What’s Happening to Our Healthcare

Updates

December 17, 2024. The New York Court of Appeals issued a unanimous ruling in favor of NYC retirees in the Campion case—the first court case brought by the NYC Organization of Public Service Retirees when the City tried to charge us extra to keep our traditional Medicare supplemental plan. Chief Judge Wilson wrote that “the City must pay—up to the statutory cap—for each health insurance plan that it offers employees and retirees.” Every single judge who has ruled on these Medicare Advantage cases has now found in our favor, yet Mayor Adams continues to appeal. For those interested, the decision can be found here. Video of the oral arguments is available here.

October, 2024.  EmblemHealth sent out letters to retirees on Senior Care notifying them that they will again be required to pay $15 co-pays as of January 1, 2025.  See the text of the letter (with details) here.

August 1, 2024. Judge Lyle Frank lifted his January 11, 2023 injunction stopping the Adams administration from charging $15 co-pays for SeniorCare, because the city amended its contract with Emblem. It is possible that beginning January 1, 2025, NYC retirees on SeniorCare will again be forced to pay $15 every time they have a medical office visit.

May 21, 2024. Retirees win again! The Appellate Division of the New York State Supreme Court upheld the August 2023 ruling issued by Judge Lyle Frank in a suit brought by the NYC Organization of Public Service Retirees. Frank’s ruling blocked the Adams administration from forcing the City’s 250,000 municipal retirees out of traditional Medicare and into a Medicare Advantage plan. This was the so-called “nuclear option” suit. The Appellate Division’s ruling was unanimous, unusually long, and strongly worded (Read it for yourself here.) Nevertheless, the City has vowed to appeal to the NYS Court of Appeals, which will choose whether or not to accept the appeal.

January 5, 2024. PSC Files Amicus Brief Supporting Retirees’ Right to Medicare

As of December 2023: we have prevented NYC from making any changes to our retiree health insurance; there has been NO forced move to a Medicare Advantage plan.  Those of us who have NYC retiree health benefits have been able to keep the same health insurance we currently have.  This is because, with the help of our union, we have fought back: we have demonstrated, written letters, called our City Council members.  Most significantly, the City has lost three separate court cases—all of which were brought by the NYC Organization of Public Service Retirees, an ad hoc group of municipal retirees created specifically to fight off the Medicare Advantage move.  The City has appealed all three cases and has so far lost on one appeal.

New York City is not the only employer trying to force its retirees off Traditional Medicare and into an inferior private Medicare Advantage plan in order to save money.  This is a national crisis, not a local one.  To help explain what is going on, the Retirees Chapter has prepared a document, “Background Information on the Privatization of Medicare.” Please feel free to share it with fellow retirees or anyone you feel might benefit from the information.

Read the October, 2023 story in the Clarion, “Another victory for retiree health care,” on the significant August court victory.  See What’s Happening to Our Healthcare to check on where things stand now and be sure to study the History and Timeline page to see how we got here.

August 11, 2023. Judge Lyle Frank permanently enjoined NYC from removing NYC Medicare-eligible retirees and their dependents from their current health plan(s) and from requiring those retirees and their dependents to enroll in Aetna Medicare Advantage or seek their own health coverage. The City has expressed its intention to appeal this decision to the NY State Appellate Division.

The following appeared on the New York City Office of Labor Relations website:

New information and updates regarding the Aetna Medicare Advantage PPO Plan – August 11, 2023

There is no Opt-Out or Waiver deadline in effect due to a preliminary injunction issued by the court.

• All current health plans remain in effect. No retiree will be moved into the new Medicare Advantage PPO Plan.
• No opt-out requests made through Aetna via their call center or website will be processed at this time.
• No waiver of City health benefits, enrollment into the Aetna Medicare Advantage PPO Plan or adding the prescription drug rider that have been submitted on the Retiree Special Enrollment/Waiver Form will be processed at this time.

Please check back frequently for additional information and updates.

