LACERS Works to Provide Great Healthcare Benefits


Retirees Update

By Tom Moutes, RLACEI Legislative Director

Tom Moutes


he provision of Retiree healthcare benefits can look quite simple to us retirees. We receive our Open Enrollment materials, determine what our subsidies cover, and make our selections.

However, the reality is that LACERS staff, health consultants and Benefits Committee are busy all year helping make great medical, dental and vision options available and to help keep costs down for Retirees and for LACERS.

Shortly after the Open Enrollment period, LACERS gets busy making decisions that won’t be implemented for another year. The first of those decisions is whether it is prudent to go out to bid on any of the medical, dental or dental (together called healthcare) contracts. If the decision to go out to bid is made, the process has to start early in the calendar year.

Even if LACERS decides to renew the existing healthcare contracts, there is a rate negotiation process that takes months. This process includes reviewing prior usage by LACERS members (no personally identifiable information is included) to determine what rates the insurers can justify. This process also helps identify commonly occurring medical conditions in the LACERS Retiree population.

After LACERS has reached agreements on the healthcare contracts, the next issue is determining the subsidies and reimbursements for which Retirees and dependents will be eligible. While many of the subsidies are determined based on Administrative Code provisions, some are decided on by the LACERS Board.

The LACERS Well program also factors into the provision of great healthcare benefits. The information regarding commonly occurring medical conditions in the LACERS Retiree population is used not only to bring the insurance carriers’ attention to them, but also so that the LACERS Well staff can consider how to implement programs in the following year to help Retirees control those conditions. This element of LACERS Well helps Retirees enjoy healthy retirements, while also helping to keep our retiree healthcare costs down. 

Lastly, the Open Enrollment materials are prepared and distributed. Then, Retirees like you and me get to sit back and make our decisions for the next year. Yeah, we get the easy part!