{"id":312750,"date":"2026-08-03T19:18:17","date_gmt":"2026-08-03T19:18:17","guid":{"rendered":"https:\/\/www.newsbeep.com\/us-ny\/312750\/"},"modified":"2026-08-03T19:18:17","modified_gmt":"2026-08-03T19:18:17","slug":"nyc-emblemhealth-to-pay-53m-worth-of-copays-back-to-250000-city-retirees-in-new-settlement","status":"publish","type":"post","link":"https:\/\/www.newsbeep.com\/us-ny\/312750\/","title":{"rendered":"NYC, EmblemHealth to pay $53M worth of copays back to 250,000 city retirees in new settlement"},"content":{"rendered":"<p>\t\t\t\t<img width=\"1200\" height=\"800\" src=\"https:\/\/www.newsbeep.com\/us-ny\/wp-content\/uploads\/2026\/08\/GettyImages-1351105760.jpg\" class=\"crop-center wp-post-image\" alt=\"Doctors medical stethoscope on money background healthcare expensive concept\" decoding=\"async\" fetchpriority=\"high\"   title=\"NYC, EmblemHealth to pay $53M worth of copays back to 250,000 city retirees in new settlement 1\"\/>\t\t\t<\/p>\n<p>Retired New York City workers will be getting $53 million back in copays they weren\u2019t supposed to pay, a new settlement holds.<\/p>\n<p>Photo via Getty Images<\/p>\n<p>Over 250,000 retired New Yorker City <a href=\"https:\/\/www.amny.com\/new-york\/nyc-workers-sue-self-funded-health-plan\/\" target=\"_blank\" rel=\"noopener nofollow\">municipal workers<\/a> enrolled in EmblemHealth\u2019s Senior Plan will be getting $53 million back that they paid in copays to the healthcare provider from 2022 to 2023 in a new <a href=\"https:\/\/static.pollockcohen.com\/docs\/2026.07.31%20Bianculli%20Settlement%20Agreement%20(JG%20%2B%20SC%20%2B%20RS%20%2B%20MG%20signatures)%20-%20UPDATED%20.pdf\" target=\"_blank\" rel=\"noopener nofollow\">settlement<\/a> which holds the retirees shouldn\u2019t have had to pay for that portion of their care.<\/p>\n<p>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 \u2013 which is exclusively available for Medicaid-eligible retired New York City municipal workers \u2013 when the contract between the city and its workers prohibited that.\u00a0<\/p>\n<p>\u201cThis is a wonderful victory for retirees,\u201d said Marianne Pizzitola, the public service retirees organization\u2019s president. \u201cThe 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.\u201d<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"size-medium wp-image-137801251\" src=\"https:\/\/www.newsbeep.com\/us-ny\/wp-content\/uploads\/2026\/08\/0BEBCE80-3720-4CF4-B0F7-93A21D8B25D8_1_105_c.jpeg\" alt=\"Retired and active city workers rally outside District Council 37 headquarters in Lower Manhattan on Tuesday, protesting the Municipal Labor Committee\u2019s approval of a new self-funded health insurance plan. Demonstrators expressed concern over the plan\u2019s secrecy, potential cost increases, and reduced member input.\" width=\"700\" height=\"525\" title=\"NYC, EmblemHealth to pay $53M worth of copays back to 250,000 city retirees in new settlement 2\"  \/>Retired and active city workers rally outside District Council 37 headquarters in Lower Manhattan protesting the Municipal Labor Committee\u2019s approval of a new self-funded health insurance plan. Demonstrators expressed concern over the plan\u2019s secrecy, potential cost increases, and reduced member input.Photo by Adam Daly<\/p>\n<p>The organization says the suit has saved elderly and disabled retirees over $106 million over the years it\u2019s played out, as it won a court order preventing the group from being charged copays in 2023 and 2024.<\/p>\n<p>Pizzitola added that the organization \u201choped\u201d 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.<\/p>\n<p>Copays on the plan are in effect now. Attorneys for the retirees said they\u2019d continue pushing the City Council and Mamdani to \u201celiminate co-pays for seniors entirely.\u201d<\/p>\n<p>\u201cIt is another step forward in ensuring affordable healthcare for our seniors,\u201d said Steve Cohen of Pollock Cohen LLP, a lead attorney for the retirees, said of the settlement. \u201cNow 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.\u201d<\/p>\n<p>A request for comment to Menin and Mamdani was not answered. The city\u2019s Law Department spoke positively of the settlement and said the city\u2019s healthcare plan was better than most other municipalities.\u00a0<\/p>\n<p>\u201cAn 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,\u201d a city Law Department spokesperson said in a statement. \u201cWe remain committed to supporting our retired City workforce.\u201d<\/p>\n<p>EmblemHealth said a process has been established to get retirees their money back and that people can expect more information in the future.\n<\/p>\n<p>\u201cWe are pleased that a settlement has been reached that avoids litigation,\u201d said EmblemHealth spokesperson Alex Gomez. \u201cFrom this agreement, a process has been established to assist members with reimbursement and provide information on next steps.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Retired New York City workers will be getting $53 million back in copays they weren\u2019t supposed to pay,&hellip;\n","protected":false},"author":2,"featured_media":312751,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[53062,4429,2710,9,11,10,14901],"class_list":["post-312750","post","type-post","status-publish","format-standard","has-post-thumbnail","category-new-york","tag-city-workers","tag-healthcare","tag-law","tag-new-york","tag-new-york-headlines","tag-new-york-news","tag-retirees"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts\/312750","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/comments?post=312750"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/posts\/312750\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/media\/312751"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/media?parent=312750"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/categories?post=312750"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us-ny\/wp-json\/wp\/v2\/tags?post=312750"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}