Eligibility

Who is Eligible?


Active Member

  • You are eligible for coverage if you are a Member of the Relief Association in good standing or you are a newly-appointed firefighter.

Relief Association Employee

  • You and your dependents are eligible for coverage if you are a regular full-time employee of the Los Angeles Firemen’s Relief Association. Full-time means you are scheduled to regularly work 80 or more hours per pay period. Your dependents are defined to be the same as “Member” dependents.

Retired Member Not Eligible For Medicare

  • You and your dependents are eligible for coverage if you are an active Firefighter as of your retirement date. Retired Members eligible for Medicare should review the separate Retiree Only Medicare Plan Summary which applies to those Retired Members.  “Retired Member” as used in this Summary refers only to a Retired Member not eligible for Medicare.

Retired Member Covered by Medicare

  • If you are a Retired Member who is an active Firefighter at time of retirement and are covered by Medicare,  you may continue coverage under the LAFRA Retiree Only Medical Plan for yourself and your Dependents covered under the Plan.

Surviving Spouse or Domestic Partner

You are eligible for coverage if:

  • you were covered as the legally married spouse or as the qualified domestic partner (as defined herein) of a covered Member at the time of the covered Member’s death. A common law spouse is not considered a “legally married spouse” or “qualified domestic partner” for any purpose under the Plan.

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 children under age 26. An eligible Child is one who has a legally-qualifying relationship with you (i.e., a son, daughter, stepson or stepdaughter, a legally adopted child, a child for whom you are appointed as the legal guardian, a child who is placed with you for legal adoption, or an eligible foster child).
  • children who are totally dependent on you because of a physical or mental total disability and are incapable of sustaining any type or level of employment at the time they reach the maximum age for coverage as a dependent. In this situation, you must notify the Los Angeles Firemen’s Relief Association and submit proof satisfactory to the Los Angeles Firemen’s Relief Association of the child’s totally disabled status and total dependence on you within 30 days of the date he or she would otherwise become ineligible. Your totally disabled children may be covered by the Plan as long as they remain so incapacitated and totally dependent on you and you remain covered under the Plan, provided you submit proof satisfactory to the Los Angeles Firemen’s Relief Association of such incapacity and dependency when requested. Even if a child meets the foregoing requirements, he or she will not be considered to be eligible under the Plan as totally disabled, unless he or she is also under the care of an appropriate health care provider for his or her disability and is fully cooperating in such care.

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 indefinitely 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.

To obtain a notarized Affidavit of Domestic Partnership, call the Los Angeles City Employee Benefits Department at (213) 978-1655. Once you receive the affidavit, contact the Relief Association Member Services at (323) 259-5223 or (323) 259-5222 to finalize eligibility.

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 six (6) 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 add a Domestic Partner for any coverage under this Plan.

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