IMPORTANT HEALTH CARE INFORMATION: CITY AND MLC AGREE ON A NEW GROUP MEDICARE ADVANTAGE PLAN

LATEST NEWS 10/21/21 The New York State Supreme Court has issued a restraining order against the City on implementation of the new Medicare Advantage Plus Plan. Therefore, the City will not be allowed to go forward with the 10/31 opt-out date and has been ordered to cure defects in its implementation of the Plan and present a revised plan to the Court for approval. In the meantime, the City has been ordered to leave Medicare-eligible retirees in the health plans they presently have. You can read the restraining order at the following link:

New York State Supreme Court Restraining Order On The New Medicare Advantage Plus Plan

11/15/21 Update: The Court directed the City to submit for review a supplemental plan of implementation to address, among other matters, better information as to provider participation. In the interim, the Court put on hold any deadline for deciding whether to opt-out of the new plan. The City submitted its plan Friday, November 5th and the retiree group submitted its view of the new implementation plan on November 12th. You can view both the new implementation plan and the response at the links below. They are being reviewed at present by the judge in the case.

The City's New Implementation Plan

The Petitioner Retiree Organization's Response To The Plan

11/19/21 Update: The Court has ordered an all attorneys meeting, according to the website of the NYC ORGANIZATION OF PUBLIC SERVICE RETIREES, INC. The meeting will be held on Tuesday November 23rd at 10am. According to the website you can can watch the meeting by livestream. They provide a link and a password on their website which they say will give you access. The meeting was held on 11/23 and so many retirees logged in that the livestream crashed.

When we learn anything new, we will post it on this page. You should also regularly check the phone hotline or the Weekly Newsline section of this site for updates.

In mid-July 2021, the City and the Municipal Labor Committee, which brings together more than 100 unions representing NYC municipal workers, agreed on a new group Medicare Advantage health plan for Medicare-eligible City retirees. The plan will become the new zero dollar basic premium health plan for most of those retirees. Current enrollees in all of the health plans for Medicare-eligible City retirees will be transferred into the new plan effective January 1, 2022 unless they complete paperwork to "opt-out" of the new plan by the end of October 2021.

We are providing below information to help you decide which health plan works for you and whether you wish to accept the new plan or "opt-out" and remain in the plan you presently have. Be aware that most of the other plans will have a monthly "buy up" price if you wish to remain in them after January 1, 2022. For example, GHI Senior Care will require a monthly $191.57 contribution from your pension check for the basic plan and $2.83 monthly for the 365-day hospitalization rider. Any "buy-up" price for the basic plan is in addition to the cost of a Medicare Part D enhanced drug rider should you elect to enroll in one. For example, the GHI Senior Care drug rider will be $125 per month after January 1, 2022, down from $150.30 monthly at present. (The union will continue to reimburse $50 monthly toward that drug rider cost.)

We provide a link below to the video of the OSARC meeting held on September 14, 2021 on Zoom that was addressed by Kim Parker, a representative from the "Alliance," the insurance partnership between Emblemhealth and Anthem/Empire Blue Cross-Blue Shield which will be administering the new NYC Medicare Advantage Plus Plan. In addition, OSA Chair Bob Croghan took questions from members about the effect of the new plan on OSA's Welfare Fund Benefits and other aspects of the transition to the new plan.

You can watch the video of the OSARC meeting held on October 13, 2021 on Zoom which provided an opportunity for follow-up questions and answers to OSA Chair Bob Croghan and representatives of the Alliance, Emblemhealth and the City's Office of Labor Relations.

Finally, you can watch the video of a webinar hosted by the "Alliance" at the following link:

Alliance webinar on the new health plan.

You may wish to download the September 2021 edition of the OSARC Newsletter, which provided an overview of the new plan and its features and background information on why the plan was established.

To reach the Alliance by phone with questions about the new Medicare Advantage Plus Plan, call the special call center at 1-833-325-1190, Monday to Friday, 8 a.m. to 9 p.m. Eastern Time, except holidays.

You can obtain more information about the new plan or search to find if your provider is in-network on the Alliance's website at this link.

