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| Manhattan Supreme Court Justice Lyle Frank |
UPDATE:
On Friday, March 4, 2022, at 5pm, mayor Eric Adams and the City of New York filed an Appeal of Judge Lyle Frank's decision. Adams wants the $191/month monthly fee reinstated to punish retirees who opt out of his new Medicare Advantage Plus Plan.
Let's hope his Appeal is denied.
Betsy Combier
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Congratulations to the lawyers for the Plaintiffs in the Supreme Court case against the City of New York, RENEE CAMPION, as Commissioner of the City of New York Office of Labor Relations, and the CITY OF NEW YORK OFFICE OF LABOR RELATIONS, and of course, a big thank you is due to Justice Lyle Frank for his excellent decision!
Judge Lyle wrote:
"The effort by the administration to levy a $191 monthly fee on retirees who opt out of the new so-called Medicare Advantage Plan runs counter to longstanding local administrative law."
See below for his decision in full, and the complaint and papers here:
NYC Retirees Opt-Out of the NYC Medicare Advantage Plus Plan
Betsy Combier
Editor, Parentadvocates.org
Editor, New York Court Corruption
Editor, National Public Voice
Editor, NYC Public Voice
Editor, Inside 3020-a Teacher Trials
Judge rules Adams admin cannot financially penalize NYC retirees who reject controversial Medicare Planontroversial Medicare plan
A Manhattan judge ruled Thursday that Mayor Adams’ administration cannot slap a financial penalty on retired municipal workers who want to stay on their current Medicare coverage instead of enrolling in a new plan favored by the city. The ruling marks a significant win for a group of retirees who have fought the health insurance switch in court for months.
The effort by the administration to levy a $191 monthly fee on retirees who opt out of the new so-called Medicare Advantage Plan runs counter to longstanding local administrative law, Manhattan Supreme Court Justice Lyle Frank wrote in a decision.
The law in question, Frank continued, requires the city to “pay the entire cost of health insurance coverage for city employees, city retirees and their dependents.” Any attempt to impose a premium or other cost for coverage is thereby illegal, he added.
“This Court holds that this is the only reasonable way of interpreting this section,” the judge wrote.
Frank’s decision caps a court battle between the city and a group of retired city workers that began last year under former Mayor Bill de Blasio’s administration.
In announcing the plan last fall, the de Blasio administration presented Medicare Advantage as a boon to the city and save taxpayers hundreds of millions of dollars every year because it is subsidized by the federal government at a higher rate. At the same time, the administration maintained the new plan would provide the city’s roughly 250,000 Medicare-aged retirees with health coverage that’s comparable to what they’re currently receiving.
But the NYC Organization of Public Service Retirees sued over the move, charging that the new plan would result in inferior coverage, including by imposing complex new preauthorization procedures for specific medical procedures.
After vowing on the campaign trail to make sure the new Medicare plan wouldn’t be a “bait and switch” for retired workers, Adams announced last month that he would move ahead with implementing it as envisioned by de Blasio, angering retirees who said he was going back on his promise by keeping the $191 penalty intact.
A spokesman for Adams did not immediately return a request for comment after Frank’s ruling.
Steve Cohen, a lawyer for the NYC Organization of Public Service Retirees, said the judge’s order validates the concerns of his clients and amounts to an “incredible victory” for them.
“The city got greedy, and held a sword over the head of retirees and said, ‘If you don’t accept your new plan, we’re not going to pay for your health care,’” Cohen said. “The judge saw right through that and said, ‘No way, you can’t do that.’”
According to data reviewed by the Daily News, despite the now-rescinded financial penalty they would face, more than 45,000 retired city workers had opted out of Medicare Advantage Plan as of mid-February.
The Adams administration can still implement the Advantage plan, starting April 1, under Frank’s ruling. It was not immediately clear how the administration would proceed because it can’t subject retirees to the monthly fee if they opt out of the new plan.
SUPREME COURT OF THE STATE OF NEW YORK
PRESENT: HON. LYLE E. FRANK X PART 11M
NYC ORGANIZATION OF PUBLIC SERVICE RETIREES,
- v -
RENEE CAMPION, CITY OF NY OFFICE OF LABOR
RELATIONS, CITY OF NEW YORK,
Defendant.
