Join the Medical Plan
With the rising cost of health care, it’s important to know that the LAFRA Fire Medical Plan is best available medical plan for firefighters and their families. Our Medical Committee works tirelessly throughout the year to provide the best plan, as no decisions are made by big insurance companies.
Listed below are a few examples of what is different and better about the Relief Fire Medical Plan:
• Pay 100% of charged amount for the first 30 days for a covered accident or injury;
• All Co-pays are waived during the first 30 days following a covered accident or injury;
• Rights to a medical appeal, which is heard by a committee made up of firefighters;
• In-house medical plan specialists available to answer and assist with any questions.
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Click here to enroll online
Click here to download form and mail-in
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Mail to: Los Angeles Firemen's Relief Association
Attn: Member Services
P.O. Box 41903
Los Angeles, CA 90041
For more information on enrolling in the LAFRA Fire Medical Plan, call 323.259.5200 Ext. 223 or 259,
or e-mail memberservices@lafra.org
Who is eligible?
Active Member
You are eligible for coverage if you are a Member of LAFRA in good standing or you are a newly appointed firefighter.
Retired Member
If you are an Active Firefighter who, as of your retirement date, has been covered under the Plan for a total of 84 months (seven years), you may continue coverage under the LAFRA Medical Plan for yourself and your Dependents covered under the Plan at the time of your retirement, at the applicable group rates.
If you do not have 84 months (seven years) of coverage in the LAFRA Medical Plan upon retirement, you will be charged the higher subscriber rate until such time as you have been covered by the plan for 84 months.
Surviving Spouse
You are eligible for coverage if: you were covered as the legally married spouse of a covered Member at the time of the covered Member’s death.
Dependents
Eligible dependents include: your legally married spouse or qualified Domestic Partner (excluding the legally married spouse or qualified Domestic Partner of a Surviving Spouse) and your unmarried children under age 19, provided they are dependent upon you for financial support and maintenance; and your unmarried children over age 19, provided they are:
a) Full-time students under the age of 25, enrolled for a minimum of 10 units per semester, or 25 hours of training per week with no monetary compensation, in an accredited educational institution, and dependent on you for financial support and maintenance (see
NOTE). Effective January 1, 2010, however, the continued eligibility of a student will not be affected by the child’s inability to continue full-time school attendance due to illness or injury (see the Extensions of Coverage section and “Michelle’s Law”) for more information;
Note: If a covered student does not attend school full-time for one semester, he/she will be eligible for a one-time semester waiver for that semester.
b) Under the age of 25, on a church mission and do not receive wages or salary for such activity; or
c) Dependent on you because of a physical or mental disability and are incapable of sustaining employment at the time they reach the maximum age for coverage as a dependent. In this situation, you must notify the Association and submit proof of the child's status within 30 days of the date he or she would otherwise become ineligible.
Your disabled children may be covered by the Plan as long as they remain incapacitated and dependent, provided you submit proof when requested.
The term "Child" shall include your natural child, legally adopted child or child placed with you for legal adoption, legal stepchild and any other child who is under your legal guardianship. “Child” will also include a child for whom the Plan has received a Qualified Medical Child Support Order (QMCSO), regardless of whether the child is in your custody or primarily dependent upon you for support.
An adopted child is any person under the age of 18 as of the date of adoption or placement for adoption. Placement for adoption means that you have assumed and retained the legal obligation for the total or partial support of a child to be adopted. Placement ends whenever the legal support obligation ends.
No person may be covered as both a Member and as a Dependent.
Domestic Partner & Domestic Partnership
A Domestic Partner is one who:
i. shares the same regular and permanent residence as the Member, and intends to
continue residing together forever with the Member; and
ii. has been in a committed non-platonic, family-type relationship with the Member for at least 365 consecutive days, a relationship which is not merely temporary, social, political, commercial or economic in nature; and
iii. is jointly responsible, with the Member, for “basic living expenses”, as defined below; and
iv. is not related to the Member by blood, closer than would bar marriage in the State of
California; and
v. is the Member’s sole Domestic Partner, and, with the Member, responsible for each
other’s common welfare.
“Basic living expenses” means the cost of basic food, shelter and any other expenses of a Domestic Partner, which are paid at least in part by a program or benefit for which the partner qualified because of the Domestic Partnership. The individuals need not contribute equally or jointly to the cost of these expenses as long as they agree that both are responsible for the cost.
A notarized Affidavit of Domestic Partnership, that meets the following conditions as set forth by the City of Los Angeles, must accompany the formal Application for coverage:
i. you and your partner are in a committed and mutually exclusive relationship in which you are jointly responsible for each other's welfare and financial obligations;
ii. you and your partner have resided together in the same principal residence for at least 12 months and intend to do so indefinitely; and
iii. you and your partner are 18 years of age or older, unmarried, and not blood relatives.
In the event of termination of the Domestic Partnership, a Statement of Termination of Domestic Partnership must be filed with the Association and the City of Los Angeles Personnel Department’s Employee Benefits Office, within 30 days of such termination. You may not file another Affidavit of Domestic Partnership until twelve (12) months after you have filed a Statement of Termination of Domestic Partnership with respect to the previous Domestic Partnership.
A surviving spouse of a previously covered Member may not include a Domestic Partner for any coverage under this Plan.
Open Enrollment
The Open Enrollment Period is generally held in the Spring of each year. Changes made during the Open Enrollment Period will be effective on July 1. The Board of Trustees of the Association may, at its sole discretion, approve additional open enrollment periods or change the existing one.