EmblemHealth

Alleged improper $15 copays charged to Medicare-eligible retirees and dependents in the EmblemHealth GHI Senior Care plan.

EmblemHealth and the City of New York have agreed to a $53 million settlement to resolve a class action lawsuit alleging improper implementation of $15 copays for medical services under the GHI Senior Care plan between January 1, 2022, and January 31, 2023. The lawsuit claimed these copays were not authorized by the plan's contract and were not properly disclosed. Eligible class members are Medicare-eligible retired New York City employees or their Medicare-eligible dependents enrolled in the GHI Senior Care plan during the class period. Those who received a claim form can seek reimbursement for listed copays, with full reimbursement possible if proof of payment is provided. Those without proof can receive up to 40% of the copay amount (up to $100 total) by attesting to payment. Payments may be reduced pro rata if total valid claims exceed the net settlement fund.

You may be eligible if you:

• Medicare-eligible retired New York City employees or Medicare-eligible dependents enrolled in the EmblemHealth-administered GHI Senior Care plan at any time between Jan. 1, 2022,...

• Basic contact information
• Dates tied to your purchase or account activity
• Proof of purchase or supporting documents

If you do not have every document, you may still be able to file. Many settlements accept claims without receipts.

• File a claim online at https://www.seniorcarecopaysettlement.com/dashboard-login/ using your claimant ID and GHI Senior Care member ID.
• Alternatively, complete the claim form received and mail it to: Senior Care Co-Pay Settlement, c/o Atticus Administration, PO Box 64053,...
• Submit receipts, canceled checks, bank or credit card statements, or a signed provider letter for full reimbursement.
• If you do not have documentation, you can sign an affirmation to claim up to 40% of the copay amount (up to $100 total for all undocumented...