving Spouse’s and Domestic Partner’s Eligibility for Health Insurance Premium Subsidy.

4.1162 Additional Subsidy for Reimbursement of Medicare Part B Basic Premium.

4.1163 Eligibility for Reimbursement of Health Insurance Premiums to Eligible Retired Members, Their Qualified Surviving Spouses or Qualified Domestic Partners.

4.1164 Dental Insurance Premium Subsidy for Retired Members.

4.1166 2011 Medical Plan Premium Subsidy and Reimbursement Freeze.

4.1167 Election to Make Voluntary Additional Contributions in Exchange for Vested Rights to Increases in Subsidies or Reimbursements for Retiree Health Benefits.

(a) Effective March 21, 1975, there is established within the respective General Pension Fund under each membership Tier (“Fund”) a separate account for the purpose of paying benefits for health, medical, hospital, or other medical plans as authorized under the programs established in this Chapter (“Health Care Plan”). The account is established pursuant to Section 401(h) of the Internal Revenue Code. The assets in this account shall be accounted for separately from the other accounts in the Fund. However, the assets of this account may be commingled for investment purposes only with the other accounts of the Fund. Investment earnings and expenses will be allocated on a reasonable basis. All assets in the 401(h) account shall be held in trust for the exclusive benefit of eligible retirees and their spouses and dependents.

(b) Effective October 3, 1989, contributions to the 401(h) account established by this Section shall be made from appropriations and any other sources. Contributions to the 401(h) account are subordinate to the contributions to the Fund. At no time shall contributions to the 401(h) account, plus any life insurance protection costs, be in excess of twenty-five percent (25%) of the total aggregate actual contributions made to the Fund for the traditional pension plan benefits (not including contributions to fund past service credits) and the 401(h) account plus any life insurance protection costs. The plan actuary shall annually determine whether the twenty-five percent (25%) limit has been exceeded.

(c) Forfeitures are not to be allocated to any individual accounts under the Health Care Plan, but shall be used to provide the defined health care benefits under the Health Care Plan.

(d) The assets of the 401(h) account shall only be used for the payment of health care coverage and medical benefits as provided in the Health Care Plan for eligible retirees, their eligible dependents, and their qualified survivors.

(e) At no time prior to the satisfaction of all liabilities under the Health Care Plan shall any assets in the 401(h) account be used for, or diverted to, any purpose other than providing the benefits under Subsection (d) of this section and the payment of administrative expenses. Assets in the 401(h) account may not be used for retirement, disability or survivor benefits, or for any other purpose under the Fire and Police Pension Plan.

(f) Upon the satisfaction of all liabilities under the law to provide benefits pursuant to Subsection (d) of this section, any assets in the 401(h) account, if any, that are not used as provided in Subsection (d) of this section shall be transferred to the City Fund, as required by Section 401(h)(5) of the Internal Revenue Code.

(g) It is the intent of the City of Los Angeles in adopting this amendment to comply in all respects with Sections 401(a) and 401(h) of the Internal Revenue Code, and regulations interpreting those sections. In applying this amendment, the Board will apply the interpretation that achieves compliance with those sections and preserves the qualified status of the Fire and Police Pension Plan as a governmental plan under Sections 401(a) and 414(d) of the Internal Revenue Code.

SECTION HISTORY

Added by Ord. No. 147,014, Eff. 3-21-75.

Renumbered and Relocated by Ord. No. 154,536, Eff. 11-30-80.

Amended by: Ord. No. 172,040, Eff. 7-3-98; Ord. No. 173,272, Eff. 6-25-00, Oper. 7-1-00.

Deleted by Ord. No. 179,538, Eff. 3-2-08.

Added by Ord. No. 182,628, Eff. 7-16-13.

(a) The Los Angeles Fire and Police Pensions Retiree Health Care Fund (the “LAFPP Health Care Fund”) is established for the sole purpose of funding the retiree health care benefits provided to eligible retirees, their eligible dependents, and their qualified survivors, of the Los Angeles Fire and Police Pension plan pursuant to the programs established by Chapter 11.5 of Division 4 of the Los Angeles Administrative Code, and is intended to qualify for exemption from federal income tax under Section 115(1) of the Internal Revenue Code. Except as provided in Subsection (d), funds in the LAFPP Health Care Fund may not be used, directly or indirectly, to pay the cost of any other benefits provided by, or expenses or obligations incurred by, the Los Angeles Fire and Police Pension plan (the “Plan”).

(b) The LAFPP Health Care Fund shall provide an alternative funding mechanism, in addition to or in lieu of the 401(h) account described in Section 4.1150, for funding benefits under the Health Care Plan described in that section. Effective July 1, 2022, on a prospective basis, the City shall provide for an annual contribution of funds from appropriations and other sources to the LAFPP Health Care Fund, in the amount determined each year by the Board of Fire and Police Pension Commissioners (the “Board”) based upon the recommendation of the Plan’s actuary. Such contributions shall be in lieu of contributions to the 401(h) account described in Section 4.1150 .

