Lausd retirement benefits 2026

1. Click ‘Get Form’ to open the lausd retirement benefits application in the editor.
2. Begin by entering your Employee Number, Last Name, First Name, and Date of Birth in the designated fields. Ensure all personal information is accurate.
3. Select your retirement type (Service or Disability) and provide your Retirement Date. This information is crucial for processing your application.
4. In the Health Plans section, choose the medical, dental, and vision plans you wish to enroll in at retirement. Make sure to review eligibility requirements for each plan.
5. Fill out the Dependent Information section if applicable. Include Social Security numbers and other required details for each dependent.
6. Complete the Medicare Information section if you or your spouse is over 65. Provide necessary Medicare Claim Numbers and effective dates.
7. Finally, sign and date the form at the bottom to authorize your selections. Remember that this form will not be processed without a signature.

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