Empire BlueCross BlueShield withdraws from NYC’s plan to switch retirees to Medicare Advantage

The City Bureau of Industrial Relations and the City Labor Committee, which represents retired city employees, originally agreed to move forward with the transition to Medicare Advantage plans in 2018.

Now that BCBS has dropped out of the plan, there is no Advantage Plus plan that retirees can switch to. Harry Nespoli, chair of the municipal working committee, said the BCBS’s decision was “an additional problem” in “trying to provide pensioners with adequate healthcare”. He called Medicare Advantage plans a “reasonable option” for retirees.

In a memo from the NYC Organization of Public Service Retirees, a group of about 2,000 retirees who have formed to oppose the city’s proposed plan, BCBS said they cannot participate in the plan to offer Advantage plans because the City did not provide BCBS with details of plan benefits by the requested date.

“This timeline was important because further delay would not give retirees sufficient time to fully understand their options, benefits and coverage prior to open enrollment prior to January 1, 2023,” read the BCBS statement released Tuesday.

Prior to the news of BCBS, the city’s plan faced legal challenges from other insurance providers and retirees, who argued both that they should be entitled to the original benefits they were offered upon retirement and that Medicare supplemental plans are a offer much better coverage than Advantage plans.

Pollock Cohen’s Steve Cohen, who represents the NYC Organization of Public Service Retirees in a lawsuit against the city filed last summer, said retirees are most concerned about Advantage plans because many doctors have refused to do so because of prior approval requirements. to participate in it.

The city originally told retirees who didn’t want to join Medicare Advantage that they could keep supplemental plans but would have to pay the cost of premiums themselves, which retirees disagreed with, and Cohen argued that a provision in the city’s own brochure prohibited it.

After BCBS pulled out, the city and city work committee are working together to determine how to offer retirees alternative Advantage plans, Nespoli said.

In the retirees’ lawsuit against the city, the court last ruled in March that retirees could keep their current supplemental plans free of charge, and the city appealed that ruling. Cohen said next steps in the appeals process will be delayed as the city figures out next steps.

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