Retired NYC employees sue to block new ‘inferior’ Medicare coverage

Nov 2, 2020
I think we all knew what was coming inevitably. The City could care less about the current employees and even less for the retirees. I just hope that those currently on the job(s) realize that one day they too will be a retiree.
Sep 7, 2020
I believe if a benefit is promised to an individual that was negotiated and agreed upon by both sides, then this should not be taken away

If in the future, any of the involved parties feel a change is needed, then that should take place under a change in contract agreements, involving all parties.

People make their choices in life.
Some want job security
Some want good benefits
Some want Big, Quick Dollars

Being a firefighter, police officer, emt, etc takes giving up time with your families on nights and certainly during the holidays and on weekends.

Sometimes these types of jobs bring on serious job related injuries or even death

If this benefit has been fairly negotiated, then I feel the city has made a written commitment and needs to honor that commitment
Well stated Willy.
May 6, 2010
Article In CHIEF

City’s Medicare plan gets cool Council reception
Posted Wednesday, January 11, 2023 12:19 am

Retired municipal workers will be deprived of choice if the City Council doesn’t sanction a change to the administrative code that allows the city to charge the retirees for a portion of their health care coverage, union leaders and Adams administration officials said Monday.
The retirees and their advocates, though, scoffed at the notion during an all-day hearing of the City Council’s Labor and Civil Service Committee, arguing that any scenario that bills retirees for health insurance would break a covenant established decades ago.
Council members, for their part, voiced skepticism about both the amendment and the city’s increasingly likely switch of retirees from a traditional Medicare program to a private, for-profit Medicare Advantage plan.
“We recognize that this presents an unbearable choice for retirees on fixed incomes and creates a disparate impact on low-income retirees,” Labor Committee Chair Carmen De La Rosa said at the hearing’s outset.
The legislation, which De La Rosa emphasized was not yet scheduled for a vote, would essentially allow the city to bill retirees the difference between a benchmark plan, likely administered by managed-care company Aetna, and any plan that costs more, in this case the retirees’ preferred supplemental plan, GHI Senior Care.
Administration officials have said the legislation, jointly drafted by the Municipal Labor Committee, the umbrella organization of public-sector unions, and the Office of Labor Relations and introduced at the behest of Mayor Eric Adams, would ensure that retirees keep Senior Care. Union and city officials contend the amendment would address a finding by a Manhattan Supreme Court justice who concluded last March that the city’s planned Medicare switch was not legal as constituted since it would require retirees who opted to keep Senior Care to pay for it, which would run against the city code. City officials have said the coverage would cost retirees an additional $191 month and likely more in coming years.
Several union leaders, including Michael Mulgrew, the president of the United Federation of Teachers, and Henry Garrido, the executive director of District Council 37, the city’s largest municipal employees union, are among those supporting the amendment.
“We have allowed fear of the unknown to truly become the perfect enemy of the good,” Garrido said at the hearing. “Amending the administrative code has always been and will always remain about choice.”
Switching to private Medicare and allowing the city to charge for the supplemental plan “may not be popular but they are responsible actions,” said Garrido, whose union represents more than one-third of the 250,000 retirees who would be affected by the Medicare switch, which the city wants to implement in July.
The hearing followed findings last month by Martin Scheinman, the chairperson of a committee tasked with addressing the delivery of health care to municipal workers and retirees, that increased financial deficits attributable to some aspects of the traditional Medicare plan required the city to switch to the private Medicare plan.
Scheinman, who is also an arbitrator, gave the Council until Jan. 29 to amend the administrative code. If it failed to do so, Senior Care will “no longer be an offering,” he wrote.
‘Fiduciary failures’
But the president of the NYC Organization of Public Service Retiree, Marianne Pizzitola, has insisted that the Council is not bound by any of Scheinman’s conclusions, calling it an opinion and not an order. The Council, she said at the hearing, does not have to adhere to “the deadline that’s being forced down your throat,” adding that city officials had “misrepresented” Scheinman’s report.