(c) The City and the Board shall enter into a written trust agreement for the LAFPP Health Care Fund (the “Trust Agreement”) on or before July 1, 2022. The Trust Agreement shall provide that the Board shall serve as the trustee of the LAFPP Health Care Fund. The Trust Agreement shall establish the respective roles and responsibilities of the Board and the City with respect to the administration and investment of the LAFPP Health Care Fund, consistent with Charter Section 1106 and Section 17 of Article XVI of the California Constitution. The Trust Agreement may include, but is not limited to, funding, distribution, expenditure, actuarial, accounting, and reporting considerations. The Board shall have sole control over the investment activity of the LAFPP Health Care Fund, as provided in Subsection (d).

(d) Consistent with Charter Section 1106 and Section 17 of Article XVI of the California Constitution, the Board shall have sole, exclusive, and plenary authority, and shall have fiduciary responsibility, over the funds in the LAFPP Health Care Fund, including the investment of such funds. The Board may commingle and/or co-invest all or any portion of the funds in the LAFPP Health Care Fund with those in the Service Pension Funds and General Pension Funds of the Los Angeles Fire and Police Pension plan (the “Pension Funds”), to the extent allowed by federal tax laws, including through a group trust under Revenue Rulings 81-100 and 2011-1. The investment earnings and investment expenses attributable to the investment activity of the LAFPP Health Care Fund shall be accounted for separately from the investment earnings and expenses of the Pension Funds. The funds in and investment earnings of the LAFPP Health Care Fund shall be used to pay the reasonable costs related to investment expenses and administration of the LAFPP Health Care Fund and the Health Care Plan to the extent allowed by federal tax laws. Those expenses shall not be deemed to be an investment or administrative expense of the Los Angeles Fire and Police Pension plan or the Pension Funds.

(e) Any amendment to the Trust Agreement shall require approval by a majority vote of all members of the Board and two of the affirmative votes must be cast by elected employee members of the Board.

(f) In accordance with the procedures established in the written Trust Agreement described in Subsection (c), the Board may elect to terminate the LAFPP Health Care Fund. If the Board so elects, the Board shall disburse the funds in the LAFPP Health Care Fund in the following order and manner:

(1) The Board shall retain an amount sufficient to fund and pay for, as applicable, all retiree health care benefits owed to eligible retired members and beneficiaries under the programs established by Chapter 11.5 of Division 4 of the Los Angeles Administrative Code.

(2) The Board shall retain an amount sufficient to pay reasonable administrative and investment costs described in this Section 4.1150.1.

(3) After the amounts in Subdivisions (1) and (2) have been retained or disbursed, the Board shall transfer any remaining funds to the general fund.

(g) The Board may establish rules and procedures governing the investments and administration of the LAFPP Health Care Fund.

(h) The Board is authorized to take any and all actions necessary to establish, administer, and maintain the LAFPP Health Care Fund in compliance with applicable federal tax laws or other legal requirements, including, but not limited to, Section 115 of the Internal Revenue Code.

(i) The Board shall have the authority to adopt any rules it deems necessary to carry out its role as trustee of the LAFPP Health Care Fund.

(j) The Trust Agreement entered into between the City and the Board, as described in Subsection (c), shall not change the obligations of the City or the Board created under other contracts, laws, ordinances, regulations, or similar actions to provide benefits for employees or retired employees of the City, or their eligible beneficiaries.

SECTION HISTORY

Added by Ord. No. 187,351, Eff. 2-21-22.

It is the purpose of this Chapter to provide a program whereby retired members or beneficiaries, if eligible, pursuant to the terms and conditions hereinafter set forth in this Chapter, shall have subsidy payments made on their behalf for such benefit program or programs specified in Sections 1330, 1428, 1518, 1618, or 1718 of the Charter or Section 4.2018 of the Administrative Code as may be authorized by the Council by ordinance, subject to such conditions of entitlement as may be set forth in such ordinance in accordance with the provisions and limitations of Sections 1330, 1428, 1518, 1618, or 1718 of the Charter or Section 4.2018 of the Administrative Code.

The cost of the subsidies provided in this Chapter and the Board’s administrative costs connected therewith shall be provided from the Health Care Coverage Account established in Section 4.1150 of this Chapter and/or the LAFPP Health Care Fund established in Section 4.1150.1 of this Chapter. Notwithstanding all of the foregoing, the cost of the subsidies provided in this Chapter, including all administrative costs, shall be paid first from the Health Care Coverage Account, until it is depleted. Upon depletion of the Health Care Coverage Account, the LAFPP Health Care Fund shall fund the cost of the subsidies provided in this Chapter, including all administrative costs. The Board shall establish the policies and/or procedures necessary to implement this section.

SECTION HISTORY

Added by Ord. No. 147,014, Eff. 3-21-75.

Renumbered and Relocated by Ord. No. 154,536, Eff. 11-30-80.

Amended by: Ord. No. 172,040, Eff. 7-3-98; Ord. No. 173,272, Eff. 6-25-00, Oper. 7-1-00; Ord. No. 176,731, Eff. 6-21-05; Ord. No. 179,538, Eff. 3-2-08; Ord. No. 181,770, Eff. 7-8-11; Second para. added, Ord. No. 182,628, Eff. 7-16-13; In Entirety, Ord. No. 187,351, Eff. 2-21-22.