 

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VIDEO OF 6/26/23 RETIREE CHAPTER MEETING ON HEALTHCARE is available here.

VIDEO OF 6/5/23 SPECIAL RETIREE CHAPTER MEETING ON HEALTHCARE is  available here.

JUNE 8, 2023. COMPTROLLER LANDER DECLINES TO REGISTER MEDICARE ADVANTAGE CONTRACT PENDING LEGISLATION:  Comptroller Brad Lander issued a press release stating that he  “returned the contract [with Aetna Medicare Avantage] to the Office of Labor Relations without registering it. Pending litigation calls into question the legality of this procurement and constrains us from fulfilling our Charter mandated responsibility to confirm that procurement rules were followed, sufficient funds are available, and the City has the necessary authority to enter into the contract.”

He also raised concerns about “about the privatization of Medicare plans, overbilling by insurance companies, and barriers to care under Medicare Advantage. ”

You can read the press release HERE.

WHAT RETIREES NEED TO KNOW TO MAKE A DECISION ABOUT THEIR HEALTHCARE:  The NYC Office of Labor Relations (OLR) has announced that as of September 1, it is (1) moving all Medicare eligible retirees and their Medicare eligible dependents to Medicare Advantage and (2) terminating NYC Senior Care.  There are lots of moving parts in this scenario.  Legislative initiatives, political action and legal suits could change the facts on the ground — and the PSC and big numbers of NYC retirees continue to push back against the City.  But as of now, the City is moving ahead to execute its September 1 move.  Retirees needs to investigate their options.  To help retirees do this, we have created a new page on the website — WHAT RETIREES NEED TO KNOW TO MAKE A DECISION ABOUT THEIR HEALTHCARE.  Click here to go to the page.

MAY 31, 2023. NYCOPSR FILES LAWSUIT AGAINST MOVE TO AETNA MA:  The NYC Organization of Public Service Retirees, whose lawsuit had previously halted NYC’s attempt to move retirees to a Medicare Advantage plan run by The Alliance, filed suit again on May 31 in an attempt to get a temporary restraining order against the move to the Aetna plan. According to an article in the New York Daily News (apologies if you can’t read it behind the paywall) the suit says that the city’s actions violate the city charter by not offering choice, violate state and city human rights laws which prohibit discrimination against disabled people, and failed to follow proper procedures. The lawsuit documents can be viewed here.

MAY 25, 2023. APPELATE COURT UNANIMOUSLY UPHOLDS DECISION PROHIBITING EMBLEM FROM CHARGING CO-PAYS FOR NYC SENIOR CARE:  The First Department of the New York State Appellate Court unanimously affirmed a decision from Manhattan Supreme Court Justice Lyle Frank prohibiting the City and EmblemHealth from charging 183,000 elderly and disabled retirees co-pays for medical services. The case was brought by the NYC Organization of Public Service Retirees.

MAY 24, 2023. WELFARE FUND CLARIFIES BENEFITS FOR RETIREES WHO WAIVE NYC HEALTH COVERAGE:  At the May 24^th 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.  Click here to read the announcement on the Welfare Fund’s website of the trustees’ decision.

VIDEO OF PSC DEBRIEF IN RESPONSE TO AETNA INFORMATION SESSION on 4/21/23.  Click here to watch the video.

THE MARCH 31 EMERGENCY RALLY AT CITY HALL   On  Thursday, March  30,  the Adams administration signed a contract with Aetna Insurance to move 250,000 muncipal retirees (including CUNY faculty and staff) from traditional Medicare to a privatized Medicare Advantage program.  The next day, several hundred NYC retirees supported by active union brothers and sisters demonstrated in protest at City Hall.  Watch a video HERE.  (Starting at the 38 minute mark, view three PSC speakers — Cecelia McCall, Jen Gaboury and Evie Rich).