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The following e-filed documents, listed by NYSCEF document number (Motion 001) 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50, 51, 52, 53, 55, 56, 58, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76, 97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110, 111, 112, 212 |
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were read on this
motion to/for |
INJUNCTION/RESTRAINING ORDER |
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The following e-filed documents, listed by NYSCEF document number (Motion 002) 2, 57, 63, 64, 65, 79, 80, 81, 82, 96, 113, 166, 205, 206 |
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were read on this
motion to/for |
INJUNCTION/RESTRAINING ORDER |
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The following e-filed documents, listed by NYSCEF document number (Motion 004) 185, 186, 187, 188, 189, 190, 191, 192, 193, 194, 195, 196, 197, 201, 208, 209, 210, 213 |
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were read
on this motion to/for |
SUMMARY JUDGMENT(AFTER JOINDER |
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The underlying petition arises out of allegations that respondents have unlawfully amended the
Medicare plan of current retirees.
The Court previously held on October 21, 2021, that the selection of the Alliance to administer the proposed Medicare Advantage Plus Plan (the “Plan”) was not arbitrary and capricious, however the implementation of the plan was irrational and many details of the plan required refinement. Based on that determination, the Court granted a preliminary injunction to allow respondents to clarify and make adjustments consistent with the Court’s order.
The parties have since made multiple submissions and appearances before
the Court; as a result, the preliminary
injunction is now vacated, and the underlying petition is ripe for resolution. For the reasons set forth below, the petition is granted to the
extent indicated below and respondents’ motion to dismiss
the petition is denied.
First, the respondent and nominal respondent have taken many strides to
improve the information available
regarding the Plan, and thus, while the steps they have taken may not make things perfect, the Court finds that at
this point the implementation of the Medicare Advantage Plan is no longer what thus Court would consider
irrational.
Second, much of the legal arguments made by the petitioners are
unavailing. The respondent was well within its right to
work with the Municipal Labor Council to change how retirees get their health insurance. As the municipal labor unions are the entities that enter into collective bargaining agreements, those
unions, through the umbrella Municipal Labor
Council may amend those agreements. Moreover, even if the Court were to find
the labor unions may not bind
retirees, this would only mean that the respondents could act alone without the Municipal Labor Council, which
nevertheless would still not invalidate the agreement that was reached
here.
Third, as the petitioners freely acknowledge, the New York State
Constitution does not guarantee specific
health insurance for retirees.
However, based on this Court’s reading of New York City Administrative Code Section 12-126, so long as the respondent is giving retirees the option of staying in their current program, they may not do so by charging them the $191 the respondent intends to charge. This section states unequivocally that “[t]he City will pay the entire cost of health insurance coverage for city employees, city retirees and their dependents, not to exceed one hundred percent of the full cost of H.I.P.-H.M.O. on a category basis.2” Respondent and nominal respondent aver that the definition of “health insurance coverage”, as defined in Admin. Code§ 12-126 (a), stating “a program” as opposed to “any program” means that the City of New York need only pay for the entire cost of one program. This Court respectfully disagrees. NYC Admin. Code § 12-126 (b)(1) is simply unequivocal and does not use terms like “provide” or “offer”; rather it uses the term will pay and it provides parameters of such payment. The definition in NYC Admin. Code
§ 12-126
(a)(iv) simply provides
what constitutes a program
or plan that the City of New York is required by law to pay for, by defining
the contents of such a plan. This
Court holds that this is the only reasonable way of interpreting
this section.
Of course, none of this is to say that the respondent must give retirees
an option of plans, nor that if the
plan goes above the threshold discussed in NYC Admin. Code § 12-126 (b)(1) that the respondent could not pass along the
cost above the threshold to the retiree; only that if there is to be an option of more than one plan,
that the respondent may not pass any cost of the prior plan to the retirees, as it is the Court’s understanding that
the threshold is not crossed by the cost of
the retirees’ current health insurance plan.
This is buoyed by the fact that the current plan has been
paid for by the respondent in full to this point. Based on the foregoing, it is therefore
ORDERED that the preliminary injunction previously put into place by this
Court is lifted, except that:
1. Enrollment in the Medicare Advantage Plan may not occur until at least April 1, 2022, and that retirees shall have the option of opting out of the Medicare Advantage Plan for not less than three months following the effective date of the Medicare Advantage Plan;
2. The respondent is permanently enjoined from passing along any costs of the New York City retirees’ current plan to the retiree or to any of their dependents, except where such plan rises above the H.I.P.-H.M.O. threshold, as provided by New York City Administrative Code Section 12-126; and
3. The respondent shall ensure that all retirees and dependents of such retirees pay the deductible for only one plan for the calendar year 2022.
3/3/2022
