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Home » No April 1 Implementation of Medicare Advantage

No April 1 Implementation of Medicare Advantage

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March 7, 2022

Dear PSC members,

I hope you and your families are well.

Late last week, Judge Lyle Frank issued a ruling which, if it stands, would preserve the right of PSC retirees and all NYC retirees to choose traditional Medicare plus “Senior Care” as their health care option, free of any monthly premium cost. The ruling came in a case in which a group of retirees challenged a decision last summer by the City and the Municipal Labor Committee (the coalition of unions representing City workers, of which PSC is a member), to change premium-free retiree health care from traditional Medicare plus Senior Care to a private “Medicare Advantage” plus (MA+) program run by an alliance of two private insurance companies. The PSC and several health care unions voted against this change.

In light of the judge’s ruling, the City has postponed the April 1 implementation date of the MA+ program. The NYC Office of Labor Relations website now says:

The NYC Medicare Advantage Plus Plan is not being implemented on April 1, 2022.
Retirees do not need to opt out of the Medicare Advantage Plus Program to remain in Senior Care or their current plan on April 1.
All retirees will remain in their current plans until further notice.

However, the City has already filed a notice of appeal of Judge Frank’s order and may seek a stay to prevent the judge’s order from being implemented.

Although the judge rejected the retirees’ other challenges, finding for example that the City was within its rights to select “the Alliance” to administer the MA+ Program, he found that Section 12-126 of the City Administrative Code requires the City to pay for any health care plan it offers to retirees, up to a cap. If the judge’s ruling stands, it means that retirees will not have to pay a $191 monthly premium to keep their current Senior Care coverage, as long as the City continues to offer that plan. Under the judge’s order, the City must give retirees at least three months to opt out of it to keep their current coverage.

If the ruling stands, PSC retirees who haven’t opted out of the MA+ Plan by the implementation date the City eventually chooses will default into the MA+ Plan, but will have at least 3 months after that to choose to move back into their previous plan. If the Judge’s order is upheld, a retiree who decides to stay in Senior Care or any other health care plan offered by the City will not have to pay a premium as long as the City continues to offer that plan and the monthly premium does not exceed the HIP-HMO threshold (currently over $700). If the ruling is overturned, the City will likely seek to implement the MA+ Plan as soon as it can.

Although the outcome is still unclear, I would like to congratulate all PSC retirees and extend thanks to our Retiree Chapter for their persistent advocacy, which was essential in bringing us to this point.

In solidarity,

James Davis, PSC President

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