Nyc Office Of Labor Relations Health Benefits Program

Date:

Important Update On The Nyc Medicare Advantage Plus Plan For Retirees

Labor Power Players: Commissioner Renee Campion, NYC OLR

EmblemHealth remains committed to supporting you and providing the New York City workforce and its retirees with high-quality coverage.

All City of New York retirees will continue to remain in their current plans until we are informed of any changes by the City of New York and Municipal Labor Committee.

As more information becomes available, we will continue to update this page. Read more updates here.

If You Need Assistance

Who you should contact for assistance and when you should contact them. Read More

Contact your agency health benefits or payroll office or NYCAPS Central at 487-0500. Department of Education employees should contact HR Connect at 935-4000:

  • For questions concerning eligibility and enrollment
  • For questions regarding deductions for health benefits
  • For Transfer Period information
  • To obtain a Health Benefits Application
  • To obtain information and an application for COBRA benefits
  • To change your address
  • If health coverage has been terminated for you and/or your dependents

Employees with access to Employee Self Service through CityShare can check their coverage status and make changes.

Coverage For Employees 65+

If you’re over 65, still working for the City and enrolled in the NYC Health Benefits Program, do not use your Medicare card when you visit your doctor’s office. Instead, be sure to use the member ID card provided to you by your current HBP health plan.

These benefits are intended to provide you and your eligible dependents with the fullest possible protection that can be purchased with the available funding.

The OLR website and the NYC Health Benefits Program Summary Program Description provide you with information about your benefits under the New York City Health Benefits Program.

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When Should I Contact My Health Plan

Find out when you should contact your Health Plan. Read More

  • If you have questions regarding covered services
  • To obtain written information about covered services
  • For information about the status of pending claims or claim disputes
  • For claim allowances
  • For health plan service areas

When writing to a health plan, include your name and address, certificate number, date of service, and claim number, if applicable. Some plans also allow inquiries through their web sites.

City Health Benefits Program Open

Crain Communications

The Citys Health Benefits Program annual Fall Transfer Period takes place from and during the whole month of . During the Open-Enrollment period, members are able to change plans, add or drop a rider, add a dependent and make other changes, which are not normally permitted during the year.

Changes made during this years Open-Enrollment period will become effective in .

If you have any questions about the Citys current Buy-Out Waiver Program, please visit the NYC Office of Labor Relations website at www.nyc.gov/olr, and refer to the Health Benefits Program section.

You can also call Active Enrollment at 6466105122 or the Office of Labor Relations Health Benefits Program at 513-0470 .

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Medicare Part B Reimbursement

The City will reimburse retirees and their eligible dependents for Medicare Part B premiums paid, excluding any penalties. You must be receiving a City pension check and be enrolled as the contract holder for City health benefits in order to receive reimbursement for Part B premiums.

For most retirees, the refund is issued automatically by the Health Benefits Program. If you are currently receiving your pension check through Electronic Fund Transfer or direct deposit, your reimbursement will be deposited directly into your bank account. This will be separate from your pension payment. If you dont have EFT or direct deposit, you will receive a check in the mail in June.

What You Need To Know To Make A Decision

TO GET YOUR QUESTIONS ANSWERED TAKE THESE STEPS IN ORDER

FAQS FROM QUESTIONS ASKED AT CHAPTER AND INFORMATION MEETINGS

ENROLLMENT GUIDES

In response to a Temporary Restraining order, the New York City Office of Labor Relations changed the opt out and enrollment dates to the end of March. Leon E. Frank, the judge who issued a Temporary Restraining Order, determined that the original enrollment guides were inaccurate or incomplete in several areas and Instructed the City to notify all municipal retirees of errors in the original MA+ material, telling them how to obtain a corrected enrollment guide.

Below are links to the original guides:

OPT OUT FORMS

OPT-OUT CONFIRMATIONS

OPT OUT PAYMENTS

VENDOR RELEASES PRE-AUTHORIZATION LIST

NY RETIREE HEALTH RATE CHARTS EFFECTIVE JANUARY 1, 2022

If you opt out of the Alliance Medicare Advantage plan in order to continue with your current NYC health care plan, you will have to pay a monthly premium . Click here to see the rates on the NYC Office of Labor Relations website. Note that you will NOT be paying for prescription drug coverage since that is already covered by the PSC CUNY Welfare Fund.

