City Coverage For Medicare
In order to maintain maximum health benefits, it is essential that you join Medicare Part A and Part B at your local Social Security Office as soon as you are eligible. If you do not join Medicare, you will lose whatever benefits Medicare would have provided. Read More
The Citys Health Benefits Program supplements Medicare but does not duplicate benefits available under Medicare. Medicare-eligible members must be enrolled in Medicare Parts A and B in order to be covered by a Medicare HMO plan. To enroll in Medicare and assure continuity of benefits upon becoming age 65, contact your Social Security Office during the three-month period before your 65th birthday. In order not to lose benefits, you must enroll in Medicare during this period even if you will not be receiving a Social Security check.
If you are over 65 or eligible for Medicare due to disability and did not join Medicare, contact your Social Security Office to find out when you may join. If you do not join Medicare Part B when you first become eligible, there is a 10% premium penalty for each year you were eligible but did not enroll. In addition, under certain circumstances there may be up to a 15-month delay before your Medicare Part B coverage can begin upon re-enrollment.
If you or your spouse are ineligible for Medicare Part A although over age 65 , contact us at:
NYC Health Benefits Program22 Cortlandt Street, 12th FloorNew York, NY 10007
How To Reach The Uft Welfare Fund
Specialists at the UFT Welfare Fund are available to take your call at 212-539-0500 Monday through Friday from 10 a.m. to 6 p.m.
You will be asked for specific identifiers, including your Social Security number or Welfare Fund Alternate ID number, which the Fund has on file. The specialist will then be able to assist you with any questions or needs. The federal privacy law governs all Welfare Fund operations so that members need not fear providing their information to fund representatives .
Changes In Family Status
Retirees should report all changes in family status. Read More
Retirees should report all changes in family status to the NYC Health Benefits Program within 30 days after the event. Changes include adding a dependent due to marriage, domestic partnership, birth or adoption of a child, and to drop dependents due to death, divorce, termination of domestic partnership, or a child reaching an ineligible age. If a covered dependent loses eligibility, that person may obtain benefits through the COBRA Continuation of Benefits provisions.
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A Message From Comptroller Thomas P Dinapoli
You already know that you will continue receiving a retirement benefit for the rest of your life. Now, I want to make sure you know about other benefits you may be entitled to receive and the services we provide retirees.
This guide has been developed to help answer questions you may have about your benefits and services. It also addresses the responsibilities you have as a retiree. Please keep it handy as a reference.
I also encourage you to register for Retirement Online, a convenient and secure way to review your benefits and conduct transactions in real time. In many cases, youll be able to use Retirement Online instead of mailing forms or calling NYSLRS. Retirees can view their benefit information, update contact information, view and update beneficiaries and generate a pension verification letter. Learn more about Retirement Online.
Remember, our experienced staff is available to assist you with any concerns or questions you may have.
Sincerely,
Medicare And Retiring Employees
At retirement, employees who have chosen Medicare as their primary plan or whose dependents have not been covered on their plan because their spouse/domestic partner elected Medicare as the primary plan may re-enroll in the City health benefits program. This is done by completing a Health Benefits Application and submitting it to their agency health benefits, payroll or personnel office. Also at retirement, Medicare-eligible employees for whom the City Health Benefits Program had provided primary coverage are permitted to change health plans effective on the same date as their retiree health coverage.
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Irmaa Or Medicare Part B Reimbursements
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 during the 3rd week of October 2022.
Required Documentation For Dependent Changes
Learn what kind of documentation you are required to submit. Read More
If you are including a spouse on your coverage, and you have been married for more than one year, you must submit a Government issued Marriage Certificate AND Federal Tax Return from the last two years, OR Proof of Joint Ownership issued within the last six months such as a mortgage statement, lease agreement, utility bills, bank statement, credit card statements and property tax statements. If you are including a domestic partner on your coverage, and you have been registered for more than one year, you must submit a Government issued Certificate of Domestic Partnership AND Proof of Joint Ownership issued within the last six months such as a mortgage statement, lease agreement, utility bills, bank statement, credit card statements and property tax statements.
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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.
Uft Welfare Fund Offices Are Open
The UFT Welfare Fund is open with full services, and our health benefit representatives are here to assist you during our office hours of Monday through Friday from 10 a.m. to 6 p.m. If you require assistance, please call our main number at . To request a health benefits form, please call our hotline at .
You can also use the following email addresses to contact the Welfare Fund:
- For prescription drug assistance,
- For COBRA assistance,
- For assistance with our dental benefits,
- For assistance with all other health benefit issues,
Should you require immediate assistance with a prescription drug issue outside of office hours, please call Express Scripts at .
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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.
Weekly New York Education
Delivered every Monday by 10 a.m., New York Education is your guide to the weeks top education news and policy in Albany and around the Empire State.
