Welfare Fund News
At the May 24th meeting of the PSC-CUNY Welfare Fund Board of Trustees, the trustees clarified that Retirees who are over 65 years of age and otherwise eligible for PSC-CUNY Welfare Fund Retiree supplemental benefits will remain eligible for all Fund supplemental benefits if they waive participation in the New York City Health Insurance Program: https://www.psccunywf.org/.
NYC ANNOUNCES THAT IT IS MOVING RETIREES TO MEDICARE ADVANTAGE.
In a letter sent to all NYC municipal retirees (including CUNY retirees) and dated March 10, 2023, the NYC Office of Labor Relations announced that “As of September 1, 2023, all Medicare-eligible retirees and Medicare-eligible dependents, with the exception of HIP VIP members, will be automatically enrolled in the Aetna Medicare Advantage PPO Plan. Retirees will also have the option to opt out of the Aetna Medicare Advantage PPO Plan and enroll in HIP VIP during a window in May and June, or waive health coverage1 . Similarly, HIP VIP members will have the option to move to the Aetna Medicare Advantage PPO Plan or waive coverage. On September 1, 2023, the City will discontinue the Senior Care Plan and all other retiree plans except Aetna Medicare Advantage and HIP VIP.”
In essence, as of September 1, NYC is (1) moving all Medicare eligible retirees and their Medicare eligible dependents to Medicare Advantage and (2) terminating NYC Senior Care. As of this reading, if members choose not to participate in either the Aetna or HIP MA plans, stay on traditional Medicare, purchase their own Medigap insurance and leave the City healthcare plan, they will no longer be eligible for Medicare Part B and IRMAA reimbursements. As of this writing, while there is a possibility they will lose PSC-CUNY Welfare Fund benefits, the PSC is working hard to make sure that Welfare Fund benefits continue even for those who waive NYC health coverage.
All of this has huge consequences for retirees and their dependents. There are lots of moving parts in this scenario. There is continuing organizing and pushback, Legislative initiatives, political action and legal suits could conceivably change the facts on the ground — or nothing might change. In this fluid and uncertain situation, we will try to provide our members constantly updated information so that they can make a decision about what to do.
At this stage, you do not have to make a decision (e.g. accepting enrollment in Medicare Advantage, waiving NYC healthcare, etc.) until the end of June. But you need to gather information and consider options between now and then. The purpose of this page is to direct you to sources of information necessary to make a decision.
BASIC INFORMATION YOU NEED TO KNOW TO MAKE A DECISION
IMPORTANT CONTACT INFORMATION
- LETTER FROM OLR: Letter to NYC retirees from the NYC Office of Labor Relations, dated March 10, 2023.
- DOES OLR HAVE YOUR CORRECT MAILING ADDRESS? Be sure the NYC Employee Benefits Program has your updated mailing address.
- THE NYC AETNA MA PLAN EVIDENCE OF COVERAGE document on the OLR website spells out the Aetna MA plan rules for how provider coverage works, how to make complaints, etc., as well as the services covered (at the end). This document is updated each calendar year to reflect changes in the plan. NOTE: PSC retirees are not covered by the Aetna Silverscripts prescription drug plan. PSC retirees who stay in NYC sponsored coverage continue to be covered by the PSC-CUNY Welfare Fund Silverscripts prescription drug plan.
- AETNA MEDICARE ADVANTAGE PPO PLAN
- AETNA VIRTUAL AND IN-PERSON ORIENTATION sessions about the plan. For information check Aetna’s website. Aetna call center for NYC retirees: (855) 648-0389, 8 a.m. – 9 p.m. ET, Monday – Friday
- MEDIGAP PLANS:
- For information about Medigap plans in NYS, begin with “Protections For Medicare Beneficiaries Residing in New York State”
- To price both Medigap and Medicare Part D drug plans around the country, start with this Medicare page https://www.medicare.
gov/plan-compare - For help in understanding Medigap options in NY and other states, contact the Medicare Rights Center at 800-333-4114
- CONTINUITY OF CARE DURING TRANSITION TO AETNA MA
- For retirees who have surgery, hospitalization, testing or treatment scheduled after 9/1/23 or are receiving ongoing medical treatment, review Aetna’s Continuity of Care brochure and submit the Continuity of Care form to discuss your needs with an Aetna nurse case manager in advance of September 1st.
- Aetna representatives say that, while they can collect information about ongoing treatments and scheduled procedures, federal CMS rules do not permit them to coordinate patients’ care with providers until patients are enrolled in the plan. Enrollments effective September 1st will not be finalized until August, so more complete interactions will not happen until then.
IN A NUTSHELL: How this all happened?
NYC announces that it will begin negotiations with the second-place bidder, Aetna, to provide an MA plan for Medicare-eligible NYC retirees, because the “Alliance” MA plan which NYC and the MLC had negotiated will not be implemented due to the withdrawal of Anthem, the national sponsor, from participation in the plan in July.
NYC proposes, with the support of the MLC, an amendment to the NYC Administrative Code to permit Medicare-eligible retirees and their dependents to be treated as a separate “class” for the purpose of establishing a benchmark health insurance plan at a cost below the full cost of HIP HMO. PSC and other unions oppose such a change because it could undermine the legal right to future premium-free health care coverage for all NYC employees and retirees. The City Council held a hearing on the change in January 2023 but did not vote on it.
PSC proposes both an alternative approach for funding the NYC Health Insurance Stabilization Fund such that savings from forcing NYC retirees into an MA plan would not be needed and the establishment of a stakeholders’ commission to identify ways to reduce the growth in NYC spending for health care with a focus on hospital pricing
PSC testifies at City Council against proposed change to Administrative Code.
MLC local union leaders vote to accept the Aetna MA plan as the only plan available to Medicare-eligible retirees, other than HIP VIP. PSC voted NO. The full Aetna contract was not made available before the vote, only a summary, and more locals voted No or abstained than in the past.
The full Aetna contract was posted on the NYC OLR website. (See the bottom of the page when you click the link.) The contract contains a provision in Addendum B to permit continuation of access for NYC retirees to traditional Medicare plus a supplemental plan. NYC has not sought to establish a supplemental plan to replace Senior Care.
NYC Office of Labor Relations Commissioner Campion sends a letter to all Medicare-eligible retirees announcing that as of September 1, 2023 all Medicare-eligible retirees and Medicare-eligible dependents will be automatically enrolled in the NYC Aetna Medicare Advantage (MA) PPO Plan, except retirees already enrolled in HIP VIP, a Medicare Advantage HMO. GHI Senior Care and all other retiree health plans except the Aetna MA PPO and HIP VIP will be discontinued as of 9/1/23. (Non-Medicare-eligible dependents will be enrolled in the GHI CBP as of 9/1/23, regardless of their current coverage, except dependents of retirees in HIP VIP who will be enrolled in HIP HMO.)
PSC testifies against proposed NYC/Aetna contract at OLR hearing.
NYC signs the contract with Aetna, and the OLR Commissioner states to the MLC that the City will exercise the options in Addendum B (see above) “…only in the event a change in circumstances in the future, whether due to litigation, legislative action, or some other event, mandates a different approach….”
For a longer term history of how this transpired, going back to June 2018, click here.