Any program established by this chapter shall be administered by the Board of Fire and Police Pension Commissioners (hereinafter referred to as “the Board”). In furtherance thereof, the Board shall provide suitable health, medical, hospital or other plans as may be authorized by ordinance, and shall have the power to adopt such rules as it deems necessary to administer the program. The Board shall have the authority to contract for suitable health, medical, hospital, dental or vision plans to be made available to retired members and their eligible beneficiaries. The Board may also contract with third-party administrators that provide or contract for suitable plans (such as health care exchanges). The Board shall adopt rules necessary to administer any such plans.

Notwithstanding the foregoing provisions, the Board may in its discretion, and subject to the approval of the City Council and the Mayor, authorize the Personnel Department to administer any program, in which case such authorization may include the power to negotiate and establish health, medical and hospital plan or plans; provided, however, that the Board shall retain the power to sign necessary service agreements or to execute contracts and that the Board shall reimburse the General Fund of the City of Los Angeles for all necessary expenses incurred by the Personnel Department in the administration of such program.

SECTION HISTORY

Added by Ord. No. 147,014, Eff. 3-21-75.

Renumbered and Relocated by Ord. No. 154,536, Eff. 11-30-80.

Amended by: Ord. No. 173,272, Eff. 6-25-00, Oper. 7-1-00; Ord. No. 179,538, Eff. 3-2-08; Ord. No. 184,853, Eff. 4-6-17.

In order that a subsidy be paid on behalf of a beneficiary as hereinafter provided, said beneficiary must be enrolled in a plan approved by the Board or by the Personnel Department if so authorized by the Board.

SECTION HISTORY

Added by Ord No. 140,714, Eff. 3-21-75.

Renumbered and Relocated by Ord. No. 154,536, Eff. 11-30-80.

Amended by: Last unnumbered para, Ord. No. 172,040, Eff. 7-3-98; Second Para., Ord. No. 173,272, Eff. 6-25-00, Oper. 7-1-00; Second Para., Ord. No. 176,731, Eff. 6-21-05; Second Para., Ord. No. 181,770, Eff. 7-8-11; Second Para. Deleted, Ord. No. 182,628, Eff. 7-16-13.

Upon written application by eligible retired members not qualified for Medicare or upon written application by eligible retired members and verification that the applicant is and remains enrolled, to the extent of the applicant’s entitlement, in federally-funded Part A or Part B or Part A and Part B of Medicare, the following monthly health subsidy amounts shall be paid:

(a) Those retired members retired pursuant to the provisions of Section 1304 or Section 1408 of the Charter respectively, who are receiving a service pension in accordance with the terms of either one of said Sections 1304 or 1408 and who are age sixty (60) years or older, shall have paid to their approved health insurance carrier on their behalf the following amount:

Basic Monthly Subsidy: For twenty (20) “years of service” as said term is defined in Section 1406(m) of the Charter, 80% of the maximum monthly health subsidy amount as established in Subsection (e) of this section, subject to the limitation hereinafter set forth in this section.

Additional Monthly Subsidy: For more than twenty (20) years of service, add to the Basic Monthly Subsidy 4% of the maximum monthly health subsidy for each whole year of service in excess of twenty (20) years.

Maximum Monthly Subsidy: No eligible retired member shall have paid to the eligible retired member’s health insurance carrier an amount exceeding the maximum monthly amount established pursuant to Subsection (e) of this section.

(b) Those eligible retired members who do not qualify for benefits under Part A of the federally- funded Medicare program shall have paid to their health insurance carrier on their behalf 4% of the maximum monthly subsidy for each whole year of service as hereinabove defined, not to exceed the maximum monthly subsidy set forth in Subsection (a) of this section.

(c) Those eligible members described in Subsection (a) of this section or those retired under the provisions of Sections 1310, 1312, 1412(a), 1412(b), 1504, 1506(a), 1506(b), 1604, 1606(a), 1606(b), 1704, 1706(a), or 1706(b) of the Charter or Sections 4.2004, 4.2006(a), or 4.2006(b) of the Administrative Code with a minimum of ten (10) Years of Service and who qualify for benefits under federally-funded Part A of Medicare, shall have paid to the approved health insurance carrier providing them with a plan supplemental to Medicare coverage the following amount:

For ten (10) but less than fifteen (15) years of service, 75% of the qualifying monthly premium of the approved health insurance plan supplemental to Medicare coverage in which the retired member is enrolled.

For fifteen (15) or more but less than twenty (20) years of service, 90% of the qualifying monthly premium of the approved health insurance plan supplemental to Medicare coverage in which the retired member is enrolled.

For twenty (20) or more years of service, 100% of the qualifying monthly premium of the approved health insurance plan supplemental to Medicare coverage in which the retired member is enrolled.

The qualifying monthly premium for eligible retired members, as used in this Subsection (c) shall mean the monthly premium of the member’s approved plan. However, if the monthly premium exceeds the highest monthly premium of an approved plan supplemental to Part A of Medicare available to retired members of the Los Angeles City Employees’ Retirement System then the premium for the latter shall be the qualifying monthly premium.

