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  1. About LACERA

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    About LACERA
    1. Who We Are

      1. News
      2. Mission, Vision, and Values
      3. Careers
      4. Business Opportunities
      5. Contact Us
    2. Leadership

      1. Board of Retirement
      2. Board of Investments
      3. Board Meetings
      4. Executive Team
      5. Divisions
    3. Accountability

      1. Retirement Law
      2. Governing Documents
      3. Investments
      4. Annual Reports
      5. Public Records
  2. Active Members

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    Member Info
      1. General Plans

      2. Plans A/B/C
      3. Plan D
      4. Plan E
      5. Plan G
      6. Safety Plans

      7. Plans A/B
      8. Plan C
    1. Active Service

      1. Contributions
      2. Service Credit
      3. Compensation
      4. Reciprocity
      5. Terminating Service
      6. Felony Forfeiture
      7. Pre-Retirement Divorce
      8. Disability Retirement
    2. Retirement Planning

      1. Benefit Estimates
      2. Workshops
      3. Steps to Prepare
      4. Ready to Retire
      5. Retirement Options
      6. Beneficiaries
      7. Power of Attorney
  3. Retirees and Families

    Get Retirees and
    Families Info
    1. Retirement Payments

      1. Your Paystub
      2. Cost of Living
      3. Direct Deposit
      4. Tax Requirements
      5. Returning to Work
      6. Divorce
      7. Admin Appeals
    2. Families and Survivors

      1. Benefits Process
      2. Eligible Beneficiaries
      3. Survivor Benefits
      4. Survivor Healthcare
      5. Taxability of Benefits
  4. Retiree Healthcare

    Get Retiree
    Healthcare Info
    1. Program Basics

      1. Healthcare Eligibility
      2. Paying for Coverage
      3. Manage Your Enrollment
      4. Medicare
      5. Healthcare Resources
      6. Healthcare Legislation
    2. Healthcare Plans

      1. Anthem Blue Cross of CA
      2. Cigna
      3. Kaiser Permanente
      4. SCAN
      5. United Healthcare
      6. Dental/Vision Plans

Retirement Planning

  1. Benefit Estimates
  2. Workshops
  3. Steps to Prepare
  4. Ready to Retire
    1. 3 Months Before
    2. Retirement Date and After
  5. Retirement Options
  6. Beneficiaries
  7. Power of Attorney
Begin content

You’ve completed you Steps to Prepare and its now 90 days or less from your target retirement date. You’re ready to retire! What’s next?

It’s time to make it official by submitting your retirement paperwork and completing any final transactions.

  • Click the 3 Months Before tab at left for retirement application options and timely action steps you will want to take during the 3-month retirement window.
  • Download any of the forms you will need to submit from the list below.
  • Review other items to complete on your Retirement Date and After.

Reminder: You can only submit your application 90 days or less from your retirement date. Applications with dates outside of the 90-day window cannot be processed and must be resubmitted.

While you are completing your retirement process, you may want to have the Service Retirement Guide on hand for reference, and use the Retirement To-Do List for tracking your completed forms.

List of Retirement Forms

Completing your required paperwork timely and accurately is extremely important during the retirement process, so we’ve compiled everything you need in one place.

Here are the essential forms you will need to complete and submit during the retirement process.

  • Service Retirement Application (service retirements only): Although we highly recommend that you retire online by logging in to My LACERA for a guided process, you can use this form to initiate your official retirement process if you prefer. Be sure to carefully review and understand your retirement options before submitting your form.
  • Beneficiary Designation Form plus any required documentation. Read more about designating beneficiaries.
  • Federal and California Tax Withholding Forms (W-4P/DE-4P). Read more about Tax Requirements.
  • Direct Deposit authorization and voided check. Read more about Direct Deposit.
  • Request to Rescind or Change Retirement Date, if you change your mind about when to retire

Retiree Healthcare Forms

Visit our Retiree healthcare section and Benefits Guide for general information about LACERA-administered healthcare benefits and medical plan overviews. Visit the Retiree Healthcare Forms and Publications page for a full list of forms, samples, brochures and rate tables, and healthcare packets.

  • Medical Plan New Enrollment/Change/or Cancellation Form: See the Medical Plan Enrollment sample for step-by-step instructions on how to complete and submit your form.
  • Medicare Advantage Prescription Drug Plan (MAPD): See the MAPD Enrollment sample for step-by-step instructions on how to complete and submit your form.
  • Dental and Vision Enrollment/Change/Cancellation Form: See the Dental and Vision Enrollment sample for step-by-step instructions on how to complete and submit your form.

Other helpful reference materials for your enrollment:

  • Medical Comparison Chart for those not enrolled in Medicare.
  • Medical Comparison Chart for those enrolled in Medicare.
  • Brochure and Chart or comparing dental/vision options.
  • Retiree Healthcare Cost Booklet and medical/dental/vision premium rate
  • Contact Information for medical providers.

Other Documents You May Need to Submit

  • If divorced: Complete copies of conformed divorce/dissolution of partnership documents for legal review (Judgment of Dissolution, Notice of Entry of Judgment, and Qualified Domestic Relations Order) Read more about pre-retirement divorce and community property laws.
  • For Plan E members subject to the Windfall Elimination Provision (WEP): Social Security Administration statement verifying your reduced benefit amount. You must provide to LACERA within six months of your retirement date.

Survivor Benefits While Your Retirement Application Is Pending

In order to secure retirement benefits and related retired death benefits, LACERA must receive your signed election form prior to your passing (retirement eligibility rules apply). If you would like to give the authority to initiate your retirement to another individual, please read the Power of Attorney information below.

Recommended: LACERA Special Durable Power of Attorney

Accidents and illnesses happen. It’s an unfortunate part of life. That’s why it’s important to plan ahead and have the right documents in place in the event you become unable to handle your own affairs. Having a LACERA special durable power of attorney in place ensures that your spouse, partner, or other trusted individual can conduct important LACERA business on your behalf if needed.

  • Special Durable Power of Attorney Guide
  • LACERA Special Durable Power of Attorney Instructions and Form

How to Submit Your Documents

  • Upload on My LACERA (Recommended: It’s fast, easy, and convenient.)
  • Use the secure drop box at our 300 N. Lake location
  • Fax to 626-564-6155
  • Mail to LACERA at P.O. Box 7060, Pasadena, CA 91109-7060

Los Angeles County Employees Retirement Association

Appointment Reservations
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Los Angeles County Employees Retirement Association

Member Service Center

M – F, 7 a.m. – 5 p.m. PT

Available by appointment only;
no walk-ins accepted.

Holiday Schedule

300 N. Lake Ave.
Pasadena, CA 91101

Contact Us

Member Services Call Center

M – F, 7 a.m. – 5:30 p.m. PT

800-786-6464

Retiree Healthcare

800-786-6464

Business

M – F, 8 a.m. – 5 p.m. PT

PO Box 7060
Pasadena, CA 91109-7060

Phone 626-564-6000

Fax 626-564-6155

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