Retired New York City workers in the GHI Senior Care plan have until October 30 to file a claim form for a share of a settlement capped at $53 million. The money reimburses the $15 co-pays that EmblemHealth, the insurer that administers the plan’s medical coverage, began charging on January 1, 2022. A retiree who skips the form gets no reimbursement but is still bound by the settlement.
Who the $15 co-pay lawsuit covers
The class is made up of Medicare-eligible retired city employees, and their Medicare-eligible dependents, who were enrolled in the Emblem-administered GHI Senior Care Plan at any time from January 1, 2022 through January 31, 2023, according to the settlement website. The court notice puts the class at about 246,000 people. Hospital co-pays are not part of the case, because Anthem/Empire Blue Cross Blue Shield runs that side of the plan.
Five retired city workers and the New York City Organization of Public Service Retirees sued in November 2022. They argued that the $15 charge broke the contract between the city and Emblem, because the plan’s certificate of insurance was silent on co-pays and said Medicare would pay 80 percent of a reasonable charge while Emblem covered the other 20 percent…