Corrected - Retirees Win Temporary Halt to Change in Medicare --- Judge calls for "rational" implementation, Public Hearing NOT Cancelled

....if the petitioners and similarly situated individuals are required to opt-in or out of a medical program by the October 31, 2021 deadline there would certainly be irreparable harm.

ATTENTION RETIREES!!!

KIM PARKER OF THE ALLIANCE, EMPIRE/ANTHEM IS REACHING OUT TO PEOPLE WHO SUBMITTED AFFIDAVITS.

DO NOT SPEAK WITH HER OR EMAIL HER.

SEND US ALL EMAILS SHE SENDS YOU, AND EMAIL US ASAP IF SHE CALLS.... NYC Organization of Public Service Retirees (for Benefit Preservation)

They are disagreeing with implementation of the plan… not the substance or the rationale.... UFT retiree

you should see the  celebration on Facebook. Like it's VE day. Don't think they grasp what the decision says.  .. A retiree

Friday, October 22, 2021, 7AM

This story broke last night and people are going hog wild. I would hold back on the celebrating over the long-term but for now it feels pretty good to see the Mulgrew/DeBlasio gang smacked down in court for such poor implementation and has ordered them to do it over. 

The Oct. 31 opt-out date is looming and assume that will be extended --- we did opt out already in three different ways (no one trusts these characters). I will reiterate that the confusion was intentional - we had to opt out of the new plan to stay  in the old plan and we had to submit papers to this brand new company that was created instead of the city -- irrational implementation as the judge stated.

Why did those who wanted to stay in Medicare (pays 80%) and Emblem/GHI Seniorcare (20%) have to be the ones to opt out? It should have been the people who wanted the new plan to be the ones to opt in. Fundamentally, few want the new plan and the major reason to take it is to avoid the extortion fee - which for us is about $4500 a year - to stay in the old plan.

There's a lot of commentary on the Retiree Advocate listserve and I will follow up with some of them interesting ones later. Here is the latest from The City --

Court Blocks Controversial Medicare Switch for Retired NYC Workers By Sam Mellins, New York Focus Oct 21, 2021, 10:55pm EDT 

The suit was filed by the NYC Organization of Public Service Retirees, a group formed in opposition to the move to a privately administered Medicare Advantage plan... The judge’s order does not, however, scrap the plan: Frank wrote that he “does not intend to disturb” the city’s choice to team with the Alliance.... many retirees are skeptical of that promise of equally good care, noting that for the first time, for example, retired city workers will have to obtain prior authorization from their insurer for a host of procedures and equipment, instead of getting coverage automatically. 

That is why we are paying the extortion fee -- for assurance - it's insurance like flood insurance which we pay every year over 40 years but all it took was the one big flood of Sandy in 2012 to make it worth it.

This is a temporary victory but the judge also smacked down the Aetna and United Health suit -- other privatiser vultures who want a piece of the action. 

Full decision here.

.....while the Court has already determined that respondents’ ultimate determination of choosing a Medicare Advantage Plan provider was rational and does not intend to disturb that determination, the Court finds that the implementation of its program is irrational and if the petitioners and similarly situated individuals are required to opt-in or out of a medical program by the October 31, 2021 deadline there would certainly be irreparable harm. 

 

Accordingly, it is hereby 

ORDERED that the respondents are enjoined from enforcing the October 31, 2021 Opt- Out/ Opt-In date; 

 

and it is further

ORDERED that petitioners maintain the status-quo enrollment in until the respondents cure deficiencies with the implementation of the proposed new Medicare Advantage Plan, and it is further

 

ORDERED that such new plan be sent to this Court for this Court to review and determine whether such plan cures the defects as indicated above, and it if further

 

ORDERED that such plan be sent to the petitioner’s counsel seven days prior to such submission to the Court and petitioner may then provide any input regarding the proposed new plan to the Court.

So they will come back with the same deal but try to get it write on informing us and all that jazz. How long will it take? The rest of my lifespan wouldn't be bad -- oops -- I better not say anything -- they could come back tomorrow and I'd go "pfoof".

And on another front, there was supposed to be a hearing next week to talk about all this stuff --- are the roaches scurrying under their rocks?

CORRECTED - There was confusion as another public hearing was cancelled

PUBLIC HEARING NOT CANCELLED  -

NOTICE IS HEREBY GIVEN that the Contract Public Hearing scheduled for Thursday, October 28, 2021, at 10:00 AM, is hereby cancelled.

IN THE MATTER OF a proposed contract between the City of New York acting through Mayor’s Office of Labor Relations – Employee Benefits Program on behalf of the Labor Management Health Insurance Policy Committee for the New York City Health Benefits Program and Anthem Insurance Companies, Inc. doing business as Empire BlueCross BlueShield Retiree SolutioFollns, 120 Monument Circle, Indianapolis, IN 46204, in strategic alliance with EmblemHealth Plan, Inc., for the provision of health benefits services in the form of a Medicare Advantage plan under Medicare Part C for the Medicare eligible retirees and dependents of the City of New York who are eligible for the City’s Health Benefits Program. The proposed contract is in the amount of approximately $23,000,000.00. The contract term shall be from January 1, 2022 to December 31, 2026 with two one-year renewal options.  E-PIN #: 0021N002.

The proposed contractor has been selected by Negotiated Acquisition Method, pursuant to Section 3-04 (b)(2)(ii) of the Procurement Policy Board Rules.

The aforesaid Public Hearing has been NOT BEEN cancelled.