Below are links to other documents you may wish to review regarding the new plan, existing plans, and the transition and opt-out process:

  • Evidence of Coverage 2022 For The New NYC MAPP Plan (this is the legal guide to the plan's coverage)

  • Frequently Asked Questions About The New Plan And The Opt-Out Process (Updated 11/19/21)

  • City Health Plan Rate Chart For Medicare Eligibles Starting in January, 2022

  • Enrollment Guide For The New Plan For Those Presently In GHI Senior Care

  • Enrollment Guide For The New Plan For Those Presently In Other City Medicare-Eligible Health Plans

  • Opt Out Form For Those Presently In Senior Care

  • Opt Out Form For Those Presently In Other City Medicare-Eligible Health Plans

  • Benefits Chart For 2022 For The New York City Medicare Advantage Plus Plan

  • Plan Design Comparison to GHI/EBCBS Senior Care Plan

  • Plan Design Comparison to HIP VIP

  • Plan Design Comparison to Cigna

  • Plan Design Comparison to Eldercare

  • Plan Design Comparison to Humana HMO

  • Plan Design Comparison to Empire Mediblue Freedom PPO & Empire Medicare Related

  • Plan Design Comparison to United Healthcare Medicare Advantage HMO (union and non union plans)

  • Plan Design Comparison to Aetna Plan for NY, NJ and PA: General

  • Plan Design Comparison to Aetna Plan for all other areas: General

  • Brochure For Providers That Introduces The New Plan

  • Short Flyer For Providers Explaining The New Plan

  • Overview of Preauthorization Requirements in the New Plan

    Members requested that we post the November 2021 OSARC meeting featuring Mary Ellen Doran, a licensed social worker, discussing a variety of planning issues of importance to seniors. The second part of the meeting has additional information on the status of the NYC Medicare Advantage Plus Plan roll-out as sof November 10th (which predates the release of the City's new implementation plan and the response from the petitioning Retiree Organization, which are posted earlier on this page.


  • OSARC: The Organization of Staff Analysts' Retirees Club

    The Organization of Staff Analysts' Retirees Club (OSARC) was formed in 1992, at a time when the union had roughly 75 retirees. OSARC began with five members and has grown, over the past 29 years, to more than 1650 dues-paying members. Each OSARC member pays $18-per-year in dues and an additional $2 at each in-person monthly meeting they attend. OSARC meetings usually draw a regular attendance of between 40 and 60 members, though the May 2016 meeting drew more than 80. The two dollar per meeting donation is used to offset the cost per person of our annual Gala Luncheon, held in June.

    Monthly meetings feature speakers of special interest to the membership on subjects from Social Security and medical issues/problems to financial planning and taxes. Trips are planned for small groups. OSARC has a monthly newsletter which is sent several times a year to all retirees and, the majority of months, only to those members who have paid their annual OSARC dues.

    Since late 2020, OSARC has been holding its monthly meetings virtually on Zoom. In September of 2021, a discussion of the new Medicare Advantage health plan for Medicare-eligible retirees drew 325 attendees!

    Here's the latest OSARC Zoom meeting, held on November 10, 2021 and featuring guest presenter, licensed social worker Mary Ellen Doran, discussing a range of issues of interest to seniors from planning documents to arranging community care. An update on the Medicare Advantage Plus Plan is also provided.

    You can catch a glimpse of the March 2011 OSARC meeting (held on Wednesday, March 9th - Ash Wednesday) in this slide show of photos by OSA Director of Media Services Rob Spencer. The subject was computer security.

    OSARC Meeting March 2011

    Celebrating OSARC's 20th Anniversary - June 13, 2012

    The Organization of Staff Analysts' Retirees Club marked its 20th birthday on June 13, 2012 with a special June luncheon at Churrascaria Rodizio Plataforma in midtown. The luncheon drew more than 130 retirees and guests. The slideshow below, by OSA Director of Media Services Rob Spencer, assembled from photos he and OSARC member and activist Jean Anmuth have taken over the years was screened for those assembled. (The slide show does not have audio.):

    OSARC Newsletter

    To view OSARC newsletters sent to all retirees, click on the appropriate year on the menu to left. The newsletters from the year 2000 on are stored on this site as PDF files. To view and print these files, and the forms on this page, you will need Adobe Reader installed on your hard drive. You can download a copy of Adobe Reader from the Adobe site.

    Join OSARC!

    To view and print out a copy of the OSARC Membership Form click here. Please mail the completed form to OSARC, 220 East 23rd Street, Suite 707, New York, New York 10010.

    OSA Retirement Information Form

    To view and print out a copy of the OSA Retirement Information Form, click here.

    City Health Benefits Program Retiree Health Benefits Frequently Asked Questions

    To view and print out a copy of a Frequently Asked Questions document produced by the City's Health Benefits Program, click here.

    Information on the City's Medicare Part B Reimbursements (Standard and Higher Income)
    and the OSA Welfare Fund's Drug Rider Premium Reimbursements for Medicare-Eligible Retirees

    There are two types of Medicare-related reimbursements that Medicare-eligible retirees receive each year.