As she and others have since the planned Medicare switch was first publicized in 2021 during the de Blasio administration, Pizzitola, a retired EMT, has argued that Medicare Advantage plans are vastly inferior to traditional Medicare. The switch and the proposed amendment, the retirees have also said, would renege on assurances made to city workers decades ago.
“You have to remember too, that when we retired, we retired with a promise of something we would have,” Pizzitola said at the hearing.
She said that retired workers who made modest salaries when working and are now earning meager pensions cannot readily come up with an extra $200, as might the presidents of the unions pushing for the amendment.
“I don’t make a $100,000 pension and I shouldn’t be asked to do this for the sake of choice, because for me, for most of them, that’s not a choice,” she said, referring to the retirees.
True choice, she said, would come about as the result of exhaustive research on the part of city officials, which Pizzitola has claimed was not done. “The city has not done its due diligence,” she said. Among what she called “fiduciary failures,” OLR has failed to conduct exhaustive audits of enrollees.
“We’re labor,” she said. “We never believed in privatization of Medicare or health care.”
She chastised the proposed plan as merely an avenue for the union leaders to secure raises for their members. “I shouldn’t be in that position because that’s treating me like cattle,” she said.
“There’s other ways to be able to do this rather than take away people’s health insurance under the guise of giving them choice.”
Assurances don’t suffice
City officials have said switching to the Aetna plan would save the city $600 million a year and $3 billion over the next five years, given a price guarantee from Aetna. It would allow the city to continue to offer premium-free coverage both to current workers and to city retirees, which the Office of Labor Relations’ Daniel Pollak said was increasingly rare as health insurance costs for municipalities and other public entities continue to rise. He said that about half of the nation’s public-sector retirees were covered by Medicare Advantage plans.
Pollak, as administration and MLC officials have contended for months, said the Aetna plan would be equal to or better than the current traditional Medicare plan. Retiree organizations, though, have pushed back on those claims, saying that private providers’ profit motives outweigh consumers’ health concerns. Those apprehensions have been supported by proposals from federal health officials to establish new regulations that would address complaints from consumers, including that some plans could be improperly denying patients’ and doctors’ requests for care.
Claire Levitt, OLR’s deputy commissioner, sought to assuage those concerns during the hearing, saying that city officials are insisting that Aetna’s plan has built-in provisions to ensure superior quality of care. It also will include penalties should the provider not meet standards set by the city and the unions.
For instance, she said the plan would not require referrals to see a specialist. Levitt also said that pre-authorization would not be required for several procedures, including for MRIs, CAT scans and others. “Only about 1 percent of all claims will require prior authorization,” she said. Appeals processes on denials, Levitt said, would be addressed quickly and fairly, according to the working agreement being carved out with the provider.
Levitt’s claims drew sustained laughter from the retirees assembled in the Council Chambers which in turn drew admonitions from De La Rosa against interruptions. About 200 retirees would address the plan during the hearing, which lasted nearly 11 hours.
Several Council members asked to see the city’s agreement with Aetna. Pollak, though, said the agreement’s provisional status made that scenario unlikely, despite Scheinman's direction that the city and the Municipal Labor Committee reach agreement with Aetna on the plan by Monday.
In any case, Pollak said, the city needs to move forward and find ways “to achieve these vital savings." If the amendment is not enacted, he said, Senior Care would be eliminated altogether, as Scheinman also cautioned. Summarizing a finding by Scheinman, Pollak said that failure to implement a Medicare Advantage plan would “inevitably result in co-premiums” for current city employees. “That is not the outcome that the city or the MLC want,” he said.
Under questioning from Council Member Joann Ariola, Pizzitola said she would be willing to sit down with the MLC to discuss alternate funding streams. “We’ve come up with ideas, because you know what, our retirees are attorneys, former OLR, retired OCB,” she said, referring to the city’s Office of Collective Bargaining. “I mean, we ran this city.”
May 6, 2010
Judge blocks NYC from charging retired city workers $15 co-pays in latest Medicare setback for Adams
By Chris Sommerfeldt
New York Daily News

Jan 11, 2023 at 6:14 pm

A Manhattan judge ordered Mayor Adams’ administration Wednesday to immediately stop charging retired city workers $15 co-pays for doctors’ visits.

