LAFCO

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General Information

This page provides general information about the post-retirement medical benefits available to LAFCO retirees. Eligibility and enrollment for retiree medical are handled by MCERA in accordance with LAFCO's rules.

All LAFCO employees are eligible to remain on their active medical and dental insurance plans going into retirement. In addition, if you meet certain requirements, you may also be eligible for a medical subsidy through a Benefit Plan to help you pay your monthly insurance premiums. Eligibility requirements and subsidy levels for each Benefit Plan are explained in the Benefit Plan section, below.

If you have questions about retiree healthcare please call MCERA Retiree Benefits at (415) 473-4149 or send an email to MCERARetirees@marincounty.org.

Medical Insurance

The retiree medical insurance plans through Kaiser and Anthem Blue Cross are the same plans offered by LAFCO for active employees and are eligible to be covered by the Benefit Plan Subsidy you may receive.

At retirement you are eligible to enroll in the plan and level of coverage you have as an active employee. For example, if you (and your dependents) have the Kaiser Low plan as an active employee, you are eligible to continue the Kaiser Low coverage as a retiree.

If you would like a different medical insurance plan in retirement than what you have as an active employee, you must change plans during open enrollment and wait until your new coverage is effective January 1 prior to retiring.

There is currently no open enrollment after retirement, and if you drop any plan you may not re-enroll.

Dental Insurance

The retiree dental insurance plan through Delta Dental is the same plan offered by LAFCO for active employees and is eligible to be covered by the Benefit Plan Subsidy you may receive.

To be eligible for retiree dental insurance you must have dental coverage in place as an active employee prior to retirement.

There is currently no open enrollment after retirement, and if you drop the plan you may not re-enroll.

Vision Insurance

The State Association of County Retirement Systems (SACRS), of which MCERA is a member, sponsors a voluntary vision insurance plan for all retirees and beneficiaries through VSP Vision Care.

The VSP Vision Care plan is separate from any plans that may be offered by your former employer. If you elect vision coverage through VSP as a retiree, you are responsible for all VSP Vision Care premiums as they are not covered by the Benefit Plan subsidy you may receive.

Enrollment and Cancellation

At the time you retire MCERA will provide you with the VSP Vision Care enrollment form. To enroll, return the completed form to MCERA with your other retirement documents.

If you are already retired and wish to enroll you may do so during the open enrollment period in the spring.

If you are already enrolled in the VSP plan and wish to cancel your coverage, please call MCERA Retiree Benefits at (415) 473-4149 or send an email to MCERARetirees@marincounty.org.

Contact VSP

For more information on the benefits available through VSP visit marincera.vspforme.com or call VSP at (800) 400-4569.

Effective Date of Coverage

The effective date of your retiree health insurance coverage is the first day of the month after you retire.

Continuous Coverage and COBRA

Your effective date of retirement may create a gap in your insurance coverage. Because continuous coverage is required for you to be eligible for retiree health insurance and Benefit Plan subsidies, if your active employee coverage ends prior to the effective date of your retiree coverage you must apply for COBRA insurance to fill the gap. COBRA is handled through LAFCO Human Resources.

Payment of Premiums

Premiums will be deducted from your monthly retirement benefit payments, beginning with the first payment you receive after you retire. If you receive a subsidy from LAFCO through a Benefit Plan, this will appear on your monthly deposit confirmation as "Employer Subsidy." Any amount you owe in addition to the subsidy will appear as "Net Medical Care Cost."

Dependent Coverage

You are eligible to maintain insurance coverage for dependents enrolled on your active employee insurance plans at the time of retirement. After retirement you may only add dependents with a qualifying life event such as marriage, birth or adoption. Generally, children may remain on your insurance plans until age 26. If you drop any dependent from your insurance plan you may not re-enroll them at a later date.

Most Benefit Plan subsidies apply only to retiree premiums, and the retiree is responsible for 100% of the cost of dependent insurance. However, if you have 30 or more years of service and are eligible for a subsidy through Benefit Plan 3, you may receive a second subsidy to help pay for your spouse's/partner's medical and dental premiums.

Coverage Areas and Relocation

You must keep MCERA informed of your address. If you fail to notify MCERA of your new address, or falsify a claim, your healthcare coverage may be denied by the carrier.

If you move outside of your primary healthcare provider's coverage area you may need to enroll in another healthcare plan. For example, if you are a Kaiser member and move outside of a Kaiser coverage area, you must enroll in the Anthem Blue Cross plan to continue to receive your Benefit Plan subsidy. If you subsequently move back into a Kaiser coverage area you are allowed to return to your original Kaiser plan.

Coverage and premiums in non-California plans may be different, and coverage areas may be different for pre-age 65 and post-age 65 plans. We recommend checking with the plan provider before relocating to determine if there will be changes to your healthcare coverage.


Benefit Plan Subsidies

LAFCO retirees who meet certain eligibility requirements may receive a monthly subsidy through a Benefit Plan to help pay for their medical and dental premiums. Your Benefit Plan subsidy can only be used toward payment of premiums for LAFCO-sponsored insurance plans.

Please note that reciprocal service earned with an employer other LAFCO does not count toward meeting the eligibility requirements for these Benefit Plans.

If you are not eligible for a Benefit Plan you may remain on the same insurance plan(s) as a retiree that you had as an active employee. In this case, all medical premiums are the responsibility of the retiree and will not be reimbursed or subsidized by LAFCO.

Benefit Plan 1 - Membership dates on or before 9/30/1987

Explanation of Benefit Plan 1 Subsidy
Eligibility Requirements
  • MCERA membership date on or before 9/30/1987
  • 5+ years of LAFCO service
  • Continuous medical coverage
  • 1+ year of continuous dental coverage
Retiree Premiums

Medical and dental premiums paid by LAFCO. Vision premiums paid by the retiree.