    The City's Basic Medicare Part B Reimbursement

    The first type of reimbursement is for Medicare Part B, which covers doctors visits. This reimbursement is made by the City's Health Benefits Program and is automatic. Each month a premium is deducted from your Social Security check to cover Medicare Part B. The amount of that monthly Part B premium is either the "standard" premium or a higher amount, if you are fortunate to have income above a set threshold for the year.

    Part B premium reimbursement occurs because of union pressure on the City Council more than a decade ago. Reimbursement was initially won by the unions in 1966, but mayor after mayor from 1966 to 2001 said the City was too poor for full reimbursement of Part B premiums and paid back less than the full premium. Legislation was fought for by the unions and passed in 2001 which ever since has mandated the full premium reimbursement.

    When you become Medicare-eligible and enroll in Part B, you should submit the form that you can download at the link below, along with a copy of your Medicare Card:

    Medicare Part B Premium Reimbursement Form

    For those who have automatic direct deposit of their pension payments into a bank account, the Part B reimbursement is likewise made by direct deposit into that account and the deposit timeframe for reimbursement for basic premiums is the end of April of the year following their payment. Those without direct deposit receive a check.

    For example, for retirees/eligible dependents with a Medicare Part B effective date between 2016 and 2019, reimbursement is made at the rate of $135.50 per covered month or $1,626 if you were covered for the full year. You should receive a check for $1,626 or a direct deposit into your bank account of that amount by the end of April.

    Retirees/eligible dependents of a retiree with a Medicare Part B effective date prior to 2016 will be reimbursed at the rate of $109 per month or $1,308 for the full year. If you had a higher premium deducted than $109, you must submit the Medicare Part B 2019 Reimbursement Differential Request Form to obtain an additional amount up to $318 for the year. The "Differential Reimbursement Form" is linked below.

    If you do not receive the standard reimbursement, you should contact the City's Health Benefits Program, which moved last year to 22 Cortlandt Street.

    PLEASE NOTE: DUE TO THE COVID-19 PANDEMIC CRISIS, the Health Benefits Retiree client service walk-in center remains closed to visitors. They recommend submitting inquires and documents as follows:

  • Inquiries and questions can be emailed to healthbenefits@olr.nyc.gov

  • Forms and documents can be submitted electronically through LeapFILE. Before you begin, you may wish to view instructions and a short video on how to submit your forms/documents.You can review the video and instructions on this page.

  • When you are ready, use the following link to submit your forms and documents: https://nycemployeebenefits.leapfile.net

  • Please do NOT submit your form/document more than once. This will only delay processing.

  • You will immediately receive notification stating "Success! Your file has been received" upon completion of your document upload. You will not receive a separate email confirmation.

  • Please allow 30-45 days from the day you submit your document(s) for them to be processed. Coverage will be retroactive to the effective date of retirement.

  • Also, please do not send forms or documents via express mail.

  • If you are a HIP-HMO member turning 65 or on Medicare due to a disability, please contact HIP at 1-800-447-9169 to enroll over the phone. Please identify yourself as a City of New York retiree or dependent of a retiree. For all other members enrolled in an HMO plan, please contact your health plan at the customer service numbers on the back of your ID card.

  • Download Adobe Scan at this linkto convert your documents into PDFs. Use your smart phone or tablet camera to take a picture of your paper form and Adobe Scan will convert it to a PDF. Adobe Scan mobile app is available for iPhone and Android.

    The City's Medicare Part B Reimbursement For Higher Income Retirees

    When payments are made for the "standard monthly part B premium" for the prior year, the City issues a special form called the IRMAA form for those who have higher incomes and paid more than the standard Part B premium. Forms must be completed and submitted to the City's Health Benefits Program. The forms for 2016 - 2019 are available at the links below.

    Payment is processed for the extra money paid and a check issued. Recently that has taken place in October of the year after payment, depending on when you file for the IRMAA reimbursement.

    The City's Medicare Part B Differential Reimbursement

    In addition to the standard Part B premium reimbursement and the IRMAA high income premium reimbursement, the City has instituted a reimbursement process for those Medicare enrollees who have received less in their standard Part B reimbursement than they actually had deducted from their Social Security payments. To determine if you are eligible for this differential reimbursement, be sure to read the forms. You can find a copy of the forms for 2017, 2018 and 2019 and the instructions lower down on this page, below the forms for IRMAA reimbursement. You must look at the total amount of Part B premiums reimbursed to you by direct deposit or check in April 2020 and compare that number to the amount of Part B Premiums on your 2019 SSA 1099 which you should have received in January or February of 2020. If the amount of the deductions is higher than the reimbursement you've received, you are likely eligible for the differential reimbursement and should complete and submit the form to OLR along with the proofs required.