NYC OFFICE OF LABOR RELATIONS ON RETIREE HEALTHCARE BENEFITS

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Office Of Labor Relations Health Benefits Program

When you start receiving a pension from NYCERS, you may be eligible for City-paid health insurance benefits. Health benefits are not offered or administered by NYCERS.

Please go here for videos and other information on how to apply for health benefits as a retiree, be reimbursed for Medicare Part B, and more.

Irmaa Or Medicare Part B Reimbursements

NYC plan to alter health benefits for retired city workers struck down

Information about Medicare and IRMAA Reimbursement Read More

Medicare Part B 2021 Reimbursement

Medicare-eligible retirees and their Medicare-eligible dependents will be reimbursed annually for the standard Medicare Part B amount of $148.50 per month , excluding any penalties and late enrollment fees, and subject to be pro-rated.

Medicare Part B 2021 reimbursements were issued in April 2022. Please check your bank account/statement for your payment.

If you already submitted your Medicare Part A & B card to the Health Benefits Program, this payment is automatic and you will receive it annually.

Medicare Part B 2020 Reimbursement

Medicare Part B 2020 reimbursements were issued in April 2021. Please check your bank account/statement for your payment.

If you already submitted your Medicare Part A & B card to the Health Benefits Program, this payment is automatic and you will receive it annually.

Medicare Part B 2019 Differential Reimbursement

Please note that if you were Medicare-eligible prior to 2016, you must complete the Medicare Part B Differential Form for 2019 in order to receive the Medicare Part B differential payment. The payment was based on the amount that you paid in 2019.

If you were enrolled in Medicare Part B effective after 2016, then you are already receiving the full payment and do not need to complete the Medicare Part B Differential Form.

IRMAA 2021 Reimbursement

IRMAA 2021 annual reimbursements will be issued in October 2022.

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Hundreds Of Thousands Of City Workers And Their Dependents Could Have Their Healthcare Shifted To A Cheaper Plan By 2024 Documents Show

EMTs respond to a person in distress on 125th Street in Harlem, July 20, 2021.

Ben Fractenberg/THE CITY

This story was published in partnership with New York Focus, an independent, investigative news site covering New York state and city politics. Sign up for their newsletter here.

New York City is seeking to replace the main health insurance plan that it provides to its employees with a new, lower-cost option, documents obtained by New York Focus reveal. The shift is currently only a possibility under consideration, but if it goes through, roughly 750,000 employees, retirees and dependents will have their current insurance switched to an as-yet undetermined plan.

One goal of the potential replacement is to cut costs by at least 10% without compromising the quality of care or forcing city workers to pay more out of pocket, the documents say.

The plan that currently covers most city employees and their dependents, GHI Emblem Health, began covering municipal workers under the administration of Mayor Fiorello LaGuardia in the 1940s.

On Thursday, the citys Office of Labor Relations will begin accepting submissions from health insurance companies outlining plans to replace GHI EmblemHealth. The target effective date of a new plan is Jan. 1, 2024.

Medwid did not respond to a request for comment from New York Focus.

How This Happened: The Mlc Vote And The Psc Response

This is how we reported in real time to the MLC vote and PSC response.On Wednesday, July 14, the Municipal Labor Committee voted to approve a contract with the NYC Office of Labor Relations to move city retirees, including CUNY retirees, from traditional Medicare with supplemental city insurance to a privatized Medicare Advantage plan. The transition would take effect on The PSC cast a NO vote.

The Medicare Advantage vendor is Alliance, a partnership of Empire BlueCross BlueShield and Emblem Health.

Members can choose to go into the Medicare Advantage plan or stay with traditional Medicare but would have to pay for their own suplementary insurance. Retirees 65 years and older will automatically be enrolled in the new Medicare Advantage Plus program effective , unless they affirmatively opt out. The retiree chapter, to put it charitably, is most unhappy that the City and MLC chose that the default for Medicare eligible retirees would be automatic enrollment in the Medicare Advantage plan.

You can choose to remain on your current NYC plan by opting out of the NYC Medicare Advantage Plus plan during the opt-out period , but you will have to pay a premium to stay on most of the current NYC plans. For retirees who opt out and wish to stay on the GHI/Empire BlueCross BlueShield Senior Care Supplementary plan, you will pay $191.57 a month per person and the plan will have co-pays . Premiums for other plans are on the OLR website here.