 

MARCH 31, 2023. PSC STATEMENT ON MAYOR ADAMS’ DECISION TO SIGN NEW AETNA MEDICARE ADVANTAGE CONTRACT:  Mayor Adams missed an opportunity to honor the City’s most essential promise to retirees when he signed the Medicare Advantage contract between the City and Aetna. He had the option to continue traditional Medicare with high quality, premium-free Medicare supplemental insurance (Senior Care), while still saving the City more than $300 million annually. But he chose not to do so. And now, as we fight on for retirees, we note Commissioner Campion’s communication to Municipal Labor Committee leaders that legislation, litigation or “some other event” could still compel the City to offer retirees the choice of traditional Medicare plus premium-free Medicare supplemental insurance.

The City’s current approach to funding healthcare is flawed, and Medicare Advantage does not offer a permanent solution….  READ FULL STATEMENT.

ARTICLES OF NOTE ON RETIREE HEALTHCARE AND MEDICARE ADVANTAGE:  We have compiled a list of recent articles with links that you can view here.

MARCH 11 – 30, 2023. EMAILS AND CALLS TO THE MAYOR TO PROTECT RETIREE HEALTH CARE!  As soon as the proposed Aetna contract was posted on March 10th, the PSC reviewed it, and discovered details that we believe were not disclosed when it was under consideration by the MLC. The proposed Aetna contract allows the City to continue to offer supplemental Medicare coverage such as Senior Care at no cost to retirees. Contrary to what the public and perhaps the Council were led to believe, Aetna does not require that Senior Care be eliminated or offered only at full cost.

If it so chooses, the City, as specified in the Aetna contract, has the option to offer premium-free Senior Care for those who want to opt out of the default Aetna plan.  This is so-called OPTION C under the Aetna contract.  Several thousand letters were written to the mayor – many followed-up with a phone call, telling him to exercise OPTION C!   The letters were delivered to the Mayor at the March 31 rally (see video above).

MARCH 23, 2023. “NYC RETIREES SPEAK OUT ABOUT HEALTH CARE CHANGES” — 3/23 BRIAN LEHRER SHOW:  Listen to the audio here.  Check out Jen Gaboury from the PSC at the 21:30 mark

MARCH 21, 2023. NYC OFFICE OF LABOR RELATIONS HOLDS HEARING ON CONTRACT WITH AETNA MEDICARE ADVANTAGE, 10 AM.  

Over the course of several hours, every speaker at the hearing opposed the Aetna Medicare Advantage contract.  Every speaker was a retiree, with one exception, James Davis, who was the only union leader to testify.  Davis’s testimony, which raises important issues about the Aetna plan, can be read here.  The hearing was recorded.  Listen to the audio here.

Links to a “DRAFT” of the full contract are available on the OLR website at the bottom of the ‘public hearings page,”

Here are some talking points that PSC members made at the hearing.

MARCH 16, 2023. LETTER FROM JAMES DAVIS ON MOVING RETIREES TO MEDICARE ADVANTAGE AND ELIMINATING PREMIUM-FREE NYC SENIOR CARE — and why the PSC continues to push back on these issues.  Click HERE to read the letter.

UNDER TERMS OF THE AETNA CONTRACT, THE CITY HAS UNTIL APRIL 1 TO NOTIFY AETNA IF IT PLANS TO CONTINUE SENIOR CARE OR ANY OTHER SUPPLEMENTAL COVERAGE FREE OF CHARGE

In a letter to City Council members, the PSC wrote:

“New information has come to light about the proposed Aetna Medicare Advantage contract with the City, which is now available on the OLR website.

The PSC has reviewed the contract and believes it contains information that was not disclosed when the contract was under consideration by the MLC.

The proposed Aetna contract allows the City to continue to offer supplemental Medicare coverage such as Senior Care at no cost to retirees. Contrary to what the public and perhaps the Council were led to believe, Aetna does not require that Senior Care be eliminated or offered only at full cost.