    Payment is processed for the extra money paid and a check issued. The City has indicated that reimbursement is likely in 2021. If you are submitting an IRMAA Form as a higher income retiree, you do not have to submit the Differential Form as the differential amount is automatically calculated and reimbursed along with the IRMAA amount.

    Medicare Part D Premiums for Higher Income Retirees

    Starting in 2011, retirees with incomes above a set threshold pay a premium for Medicare Part D, which covers drugs. These higher income individuals see a deduction from their Social Security check each month for Part D premiums, in addition to the monthly deduction for Part B premiums. Unlike Part B, there is no reimbursement for the Part D premiums for higher income retirees.

    The OSA Welfare Fund's Partial Drug Rider Reimbursement For Medicare Eligible Retirees

    The second type of reimbursement is provided by the OSA Welfare Fund rather than the City and represents a partial reimbursement by the union of drug rider premiums for Medicare-eligible retirees. This reimbursement, which amounts to $50 per month for each covered member ($600 maximum a year) and their covered spouse/domestic partner (another $600 maximum per year) is issued in one of two ways.

    If you are enrolled in GHI's Medicare plan, GHI Senior Care, the monthly cost of your Medicare Part D Enhanced drug rider is deducted from your pension check and is reduced by $50 a month for each covered individual. For example, the monthly premium for GHI Senior Care is presently $143.50 per month per person ($142.50 for the drug rider and $1 for hospitalization). OSA retirees in GHI Senior Care will only see $93.50 deducted per month per person from their pension check. The OSA Welfare Fund's $50 subsidy is paid directly to the City. Since GHI enrollees receive the drug rider reduction of $50 on a monthly basis from the Welfare Fund, they receive no additional payment from in the following year.

    Enrollees in all other Medicare Part D enhanced drug riders on other City health plans, such as HIP VIP Premier, do not have their drug rider premiums reduced during the year. Instead, the OSA Welfare Fund sends that member a lump sum check for the full prior year for themselves and any covered spouse/domestic partner, usually by April of the following year.

    Frequently Asked Questions About Medicare Part B Reimbursement

    2017-2019 Medicare Part B Higher Income Reimbursement Form

    To view and print out a copy of the New York City Employee Benefits Program's form and instructions for reimbursement of higher Medicare Part B premiums paid by certain beneficiaries who earned beyond certain thresholds in 2017, 2018 and/or 2019 click here. This form is to be filed by those Medicare beneficiaries who paid more than the standard Medicare Part B premiums in 2017, 2018 and/or 2019. You must supply copies of specific documents including the 1099 form for the prior year (2019, for example) you received from the Social Security Administration at the beginning of the following year (January of 2020, for example). You can expect the additional reimbursement sometime in or after October 2020.

    2016 Medicare Part B Higher Income Reimbursement Form

    To view and print out a copy of the New York City Employee Benefits Program's form and instructions for reimbursement of higher Medicare Part B premiums paid by certain beneficiaries who earned beyond certain thresholds in 2016 click here. This form is to be filed by those Medicare beneficiaries who paid more than the standard Medicare Part B premiums in 2016. You must supply copies of specific documents including the 1099 form for 2016 you received from the Social Security Administration at the beginning of 2017. You can expect the additional reimbursement sometime in or after October 2017.

    2019 Medicare Part B Differential Request Form

    To view and print out a copy of the New York City Employee Benefits Program's form and instructions for reimbursement if you paid a monthly Part B premium in 2019 between $110 and $135.50 but only received the standard reimbursement for $109/month for 2019 click here. It explains what proofs of payment you must submit. Note: If you are applying for IRMAA reimbursement, you do not have to submit this form. You will automatically receive a separate payment for the differential amount, in addition to the IRMAA reimbursement.

    2018 Medicare Part B Differential Request Form

    To view and print out a copy of the New York City Employee Benefits Program's form and instructions for reimbursement if you paid a monthly Part B premium in 2018 between $110 and $134 but only received the standard reimbursement for $109/month for 2018 click here. It explains what proofs of payment you must submit. Note: If you are applying for IRMAA reimbursement, you do not have to submit this form. You will automatically receive a separate payment for the differential amount in November 2019, in addition to the IRMAA reimbursement.

    2017 Medicare Part B Differential Request Form

    To view and print out a copy of the New York City Employee Benefits Program's form and instructions for reimbursement if you paid a monthly Part B premium in 2017 between $110 and $134 but only received the standard reimbursement for $109/month for 2017 click here. Please read the information contained in the letter from OLR that you can read at this link. Both explain what proofs of payment you must submit. Note: If you are applying for IRMAA reimbursement, you do not have to submit this form. You will automatically receive a separate payment for the differential amount, in addition to the IRMAA reimbursement.You can expect the reimbursement in the first quarter of 2019


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