The amount of the medical plan premium subsidy applied toward the coverage of dependents of a retired member enrolled in both Part A and Part B of Medicare (“fully enrolled”) shall not exceed the amount which may be applied toward the coverage of the dependent(s) of a retired member who is not enrolled in Medicare or is only enrolled in Part B of Medicare (“partially enrolled”), whichever is greater. The maximum coverage for a fully enrolled retired member’s dependents shall not exceed the highest amount available to a retired member with the same years of service, who is not enrolled or partially enrolled in Medicare but covered by the same medical plan. If the same medical plan does not offer coverage for retirees who do not have both Medicare Parts A and B, the Board shall, by rule, determine the dependent subsidies in a manner that is consistent with plans that do offer both types of coverage.

(d) Those members retired under the provisions of Sections 1310, 1312, 1412(a), 1412(b), 1504, 1506(a), 1506(b), 1604, 1606(a), 1606(b), 1704, 1706(a), or 1706(b) of the Charter or Sections 4.2004, 4.2006(a) or 4.2006(b) of the Administrative Code and receiving a pension under the terms of any of those sections and who are age sixty (60) years or older, shall have paid to their approved health insurance carrier on their behalf the following amount:

Basic Monthly Subsidy: For ten (10) Years of Service as said term is defined in Sections 1406(m), 1502(m), 1602(m), and 1702(p) of the Charter and Section 4.2002(m) of the Administrative Code, 40% of the maximum monthly health subsidy amount as established in Subsection (e) of this Section, subject to the limitations hereinafter set forth in this Section.

Additional Monthly Subsidy: For more than ten (10) Years of Service, add to the Basic Monthly Subsidy 4% of the maximum monthly health subsidy for each whole year of service in excess of ten (10) years.

Maximum Monthly Subsidy: No eligible retired member under the provisions of this Subsection (d) of this Section shall have paid to the eligible retired member’s health insurance carrier an amount exceeding the maximum monthly amount established pursuant to Subsection (e) of this Section.

(e) The maximum monthly subsidy towards the health insurance premium, effective July 1, 2005, but paid from the June 2005 payroll, is fixed at $735.38 per month for all retired Plan members. The Board is authorized to make discretionary changes, on an annual basis beginning in 2006, to the maximum monthly subsidy, so long as no increase exceeds the lesser of a 7% increase or the actuarial assumed rate for medical inflation for pre-65 health benefits established by the Board for the applicable fiscal year.

Any change made by the Board that exceeds this limitation must be submitted for Council review accompanied by an actuarial report. Any increase that is not acted upon by the Council within 45 days after receipt of the report to Council for consideration of the increase shall be deemed approved. Should the Council reject the subsidy set by the Board, the Council shall determine the amount, if any, by which the subsidy shall be increased and shall adopt this increase by resolution.

Notwithstanding the authority given to the Board in this subsection, the Council retains the right to establish, by ordinance, the maximum monthly subsidy either if the Board fails to act timely to grant an increase or if the Council desires to approve an increase in excess of the amount authorized by the Board.

The maximum monthly subsidy shall be reduced by the amount of any subsidy a retired Plan member receives from any other City source.

(f) “System Members” or “Plan Members” as defined in Sections 1406(c), 1502(c), 1602(c) or 1702(d) of the Charter or Section 4.2002(c) of the Administrative Code who retire on or after July 1, 1998 shall be eligible for the monthly health subsidy amounts and other benefits provided for in Subsections (a) through (e) above at age fifty-five (55) rather than age sixty (60) if all other conditions of eligibility prescribed in those subsections are met.

(g) Those members retired under the provisions of Section 1706(a) of the Charter with less than ten (10) years of service and who are age fifty-five (55) years or older shall have paid to their approved health insurance carrier on their behalf the following amount:

(1) For retirees not eligible for Medicare or enrolled in Medicare Part B only, 40% of the maximum monthly health subsidy amount as established in Subsection (e) of this Section or 40% of the single-party cost of the retiree’s plan, whichever is lower; or

(2) For retirees enrolled in Medicare Parts A and B, 75% of the qualifying monthly premium that would be paid under Subsection (c) herein for an eligible retiree with ten (10) years of service or 75% of the single-party cost of the retiree’s plan, whichever is lower.

Retirees eligible for a subsidy from any other source shall not be eligible for the subsidy provided in this subsection. Further, no survivor subsidy shall be paid under Section 4.1161 based upon eligibility for the subsidy provided in this Subsection.

SECTION HISTORY

Added by Ord. No. 147,014, Eff. 3-21-75.

Amended by: Subsec. (c), Ord. No. 147,952, Eff. 12-26-75; Renumbered and Relocated by Ord. No. 154,536, Eff. 11-30-80; In Entirety and Subsec. (f) added, Ord. No. 172,040, Eff. 7-3-98; Subsecs. (a), (c), (d), (e) and (f), Last Para. of Section, Ord. No. 173,272, Eff. 6-25-00, Oper. 7-1-00; In Entirety, Ord. No. 176,731, Eff. 6-21-05; Subsec. (e), Ord. No. 177630, Eff. 6-19-06; Subsecs. (c), (d) and (f) amended and Subsec. (g) added, Ord. No. 181,770, Eff. 7-8-11; Subsec. (c), Ord. No. 188,756, Eff. 11-16-25.

[SUPPLEMENTAL REFERENCES]

For Paragraph (a) re Identification of Members. See also Charter, Sec. 523.

