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Get CA LAUSD Health Benefits Enrollment Form 2008-2024
SINGLE MARRIED INITIALS MI ZIP PHONE NUMBER SOCIAL SECURITY NUMBER DATE PROCESSED BARGAINING UNIT I HAVE REVIEWED THE HEALTH PLAN OPTIONS AVAILABLE. PLEASE ENROLL ME IN THE PLAN(S) CHECKED BELOW. Coverage under the District s health care and life insurance plans begin the first day of the month following the date your properly completed Enrollment Form is received by the Health Benefits Administration, provided you are actively at work. CHECK (/) ONLY ONE PLAN NAME MEDICAL 0070 M.
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LAUSD FAQ
For employees hired on or after April 1, 2009, years of qualifying service and age must total at least eighty-five (85) in order to qualify for retiree health benefits. This must include a minimum of twenty-five (25) consecutive years of service with the District immediately prior to retirement.
Under normal retirement eligibility requirements, a Los Angeles teacher qualifies for full pension benefits at age 62 with five years of service. The annual benefit is equal to a teacher's years of service, multiplied by the average salary of her final three years, times an accrual factor of 2.0 percent.
Filing Dates: Both the Certificated Resignation Form (8152) and the CalSTRS Retirement Application (SR 0059) are required for employees who wish to retire. Certificated employees must submit the Certificated Resignation Form (8152) to their immediate administrator at least one month in advance of their retirement date.
For employees hired on or after June 1, 1992, years of qualifying service and age must total at least eighty (80) in order to qualify for retiree health benefits. For employees who have a break in service, this must include at least ten (10) consecutive years immediately prior to retirement.
Enrollment is not automatic. The form is available online at http://benefits.lausd.net and can be submitted electronically to the district. Call 213-241-4262 for assistance.
To be eligible for service retirement, you must have five years of CalPERS-credited service and be at least age 50 if your retirement formula is 2% at 55, or age 52 if your retirement formula is 2% at 62 . If you have a combination of classic and PEPRA service, you may be eligible to retire at age 50 .
Under normal retirement eligibility requirements, a Los Angeles teacher qualifies for full pension benefits at age 62 with five years of service. The annual benefit is equal to a teacher's years of service, multiplied by the average salary of her final three years, times an accrual factor of 2.0 percent.
Please contact the Employee Benefits Administration at (213) 241-4262 for information.
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