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By KATELYN CORDERO and MADINA TOURÉ
10/31/2022 10:00 AM EDT
Good morning and welcome to the Monday edition of the New York Education newsletter. We’ll take a look at the week ahead and a look back at the past week.
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Choosing A Health Plan
Contact all the plans in which you are interested for benefits packages and provider directories. To select a health plan that best meets your needs, you should consider at least four factors:
Coverage – The services covered by the plans differ. For example, some provide preventive services while others do not cover them at all some plans cover routine podiatric care, while others do not.
Choice of Doctor – Some plans provide partial reimbursement when non-participating providers are used. Other plans only pay for, or allow the use of, participating providers.
Convenience of Access – Certain plans may have participating providers or centers that are more convenient to your home or workplace. You should consider the location of physicians offices and hospital affiliations.
NOTE – Double City Coverage ProhibitedIf a person is eligible for the City program as both an employee/retiree or a dependent, the person must choose one status or the other. No person can be covered by two City health contracts at the same time. Eligible dependent children must all be enrolled as dependents of one parent. If either spouses or domestic partners are eligible and one is enrolled as the dependent of the other, the dependent may pick up coverage in his or her own name if the others contract is terminated.
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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/7 Telemedicine Program With Teladoc
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.
Important Update On The Nyc Medicare Advantage Plus Plan For Retirees
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.
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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.
Waiver Of Health Benefits
Every employee or retiree eligible for City health benefits must either enroll for coverage or waive membership. Read More
Every retiree eligible for City health benefits must either enroll for coverage or waive membership by completing the appropriate sections of the Health Benefits Application. Those who waive or cancel City health plan coverage and subsequently wish to enroll or reinstate benefits will not have coverage until the first of the month following 90 days after the Health Benefits Application is processed, unless the retiree has lost other coverage.
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Manhattan Judge Strikes Down Nyc’s Plan To Force Retired City Workers To Pay To Keep Insurance They Were Promised For Life
NEW YORK — There was a major victory Thursday for 250,000 retired city workers.
A Manhattan judge struck down New York City’s plan to alter their health benefits and make them pay to keep the the insurance they were promised for life. CBS2’s Marcia Kramer first exposed the city’s efforts to disenfranchise its workers last year.
A handful of retired workers stood outside the gates of City Hall to bask in the glow of a hard won, David-over-Goliath victory over former Mayor Bill de Blasio and his successor Eric Adams.
“You know, there’s an expression that you can’t fight city hall. They did and they won,” retirees’ lawyer Steve Cohen said.
Cohen was referring to a decision by Manhattan Supreme Court Judge Lyle Frank that prevents the city from pulling a bait and switch with the health insurance of 250,000 retirees. The city wanted to switch them to a less expensive program or force them to pay nearly $1,200 a year to keep their old insurance.
The judge said that while the city could offer the less expensive program, it couldn’t charge people to stay in the old program because they were promised health benefits for life.
In his ruling, the judge said the city “is permanently enjoined from passing along any costs of the New York City retirees’ current plan to the retirees.”
“Good, quality, free medical insurance is a human right for everyone,” retiree Gloria Bram said.
- In:
Nyc Health Benefits Program
On May 4, 2020 the Employee Benefits Security Administration in the Department of Labor and the Internal Revenue Service issued a Joint Notice providing new guidance on delays due to COVID-19 affecting all health and retirement plans, with implications for governmental plans.
The Joint Notice designates a period of time, called the “Outbreak Period,” that begins on March 1, 2020 and ends 60 days after the announced date of the end of national emergency related to COVID-19 or such other date announced by EBSA and IRS. Thus, the end date of the period is currently unknown.Changes In Family Status – Adding/Dropping Dependents.
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Incorrect Deductions From Your Pension Check
Please review your health deduction carefully to be sure the amount is correct. If the deduction is incorrect, you must contact the NYC Health Benefits Program within 30 days. Adjustments will be made accordingly. Otherwise, the deduction will be deemed as accurate.
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:
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City Council Must Enable Budget
Mayor Eric Adams speaks at City Hall about signing bills to aid maternal health, Aug. 29, 2022.
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.
Mayor Eric Adams is giving employee unions and the City Council an ultimatum, aiming to end a standoff over retirees health insurance that could cost the city budget billions.
The Council must either allow his administration to switch retired city workers to a private Medicare Advantage plan, with an option to opt out for a price, or the Adams administration will unilaterally discontinue all health insurance plans that currently cover retired city workers and replace them with a Medicare Advantage plan, according to a letter sent Friday by Office of Labor Relations Commissioner Renee Campion.
The administration says it will pull the plug on the current insurance plans unless the City Council immediately comes up with a gameplan this week to pass legislation allowing the city to charge retired city workers for the insurance that they currently get for free.
The city had planned to save an estimated $600 million a year, largely by tapping into federal subsidies for Medicare Advantage all part of a cost-saving program negotiated between unions and former Mayor Bill de Blasio.
