Open for claimsHealthcareSenior Care Co-Pay Settlement: Eligibility, Reimbursement & Deadline
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The Senior Care co-pay settlement concerns $15 co-pays in the Emblem-administered medical GHI Senior Care Plan for Medicare-eligible retired New York City employees and their Medicare-eligible dependents enrolled between January 1, 2022 and January 31, 2023. It does not cover the Anthem/Empire hospital component.
Eligible claimants must submit a completed, signed customized claim form and all supporting documents online or by mail postmarked by October 30, 2026. Use the form supplied by the administrator or the authenticated official portal. Email submissions are not accepted. No exact cutoff time or timezone is stated in the materials reviewed.
The settlement limits defendants’ total liability to $53 million; this is not a promised payout to class members. Subject to approval and available net funds, documented co-pays may be reimbursed up to the full amount. Undocumented co-pays require an affirmation of payment and may receive up to 40%, capped at $100 per class member. Payments can be reduced proportionally if approved claims exceed the available net amount.
The lawsuit is Bianculli, et al. v. City of New York Office of Labor Relations, et al., Index No. 160234/2022, in New York County Supreme Court. Defendants denied the allegations. Final approval is still required; the hearing is scheduled for March 24, 2027 at 2:15 p.m., subject to court changes.
Key facts
- Settlement ceiling
- Up to $53 million total liability, including fees and awards
- Claim deadline
- October 30, 2026 — online submission or mail postmark
- Covered enrollment period
- January 1, 2022–January 31, 2023
- Documented co-pays
- Up to full reimbursement, subject to approval and available net funds
- Without payment documents
- Affirm payment; up to 40%, maximum $100 per class member
- Who is covered
- Eligible NYC retirees and dependents enrolled in medical GHI Senior Care
- Administrator
- Atticus Administration
Official settlement administrator: Atticus Administration
Evidence for key facts
These excerpts record what official sources said when checked. Open a fact to see its source and supporting passage. Follow the source for the latest information.
Claim statusChecked
To claim reimbursement, assuming Court approval of this Settlement, you must complete and return the enclosed Claim Form by mail or submit a Claim Form online by October 30, 2026.
Official class noticep1; p7 submission deadlines
Who qualifiesChecked
All Medicare-eligible retired New York City employees and their Medicare-eligible dependents who were enrolled in the Emblem Health, Inc. (“Emblem”) administered medical GHI Senior Care Plan at any time during the period of January 1, 2022 through January 31, 2023.
Official class noticep1 class definition; pp3,5 covered copays
Who qualifiesChecked
Excluded from the Settlement Class are: (1) the Organization, however, this exclusion does not apply to any of its members; (2) Class Members who properly execute and submit a Request for Exclusion prior to the expiration of the Opt-Out Period; and (3) the successors or assigns of any such excluded Class Member.
Settlement agreement and approved claim-form exhibitPDF p15, agreement section1.48
Payment and benefitsChecked
Defendants’ liability is limited to an amount that shall not exceed $53,000,000
Official class noticep4 question4; liability ceiling, not guaranteed payout pool
Payment and benefitsChecked
Any partial reimbursement for undocumented co-pays will be limited to up to 40% of the co-pay amounts incurred, up to a maximum of $100 per Class Member.
Official class noticep4 question4; sufficient-net-amount condition and pro-rata reduction also stated
Proof requirementsChecked
If you are submitting a claim on behalf of a Class Member who is deceased or incapacitated, you MUST provide proof of your authority to act on their behalf.
Official class noticepp5–6 question5; proof of legal name change also mandatory
Proof requirementsChecked
By signing (including electronically) and dating below, I affirm under penalty of perjury that: I am a Class Member or an authorized representative of a Class Member in this settlement
Settlement agreement and approved claim-form exhibitPDF p39, claim-form exhibit affirmation; visually checked
Claim deadlineChecked
To be eligible for any payment from the Settlement, the signed and completed Claim Form and all documents must be submitted online, or by mail and postmarked, by October 30, 2026.
Official class noticep7, Claim Submission Must be Timely
Who qualifies
- You were a Medicare-eligible retired New York City employee or Medicare-eligible dependent enrolled in the Emblem-administered medical GHI Senior Care Plan at any time from January 1, 2022 through January 31, 2023. Eligibility is tied to that employment/dependent relationship and plan enrollment; the class definition does not impose a separate current-residence requirement.