The contract was posted on March 10 and will be available for public inspection until March 21. It was not available when the Municipal Labor Committee voted to support it on March 9. We offer this update to alert Councilmembers to the information and to ask you to contact the Mayor in support of the City continuing to offer no-cost supplemental Medicare coverage to retirees, as it has for decades.

Under the terms of the contract, the City has until April 1 to notify Aetna if it plans to continue Senior Care or other supplemental coverage free of charge. Notifying Aetna by April 1 would enable retirees to opt out of Aetna MA effective September 1. Given the importance many City Councilmembers placed on “choice” in their public statements about retiree health care, we believe that Councilmembers may want to focus on this provision of the contract.”

The clock is ticking. By April 1, we need to convince the City to preserve Senior Care.  Watch these pages for information on how we mobilize to do this.

MARCH 9, 2023. PSC VOTED “NO” ON THE CONTRACT FOR THE NEW MEDICARE ADVANTAGE PLAN:  The Municipal Labor Committee voted on Thursday, March 9 to approve a contract with Aetna for a Medicare Advantage plan and to remove premium-free NYC Senior Care as an option for retirees.  The PSC voted “NO”  together with 25 other unions.  Click here to fnd out why.

MARCH 2023. TAKE ACTION AGAINST THE SWITCH TO MEDICARE ADVANTAGE AND TO PRESERVE PREMIUM-FREE NYC SENIOR CARE.  WRITE/CALL NYC COUNCIL MEMBERS URGING THEM TO SIGN-ON TO THE LETTER TO THE MAYOR.  The PSC Retiree Chapter mobilized its members to enlist their NYC Council Members to sign the letter to Mayor Adams.  In-service members (future retirees) should join this action.  Click here to read more.

VIDEOS OF SEPTEMBER 2022 – MAY 2023  RETIREE CHAPTER UPDATES ON HEALTHCARE: There were updates in the second part of chapter meetings on 9/12/22, 10/3/22, 11/7/22, 12/5/22, 1/23/23, 2/6/23, 3/6/23. 4/3/23, 5/1/23 and the entire meetings on 3/27/23 and 4/21/23.

• Here is a link to a video of the 9/12 chapter meeting.  The discussion of retiree healthcare begins at the one hour six minute mark of the video.
• HERE is a link to a video of the 10/3 chapter meeting.  The second part of the meeting, on retiree healthcare, begins at the one hour fifteen minute mark of the video.
• HERE is a link to a video of the 11/7 chapter meeting.  The second part of the meeting, on retiree healthcare, begins at the one hour twenty-nine minute mark of the video.
• HERE is a link to a video of the 12/5 chapter meeting with retiree healthcare beginning at the one hour nine minute mark.
• HERE is a link to a video of  the 1/23/23 special Retiree Chapter meeting on retiree healthcare.
• HERE is a link to a video of  the 2/6/23 Retiree Chapter meeting with retiree healthcare beginning at the one hour fifty-seven minute mark.
• HERE is a link to a video of  the 3/6/23 Retiree Chapter meeting with retiree healthcare beginning at the one hour seventeen minute mark.
• HERE is a link to a video of the special 3/27/23 on NYC moving retirees to Aetna Medicare Advantage and removing NYC Senior Care as a premium-free option.
• HERE is a link to a video of the 4/3/23 Retiree Chapter meeting with retiree healthcare beginning at the one hour four minute mark.
• HERE is a link to the 4/21/23 special debrief in response to the Aetna information meeting earlier that day.
• HERE is a link to the 5/1/23 Retiree Chapter meeting with retiree healthcare beginning at the fifty one minute mark.

JANUARY 31, 2023. “With deadline passed, Medicare amendment appears doomed.  But PSC union’s ‘third way’ proposal has some traction.”  This is a headline from The Chief.  Click here to read the story.

JANUARY 2023. PSC CITY COUNCIL TESTIMONY.  The City Council Committee on Civil Service and Labor held a hearing on January 9th on a proposed NYC Administrative Code change that would clear the path for the City to implement a Medicare Advantage plan and begin charging retirees a premium to opt out.  PSC leadership and scores of PSC members testified in opposition to the change.  Read their testimony HERE.

