The proposed $53 million settlement covers Medicare-eligible retired New York City workers and dependents in the EmblemHealth GHI Senior Care plan from January 1, 2022 to January 31, 2023. Members can claim the $15 co-pays they paid, up to $100 without proof, by October 30, 2026. The court has not yet approved it.
Benefit Summary
Members with eligible copays: Members identified in Emblem’s records as having eligible medical copays who confirm payment and submit an approved claim.
These benefits can combine when their individual eligibility and claim requirements are met. Copays supported by accepted proof of payment may be reimbursed in full, subject to the money available and any proportional reduction. The evidence must substantially match the visits and amounts in Emblem’s records. For listed copays you paid but cannot document, sign the affirmation. Reimbursement is up to 40% of those amounts, with a $100 limit per member across all undocumented copays, and may be reduced. This can accompany reimbursement for different documented copays; the same copay is not paid twice.
Members without eligible copay exposure: People in the covered plan and period whose Emblem records do not show eligible copay exposure.
These members receive no copay reimbursement but retain the right to object or leave the settlement. If they remain, the approved settlement binds them even without a payment.
The $53 million ceiling covers reimbursements and court-approved fees, costs and service awards. Those deductions are paid first. If approved claims exceed the amount left, payments are reduced proportionally. Unused money returns to the defendants.
Aggregate benefits cap: $53,000,000.
Available Awards
Members with eligible copays: Up to full paid copays + Up to 40%, capped at $100; Members without eligible copay exposure: See benefit details
Who Is Included
The class includes Medicare-eligible retired New York City employees and their Medicare-eligible dependents enrolled in Emblem’s medical GHI Senior Care plan at any point from January 1, 2022 through January 31, 2023. Membership alone does not mean a payment is available: Emblem’s records determine who had eligible copay exposure and receives a customized claim form. People without that exposure remain class members with legal rights but cannot claim reimbursement. Hospital copays administered by Anthem/Empire are outside this case.
- Proof required: Sign the claim affirmation and identify which listed copays you actually paid. For up to full reimbursement, provide payment records for each copay. Without payment records, a signed statement can support limited reimbursement. Proof of a legal name change or authority to claim for someone else is required when applicable, even for an undocumented-copay claim.
Claim and Payment Information
- Claim method: Online or mail only
- Claim deadline: 2026-10-30
- Instructions: Use either the online dashboard or mail, not both. Email claims are not accepted. For online filing, use your Claimant ID and medical GHI Senior Care member ID. Complete and sign the customized form and submit all documents online by October 30, 2026, or mail them postmarked by that date to Senior Care Co-Pay Settlement, c/o Atticus Administration, PO Box 64053, St. Paul, MN 55164.
Questions & Answers
Why did I get a notice but no claim form?
The class is broader than the group eligible for reimbursement. Emblem sends customized forms to members whose records show at least one potentially eligible medical copay. Other members receive a notice because the settlement still affects their legal rights.
The notice treats Emblem’s records as conclusive on identity and copay exposure. If you need help understanding what you received, contact Atticus at 1-800-814-2610 or [email protected]. Do not email your claim or medical documents.
Can I claim some copays with receipts and others without them?
Yes. Review each copay on your customized form and confirm whether you paid it. Accepted payment evidence can support up to full reimbursement for that copay. For other listed copays you paid but cannot document, sign the statement confirming payment.
The undocumented portion is limited to 40% of those copays and no more than $100 per member in total. That $100 is not a limit on documented reimbursements, and it is not a guaranteed payment. All awards may be reduced if available money is insufficient.
What counts as proof that I paid?
The notice accepts receipts, cancelled checks, bank or credit-card statements, or a provider’s written confirmation. The proof must substantially match the dates, providers and copays listed from Emblem’s records.
Send copies rather than originals and black out unrelated sensitive details. A blank provider confirmation letter is available on the official site for your provider to complete; it records service dates and amounts paid.
Provider form checked September 8, 2026: https://www.seniorcarecopaysettlement.com/wp-content/uploads/2026/08/Ex-D-2026.06.02-Medical-Provider-Letter_FINAL.pdf
What if my name changed or I am claiming for someone else?
Submit documentation of the legal name change, such as a marriage certificate or court record. If you claim for a deceased or incapacitated member, provide evidence of your authority to act. The notice gives examples including estate documents, powers of attorney and court appointments.