- To claim reimbursement, Emblem’s records must identify potential exposure to at least one eligible co-pay, and you must affirm that you actually paid the listed co-pay. Emblem’s data is conclusive for class identity and the amount of co-pay exposure. Receiving a customized form does not guarantee payment.
- Only the $15 co-pays at issue in the Emblem-administered medical component are covered. Co-pays for the Anthem/Empire hospital component are outside this lawsuit.
- The NYC Organization of Public Service Retirees, Inc. itself is excluded, but its members are not excluded for that reason. People who validly opted out, and successors or assigns of such excluded class members, are excluded under the agreement.
- A class notice without a customized claim form does not itself establish reimbursement eligibility. The notice explains that those recipients remain class members but are not eligible to claim these co-pay reimbursements. Contact the administrator about missing or incorrect materials; do not invent eligible visits or payments.
How to submit a Senior Care co-pay claim
- 1
Find your customized form and credentials
Use the claim form sent by Atticus Administration. Online access requires its unique Claimant ID and the member ID from your medical GHI Senior Care insurance card. Contact the administrator at 1-800-814-2610 if you need help with your materials.
- 2
Check each listed co-pay
Review your prefilled contact details and the listed service dates, providers and co-pay amounts. For each item, confirm whether you actually paid it and identify any payment evidence you are submitting.
- 3
Attach supporting documents where required
For up to full reimbursement, provide a receipt, cancelled check, bank or credit-card statement, or the provider confirmation letter. Evidence must substantially match Emblem’s records. Without payment evidence, sign the payment affirmation for consideration at the lower undocumented rate. Proof of legal name change or authority to act for someone deceased or incapacitated is mandatory when applicable. Send copies and redact unrelated sensitive information.
- 4
Sign, date and submit by October 30
Sign the affirmation under penalty of perjury and date the form. Submit online through the official portal, or mail the completed form and documents to Senior Care Co-Pay Settlement, c/o Atticus Administration, PO Box 64053, St. Paul, MN 55164, postmarked by October 30, 2026. Use one submission method; do not submit both online and by mail. Claims and documents cannot be emailed.
- 5
Keep records and answer any cure letter
Keep copies of your submission. Online changes and added documents are allowed through the claim deadline. If the administrator sends a cure letter, follow its instructions and response deadline. Unresolved signature or representative-authority problems may cause denial; insufficient payment evidence may reduce an otherwise valid claim to the undocumented tier.
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Frequently asked questions
Is this a guaranteed $53 million fund for retirees?
No. $53 million is the defendants’ maximum total liability and reflects estimated potential co-pays, not necessarily co-pays actually paid. Subject to court approval, $9.9 million in counsel fees, up to $100,000 in counsel costs and up to $25,000 in service awards are paid first. Approved reimbursements come from the remainder, and unused amounts revert to defendants.
What can I receive without receipts?
You must still complete and sign the customized form affirming that you actually paid the listed co-pays. Approved undocumented co-pays may receive up to 40% of the co-pay amount, up to $100 in total per class member. These amounts may be reduced proportionally if net funds are insufficient. This is not an automatic payment or a guarantee of $100.
Can I claim for a deceased or incapacitated family member?
A legal representative may submit a claim but must provide proof of authority. The notice lists examples such as estate or court-issued documents for a deceased member, or a power of attorney or other acceptable authority document for an incapacitated member. Missing or insufficient authority can result in denial. Follow the official form and administrator’s instructions.
Do I need to be living in New York now?
The class definition is based on Medicare eligibility, NYC retiree or dependent status and enrollment in medical GHI Senior Care during the covered period. It does not state a separate current-residence restriction.
Can I email my claim or supporting documents?
No. The official notice permits online portal submission or postal mail only and specifically prohibits email submission of claims and documents. Use one method, not both. Your customized form contains protected health information.
Is October 30 a receipt or postmark deadline?
October 30, 2026 is the online submission deadline and the mail postmark deadline. The completed, signed claim and all documents must meet that deadline. No exact cutoff time or timezone is stated in the reviewed notice.
When will payments be issued?
There is no fixed payment date. Payments require final court approval and resolution of any appeals. The March 24, 2027 hearing is an approval hearing, not a promised payout date. Online claimants can choose an available payment method; mailed claims receive a mailed check.
Sources and official records
Consult these records for the official terms and current updates. ClaimBee's summary helps explain the settlement; the administrator and court documents determine the claim requirements and benefits.
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