The ruling from Manhattan Supreme Court Justice Lyle Frank marks the latest in a long string of health insurance setbacks for Adams’ administration, which has tried unsuccessfully for over a year to shift the city’s 250,000 retirees into a controversial, cost-cutting Medicare Advantage Plan.

The co-pay case is separate from the Advantage dilemma, but also pertains to how the city bankrolls health care for retired municipal workers.
Last January, the $15 co-pay was imposed on retirees benefiting from city-backed Medicare plans — a charge the administration estimated would allocate significant savings at a time that it is scrambling to address gaping budget deficits and skyrocketing health care costs.

But the NYC Organization of Public Service Retirees, which has been engaged in several health care-related court battles with the administration in the past year, filed a lawsuit in November alleging the co-pay would violate a local law that requires the city to provide its retired workers with cost-free coverage for life.
RBK2WKDNW5F5FHMF7EJGENGRXI.jpgRetired city workers are pictured marching near Brooklyn Borough Hall to call on Mayor-elect Adams to preserve their Medicare coverage. (Luiz C. Ribeiro/for New York Daily News)
In a ruling Wednesday afternoon, Frank said the retiree group’s argument is “highly likely to succeed” before his court and issued a preliminary injunction against the administration barring it from charging the $15 levy as the case moves forward.
“The co-payments are being made by retirees, most of whom likely are on fixed incomes and with modest means,” Frank wrote in the six-page decision, adding that the charge could cause “irreparable harm” to retirees “should they have to prioritize other costs over their health care.”
Adams spokesman Jonah Allon said the administration is “extremely disappointed” with Frank‘s ruling.
“We will appeal this decision and seek a stay,” he said.

Steve Cohen, an attorney for the retiree organization, called Frank’s ruling “a major win” and tied it to the battle over Medicare Advantage, which his clients have also sued the city over.
“Again, retirees were promised certain benefits, and again the city chose to ignore those promises,” Cohen told the Daily News. “We are grateful to Judge Frank for reading the contract carefully.”
[ NYC pols, retired city workers blast Mayor Adams’ health insurance proposal ]
The ruling comes as Adams continues his push to enroll retirees in Medicare Advantage.

The mayor has maintained Advantage would provide retirees with robust coverage while also saving the city as much as $600 million per year — a critical cushion against budget deficits that his administration estimates could grow as large as $6 billion in coming years. His administration’s plan would provide Advantage to retirees for free, while offering them the option of staying on traditional Medicare if they pay a monthly $191 premium.
But thousands of retirees have balked at that proposal.

They say Advantage would destroy their benefits, pointing to federal studies showing that the plans — which are administered by private companies — can result in delays or denials of “medically necessary” care. They also say the $191 opt-out fee would violate city law.
Two courts have sided with the retirees, ruling the city can’t implement the plan with the $191 penalty attached due to the same law Frank cited in Wednesday’s ruling.

Adams has as a result turned to the City Council, asking it to amend that law in such a way that the penalty would become legal.
At a contentious hearing on the matter this week, Council members seemed skeptical of Adams’ proposal and several voiced outright opposition to it.

