Our Healthcare
Visit our Latest Developments Page for the latest Up-to-date information on the Litigation.
COPAYS
You do not pay a copay until you meet your deductible. Print this letter and bring to your doctor if they ask before you meet your deductible.
Class Action CoPay Case Settlement Details
First, stop listening to your former union or knuckleheads on the internet.
We are distributing OFFICIAL information on this process since WE negotiated it. The official forms and instructional videos are coming soon! There is NOTHING for you to do at this time.
DO NOT call Emblem, and you DO NOT NEED EOBs.
In 21 days, the selected class action administrator, Atticus, will develop a portal and website for us to file our claims. You, the Medicare retiree on Senior Care, must have been on Senior Care in 2022, to be eligible, and incurred copays for medical visits. You will receive a personalize letter in the mail from them listing all of your medical visits during the claim period of January 1 2022 - January 31, 2023. If you had a visit that was not billed through Medicare/Emblem, it does not qualify. You will be required to submit a timely claim, no later than 60 days from the date of that Notice, so be prepared to move on it! All claim forms must be postmarked by that date.
Any class member may request that they wish to be excluded from the Class, and that must be sent to the Claims Administrator no later than 45 days after the date of Notice.Claim forms will also be mailed. If your Notice does not include a claim form, it is because you are not eligible for copays, but remain a class member due to being in the plan during the claim period. (You had no copays).
A custom claim form will list all your potential copays from claims that were processed through Emblem. To be eligible for reimbursement, you must submit that claim timely, online or by mail. We will publish the date after the Notice is sent and guide you through that process.
Any Class Member whose claim is determined to be valid by the Claims Administrator will be eligible to receive up to full reimbursement of all co-pays for which proof of payment is submitted in accordance with the guidelines.
If you submit a valid claim for a co-pay but do not submit proof of payment for that co-pay, you may still be eligible for a partial reimbursement of such an “undocumented” co-pay, if you simply affirm that you actually paid the co-pay.
Any partial reimbursement for undocumented co-pays will be limited to up to 40% of the co-pay amounts incurred, up to a maximum of $100 per Class Member. (about 7 copays equivalent)
Proof of Payment Documents — Required To Be Eligible For Up To Full ReimbursementTo be eligible for up to full reimbursement for any or all of the $15 co-pay(s) listed on your Claim Form, you must submit proof of payment of each co-pay.
Acceptable proof includes a receipt, cancelled check, bank statement, credit card statement, or a written letter from the provider confirming that you paid the co-pay (use the provider form letter attached to your Claim Form). Any proof of payment you submit must be substantially consistent with Emblem’s data provided on the Claim Form.
The forms and videos are coming soon! There is NOTHING for you to do at this time. DO NOT call Emblem, and you DO NOT NEED EOBs. Be patient!
Why is Traditional Medicare is Better than Medicare Advantage?
Freedom of Choice
With Traditional Medicare, you have the freedom to choose any doctor or hospital that accepts Medicare, whereas Medicare Advantage plans often have limited provider networks.
01
Predictable Costs
Traditional Medicare typically has more predictable out-of-pocket costs, such as deductibles and copayments, compared to Medicare Advantage plans, which may have varying costs depending on the services you use.
02
Rare Prior Authorization
Traditional Medicare allows you has rare prior authorizations so you get the treatment and tests your doctor wants you to have. You don't have a for profit insurance company making that medical necessity decision like exists in Medicare Advantage.
03
Nationwide Coverage
Traditional Medicare provides coverage nationwide, making it convenient for retirees who travel or reside in different states for part of the year, while Medicare Advantage plans may have restrictions on coverage outside their service area.
04
Retirees and Active Employees: Preserving Healthcare Benefits:
We understand the significance of healthcare benefits, especially as you transition into retirement. It's crucial to make informed decisions to safeguard your well-being. Explore why Medicare Advantage might not be the optimal choice through our in-depth video "Health Care Facts They Don't Want You to Know!"
Protecting Your Future
Your active involvement in understanding and advocating for your benefits is paramount. Learn about the evolution of our Health Program since the inception of Medicare, gaining insights into the historical context and implications for current and future retirees.
How did the Union Let Us Down?
Betrayal of Trust:
Retirees were promised continued healthcare benefits into retirement, as stated in collective bargaining agreements, but union leaders may have disregarded these promises by making side deals that compromise retirees' benefits.
Prioritization of Active Workers:
Union leaders may have prioritized benefits for active workers over retirees, incorporating agreements into contracts that strip away healthcare benefits from retirees to benefit active workers, leading to a shift in funds from healthcare to raises and budget shortfalls.
Loss of Options and Protection
Retirees have lost their insurance options and union Protection, making them vulnerable to decisions made by active workers and union leaders. The lack of representation prevents retirees from having a say in contracts or voting on union officers, further exacerbating their situation.
Misrepresentation of Retirees' Impact on Benefits:
Retirees are unfairly blamed for potential loss of benefits by active workers, despite city law requiring equal health coverage at the same cost for retirees. The Municipal Labor Committee, under certain leadership, allowed retirees to be forced into managed healthcare and removed from federal health benefits like Medicare, further exacerbating their plight.
Our Experience as Retirees:
As retirees, we've walked the same path you're on now. We were once dedicated union members who fought for our rights through collective bargaining agreements. However, recent developments have posed challenges to the continuity of our healthcare benefits, prompting us to advocate for preservation.
Get Involved:
Engage with the issues at hand by exploring Collective Bargaining and Health Savings Agreements. These documents offer a detailed understanding of the decisions impacting your benefits.
Stay Informed:
Listen to RTC Meeting Audio Clips and watch video explainers for a comprehensive understanding of the ongoing challenges. Stay engaged by contributing through donations and subscriptions, ensuring the continuity of advocacy efforts.
Faces of Retirees
Meet retirees who are directly impacted by recent developments. Their personal stories provide valuable perspectives on the realities of navigating healthcare as retirees, highlighting the importance of collective advocacy.
In Conclusion:
As you navigate your career and prepare for retirement, remember that healthcare benefits are a crucial component of your overall financial security. By staying informed, engaged, and proactive, we can collectively ensure the preservation of healthcare benefits for retirees and future employees alike.
