Retired New York City workers will be getting $53 million back in copays they weren’t supposed to pay, a new settlement holds.
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Over 250,000 retired New Yorker City municipal workers enrolled in EmblemHealth’s Senior Plan will be getting $53 million back that they paid in copays to the healthcare provider from 2022 to 2023 in a new settlement which holds the retirees shouldn’t have had to pay for that portion of their care.
The class action settlement comes in a suit brought in 2022 by the New York City Organization of Public Service Retirees and retired municipal workers after the city and Emblem implemented copays on its Senior Plan – which is exclusively available for Medicaid-eligible retired New York City municipal workers – when the contract between the city and its workers prohibited that.
“This is a wonderful victory for retirees,” said Marianne Pizzitola, the public service retirees organization’s president. “The older people get, the more likely they are to need medical care, and co-pays are one of the worst, most regressive burdens making healthcare unaffordable.”
Retired and active city workers rally outside District Council 37 headquarters in Lower Manhattan protesting the Municipal Labor Committee’s approval of a new self-funded health insurance plan. Demonstrators expressed concern over the plan’s secrecy, potential cost increases, and reduced member input.Photo by Adam Daly
The organization says the suit has saved elderly and disabled retirees over $106 million over the years it’s played out, as it won a court order preventing the group from being charged copays in 2023 and 2024.
Pizzitola added that the organization “hoped” Mayor Zohran Mamdani and City Council Speaker Julie Menin would recognize the obstacle copays are to affordable healthcare and work to pass legislation to roll them back entirely, since the city and Emblem changed its healthcare contract for the plan as the suit proceeded in court, making copays permissible in 2025.
Copays on the plan are in effect now. Attorneys for the retirees said they’d continue pushing the City Council and Mamdani to “eliminate co-pays for seniors entirely.”
“It is another step forward in ensuring affordable healthcare for our seniors,” said Steve Cohen of Pollock Cohen LLP, a lead attorney for the retirees, said of the settlement. “Now we have to get the City Council and the Mayor to eliminate co-pays for seniors entirely. They were promised and deserve free healthcare in retirement.”
A request for comment to Menin and Mamdani was not answered. The city’s Law Department spoke positively of the settlement and said the city’s healthcare plan was better than most other municipalities.
“An amicable settlement has been reached to resolve a class action lawsuit brought by Medicare-eligible retired City workers and their dependents regarding medical co-pays under the GHI Senior Care health insurance plan,” a city Law Department spokesperson said in a statement. “We remain committed to supporting our retired City workforce.”
EmblemHealth said a process has been established to get retirees their money back and that people can expect more information in the future.
“We are pleased that a settlement has been reached that avoids litigation,” said EmblemHealth spokesperson Alex Gomez. “From this agreement, a process has been established to assist members with reimbursement and provide information on next steps.”