Health insurance giant Empire pulls out of NYC’s controversial Medicare plan for retired city workers

A major insurance company has pulled out of a deal to administer New York City’s new Medicare Advantage Plan — the latest setback in the city’s effort to shift roughly 250,000 retired municipal workers onto the controversial health coverage.

Empire BlueCross BlueShield, one of the country’s largest health insurance providers, notified Mayor Adams’ office that it’s not going to help roll out the Advantage plan after the city failed to provide a start date and benefit specifics as requested by July 15, the company said in a statement Tuesday.

“This timeline was important because delaying any further would not give retirees enough time to fully understand their options, benefits, and coverage in advance of open enrollment,” the statement read. “Given the level of uncertainty at this time, we informed the city that (Empire) is not able to participate.”

In light of Empire’s withdrawal, City Hall spokesman Jonah Allon said Adams’ administration is on the hunt for a new provider.

“We remain committed to moving forward with the program and are exploring alternative options,” Allon said.

Empire’s exit is the latest hiccup in the Adams administration’s push to implement the Advantage plan, which is supposed to save the city hundreds of millions of taxpayer dollars annually thanks to the partnership with a private insurance provider.

First proposed by former Mayor Bill de Blasio, the plan was supposed to go into effect earlier this year with Adams’ blessing.

But Manhattan Supreme Court Justice Lyle Frank blocked the plan, ruling in March that it was illegal because it contained a provision that would slap a $191 monthly penalty on retirees who opted to keep their current traditional Medicare instead of getting automatically enrolled in the Advantage plan for free.

The Adams administration is appealing Frank’s ruling. City Hall confirmed Tuesday that the appeal is ongoing.

Frank’s decision was the result of a lawsuit filed by the NYC Organization of Public Service Retirees, which has argued the Advantage plan would water down health coverage for the city’s tens of thousands of retirees, including by instituting complicated pre-authorization requirements for certain medical procedures and treatments.

Marianne Pizzitola, the organization’s president, said she has for months asked City Hall for an opportunity to discuss the matter with Adams — and that she finally got a meeting scheduled with the mayor for this past Monday.

However, late Sunday, Pizzitola said she got word from City Hall that Adams could no longer meet after finding out the city remains in litigation with her group.

Pizzitola, a retired FDNY EMT, said she wishes Adams would take time to hear from her and the thousands of other former city workers who have pleaded with him to scrap the Advantage plan and let them stay on traditional Medicare.

“I really wish that he would just listen,” she said.

Similar Posts