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Aug 28, 2026

Appellate Division finds employment agreement did not provide for certain health insurance premium payment claimed by retiree

Plaintiff, the school district's former District Superintendent, and the School District [District] had entered into an employment agreement pursuant to which Plaintiff was hired as the District's superintendent. 

As relevant in the instant litigation, the employment agreement provided that Plaintiff and her qualified dependents "shall be eligible, during retirement, for continuing health, dental and vision insurance coverages under the plan(s) available through the District" and that the District "will pay one hundred percent (100%) of the premiums of such coverage."

Upon her retirement in 2017, Plaintiff obtained retiree health insurance through the District's plan. Several years later, Plaintiff applied for Medicare Part B—an insurance plan not available through the District—and paid premiums for that coverage. Plaintiff then asked District for reimbursement for the Medicare premiums she had paid. 

The District denied Plaintiff's request on the ground that the District's plan did not allow individuals who received 100% of the retiree health coverage paid for by the District to receive reimbursement for Medicare Part B premiums. 

Claiming "breach of contract", Plaintiff commenced the instant action seeking reimbursement of Medicare premiums paid by Plaintiff and a declaration that the District was required to pay such premiums for her and her qualified dependents'. Supreme Court granted District's motion for summary judgment dismissing the complaint and  Plaintiff appealed.

The Appellate Division said that the District met its initial burden on the motion inasmuch as it had submitted the employment agreement, Plaintiff's deposition testimony, the District's policy documents, and its health plan documents ... all of which established that the employment agreement did not require the District to reimburse Plaintiff for the premiums for Medicare Part B, which was not an insurance plan offered by the District. 

The Appellate Division's decision noted that the agreement provided that Plaintiff was entitled to "continuing health, dental and vision insurance coverages under the plan(s) available through the District" but Plaintiff sought "reimbursement for premiums under a Medicare plan not provided through the District". 

Accordingly, the Appellate Division held that Plaintiff was not entitled to reimbursement of the premiums for the Medicare Part B coverage Plaintiff had purchased.

Click HERE to access the Appellate Division's decision posted on the Internet.



Editor in Chief Harvey Randall served as Director of Personnel, State University of New York Central Administration; Director of Research, Governor's Office of Employee Relations; Principal Attorney, Counsel's Office, New York State Department of Civil Service; and Colonel, JAG, Command Headquarters, New York Guard. Consistent with the Declaration of Principles jointly adopted by a Committee of the American Bar Association and a Committee of Publishers and Associations, the material posted to this blog is presented with the understanding that neither the publisher nor NYPPL and, or, its staff and contributors are providing legal advice to the reader and in the event legal or other expert assistance is needed, the reader is urged to seek such advice from a knowledgeable professional.

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