For Paragraph (a) re Basic Subsidy. See also Charter, Sec. 521(t).

For Paragraphs (c) and (d) re Other Eligible Members. See also Charter, Secs. 531(a) and 531(b).

For Paragraph (d) re Basic Subsidy. See also Charter, Sec. 521(t).

For Paragraph (e) re Maximum Subsidy. See also Charter, Secs. 521(g) and 523 re applicability to Safety Members Pension Plan Members.

SECTION HISTORY

Supplemental References Added by Ord. No. 158,965, Eff. 6-30-84.

SECTION HISTORY

Added by Ord. No. 164,851, Eff. 6-19-89.

Amended by: Subsecs. (h) and (i) added, Ord. No. 170,092, Eff. 12-8-94; Subsec. (j) added, Ord. No. 172,040, Eff. 7-3-98; Subsecs. (a), (c), (f) and (h), Ord. No. 173,272, Eff. 6-25-00, Oper. 7-1-00.

Deleted by Ord. No. 184,853, Eff. 4-7-17.

SECTION HISTORY

Added by Ord. No, 165,333, Eff. 1-14-90.

Amended by: Subsecs. (g) and (h) added, Ord. No. 170,418, Eff. 4-16-95; Subsec. (i) added, Ord. No. 172,040, Eff. 7-3-98; Subsecs. (a), (c), (f) and (g), Ord. No. 173,272, Eff. 6-25-00, Oper. 7-1-00.

Deleted by Ord. No. 184,853, Eff. 4-7-17.

SECTION HISTORY

Added by Ord. No. 165,296, Eff. 12-21-89.

Amended by: Subsec. (g) added, Ord. No. 169,328, Eff 2-28-94; Subsecs. (h) and (i) added, Ord. No. 170,091, Eff. 12-8-94; Subsec. (j) added, Ord. No. 172,040, Eff. 7-3-98; Subsecs. (a), (c), (f), (g) and (h), Ord. No. 173,272, Eff. 6-25-00, Oper. 7-1-00.

Deleted by Ord. No. 184,853, Eff. 4-7-17.

SECTION HISTORY

Added by Ord. No. 165,488, Eff. 3-5-90.

Amended by: Subsecs. (g) and (h) added, Ord. No. 170,160, Eff. 1-16-95; Subsec. (i) added, Ord. No. 172,040, Eff. 7-3-98; Subsecs. (a), (c), (f) and (g), Ord. No. 173,272, Eff. 6-25-00, Oper. 7-1-00.

Deleted by Ord. No. 184,853, Eff. 4-7-17.

SECTION HISTORY

Added by Ord. No. 167,138, Eff. 9-5-91; Subsecs. (a), (c) and (f), Ord. No. 173,272, Eff. 6-25-00, Oper. 7-1-00.

Repealed by Ord. No. 173,791, Eff. 3-2-01.

Eligible retired members who are receiving a health insurance subsidy payable to their health insurance carrier pursuant to the provisions of this chapter, may be required from time to time to provide evidence satisfactory to the Board that their health insurance coverage or Medicare or other federal or state funded health insurance plan is in full force and effect.

SECTION HISTORY

Added by Ord. No. 147,014, Eff. 3-21-75.

Amended by: Renumbered and Relocated by Ord. No. 154,536, Eff. 11-30-80; Ord. No. 179,538, Eff. 3-2-08.

SECTION HISTORY

Added by Ord. No. 147,014, Eff. 3-21-75.

Amended by: Renumbered and Relocated by Ord. No. 154,536, Eff. 11-30-80.

Deleted by Ord. No. 179,538, Eff. 3-2-08.

The Office of the City Administrative Officer shall periodically review the Health Insurance Program established by this chapter and shall recommend such changes in said program to the Board as the Office of the City Administrative Officer deems appropriate.

SECTION HISTORY

Added by Ord. No. 147,014, Eff. 3-21-75.

Amended by: Renumbered and Relocated by Ord. No. 154,536, Eff. 11-30-80; Title and Sec., Ord. No. 173,272, Eff. 6-25-00, Oper. 7-1-00; Title and Sec., Ord. No. 184,853, Eff. 4-6-17.

SECTION HISTORY

Added by Ord. No. 147,014, Eff. 3-21-75.

Amended by: Renumbered and Relocated by Ord. No. 154,536, Eff. 11-30-80.

Deleted by Ord. No. 179,538, Eff. 3-2-08.

SECTION HISTORY

Added by Ord. No. 173,028, Eff. 1-17-00.

Amended by: Sec. Number, Ord. No. 173,136, Eff. 3-24-00; Subsec. (a)(1), Ord. No. 176,731, Eff. 6-21-05.

Renumbered as Sec. 4.2204 by Ord. No. 179,538, Eff. 3-2-08.

SECTION HISTORY

Added by Ord. No. 173,028, Eff. 1-17-00.

Amended by: Sec. Number, Ord. No. 173,136, Eff. 3-24-00; Subsec. (a), Ord. No. 176,731, Eff. 6-21-05; Subsec. (e) added, Ord. No. 177,900, Eff. 9-28-06.

Renumbered as Sec. 4.2206 by Ord. No. 179,538, Eff. 3-2-08.