Dependent Premiums

All dependent premiums paid by the retiree.

Additional Notes

Members eligible for Benefit Plan 1 may elect Benefit Plan 3 at retirement, which may be more beneficial if you have at least 30 years of service and are married/partnered.

Benefit Plan 2 - Membership dates on or before 9/30/1993

Explanation of Benefit Plan 2 Subsidy
Eligibility Requirements
  • MCERA membership date on or before 9/30/1993
  • 5+ years of LAFCO service
  • Continuous medical coverage
  • 1+ year of continuous dental coverage
Retiree Premiums

LAFCO pays a maximum of $2,275 per year ($189.58 per month) to subsidize a portion (or all) of the cost of the retiree's medical and dental premiums. The retiree is responsible for any difference over this amount. There is no cash back if the subsidy is not used completely, nor can it be applied to the cost of dependent coverage.

Dependent Premiums

All dependent premiums paid by the retiree.

Additional Notes

Members eligible for Benefit Plan 2 may elect Benefit Plan 3 at retirement, which may be more beneficial if you have over 5 years of service.

Benefit Plan 3 - Membership dates on or before 12/31/2007

Explanation of Benefit Plan 3 Subsidy
Eligibility Requirements
  • MCERA membership date on or before 12/31/2007
  • 5+ years of LAFCO service
  • Continuous medical coverage
  • 1+ year of continuous dental coverage
Retiree Premiums

A formula is used to calculate the maximum annual subsidy provided to cover a portion (or all) of the retiree's medical and dental premiums. The maximum annual subsidy is determined by multiplying your years of LAFCO service (up to a maximum of 20 years) by an allocation factor. The allocation factor is set annually by LAFCO and may go up or down. The 2016 allocation factor is $442.65 per year of service for a maximum subsidy of $8,853 for the year ($737.75 per month). The retiree is responsible for any difference over this amount. There is no cash back if the subsidy is not used completely, nor can it be applied to the cost of dependent coverage.

Dependent Premiums

If the retiree has less than 30 years of LAFCO service, the retiree is responsible for all dependent premiums. If the retiree has more than 30 years of LAFCO service they are eligible for a second subsidy, equal to their own, to help pay for their spouse's/partner's medical and dental premiums.

Only your spouse/partner at the time of retirement is eligible for the second subsidy. If the retiree marries after retirement and adds the new spouse/partner to their insurance plans, the retiree is responsible for 100% of the dependent premiums, even if they retired with over 30 years of service and elected Benefit Plan 3.

Benefit Plan 4 - Membership dates on or after 1/1/2008

Explanation of Benefit Plan 4 Subsidy
Eligibility Requirements
  • MCERA membership date on or after 1/1/2008
  • 5+ years of LAFCO service
  • 5+ years of continuous coverage in the same medical plan
  • 5+ years of continuous dental coverage
Retiree Premiums

A formula is used to calculate the maximum annual subsidy provided to cover a portion (or all) of the retiree's medical and dental premiums. The maximum annual subsidy is determined by multiplying your years of LAFCO service (up to a maximum of 20 years) by $150, for a maximum annual subsidy of $3,000 per year ($250 per month). The retiree is responsible for any difference over this amount. There is no cash back if the subsidy is not used completely, nor can it be applied to the cost of dependent coverage.

Dependent Premiums

All dependent premiums paid by the retiree.


Medicare

Most MCERA members have contributed to Medicare and are eligible for Medicare at age 65. If you continue to work full-time beyond age 65, contact Human Resources for information regarding Medicare for active employees. If you are not eligible for Medicare, please obtain proof of your non-eligibility (commonly in the form of a letter from Medicare) and submit it to MCERA.

When to Enroll

If You Are Over 65 at the Time of Retirement

If you are over age 65 at retirement your Medicare benefits must be effective on or prior to your retirement date. There are premium penalties if your benefits are effective after retirement, so we recommend beginning the enrollment process no later than three months before you plan to retire.

MCERA must receive one of the following with your retirement application:

  • Medicare enrollment card
  • Letter from Medicare confirming enrollment
  • Letter from Medicare confirming non-eligibility

A higher premium will be deducted from your retirement benefit payment if we do not have one of these items with your retirement application. The higher premium is a surcharge that is not covered by your Benefit Plan subsidy and is not eligible for reimbursement.

If You Turn 65 After Retirement

If you are already retired when you turn 65 your Medicare benefits must be effective on your 65th birthday. We recommend beginning the enrollment process no later than three months before you turn 65.

If you are eligible for Medicare and do not enroll, a higher premium will be deducted from your retirement benefit payment. The higher premium is a surcharge that is not covered by your Benefit Plan subsidy and is not eligible for reimbursement.

How to Enroll

Contact Medicare to apply for Medicare Parts A and B. When you apply for Parts A and B you automatically receive Part D, the prescription drug program. You should assign your Part D benefits to your insurance carrier (either Kaiser or Anthem Blue Cross). You may only assign Medicare Part D benefits to one carrier at a time, so if you have dual coverage let MCERA know in advance.

You will also need to enroll in the Kaiser Senior Advantage or Anthem Blue Cross Medicare Advantage plan. If you are over 65 at the time of retirement MCERA will provide the enrollment forms with your retirement application. If you turn 65 after retirement MCERA will mail you the enrollment forms prior to your 65th birthday.

Health Coverage and Premiums

Your Medicare coverage will combine with your current coverage for a single comprehensive health plan. You will retain your current benefits, but your monthly premiums will likely decrease. Medicare will become your primary payor with Kaiser or Blue Cross becoming the secondary payor. You are responsible for any payments owed after what Medicare and your insurance carrier pay.

Please contact your health plan provider for more information specific to your individual situation.

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