You are eligible to participate in the reimbursement program if you:

• Have at least 10 years of service as a sworn fire or police pension member, or are the qualified survivor of the deceased member who had at least 10 years of service; and
• Meet the minimum age requirement in place on the effective date of retirement or are a Qualified Surviving Spouse/Domestic Partner of the deceased pensioner who would have met the minimum age requirement; or
• Are a Tier 6 retiree with a service-connected disability and less than 10 years of service.

• State-regulated health insurance plans offered within the United States and verified by LAFPP.
• Non-Medicare plans where the eligible member is the primary subscriber or covered dependent. (All covered parties must be on the same plan)
• Medicare Parts A, B & D premiums up to your maximum Medicare subsidy amount.
• Dental plan premiums and vision plan premiums are not eligible reimbursements.

• You can be reimbursed up to the maximum health subsidy amount for which you are eligible.
• If you reside outside of the United States, reimbursement will be determined using the Federal Reserve Economic Data online database exchange rates in effect on the date(s) the premium(s) were paid to the health plan. Coverage for dependents is permitted as defined under the regular guidelines of the Health Insurance Subsidy for Members Program.

• Their eligible dependent(s) is enrolled in the member’s own Medicare health plan, or
• Their eligible dependent(s) is enrolled in a health insurance plan that is issued by the same provider as the member’s plan (e.g., Anthem Blue Cross, Kaiser, AARP, etc.).

If you receive a subsidy reimbursement of premiums from LAFPP for a health insurance plan you purchase through a state or federal health insurance exchange, you may NOT claim a federal tax credit under the Pension Protection Act. For any month that LAFPP reimburses your health insurance premiums, you are considered to be in an employer health plan and thus ineligible for federal tax credits toward your out of pocket insurance premiums. Members who are eligible to claim a federal subsidy for a health insurance plan from one of the state or federal health insurance exchanges are encouraged to compare this federal subsidy to their reimbursement eligibility from Fire and Police Pensions. Please contact the Medical and Dental Benefits Section at (213) 279-3115 or (844) 885-2377 if you have questions regarding HIPR and health insurance offered on one of the federal or state health insurance exchanges.

Under the Pension Protection Act of 2006, Section 845, retired public safety officers with a taxable pension who meet eligibility requirements may have a tax exclusion from gross income for up to $3,000 per year for health and dental insurance premiums. Only the premium balance you pay after subtracting any LAFPP subsidy or reimbursement can count toward the tax exclusion. For example, if your health plan premium is $2,000 per month and your LAFPP health subsidy is $1,500 per month, the remaining $500 that is not covered by the subsidy can be included in the total amount you exclude from your taxable income.

For health plan premiums paid on or before December 29, 2022, the premiums must have been directly deducted from your pension check and remitted to your health plan provider by LAFPP to qualify. This provision, known as the “direct payment requirement,” previously barred HIPR participants from claiming the tax exclusion.  However, the passage of the Secure 2.0 Act removed this requirement. HIPR participants may be able to apply premium amounts they paid to their health insurers on or after December 30, 2022, to the tax exclusion. Please note, you may only include premiums paid in excess of your HIPR reimbursement towards the amount you exclude from your taxable income. Please contact your tax advisor for more information.

Learn HOW TO: Apply for Health Insurance Premium Reimbursement 

Note: Claim forms received after the deadline will be processed according to the payment schedule for the following quarter. Claim forms received later than 12 months after the end of the coverage period will not be processed.