(a) Effective January 1, 2000, a qualified surviving spouse or qualified surviving domestic partner of a deceased member of the Fire and Police Pension Plans shall be entitled to a health insurance subsidy if, at the time of the member’s death, the member was retired and receiving a health subsidy. Effective January 1, 2000, if a member dies after retirement, but prior to receiving a health subsidy, or if the member dies prior to retirement, then the qualified surviving spouse or qualified surviving domestic partner shall be eligible to receive a health insurance subsidy upon the date when the member would have attained age 55, or on January 1, 2000, whichever occurs later, provided the member had a minimum of 10 years of service in the retirement system. Notwithstanding the foregoing, a qualified surviving spouse or qualified surviving domestic partner of a deceased Tier 6 Plan Member retired under the provisions of 1706(a) with less than ten (10) years of service shall not be eligible for a health insurance subsidy.

(b) The maximum health subsidy payment available for a qualified surviving spouse or qualified surviving domestic partner shall not exceed the Los Angeles City Employees’ Retirement System (LACERS) Kaiser single-party premium for retired members without Part A and B of Medicare nor may such subsidy payment be in excess of any amounts allowed active members of the Fire and Police Pension Plans.

(c) The health subsidy provided to a qualified surviving spouse or qualified surviving domestic partner who does not qualify for Part A of Medicare shall be 4% of the maximum survivor subsidy for each year of the retired member’s service, up to 100% of the maximum survivor subsidy.

(d) The health subsidy provided to a qualified surviving spouse or qualified surviving domestic partner with both Parts A and B of Medicare shall be as follows:

(1) For ten (10) to fourteen (14) years of service by the member, 75% of the qualifying monthly premium.

(2) For fifteen (15) to nineteen (19) years of service by the member, 90% of the qualifying monthly premium.

(3) For twenty (20) or more years of service by the member, 100% of the qualifying monthly premium.

(e) The qualifying monthly premium for qualified surviving spouses and qualified surviving domestic partners, as used in Subsection (d), shall mean the single party monthly premium of the qualified surviving spouse or qualified surviving domestic partner’s approved plan. However, if the monthly premium exceeds the highest single party monthly premium of Medicare A & B plans available to retired members of LACERS, then the premium for the latter shall be the qualifying monthly premium.

(f) A qualified surviving spouse or qualified surviving domestic partner who receives a health subsidy pursuant to Subsection (d) above shall also receive a subsidy for reimbursement of the Medicare Part B basic premium on the terms set forth in Section 4.1162 of this chapter.

(g) As a prerequisite to receiving the health subsidy, a qualified surviving spouse or qualified surviving domestic partner must enroll in Medicare to the full extent of their entitlement at the earliest date of eligibility.

(h) A qualified surviving spouse or qualified surviving domestic partner who is also entitled to a health subsidy pursuant to the provisions for active death health benefits from any Memorandum of Understanding (MOU) shall not be entitled to the health subsidy provided herein for as long as they shall receive that other health subsidy.

(i) The health subsidy provided in this section shall only be used to pay the single party premium cost for approved health insurance plans. Any unused subsidy amount can not be received as cash compensation.

(j) This health insurance subsidy will also be provided to current qualified surviving spouses of deceased members who are receiving monthly survivorship benefits on the effective date of this section.

(k) For purposes of this section, the term “qualified surviving spouse” shall also include an eligible widow as defined in the Charter provisions dealing with the Fire and Police Pension Plans.

SECTION HISTORY

Added by Ord. No. 173,028, Eff. 1-17-00.

Amended by: Sec. Number, Ord. No. 173,136, Eff. 3-24-00; Subsec. (f), Ord. No. 179,538, Eff. 3-2-08; Last Sentence of Subsec. (a) added, Ord. No. 181,770, Eff. 7-8-11.

In addition to any other subsidies to which a beneficiary may be entitled under this chapter, a subsidy may be paid to reimburse eligible beneficiaries for the Medicare Part B basic/standard premium, provided that no reimbursement shall be paid for any premium in excess of the basic/standard amount due to charges for income-related monthly adjustment amounts or for any other reason, such as delays in applying for coverage or late fees.

In order to be eligible for Medicare Part B reimbursement, a retired member, a qualified surviving spouse, or a qualified surviving domestic partner, must be:

(1) enrolled in Medicare Parts A and B; and

(2) eligible to receive either a health insurance subsidy or a health insurance premium reimbursement from the Fire and Police Pension Plan.

The Medicare Part B reimbursement subsidy and administrative costs will be provided solely by the Fire and Police Pension Plan, as provided in Sections 1320, 1416, 1510, 1610 and 1710 of the Charter and Section 4.2010 of the Administrative Code. Reimbursement shall not be paid until sufficient proof of the eligible beneficiary’s enrollment, coverage and premium payment has been made as required by the Board.

SECTION HISTORY

Added by Ord. No. 173,275, Eff. 6-25-00, Oper. 7-1-00; new Sec. and Title, Ord. No. 179,538, Eff. 3-2-08.

Former Sec. 4.1162 renumbered as Sec. 4.2210 by Ord. No. 179,538, Eff. 3-2-08.

Amended by: Last Para., Ord. No. 181,770, Eff. 7-8-11; Ord. No. 184,853, Eff. 4-6-17.

