NYC Retirees Win Settlement To Refund Copays To Retired Workers From EmblemHealth, NYC

Editor’s note: Some good news for retirees in NYC! This new mayor may be responsible for this, just as Mayor Adams was fully responsible for the lawsuit retirees had to file in the first – as well as all the other lawsuits the retirees had to start against the city and its Medicare Advantage program. It was also Mayor Adams who chose to stop forcing these retirees to accept the inferior, low-coverage health plans during his campaign.  Here the choice was made to support retired workers instead of continuing the trend of trying to balance the budget on their backs.  Affected individuals, once this is approved, should get more information in the coming weeks about what they need to do, if anything, or if it’s automatic. 

NYC and EmblemHealth Settle Senior Care Co-Pay Class Action for $53Million

New York, NY, August 3, 2026 – In a major development, the City of New York and EmblemHealth agreed to pay $53 million to settle a class action lawsuit on behalf of more than 250,000 elderly and disabled retired City workers enrolled in EmblemHealth’s GHI Senior Care Plan. The suit was brought by the NYC Organization of Public Service Retirees and a handful of retirees. The signed settlement papers were sent to New York County Supreme Court Justice Lyle E. Frank for the Court’s approval.

The settlement refunds co-pays that retirees were unlawfully charged for medical visits between January 1, 2022 through January 31, 2023. The $53 million represents 100 percent of the co-pays retirees had been charged. In addition to the monetary settlement, the City and EmblemHealth also agreed not to increase the existing $15 Senior Care co-pays through at least December 31, 2027.

The $53 million settlement amount is one of the largest class action settlements inNew York City history. In addition, the lawsuit saved retirees an estimated $106million through a temporary injunction, which halted the co-pays for two years.

This settlement is just the latest healthcare victory by the NYC Organization of Public Service Retirees, which has, to date, collectively saved retirees approximately $3.16 billion since 2022. The Organization stopped the City from forcing retirees to pay for Senior Care, which the City itself has valued at $600 million per year; prevented the City and EmblemHealth from charging retirees co-pays in 2023 and 2024, which (according to EmblemHealth’s records) was worth approximately $106 million; and pioneered this class action settlement that is returning $53 million to the pockets of retirees.

“This is a wonderful victory for retirees,” said Marianne Pizzitola, president of the NYC Organization of Public Service Retirees, one of the named plaintiffs. “The older people get, the more likely they are to need medical care, and co-pays are one of the worst, most regressive burdens making healthcare unaffordable. We hope Mayor Mamdani and City Council Speaker Menin recognize this and roll back co-pays.”

“Retired City workers have proven once again that they will fight relentlessly, and successfully, to protect their healthcare rights, which have been under constant attack for the past five years,” said Jacob Gardener of Walden Haran Williams LLP, one of the lead attorneys for the retirees.

“It is another step forward in ensuring affordable healthcare for our seniors,” said Steve Cohen of Pollock Cohen LLP, the other lead attorney for the retirees. “Now we have to get the City Council and the Mayor to eliminate co-pays for seniors entirely. They were promised and deserve free healthcare in retirement.”

The settlement papers can be found here

Banner Image: Elderly couple.  Image Credit – Sven Mieke