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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.
(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.
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