When
Medicare
Subsidy
Forms
Misc
100

October15- November 15

Open Enrolment

100

Medicare Hospitalization

Part A

100

Age 55

The age you qualify for a medical subsidy

100

Delta Dental enrollment needed

2021 Dental Plan enrollment Form

100

Form to Enroll in Kaiser Atlanta

MPRP

200

The 1st of the month

The day your health Plan will start after Retirement

200

Doctors Visits

Part B

200

25 Years Service Credit

Maximum Subsidy

200

Anthem Blue Cross

Non Kaiser Medical enrollment form

200

Preferred Provider Organization AKA

PPO

300

Moving, getting Married, having a child

Qualifying Event

300

What goes out 3 months prior to 65th birthdate

Medicare enrollment Packet

300

10 Years Service Credit

Minimum Subsidy

300

Delta care USA

2021 Dental plan enrollment form

300

Health Maintenance Organization  AKA

HMO

400

Age 65

Age to enroll in Medicare

400

Reimbursement is paid when

Part A

400

Who determines the subsidy amount

LACERS Board

400

Deleting a child from your plan

Family account change form

400

Lacers members cost for Dr's visits

Copay

500

Day you have to make a status Change

30

500

Governing Document requiring members to have Medicare

Los Angeles Administrative Code

500

Taxable Subsidy Lacers Participant

Surviving Spouse

500

Adding a new Wife to the plan

Certification of dependent Form

500

Transportation, Personal Care, Home Delivered Meals

Enhanced Services

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