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Benefits 
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Active Employees Planning to Retire Retirees Plans and Providers Wellness

 

Publications-Forms

 

Active Employees:

  • Active Employees' Health Plan Forms and Publications

 

FSA:

  • 2013 FSA Enrollment Form
  • FSA Request for Change Form
  • 2013 FSA Newsletter
  • UniAccount FSA Claim Form

 

Optional Life Insurance:

  • Optional Life Insurance

 

403(b)/457(b) Deferred Compensation:

  • 2013 LAUSD 457(b) Plan Enrollment Application
  • 2013 457(b) flyer
  • http://457b.lausd.net
  • 2013 403(b) plan information
  • Approved 403(b) vendors
  • http://403b.lausd.net
  • Important information regarding the 403(b) Plan Administrator change in 2012
  • Important information regarding the 457(b) Plan Administrator change in 2012
  • Transaction Routing Request form

 

Retirees:

  • Retirees Health Plan Forms and Publications

 

COBRA:

  • COBRA Rates

    WageWorks (formerly known as FBMC): http://www.myfbmc.com

 

2013 Summary of Benefits and Coverage (SBC)

 

Miscellaneous:

  • State and Federally Mandated Benefits

333 South Beaudry Avenue, 28th Floor - Los Angeles, CA 90017 - Phone: 213-241-4262 - Fax: 213-241-4247 - benefits@lausd.net


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