(a) Effective January 1, 2001, upon written application and verification as required by the Department of Fire and Police Pensions and subject to the rules and regulations promulgated by the Board of Fire and Police Pension Commissioners, retired members, their qualified surviving spouses or qualified domestic partners are eligible to receive a health insurance premium reimbursement if all of the following conditions are met:

(1) the eligible member or the member’s qualified surviving spouse or qualified domestic partner is enrolled to the extent of the member’s entitlement in Medicare;

(2) the eligible member or the member’s qualified surviving spouse or qualified domestic partner is receiving an allowance pursuant to any benefit tier of the Fire and Police Pension System;

(3) the eligible member is the primary subscriber or a dependent on the medical plan;

(4) the qualified surviving spouse or qualified domestic partner is the primary subscriber;

(5) the eligible member or the member’s qualified surviving spouse or qualified domestic partner is eligible to receive a Fire and Police Pension Plan health subsidy pursuant to the provisions of this Code; and

(6) the eligible member or the member’s qualified surviving spouse or qualified domestic partner is not enrolled in a Department of Fire and Police Pensions approved medical plan.

(b) The maximum reimbursement available to eligible retired members cannot exceed the lower of:

(1) Any subsidy available to eligible retired members pursuant to this Administrative Code or any applicable Memorandum of Understanding; or

(2) The cost of the health plan the eligible retired members are enrolled in and for which they are seeking reimbursement.

(c) The maximum reimbursement available to qualified surviving spouses or qualified surviving domestic partners cannot exceed the lower of:

(1) Any subsidy available to qualified surviving spouses or qualified surviving domestic partners pursuant to this Administrative Code or any applicable Memorandum of Understanding, or

(2) The single-party cost of the health plan that the qualified surviving spouses or qualified domestic partners are enrolled in and for which they are seeking reimbursement.

(d) In no event shall the health insurance reimbursement provided in this section, when added to any health insurance subsidy paid from the funds of the Department of Water and Power and/or the Los Angeles City Employees’ Retirement System (LACERS) exceed the maximum subsidy available pursuant to the provisions of this Administrative Code.

SECTION HISTORY

Added by Ord. No. 174,369, Eff. 12-19-01.

Amended by: Subsecs. (b) and (c) amended and Subsec. (d) added, Ord. No. 176,731, Eff. 6-21-05; Ord. No. 184,853, Eff. 4-6-17.

(a) Those members who were retired pursuant to Charter Sections 1304, 1310, 1312, 1408, 1412(a), 1412(b), 1504, 1506(a), 1506(b), 1604, 1606(a), 1606(b), 1704, 1706(a) or 1706(b), or Administrative Code Sections 4.2004, 4.2006(a) or 4.2006(b), and who have at least ten (10) Years of Service, including those years for which they acquired additional retirement service credits from said Plan, and who are age fifty-five (55) years or older, shall have paid to their approved dental insurance carrier on their behalf a monthly subsidy consisting of 4% of the maximum monthly dental subsidy for each whole year of service as defined in their applicable Tier. In no case shall a retired member have paid to the retired member’s dental insurance carrier an amount exceeding the maximum monthly amount established pursuant to paragraph (b) of this Section.

(b) The maximum monthly subsidy shall be the lower of the Los Angeles City Employees’ Retirement System (LACERS) maximum subsidy or any amount allowed active members of any Fire and Police Plan Tier.

(c) In no event shall the subsidy provided in this section, when added to any other dental subsidy paid from the funds of the Department of Water & Power and/or LACERS exceed the maximum subsidy available pursuant to the provisions of this Administrative Code.

(d) As provided under Charter Sections 1330(d), 1428(d), 1518(d), 1618(d) and 1718(d) and Administrative Code Section 4.2018(d), the Board of Fire and Police Pension Commissioners shall administer the subsidy program established herein.

(e) Entitlement for the subsidy provided herein shall commence with the premiums due for the month of January 2002. There shall be no retroactive entitlement to the dental insurance premium subsidies provided in this section prior to this commencement date.

SECTION HISTORY

Added by Ord. No. 174,368, Eff. 12-19-01.

Amended by: Subsec. (b), Ord. No. 176,731, Eff. 6-21-05; Subsecs. (a) and (d), Ord. No. 181,770, Eff. 7-8-11; Subsec. (d), Ord. No. 184,853, Eff. 4-6-17.

SECTION HISTORY

Added by Ord. No. 174,612, Eff. 6-6-02.

Renumbered as Sec. 4.2208 by Ord. No. 179,538, Eff. 3-2-08.

(a) The maximum monthly subsidies and reimbursements paid toward any health insurance premiums provided pursuant to Chapter 11.5 of Division 4 of the Los Angeles Administrative Code shall be frozen at the rate in effect as of July 1, 2011.

(b) The freeze established in Subsection (a) above shall apply to the following persons:

1. Employees who retire on or after July 15, 2011;

2. Employees who enter the Deferred Retirement Option Plan (DROP) on or after July 15, 2011;

3. Employees who opt not to make a contribution for vesting increases in the Maximum Medical Subsidy as allowed by an applicable written agreement between the City and the employee’s union.