“Our retirees deserve the retirement benefits and health care benefits that they were promised, and it is our job as their elected officials to make sure that remains intact,” Republican Queens Councilwoman Joann Ariola said Monday.
May 6, 2010
HeyJoe said:
do those critical of marianne the voice of the retiree organization prefer no challenge and resistance. do they suggest we just roll over and stay silent like unions did and just accept what the city and unions are attempting to do to retirees and future retirees?.... because that aint happening ,and its either maryanne or nobody.

do they want her to fail and nyc and mlc to succeed. do they agree and accept accept that advantage is equal to or better then govt medicare or that it is dimished.
the mlc the city or the unions are telling us its equal or even better , but we all know its dimished .and we all know its a big lie, and liers have no credibility.

and if union or retiree benefits are being diminished shouldnt well compensated union leaders fight to preserve them ,
so there would be no need for volunteers like marianne and her organization . retirees, active ,and retiree groups have had to fight for themselves out of their own pocket .

"marianne has a clear agenda here. she is creating a spot for herself."....yes her agenda is very clear and it is to maintain government medicare for all retirees and future retirees.
creating a spot for herself i dont know about that. but if she is she clearly deserves one as she has invested much time and energy and achieved success .

she has had legal success where the city the mlc and the unions have had none. remember these fools were the ones who agreed to 11% over 7 years, or 1.5 % per year
and also surrended 1 billion from the stabilization plus got the city 600 mil a year....for a diminshed health benefit, for both retired and active for the rest of their lives .

who here would make that deal. and what would you think of those who did. should unions just agree to fund current worker contacts on the backs or retirees as well as current who will be retirees . because this opened that door wide open. and if those responsible are not held accountable whats to prevent a repeat.

weak leadership does not deserve to be rewarded. its not the responsibility of the mlc or its unions or their retirees to fund raises. its the sole responsibility of nyc .
and all union leaders should know that ,and if they dont they dont belong there. because thats losing strategy and its not a road they should ever want to do down.

our unions can and do make the argument that they were bullied by the mlc and its structure. and that is legitimate and we all understand that. but what we dont understand nor accept is how they bowed to the mlc. why didnt they speak out early and often telling both active and retirees we think this is wrong and we are totally against it.

the answer can only be because they dont think its wrong and they are not against it . they never encouraged active members or retirees to join the retirees organization,
or to attend any rally or protest, or to contact the city council, or the nyc comptroller, or the mayor.

they never once said your benefits are being dimished and we encourage both retired and active to organize and resist,only because they wanted no resistance at all.
and the only reason why can be they saw benefit in the form of possibly more timely and more generous contracts as well as gain sharing, and that was what motivated them to remain silent.

they are there to be our watchdogs. instead they chose to be lapdogs for the city and the mlc.
some unions claim the bully mlc abused them and maybe they did. but they then continued to stand by the bullies side and allow them to bully others.

and so maybe the unions werent really bullied at all.
and its nothing more then a weak defense, because thats really all they got. they can just take cover and hide behind the mlc voting structure.

in the beginning if by chance they didnt know what they were agreeing to eventually they had to know. but now all its all very clear to all .
they initially sided with the law breakers. and when they became aware the city and mlc were indeed law breakers they still continued to support them.

and in doing so they chose to abandon those who needed their voice and representation from the day this sellout was introduced.and so given a choice between nyc ,mlc, and unions,
or marinanne and the organization its no contest . we dont expect our unions to always win .but we expect them to fight and do whats right. and in this case they have done neither.

marianne and the the organization have always fought and won . while the unions who chose not to fight for their retirees and active have only lost.
and its only right and just.

May 6, 2010
I want what I was promised when I raised my right hand & signed on...... ......I know the college requirement was changed in midstream but this health plan business is much, much, more serious & should not be altered !........also any young Brothers who think they can worry about it "down the road" should realize how fast you move "down the road" & how many things happen to your body that you never envisioned or thought that it would only happen to the other guy.
Feb 9, 2018
I want what I was promised when I raised my right hand & signed on...... ......I know the college requirement was changed in midstream but this health plan business is much, much, more serious & should not be altered !........also any young Brothers who think they can worry about it "down the road" should realize how fast you move "down the road" & how many things happen to your body that you never envisioned or thought that it would only happen to the other guy.
May 6, 2010

We thank the retiree who sent us this response from the Comptroller's office.