The entire 1/9/23 City Council hearing is available HERE with testimony by James Davis and a PSC panel beginning at the 5:48:15 timestamp.  The committee never voted to send the proposed amendment to the full City Council.  At t his point, the proposed amendment appears to be a non-starter.

JANUARY 23, 2023. LATEST ON PROPOSED CHANGES TO RETIREE HEALTHCARE.  Click here for a video of  the 1/23/23 special Retiree Chapter meeting on the latest developments on the continuing saga of the push to move retiree healthcare insurance fro traditional Medicare to Medicare Avantage.

JANUARY 11, 2023. JUDGE ISSUES INJUNCTION BARRING CITY FROM CHARGING $15 CO-PAYS FOR NYC SENIOR CARE.  In a suit brought by the NYC Organization of Public Service Retirees, Judge Lyle Frank, on Wednesday, January 11, issued a preliminary injunction stopping the Adams administration from charging $15 co-pays for Senior Care.  Click HERE for more details in this NY Daily News story.

DECEMBER 2022. PSC PROPOSES AN ALTERNATIVE PATH FOR NYC HEALTH BENEFITS PROGRAM IN RESPONSE TO ARBITRATOR’S DECISION AND PROPOSED NYC COUNCIL HEARINGS ON CHANGING THE CITY’S ADMINISTRATIVE CODE.  Click HERE to read the PSC’s analysis and proposal.

Share the PSC proposal with your City Council representative and urge Council members to vote “NO” on changing the administrative code.

DECEMBER 15, 2022. ARBITRATOR CALLS FOR NEGOTIATIONS ON MEDICARE ADVANTAGE TO BE COMPLETED BY JANUARY 9 AND IMPLEMENTED BY JULY 1.  On December 15, an arbitrator issued a decision ordering the City to complete negotiations with Aetna Insurance on a Medicare Advantage plan by January 9th  and calling on the Municipal Labor Committee to vote on the plan immediately thereafter, with July 1 target for the MA plan to go into effect as possibly the only healthcare option for municipal retirees.  Here is an article (NY Focus/The City) on the decision and here is the arbitrator’s ruling.

The Davis Letter.  On Thursday, December 22, James Davis, President of the PSC sent a letter to members:

• Explaining the implications of the arbitrator’s decision for all PSC membera — retirees and in-service.
• Warning that such a path suggests a “classic anti-labor maneuver to pit in-service members against retirees.”
• Calling for an alternative path to the healthcare dilemma faced by NYC and the MLC. Click here to read his letter.

NOVEMBER 22, 2022. APPELLATE DIVISION OF NYS SUPREME COURT UPHOLDS JUDGE FRANK’S DECISION.  Appeals court unanimously upholds decision keeping NYC Senior Care premium-free.  A state appeals court on 11/22/22 unanimously upheld the decision of a lower court (Judge Lyle Frank) that prohibits NYC from charging a premium to municipal retirees for NYC Senior Care.  For more detail, click here.  A PDF of the decision can be read here.

SEPTEMBER – NOVEMBER 2022. PSC OPPOSES WEAKENING NYC HEALTH INSURANCE PROTECTIONS.  Proposed changes in NYC administrative code threaten retiree healthcare and, in the longer term, potentially in-service members.  Read James Davis’ 9/9/22 message and 11/7/22 update to PSC members about these proposed changes.

You may also find this primer, written by a Retiree Chapter Executive Committee member, useful in breaking down the legal complexities of the proposed administrative code — and its implications for all union members.

SEPTEMBER – DECEMBER 2023. WHAT YOU CAN DO TO OPPOSE THE CHANGE TO THE ADMINISTRATIVE CODE:  This is what we were asking members to do  in September through December.

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Published: March 3, 2022 | Last Modified: July 25, 2022