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Judge’s decision temporarily blocks Aetna Medicare Advantage

Jul 07, 2023

Good news in the struggle to preserve high quality health coverage for NYC retirees. On Friday, July 7, Justice Lyle Frank issued a preliminary injunction temporarily blocking the City’s plan to force retired City workers into the Aetna Medicare Advantage Plan.

The PSC has consistently taken the position affirmed in this decision: “[N]umerous promises were made by the City to then New York City employees and future retirees that they would receive a Medicare supplemental plan when they retired, and that their first level of coverage once that retired would be Medicare.”

The judge’s order states that the City is “temporarily enjoined until further order of this Court from requiring any City retirees, and their dependents from being removed from their current health insurance plan(s), and from being required to either enroll in an Aetna Medicare Advantage Plan or seek their own health coverage.”

Requiring retirees to find and pay for their own Medicare supplemental insurance (or Medigap) would violate the Judge’s order.  As the City acknowledges on its Office of Labor Relations website, the order also means that, for now:

  • There is no Opt-Out or Waiver deadline in effect.
  • All current health plans remain in effect. No retiree will be moved into the Aetna Medicare Advantage PPO Plan.
  • No opt-out requests made through Aetna via their call center or website will be processed.
  • No waiver of City health benefits, enrollment into the Aetna Medicare Advantage PPO Plan, or…prescription drug rider [addition]…will be processed at this time.

So there is no July 10 deadline to waive NYC health coverage. There are no decisions for retirees to make right now. Current health insurance coverage for retirees and their Medicare-eligible dependents remains unchanged until the Judge decides otherwise, or the City wins an appeal.

The judge reasoned, “As this matter deals with health decisions of an ageing and a potentially vulnerable population, mostly on fixed incomes, any lapse in care for these people could lead to deleterious impacts.”

The City has stated its intention to appeal Judge Frank’s order.  A decision on such an appeal will likely take several months. Meanwhile, the judge will seek to require the City and Aetna to minimize, if not eliminate, the adverse effects on retirees and their dependents of the shift to Medicare Advantage before allowing a transition to take place.

The judge’s decision is not a final ruling, so we don’t know yet how the courts will ultimately decide several important issues, including whether the City Administrative Code requires the City to pay for Medicare supplemental coverage, like Senior Care.

So, while the immediate time pressure is off, we still have work to do. Our elected leaders need to take steps to clarify the City’s commitment to continue to pay for Medicare supplemental coverage. They need to control skyrocketing health insurance costs that contributed to the ill-advised decision to force retirees into Medicare Advantage. And they need to make sure that the City does not force in-service workers to shoulder these out-of-control costs in the process of choosing a new health insurance provider for those workers.

But for now, PSC retirees and their dependents can rest secure in the knowledge that their health insurance will not change in the immediate future. Please continue to consult the PSC retiree chapter website and the PSC-CUNY Welfare Fund for current information.

In solidarity,
James Davis, President

Published: July 7, 2023 | Last Modified: July 8, 2023

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