Dependent Eligibility
Eligible Dependents
If you are eligible for LAwell benefits, you can also enroll your eligible family members (your eligible dependents).
Before you request enrollment of a dependent:
- Ensure your dependents meet the eligibility criteria listed in the table below.See the Life Events page to read about when you can enroll eligible dependents. Ensure that you can provided the required documentation to confirm your dependents, as determined by the LAwell Benefits Program.
Once you have added an eligible dependent:
- That individual is not entitled to coverage unless the City receives the required documentation of eligibility (e.g., birth certificate, marriage certificate) within 60 days of your election.
- Review your dependent elections and verify that each dependent enrolled — and dependents you add — continue to meet the LAwell eligibility criteria at all times.
- Remember that eligibility continues up to the end of the month in which your dependent turns age 26.
| Dependent Type | Age | Eligibility Definition | Documents Required for Verifying Eligibility |
|---|---|---|---|
| Spouse | N/A | Person of the opposite or same sex to whom you are legally married | Marriage certificate |
| Domestic Partner | N/A | Meet City’s domestic partner eligibility requirements. See Domestic Partnership Information Sheet and Affidavit form at keepingLAwell.com/dp-forms | City of Los Angeles Affidavit of Domestic Partnership, or Declaration of Partnership filed with the California Secretary of State |
| Biological Child (Natural child) | Up to age 26* | Employee’s married or unmarried child(ren) under age 26 | Child’s birth certificate, hospital verification of birth, or court document that verifies your relation to the child (an abstract document is not sufficient in most cases) |
| Stepchild | Up to age 26* | Employee’s spouse’s married or unmarried child(ren) under age 26 | Child’s birth certificate and certificate showing spouse/domestic partner as parent |
| Adopted child or child placed for adoption | Up to age 26* | Minor or adult child legally adopted by employee, foster child, or child placed for adoption with employee under age 26 (married or unmarried) | Child’s birth certificate and court documentation |
| Child of Domestic Partner | Up to age 26* | Minor or adult child of employee’s domestic partner under age 26 (married or unmarried) | Child’s birth certificate and City of Los Angeles Domestic Partner Affidavit or Declaration of Partnership filed with the California Secretary of State |
| Disabled Child | Age 26 and older | Disabled child over the age of 26 who is dependent on you for support and was disabled before age 26. To be eligible, your child must remain unmarried, dependent on you for financial support, and disabled as determined by your health plan. | Birth certificate and disability application from your health plan, completed by your child’s doctor and returned to your health plan for approval each year, or as requested by the insurance company |
| Child under a legal guardianship | Up to age 26* | Child (unmarried) up to age 26 if you show proof of legal custody | Child’s birth certificate and court documentation |
| Grandchildren | Up to age 26* | Your grandchildren can be added to the plan if their parent is your child who • is under age 19, unmarried, and financially dependent on you or •is age 19-26 and meets the full-time student status, is unmarried, and financially dependent on you If coverage for your child ends, coverage for your grandchildren will end. | Child’s and grandchild’s birth certificates; the current or most recent tax document indicating the child as a dependent full-time student certification for your child. |
Ineligible Dependents
Not every family member who lives with you is an eligible dependent. Examples of individuals who are ineligible dependents are:
- Your spouse following a divorce
- Someone else’s child (such as your nieces or nephews), unless you have been awarded legal custody or guardianship
- Your parents, parents-in-law, or grandparents, regardless of their IRS dependent status.
The table below illustrates some common examples of individuals who are considered ineligible dependents. This is not an exhaustive list.
| Dependent Type | What Is an Eligible Termination Life Event? | When Coverage Can Terminate | Documents* Required for Verifying Termination (must be submitted within 60 days of reporting) |
|---|---|---|---|
| Spouse | A final divorce | The date you report, as long as the report date is on or after the event date | Signed divorce judgment |
| Notes • Hiring an attorney to initiate the divorce process does not qualify as a termination life event. • A divorce event will also terminate coverage of any covered stepchild. | |||
| Domestic Partner (DP) | •Terminating your relationship •Marrying your DP | The date you report, as long as the report date is on or after the event date | • City of Los Angeles Termination of Domestic Partnership • Marriage certificate |
| Child | Turning age 26 | Coverage will terminate the end of the month that your child turns 26 | None |
| Legal change in custody; disabled child age 26 and older is no longer disabled | The date you report, as long as the report date is on or after the event date | Court order or other official documentation | |
| Grandchildren | Your child (parent of grandchild) turns 26 | Coverage will terminate the end of the month that your child turns 26 | None |
If your Eligible Dependent Becomes Ineligible
- You must drop coverage for your enrolled dependents within 30 days of the date they no longer meet the City’s eligibility requirements.
- If you fail to remove ineligible dependents, you will be required to pay all costs for any benefits that were paid on their behalf, and you may be subject to disciplinary action.
- Leaving an ineligible dependent on City coverage may be considered fraud.
Required Document Verification
Document Verification Deadlines
Documentation is required to verify any enrolled dependents. If you do not provide the required documentation as verification of dependent status, your dependent will be ineligible for coverage.
| If You Added Your Dependent During… |
Deadline |
Important Considerations |
|---|---|---|
| New Hire Enrollment |
If you enroll your dependent during the year, documents must be received within 60 days of your election. |
If you fail to provide the required documentation to the Personnel Department, Employee Benefits Division by the deadline, your dependent coverage will not take effect. You will not be able to re-enroll your dependent until the next Open Enrollment period or within 30 days of a qualifying life event. |
| Open Enrollment |
If you enroll your dependent who is not currently covered during Open Enrollment, documents must be received by the published deadline, usually in early December. |
If you fail to provide the required documentation to the Personnel Department, Employee Benefits Division by the deadline. Your dependent coverage will not take effect on January 1st of the following year, for your added dependent who was enrolled during Open Enrollment. You will not be able to re-enroll your dropped dependent until the next Open Enrollment period or within 30 days of a qualifying life event. |
| Outside Open Enrollment |
If you enroll your dependent during the year, documents must be received within 60 days of the date on the confirmation statement you receive after enrolling the dependent. |
If you fail to provide the required documentation to the Personnel Department, Employee Benefits Division by the deadline, your dependent coverage will not take effect. You will not be able to re-enroll your dependent until the next Open Enrollment period or within 30 days of a qualifying life event. |
Where to Send Required Documents
Documentation is required to verify any enrolled dependents. If you do not provide the required documentation as verification of dependent status, your dependent will be ineligible for coverage. Contact the Benefits Service Center at 833-4LA-WELL with any questions.
There are several ways to submit required documents:
Online: Log in to the Benefits Central Portal and upload your documents.
Email or Fax: Write your name and employee ID number on each document and send.
- Email: per.empbenefits@lacity.org
- Fax: 213-978-1623
Mail:
LAwell Benefits Service Center
PO Box 530477
St. Petersburg, FL 33747-4077
In-Person: Deliver to the drop box outside the Employee Benefits Division at:
Los Angeles City Hall
200 N Spring Street, Room 867
Los Angeles, CA 90012
Our in-person public counter service currently holds limited available hours Monday to Thursday, subject to change. We strongly recommend making an appointment using the scheduling system. However, our Division is fully operational and employees needing assistance may conduct transactions either telephonically and/or electronically.