November 23, 2022

The Appellate Division affirms Supreme Court's ruling allowing New York City retirees to have the ability to opt out of the City's Medicare Advantage Plan

In the Matter of NYC Organization of Public Service Retirees, Inc., [OPSR] et al. v Renee Campion [NYC] et al. Supreme Court granted the OPSR's petition to the extent of:

[i] allowing New York City retirees to have the option of opting out of the City's Medicare Advantage Plan;

[ii] enjoining NYC from passing along any costs of the retirees' current plan to the retirees or their dependents except where such plan rises above the H.I.P-H.M.O threshold provided by Administrative Code of City of NY §12-126;

[iii] requiring NYC to ensure that all retirees and their dependents pay the deductible for only one plan for the calendar year 2022; and

[iv] denied NYC's motion to dismiss the proceeding brought pursuant to CPLR Article 78.

The Appellate Division unanimously affirmed Supreme Court's ruling, without costs, explaining:

1. The issue raised on this "appeal is one of pure statutory interpretation subject to de novo review, and not one requiring deference to the special expertise of respondent agency";

2. Administrative Code §12-126(b)(1) provides: "The 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"; and

3. Supreme Court correctly determined that Administrative Code §12-126(b)(1) requires NYC "to pay the entire cost, up to the statutory cap, of any health insurance plan a retiree selects."

This interpretation, said the Appellate Division, "comports with the plain language of the provision as well as its legislative history," citing Matter of Albany Law School v New York State Off. of Mental Retardation and Dev. Disabilities, 19 NY3d 106

Further, opined the Appellate Division, "Nothing in the statutory text or history supports [NYC's] interpretation that the provision is satisfied so long as [it pays] for the costs of one of the health insurance plans offered to retirees, which [it] determined to be the Medicare Advantage Plus Plan."

Click HEREto access the text of the Appellate Division's decision.