New York City is close to getting more than 250,000 retired city employees into its new health plan. The planned switch of retirees from their current Medicare plans to a fully privatized plan called Medicare Advantage has come a long way since it was proposed in an agreement between the city’s unions and the administration of former mayor Bill de Blasio. It receives constant backlash from retirees in the department. savings. In the latest turn of the saga, the city council plans to consider legislation to allow retirees to opt out of Medicare Advantage and keep their current insurance, but at a cost of about $200 a month.
Here’s what you need to know about drawn disputes.
Why is the city proposing this switch?
New York City employees and their dependents have had health insurance long after retirement. When retirees become eligible, they enroll in traditional Medicare, but the city also fully subsidizes the popular supplemental coverage plan offered by Emblem Health and known as Senior Care.
But New York City and its union had to find savings due to rising medical costs. The fund that covers insurance premiums and other benefits, jointly managed by the city and the union, is running out. It is called the Joint Health Insurance Premium Stabilization Fund. The city and the City Labor Board, the governing body of the city’s union, agreed in 2018 to find significant savings in the city’s health care costs, including $600 million in regular savings. . One option in that agreement that the city and union decided to pursue was to switch retirees to Medicare Advantage, an alternative to traditional Medicare provided by private companies contracted by the federal government. Thing. Plans tend to have lower premiums, but can also have a narrower network and higher out-of-pocket costs. We estimated that we could save $600 million a year because of gold.
Why are some retirees opposed to switching to Medicare Advantage?
The switch to Medicare Advantage was agreed upon by the city and unions, but many city retirees oppose the change. Although Medicare Advantage remains free, New York City’s Public Service Retirees Organization has expressed concern that retirees will have a smaller network of providers and a larger out-of-pocket expense.
It’s unclear how well the new Medicare Advantage plans will match current coverage for retirees. Details of the plan are still being negotiated with Aetna, which won a contract to provide Medicare Advantage. An arbitrator named in the original agreement between the city and the union said plans must be negotiated by January 9 for implementation this July.
Do all city retirees have Medicare Advantage?
necessarily. The city offered retirees the option to opt out of Medicare Advantage and maintain their current coverage, but said retirees would have to pay a $191 monthly fee to maintain that coverage.
Organizations for public service retirees sued the city to stop retirees from paying to keep their current coverage before the switch took effect last January. In March, a judge ruled in favor of retirees, citing a section of the city’s administrative law that requires the city to pay the full cost of health insurance for employees, retirees, and dependents. The ruling upheld on appeal ruled that the city could continue to proceed with the switch to Medicare Advantage but would force retirees to pay to keep their current coverage if they wished to opt out. If they go ahead and have to continue to cover the premiums of the large number of opting-out retirees, the city and local labor commissions will ensure that the promised health savings are met. It will be difficult to realize
The Adams administration asked the city council to amend the city’s administrative law to allow it to proceed with its original plan to switch to Medicare Advantage but allow retirees to opt out at a cost. . At the mayor’s request, Municipal Councilor Carmen de la Rosa, chairman of the Civil Service Commission, has introduced a bill to do so, which will be discussed in a public hearing in Congress on Monday. De La Rosa and her chairman, Adrienne Adams, released a statement suggesting the city was in the process of making the switch. This proposed law would stop all retirees from automatically enrolling in Medicare Advantage. “The Board is formally considering legislation to retain retirees’ health insurance choices, rather than automatically enrolling them in Medicare Advantage, as the only plan for January 29. I will,” the statement read.
A city hall spokesperson said the $600 million savings were “especially important as we continue to face a burgeoning medical crisis and other financial challenges.”
However, in the meantime, some Council member Both parties oppose amending the code, arguing that retirees do not have to pay premiums to maintain their current coverage.
Marianne Picitra, president of the NYC Public Service Retirees Organization, has urged Congress to vote down proposed legislation, calling for alternatives to choosing Medicare Advantage or paying to maintain current coverage. “We met with the Adams administration and Congressman Adams to discuss potential savings of over $300 million without overburdening the hundreds of thousands of retirees who have kept New York City alive for decades. I am pleased to outline the
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