NYC Senior Care Retiree Co-Pay Class Action Settlement
NYC Senior Care Retiree Co-Pay Class Action Settlement
The City of New York agreed to settle claims that Medicare-eligible City retirees were improperly charged $15 co-pays under the EmblemHealth-administered GHI Senior Care plan, covering roughly $53 million in co-pays collected between January 1, 2022 and January 31, 2023. Retirees and their Medicare-eligible dependents who were enrolled during that window can seek reimbursement of those co-pays. Claims with documentation can be reimbursed in full, and claims without documentation are paid up to 40% of the co-pay amount, capped at $100 per class member. The claim deadline is October 30, 2026.
Settlement fund
$53M
Co-pays at issue
Top payout
Up to full $15 co-pays
Or up to $100 with no documents
Claim deadline
Oct 30, 2026
44 days remaining
You may be owed money
Filing is free and takes a few minutes. Deadline: Oct 30, 2026.
Do you qualify?
You are a Class Member if ALL of the following apply:
- You are a Medicare-eligible retired New York City employee, or the Medicare-eligible dependent of one.
- You were enrolled in the EmblemHealth-administered medical GHI Senior Care Plan at any time from January 1, 2022 through January 31, 2023.
- You paid one or more $15 co-pays under that plan during the class period.
- Excluded: Retirees and dependents who were not Medicare-eligible or not enrolled in GHI Senior Care during the class period.
- Excluded: Anyone who timely excludes themselves from the settlement by the October 15, 2026 opt-out deadline.
Not sure if you qualify? Call the Settlement Administrator at 1-800-814-2610, or visit SeniorCareCopaySettlement.com.
What happened
The named plaintiffs, a group of retired New York City employees, alleged that the City and EmblemHealth improperly imposed $15 co-pays on Medicare-eligible retirees enrolled in the GHI Senior Care plan. The litigation was brought in New York County Supreme Court and covers co-pays charged between January 1, 2022 and January 31, 2023, a period in which approximately $53 million in co-pays were collected from class members.
The defendants denied all of the claims alleged in the complaint and the settlement contains no admission of liability. The Court has not decided who is right. The parties agreed to settle to avoid the cost, risk, and delay of continued litigation, and class members may now seek reimbursement of the co-pays they paid.
How to file a claim
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1. Confirm you are eligible
You qualify if you are a Medicare-eligible retired New York City employee, or the Medicare-eligible dependent of one, and you were enrolled in the EmblemHealth-administered GHI Senior Care plan at any time between January 1, 2022 and January 31, 2023.
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2. Decide whether to submit documentation
Proof of payment of each co-pay, such as a receipt, cancelled check, bank statement, credit card statement, or a letter from your provider, supports reimbursement of up to the full $15 per co-pay. If you cannot document your co-pays, you can still claim, but reimbursement is limited to 40% of the co-pay amount and capped at $100 per class member. Payments are reduced pro rata if approved claims exceed what remains of the fund.
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3. File online or by mail
Submit your customized Claim Form online at seniorcarecopaysettlement.com by October 30, 2026, or mail a paper Claim Form postmarked by that date to: Senior Care Co-Pay Settlement, c/o Atticus Administration, PO Box 64053, St. Paul, MN 55164. Because the claim involves protected health information, the administrator does not accept Claim Forms or supporting documents by email. Notice documents and FAQs are posted at SeniorCareCopaySettlement.com.
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4. Receive your payment
Payments are issued after the Court grants final approval at the March 24, 2027 Fairness Hearing and any appeals are resolved. No follow-up is required once your claim is submitted.
Key dates
- Oct 15, 2026 Opt-out & objection deadline Soon
- Oct 30, 2026 Claim filing deadline Upcoming
- Mar 24, 2027 Final Fairness Hearing (2:15 p.m. ET, in person) Upcoming
- TBD after final approval Payments issued to claimants Pending
The Fairness Hearing is scheduled for March 24, 2027 at 2:15 p.m. ET before the Honorable Lyle E. Frank at 60 Centre Street, Room 412, New York, NY 10007. Note that the objection deadline of November 30, 2026 falls after the October 30, 2026 claim deadline. The Court may move the hearing, so check SeniorCareCopaySettlement.com for updates before traveling.
Where the money is going
The settlement addresses roughly $53 million in $15 co-pays collected from January 1, 2022 through January 31, 2023. Class counsel fees, costs, and service awards are paid first, and the remainder is distributed to approved class member claims.
All amounts listed above are pending and subject to final court approval at the Fairness Hearing. The Court may award less than the amounts requested. If approved claims exceed what remains of the fund, payments will be reduced on a pro rata basis.
Common questions
How much money will I receive?
There is no fixed per-person amount. If you submit proof of payment, you can be reimbursed up to the full $15 for each co-pay you paid during the class period. If you do not submit proof, you can be reimbursed up to 40% of the co-pay amount, capped at $100 per class member. Payments are reduced proportionally if approved claims exceed what remains of the fund.
Do I need to submit proof of purchase?
Proof is not required to file, but it changes what you can recover. With proof of payment for each co-pay, such as a receipt, cancelled check, bank or credit card statement, or a letter from your provider, you can seek full reimbursement. Without proof, reimbursement is limited to 40% of the co-pay amount and a $100 maximum per class member.
What if I didn’t receive a notice?
Contact the Claims Administrator right away at 1-800-814-2610 if you did not receive a notice or if your address has changed. Claim Forms in this settlement are customized to each class member, so the administrator needs to reach you to issue one before the October 30, 2026 deadline.
Does staying in the class affect my right to sue later?
If you stay in the settlement, you fully release the claims described in the Settlement Agreement against the City of New York, EmblemHealth, and the other released parties, whether or not you file a claim. To keep your right to sue separately, you must submit a written exclusion request postmarked by October 15, 2026.
When will payments be sent out?
Payments come after the Court grants final approval at the March 24, 2027 Fairness Hearing and after any appeals are resolved. The administrator has asked class members to be patient, since an appeal can add a year or more.
Dapeer Law, P.A.
Consumer class action attorneys based in South Florida. We track settlements so you don’t have to.
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This page is for informational purposes only and does not constitute legal advice. Dapeer Law, P.A. is not the administrator of this settlement and is not affiliated with the City of New York and EmblemHealth, Inc., Atticus Administration (the Settlement Administrator), or Class Counsel Jacob Gardener of Walden Macht Haran & Williams LLP and Steve Cohen of Pollock Cohen LLP. The case is Bianculli, et al. v. City of New York, et al., Index No. 160234/2022, pending in the Supreme Court of the State of New York, County of New York before the Honorable Lyle E. Frank. Class representatives are Margaretann Bianculli, Janet Kobren, Merri Lasky, Phyllis Lipman, and Barry Skolnick. the City denies wrongdoing. This website is attorney advertising. Past results do not guarantee future outcomes.