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How To Contact Olr

Employee Benefit Program client service walk-in centers remain closed to visitors. Retiree Health Benefits, the Deferred Compensation Plan, Flexible Spending Accounts Program and the Managment Benefits Fund can be reached via email. Please see below for additional information.

/7 Telemedicine Program With Teladoc

Office of Payroll Administration

With Teladoc, you can talk with a doctor within minutes rather than days or hours. Teladoc doctors can diagnose, treat and prescribe medication for non-emergency medications. This includes treatments for the flu, sore throat, allergies, stomach aches, eye infections, bronchitis, and much more. Copays are waived during the COVID outbreak. To set up your account now so you can talk with one of Teladocs board-certified doctors anytime when you don’t feel well, call 1-800-Teladoc or visit Teladoc.com/emblemhealth

View the Teladoc Registration Guide for instructions on setting up your account on Teladocs website or mobile app.

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Nyc Health Benefits Program Rate Changes

Aug 8, 2022 | The Bulletin

The New York City Office of Labor Relations has published the new health plan rates for July 2022. The new health insurance rate changes will be reflected on the Aug. 11, 2022 paycheck.

To view the new 2022 health insurance rates please go online.

Please also note, that the annual Transfer Period will be held in November this year. During that period, employees can:

Transfer to another health plan

Add or drop an optional rider

Elect the Buy-Out Waiver Program

Any changes selected during the Fall Transfer Period will become effective the first day of the first full pay period in Jan. 2023.

Tier 6 Member Vesting Update

On April 9, 2022, Governor Hochul signed Chapter 56 of the Laws of 2022 relating to the New York State budget for the 2022-2023 state fiscal year. Part TT of the 2022-2023 Budget Bill amended the Retirement and Social Security Law to lower the minimum number of years required for Tier 6 members to vest for service retirement from 10 years to 5 years of credited service.

IMPORTANT: Eligibility for Retiree City Health Benefits has NOT changed by the above Part TT of the Budget Bill. Pursuant to the Section 12-126 of the NYC Administrative Code and New York City Health Benefits Summary Program Description, below summarizes enrollment eligibility for City Health Benefits as a retiree:

  • You have at least ten years of credited service as a member of a retirement system maintained by the City or the Department of Education years of credited service as a member of a retirement system maintained by the City) OR
  • You have at least fifteen years of credited service as a member of either the Teachers Retirement System or the Board of Education Retirement System if you were an employee of the City or the Department of Education appointed on or after April 28, 2010, and held a position represented by the recognized teacher organization on the last day of paid service. Where this paragraph and paragraph both apply, this paragraph controls. AND
  • You receive a pension check from a retirement system maintained by the City or the Department of Education.
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    Retiree Health Benefits Program

    Retiree Client Service Center Update: The Retiree Health Benefits Program is happy to announce that it has overhauled its Direct Customer Service Department in order to improve the call center and re-establish the walk-in center as follows:

    Effective Immediately: Retirees can speak with a Client Service Representative between 10am and 4pm, Monday through Friday, except holidays, by calling 513-0470. Additional staff have been added to assist callers.

    Effective November 2022: The Health Benefits Retiree Client Service Walk-in Center will open in November by appointment only. It remains closed to walk-in visitors. Please check back for updates on how you can make an appointment and for further information.

    Please submit your documents as follows:

    1) Forms and documents can be submitted electronically using the following link:

    For detailed instructions on how to submit your form/document securely through LeapFile and to view a short video, click here.

    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.

    2) Forms and documents can also be mailed to:

    NYC Office of Labor RelationsHealth Benefits Program22 Cortlandt Street, 12th FloorNew York, NY 10007

    3) Forms and documents can also be faxed to: 306-7373

    Welcome City Of New York Employees And Retirees

    Department of Industrial Relations Recruitment Video

    As a City of New York employee, non-Medicare-eligible retiree or Medicare-eligible retiree, the plans listed below are available to you and your family. Sign in to get information related directly to your plan and to get plan-related updates including checking claim status and requesting ID cards.

