"A coalition of NYC workers, retirees, and an advocacy organization is suing to block a sweeping health-benefits restructuring that would reshape coverage for roughly 750,000 public-sector workers and retirees. The lawsuit, filed Tuesday, challenges the city's plan to replace its long-standing, insured health-care coverage with what the coalition calls an unlawful, self-funded model that would strip away protections guaranteed by state law."
"The City has previously stated that the new plan will maintain zero premiums and save approximately $1 billion annually in health-benefit costs. A City Hall spokesperson said officials would review the Oct. 29 lawsuit but maintained that the new city health plan will strengthen coverage, expand provider access, and deliver necessary savings at a time of fiscal uncertainty, all while maintaining the premium-free coverage and continued high-quality care our employees expect and deserve."
"The legal challenge argues that the city's plan to replace the GHI Comprehensive Benefits Plan with a new Administrative Services Only model, branded NYCE PPO, violates the New York City Administrative Code. The code requires that municipal workers, retirees, and their dependents be provided with health insurance coverage through licensed insurers that assume financial risk and are regulated by the state."
A coalition of NYC workers and retirees filed suit to block a health-benefits restructuring affecting roughly 750,000 public-sector members. The lawsuit challenges the city's plan to replace insured coverage with a self-funded Administrative Services Only model branded NYCE PPO, arguing it violates the New York City Administrative Code, which requires coverage through licensed insurers that assume financial risk and are state-regulated. Under the proposed model the City would pay claims directly while UMR and EmblemHealth administer claims but do not insure them. The City says the plan keeps zero premiums and will save about $1 billion annually while expanding provider access.
Read at www.amny.com
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