These documents are required for any payment when applicable. A signed statement about paying copays does not replace them. Notice Question 5 has the full requirements; ask the administrator which documents apply to your situation.
How do I file, and can I email my claim?
Choose online filing or mail. Do not submit through both, and do not email a claim or its supporting medical documents. The notice prohibits email because the materials contain protected health information.
For online filing, sign in with the Claimant ID from your form and the member ID on your medical GHI Senior Care card. Confirm each listed payment, upload supporting records and sign the affirmation. Submit everything by October 30, 2026.
For mail, send the completed, signed form and records to Senior Care Co-Pay Settlement, c/o Atticus Administration, PO Box 64053, St. Paul, MN 55164, postmarked by October 30, 2026. Signing is required for every reimbursement.
Can I correct my claim or add documents later?
Before October 30, 2026, online filers can edit their saved form and add records in the dashboard. Mail filers should contact the administrator for help making changes before that deadline. After the deadline, the dashboard remains available for status checks.
If a timely claim has a problem, the administrator may send a correction request called a cure letter. Follow that letter’s directions and deadline. Missing signatures, required information or legal-authority documents can lead to denial. Inadequate payment evidence can instead move an otherwise valid copay to the lower undocumented-payment limit.
The official dates page lists December 30, 2026 for cure documents. This is not an extension of the October 30 initial claim deadline. Check your own correction letter and respond promptly. Schedule checked September 8, 2026: https://www.seniorcarecopaysettlement.com/important-dates/
How and when will I be paid?
Online filers can select PayPal, Venmo, Zelle, direct deposit or a mailed check. Mail filers receive a mailed check. Payments wait until final approval and completion of any appeals; the notice gives no definite payment date.
How do fees affect the $53 million amount?
The settlement caps total payments at $53 million. Subject to court approval, $9.9 million in legal fees, up to $100,000 in costs and up to $25,000 in combined service awards are paid before reimbursements.
The remaining money pays approved claims. If it is insufficient, payments are reduced proportionally; if money is left after claims are paid, it returns to the defendants. The $53 million is not a promise that the full amount will reach members.
Does this end future $15 copays?
No. The notice says $15 medical copays resumed on January 1, 2025. The settlement prevents them from increasing above $15 before December 31, 2027. It does not say all future copays disappear, and this lawsuit does not cover the Anthem/Empire hospital portion of Senior Care.
How do I leave the settlement?
To leave, mail a written, physically signed exclusion request to the administrator, postmarked by October 15, 2026. You can request exclusion only for yourself. Notice Question 8 lists the required case identification, personal details, lawyer information if applicable and exclusion statement; follow those complete instructions.
Leaving gives up this settlement’s payment but preserves your ability to pursue the claims yourself. You cannot object after leaving. The notice also says a valid, timely claim form makes an exclusion request ineffective.
How do I object or ask to speak at the hearing?
You may object while staying in the class, whether or not you received a claim form. File your objection with the court and send it to both sides’ lawyers by November 30, 2026. Court filing is available by mail, in person or through NYSCEF.
Notice Question 9 lists addresses and all required details, including your grounds, any lawyer, prior settlement objections during the past five years and whether you intend to attend. Follow that full list. To ask to speak, also send the signed notice of intention to appear described in Question 13 so the court and counsel receive it by November 30.
When is the final approval hearing?
The hearing is scheduled for March 24, 2027 at 2:15 p.m. in New York Supreme Court, 60 Centre Street, Room 412, New York, NY 10007. You do not have to attend to receive an approved payment. Check the official website for changes.
What happens if I do nothing?
You receive no reimbursement without a timely, completed claim. Unless you validly leave, you remain bound by the approved settlement even if you receive no money. The claims released are described in settlement agreement section 1.42 and section 4; the release is not limited to people who submit a form.
Other Important Dates
- Exclusion deadline: 2026-10-15
- Objection deadline: 2026-11-30
- Final approval hearing: March 24, 2027 at 2:15 p.m.
- Hearing location: 60 Centre Street, Room 412, New York, NY 10007
Case Details
- Case name: Bianculli, et al. v. City of New York Office of Labor Relations, et al.
- Case number: 160234/2022
- Court: Supreme Court of the State of New York, County of New York
- Administrator: Atticus Administration
- Official Settlement Website: https://www.seniorcarecopaysettlement.com/
Sources
Claim form, FAQ, deadlines, administrator information
Court-approved notice describing eligibility and benefits