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    Questions About Your Irmaa Or Medicare Part B Reimbursements

    Medicare Part B 2021 Reimbursement

    Medicare-eligible retirees and their Medicare-eligible dependents will be reimbursed annually for the standard Medicare Part B amount of $148.50 per month , excluding any penalties and late enrollment fees, and subject to be pro-rated.

    Medicare Part B reimbursements were issued in April 2022. Please check your bank account/statement .

    If you already submitted your Medicare Part A & B card to the Health Benefits Program, this payment is automatic and you will receive it annually.

    Medicare Part B 2020 Reimbursement

    Medicare Part B 2020 reimbursements were issued in April 2021. Please check your bank account/statement for your payment.

    If you already submitted your Medicare Part A & B card to the Health Benefits Program, this payment is automatic and you will receive it annually.

    Medicare Part B 2019 Differential Reimbursement

    Please note that if you were Medicare-eligible prior to 2016, you must complete the Medicare Part B Differential Form for 2019 in order to receive the Medicare Part B differential payment. The payment was based on the amount that you paid in 2019.

    If you were enrolled in Medicare Part B effective after 2016, then you are already receiving the full payment and do not need to complete the Medicare Part B Differential Form.

    Medicare Part B 2019 differential reimbursements were issued in March 2021. Please check your bank account/statement for your payment.

    IRMAA 2021 Reimbursement

    IRMAA 2020 Reimbursement

    Nyc Health Benefits Program

    Welcome to the Employees Benefits Program Secure File Upload. You can use this service to send documents securely. All transfers are confidential and SSL encrypted. Once you select the topic below you will be able to enter your information on the next page and to attach your document for submission to the Employee Benefits Program. Please allow 30-45 days from the day you submit your document for them to be processed. Coverage will be retroactive to the effective date of retirement. Please do not submit your forms more than once, as that will only slow down the processing of all forms.Please note: Employees should contact their agency health benefits/payroll office or 1) NYCAPS Central by Phone 487-0500 or email at nycapscentral@dcas.nyc.gov or HealthBenefits@dcas.nyc.gov or 2) Department of Education employees can contact HR Connect at 935-4000 or email: HRCONNECTBENEFAX@SCHOOLS.NYC.GOV, or 3) H + H employees can contact Shared Services at 458-5634 or email:hhcbenefits@nychhc.org

    If you are having problems uploading please see the tutorial HERE.

    Available Recipients

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    New York City Benefits

    New York City provides the Basic Medical Plan for CSA Welfare Fund and CSA Retiree Welfare Fund members. The New York City Office of Labor Relations Employee Benefit Plan web site describes eligibility for coverage and the various plans, and their associated costs, that are available.

    The cost of the basic plan and optional rider costs, for active members are listed here. Costs for retirees are listed here

    The Summary Program Description contains descriptions of all available plans and the rules for participation in the City health benefits program.

    Dc 37 Health & Security Plan Benefits

    About Us

    Important Information for DC 37 Members About to Retire

    For medicare-eligible* retirees who are eligible to receive a pension from NYCERS/BERS/TRS/NYSERS/CIRS* Medicare-eligible = age 65 and/or disability

    Eligibility

    You must be a DC 37 member, Medicare eligible, and be pension eligible under NYCERS/BERS/TRS/NYSERS/CIRS.

    City Health Insurance

    You may wish to refer to the City of New Yorks Health Benefits Program Summary Program Description booklet.

    Complete a Health Benefits Application form.

    Apply for Medicare Parts A and B at your nearest Social Security office. If you are retiring before or at the age of 65, ` apply for Medicare Parts A and B in the three months before your 65th birthday. You will not be eligible for Medicare Parts A and B until you reach your 65th birthday.

    When you retire and are age 65 or over, you must have Medicare Parts A and B to continue your City health insurance. The premium cost of Medicare Part B will be taken out of your Social Security check. When you retire, you and your eligible dependents will be reimbursed for the cost of Medicare Part B once a year.

    City of New York40 Rector Street, 3rd FloorNew York, NY 10006 513-0470

    Medicare

    Medicare is the primary health insurance for retirees age 65 or over . City health insurance is the secondary health insurance. If you are retired and receiving Medicare Parts A and B, you may choose a supplement to Medicare or a Medicare + Choice health insurance plan.

    Social Security

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