(c) The freeze established by this Section may be revisited periodically by the City Council, with appropriate discussions with the affected labor organizations, to determine whether, in the Council’s discretion, the freeze may be lifted or adjusted in light of improving economic conditions, or other factors.

(d) The freeze established in Subsection (a) above shall not apply to the following persons:

1. Employees who irrevocably opt to make voluntary Additional Contributions in exchange for vested rights to increases in subsidies or reimbursements for retiree health benefits as provided in Section 4.1167 of this Chapter.

2. Employees who retire on service connected disability pensions and their survivors who are eligible for health benefits.

3. Survivors receiving service-connected death benefits who are eligible for health benefits.

4. Members of Tier 3 and Tier 5 who separated from City service prior to July 15, 2011, and were eligible for a deferred retirement at the time of separation, based on years of service.

5. All members of Tier 6, since they are required to make an additional contribution to support the City’s ability to fund retiree health benefits.

(e) The freeze established in Subsection (a) above shall not apply to any subsidy for reimbursement of Medicare Part B basic premium or any dental insurance premium subsidy.

SECTION HISTORY

Added by Ord. No. 181,814, Eff. 7-29-11.

Amended by: Subsec. (b) amended and Subsecs. (d) and (e) added, Ord. No. 181,893, Eff. 10-11-11; Subsec (d)5. added, Ord. No. 183,163, Eff. 8-8-14.

A member who is not represented by an employee union, or who is represented by an employee union which has entered into a written agreement with the City to provide for the election specified herein, may irrevocably elect to make voluntary additional contributions (Additional Contributions) to the member’s tier of the Fire and Police Pension Plan by salary deduction at the rate of 2% of the member’s regular bi-weekly base salary (as distinguished from pay actually received) in order to support the City’s ability to fund retiree health benefits. These Additional Contributions shall be deposited into each such member’s individual contribution account and shall be treated for any and all purposes the same as the member’s regular contributions to the Fire and Police Pension Plan. These Additional Contributions shall be paid by the member on a post-tax basis unless and until the Internal Revenue Service rules that such contributions may be tax-deferred through a reduction in wages pursuant to the provisions of Sections 4.1505 through 4.1509 of this Code.

Once a member irrevocably elects to make these Additional Contributions, the member shall continue to make such Additional Contributions until the member has done one of the following, whichever is earliest, at which time the member’s obligation to make further Additional Contributions shall terminate: (i) made such Additional Contributions for 25 years, or (ii) retired under the provisions of Sections 1408, 1412(a), 1412(b), 1504, 1506(a), 1506(b), 1604, 1606(a), or 1606(b) of the Charter or Sections 4.2004, 4.2006(a), or 4.2006(b) of the Los Angeles Administrative Code, or (iii) terminated participation in the City’s Deferred Retirement Option Plan (DROP) pursuant to Section 4.2105 of the Los Angeles Administrative Code. In consideration for such Additional Contributions being made for the period specified above, each such member and the member’s survivors shall have a vested right to receive the retiree health benefits that were provided in this Chapter on July 1, 2011, and to receive the maximum amount of annual increases in subsidies or reimbursements for retiree health benefits in all subsequent years thereafter as authorized in this Chapter on June 30, 2011, provided that all conditions of eligibility prescribed in this Chapter are satisfied. The freeze established in Section 4.1166(a) of this Chapter shall not apply to these members and their survivors.

The right to make the irrevocable election provided in this Section 4.1167 shall be limited to a 45-day opt-in period, except as required by applicable law or as otherwise provided below. In order to make such irrevocable election, a member must file with the Department of Fire and Police Pensions (LAFPP) an election form prescribed by the LAFPP. Based upon input from the Office of the City Administrative Officer (CAO), the LAFPP shall establish the 45-day period during which members’ election forms may be accepted. If a member does not file the election form within the 45-day period, the member is assumed to have irrevocably elected to not make the Additional Contributions and the freeze established in Section 4.1166 of this Chapter shall apply to the member and the member’s survivors.

The CAO shall establish a Dispute Resolution Committee (DRC) to review member requests to make an election after the 45-day period. The LAFPP shall have no authority to decide whether or not to accept late election forms after the close of the 45-day period (a late election form) and shall refer members to the DRC for that purpose. The DRC may approve a member’s request to irrevocably elect to make the Additional Contributions only if the DRC determines that the member did not timely elect to make the Additional Contributions due to a personal hardship that occurred outside of the opt-in period. The DRC’s decision to approve or deny a member’s request shall be final and conclusive. If the DRC approves the member’s request, the CAO shall so advise the LAFPP in writing, whereupon the LAFPP shall accept the member’s late election form. The Additional Contributions shall commence after the DRC’s approval of the late election form, and the LAFPP shall be authorized to collect back contributions as determined by the DRC in its sole discretion and communicated in writing to the LAFPP by the CAO. The DRC is not authorized to allow a member to revoke the member’s irrevocable election.

The City Council, on a Motion that is adopted by a two-thirds majority, may authorize the LAFPP to conduct additional opt-in periods during which members shall have the right to make the irrevocable election provided in this Section.

SECTION HISTORY

Added by Ord. No. 181,893, Eff. 10-11-11.

Amended by: Second Para., Ord. No. 183,163, Eff. 8-8-14.