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NYC Health Benefits Program
The NYC Medicare Advantage Plus Plan, a Custom Program for City Retirees, Beginning January 1, 2022
The City and the Municipal Labor Committee selected an alliance between Empire BlueCross BlueShield and Emblem Health to provide the NYC Medicare Advantage Plus Plan to retirees and their eligible dependents. The NYC Medicare Advantage Plus Plan is a Medicare Advantage plan which is an alternative to the traditional Medicare program. It will replace the current Senior Care program, which is a supplement to traditional Medicare, as the program that is free to all retirees. Retirees will automatically be enrolled in the new NYC Medicare Advantage Plus Plan with an effective date of January 1, 2022. Retirees will have the ability to opt-out of the NYC Medicare Advantage Plus Plan and buy up to and remain in the health plan they are currently a member of during September and October before the program start date.
- View the NYC Medicare Advantage Plus Plan Enrollment Guide for Senior Care Members
- View the NYC Medicare Advantage Plus Plan Opt-Out Form for Senior Care Members
- View the NYC Medicare Advantage Plus Plan Enrollment Guide for Non-Senior Care Members
- View the NYC Medicare Advantage Plus Plan Opt-Out Form for Non-Senior Care Members
- View the Plan Design Comparison to Aetna Plan for NY, NJ and PA: General
- View the Plan Design Comparison to Aetna Plan for all other areas: General
- View the Plan Design Comparison to Cigna
- View the Plan Design Comparison to Eldercare
- View the Plan Design Comparison to Empire Mediblue Freedom PPO & Empire Medicare Related
- View the Plan Design Comparison to HIP VIP
- View the Plan Design Comparison to Humana HMO
- View the Plan Design Comparison to GHI/EBCBS Senior Care Plan
- View the Plan Design Comparison to United HealthcareMedicare Advantage HMO (union and non union plans)
Retiree Responsibilities and Assistance
IRMAA or Medicare Part B Reimbursements Learn More
Medicare Part B 2020 Reimbursement
Medicare Part B 2020 reimbursements were issued in April 2021. Please check your bank account/statement (or the mail, if you are receiving a physical check) 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
Medicare Part B 2019 differential reimbursements were issued in March 2021. Please check your bank account/statement (or the mail, if you are receiving a physical check) for your payment.
- For those retirees/eligible dependents who are not eligible for IRMAA, Medicare Part B 2019 differential payments up to $318 will be issued once the Medicare Part B and IRMAA payments are processed in calendar year 2020.
- Those retirees/eligible dependents who are eligible for 2019 Medicare Part B differential reimbursements must submit the Medicare Part B 2019 Reimbursement Differential Request Form, along with required documentation.
- Please submit this form, along with all required documents, electronically to: https://nycemployeebenefits.leapfile.net
IRMAA 2020 reimbursements will be issued in October 2021.
- If you are currently receiving your pension check through Electronic Fund Transfer (EFT) or direct deposit, your reimbursement will be deposited directly into your bank account. This is separate from your pension payment. If you don’t have EFT or direct deposit, you should receive a check in the mail.
- Please submit the IRMAA 2020 Reimbursement Application, along with all required documents, electronically to: https://nycemployeebenefits.leapfile.net
IRMAA 2019 Reimbursement
IRMAA 2019 reimbursements were issued during October and November 2020. Please check your bank account/statement (or the mail, if you are receiving a physical check) for your payment.
- If you are currently receiving your pension check through Electronic Fund Transfer (EFT) or direct deposit, your reimbursement was deposited directly into your bank account. This is separate from your pension payment. If you don’t have EFT or direct deposit, you should have received a check in the mail.
- If you did not receive your IRMAA reimbursement by December 1, 2020 or if you did receive the reimbursement and you believe the amount is incorrect, you must resubmit the IRMAA 2019 Reimbursement Application.
- Please submit this application, along with all required documents, electronically to: https://nycemployeebenefits.leapfile.net
IRMAA 2019 Differential Reimbursement
IRMAA 2019 Differential payments were issued at the end of November 2020.
- For those retirees/eligible dependents of a retiree with a Medicare Part B effective date prior to 2016, they received an additional amount up to $318.
The Medicare Part B Reimbursement Program video provides information about the different types of Medicare Part B reimbursements that the City provides, as well as information to help you to see whether you qualify to receive these payments, and how to apply.
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 is based on the amount that you paid in 2019.
If you are applying for IRMAA, you will be receiving the differential payment once IRMAA 2019 payments are processed in October 2020.
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.
Your Responsibilities
It is important that you know how your health plan works and what is required of you. Read More
Here are some important things that you need to remember:
- Complete an enrollment form to add new dependents (newborn, adoption, marriage) within 30 days after the event;
- Notify the NYC Health Benefits Program and your health plan in writing when your address changes;
- Review your pension check to ensure appropriate premiums are deducted;
- Know your rights and responsibilities under COBRA continuation coverage.
If You Need Assistance
Who you should contact for assistance and when you should contact them. Read More
Retirees with questions about benefits, services, or claims should write or call their health plan.
When writing to the plan, give your certificate number, name and address.
The Health Benefits Program is also available to provide service and information to City retirees who have questions about or problems with their health benefits or pension check deductions.
Retirees contacting the Health Benefits Program should always include the following information (please print clearly):
Name, Address and Telephone Number
Complete Social Security Number
Pension Number
Inquiries and questions can be emailed to healthbenefits@olr.nyc.gov
Who Do I Contact After Retirement?
Find out who you should contact after retirement. Read More
Retirees can contact the Health Benefits Program:
- For questions concerning eligibility and enrollment
- For questions regarding deductions for health benefits taken from your pension check
- For Transfer Period information
- To obtain applications to make changes to your coverage such as adding/dropping dependents, adding/dropping the optional rider, waiving health coverage and to change plans (excluding Medicare HMOs, which require a special application from the health plan).
- For notification of enrollment in Medicare
- For questions regarding Medicare Part B premium reimbursements
- 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
When Should I Contact My Health Plan?
Find out when you should contact your Health Plan.Read More
(Refer to your health plan identification card or plan booklet for telephone numbers.)
- 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 (How much will a plan pay towards a claim?)
- For health plan service areas
When writing to a health plan, include your name and address, certificate number, date(s) of service, and claim number(s), if applicable. Some plans also allow inquiries through their web sites.
When Should I Contact My Union/Welfare Fund?
Find out when you should contact your Union/Welfare Fund.Read More
For information about:
- Prescription drug coverage (if applicable)
- Vision benefits
- Dental benefits
- Life Insurance (if applicable)
The Health Benefits Program is also available to provide service and information to City retirees who have questions about or problems with their health benefits or pension check deductions.
Retirees contacting the Health Benefits Program should always include the following information (please print clearly):
Name, Address and Telephone Number
Complete Social Security Number
Pension Number
Inquiries and questions can be emailed to healthbenefits@olr.nyc.gov