From: Community Action Center <>
Sent: Wednesday, May 17, 2023 5:00 PM
Subject: Aetna Medicare Advantage Contract

Good Afternoon,

Thank you for reaching out to the Comptroller’s office to share your concerns about the Administration’s decision to transfer New York City retirees to Medicare Advantage health plans managed by Aetna.

Comptroller Lander is concerned that Medicare privatization will lead to worse health outcomes, and he does not like the approach of balancing the City’s budget by diminishing retiree health care.

However, the Comptroller’s office’s authority in regard to contract registration is limited by the City Charter to ensuring that the procurement process followed all the relevant laws and regulations. The Comptroller’s Bureau of Contract Administration is currently conducting a rigorous review of the procurement process for the City’s Medicare Advantage contract with Aetna, and has until June 9 to register or return the contract to the Mayor’s Administration.

During this process, our office will ask a series of detailed questions of the Office of Labor Relations (OLR). While the Comptroller’s office may only decline to register a contract based on procurement rules, we will nonetheless ask the OLR to answer questions and concerns we have received from retirees regarding the care experience, prior authorizations, pre-existing conditions, and cost savings.

In addition, it is important to note that the Charter empowers the Mayor to deem contracts registered, even if the Comptroller declines to register the contract – in which case the contract still goes into effect.

We will keep you posted on the results of our office’s review of the contract. Thank you, as always, for your feedback and your service to our city.


Ricky M. Da Costa
Deputy Comptroller for Public Affairs
Office of New York City Comptroller Brad Lander
1 Centre Street, RM 530, New York, NY 10007

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Retired Lieutenants Association NYPD | 266-19 Hillside Avenue, Floral Park, NY 11004
May 6, 2010


we also note that the court pushed back the city's deadline to opt out to July 10, 2023
more when it is published​
NEW YORK, NY 10007


OLR Has Informed City Comptroller He Had No Statutory Basis for Declining to Register Medicare Advantage Contract Last Week
NEW YORK – The New York City Office of Labor Relations, under the Adams administration, today announced that it has deemed the Medicare Advantage contract registered, allowing implementation of the plan to move forward effective September 1st of this year. This step was taken after the two agencies informed the New York City Comptroller’s Office that they did not have any statutory basis for declining to register the contract, as required under the City Charter, and because failing to register the contract only increases confusion and misinformation among retirees regarding Medicare Advantage.

“As we’ve said repeatedly, this Medicare Advantage plan improves retirees’ current plans, including offering a lower deductible, a cap on out-of-pocket expenses, and new benefits, like transportation, fitness programs, and wellness incentives,” said New York City Mayor Eric Adams. “We are clearly within our authority under the charter to deem this contract registered, and we look forward to working with Aetna to ensure a smooth transition to the plan for our city’s eligible retirees and their dependents come September 1st.”

The city’s Aetna Medicare Advantage plan will provide a lower deductible for retirees than their current Senior Care plan. The plan also places a cap on out-of-pocket expenses and offers new benefits to retirees, including transportation to certain doctors’ appointments, fitness programs, and wellness incentives. Additionally, the plan significantly limits the number of procedures requiring prior authorization.

The city is working with Aetna to ease the transition to the new plan and answer any questions from eligible retirees. Aetna has built a custom website specifically for City of New York retirees. The website has resources for retirees to look up their doctor, find out detailed information about their plan, and register for online and in-person information sessions. Retirees can also contact Aetna’s dedicated call center at 855-648-0389 (TTY: 711), Monday to Friday, from 8:00 AM to 9:00 PM. Additionally, Aetna has held a series of in-person town hall meetings in the New York metro area and other states with high Medicare-eligible retiree populations to answer retirees’ questions and assist them with the transition.


Office of The Mayor, City of New York · City Hall, New York, NY 10007
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Retired Lieutenants Association NYPD | 266-19 Hillside Avenue, Floral Park, NY 11004​