Overview
- A settlement announced Monday calls for $53 million to be returned to as many as 250,000 retired New York City municipal workers who paid $15 copays under the GHI Senior Care plan.
- The payment covers 100 percent of copays charged for medical visits between Jan. 1, 2022, and Jan. 31, 2023, according to plaintiffs’ lawyers and the retirees’ organization.
- EmblemHealth said it will notify members and set up a reimbursement process, and the signed settlement papers were submitted to New York County Supreme Court Justice Lyle E. Frank for approval.
- The city and insurer also agreed not to raise the $15 Senior Care copay through a multi-year period the city says runs to 2028, and copays had been reinstated under revised contracts in January 2025.
- Retiree advocates praised the settlement but continue to press the mayor and City Council to eliminate copays entirely and to block future moves toward privatized Medicare plans that they say reduce benefits and raise costs.