Senior Care Co-Pay Settlement: Up to $53 Million for NYC Retirees, Claims Close October 30, 2026
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File by October 30, 2026 · 14 days left · as of Oct 16, 2026
If you searched for the senior care pay settlement, this is almost certainly the one in the news: the City of New York and EmblemHealth agreed to refund $15 co-pays that Medicare-eligible City retirees in the GHI Senior Care plan were charged for doctor visits from January 1, 2022 through January 31, 2023. Only people who received a personalized claim form in the mail can claim. The claim deadline is October 30, 2026. Final approval has not been granted, so no money has been paid.
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Can I Still File?
The claim deadline, what the settlement pays and where to file — plus other settlements still taking claims.
File by Oct 30 · 14 days left
Senior Care Co-Pay Settlement
Fund: $53 million
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We are not a claims administrator and not affiliated with any settlement. File only at the official settlement website — filing is always free.
What the Lawsuit Said
On January 1, 2022 the City and EmblemHealth began charging a $15 co-pay for certain medical services in the Emblem-administered part of the GHI Senior Care plan.
The lawsuit alleged the co-pays violated the contract between the City and Emblem. The plaintiffs argued the Certificate of Insurance was silent on co-pays and said Medicare pays the first 80% of a reasonable charge and Emblem the remaining 20%. The defendants denied all claims, and the court never decided who was right.
The court halted the co-pays with a preliminary injunction on January 11, 2023. That injunction ended effective January 1, 2025, after Emblem filed a revised Certificate of Insurance that expressly provides for $15 co-pays — so the co-pays are back today.
Case details
Bianculli et al. v. City of New York Office of Labor Relations et al., Index No. 160234/2022, Supreme Court of the State of New York, New York County, before Justice Lyle E. Frank. It is a state-court case, not a federal one. Defendants are the City of New York, its Office of Labor Relations, EmblemHealth, Inc. and Group Health Incorporated. Five named retirees and the NYC Organization of Public Service Retirees, Inc. brought the suit on November 29, 2022. The court certified the class on October 20, 2023 (entered October 23, 2023). Class counsel are Pollock Cohen LLP and Walden Haran Williams LLP. The claims administrator is Atticus Administration LLC.
Status: Claims Open Until October 30, 2026
Claim deadline: October 30, 2026 (postmarked if mailed, received if filed online).
Opt-out deadline: October 15, 2026 — that date has passed.
Final approval hearing: March 24, 2027.
No payment date exists yet. Under the agreement, money goes out only after final approval and after any appeal is resolved. The official site, SeniorCareCopaySettlement.com, blocked our access, so the dates above come from published settlement listings — confirm them on your own claim form or at 800-814-2610. Our earlier report on the reversion clause is here.
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Who Can Claim
The class is Medicare-eligible retired New York City employees and their Medicare-eligible dependents who were enrolled in the Emblem-administered medical GHI Senior Care plan at any time from January 1, 2022 through January 31, 2023 — approximately 246,000 people, per the class notice.
The practical test is your mailbox. The administrator used EmblemHealth’s claims data to mail each eligible person a customized claim form listing dates of service and co-pay amounts. The notice says that if no claim form came with it, “you are not eligible to claim any reimbursement” — because claim forms are sent only to members whose Emblem claims data shows they could have incurred a co-pay. You are still in the class and bound by the release.
Hospital co-pays are not part of this case. The hospital side of Senior Care is run by Anthem/Empire Blue Cross Blue Shield, and the notice says the litigation does not involve those co-pays.
How Much You Can Get
1. Attorneys’ fees of $9,900,000 plus up to $100,000 in costs, if approved.
2. Up to $5,000 each for the five class representatives ($25,000 total).
3. Retiree reimbursements.
With proof (receipts, canceled checks, bank or card statements, or a signed provider letter): up to the full $15 for each co-pay listed on your form.
Without proof, if you affirm you paid: 40% of the co-pay amounts, capped at $100 per person.
If approved claims exceed what is left, payments are cut pro rata. Anything left over reverts to the City and EmblemHealth, so unclaimed money does not go to other retirees. Separately, the defendants agreed not to raise the $15 co-pay through December 31, 2027.
Senior Care Co-Pay Case Timeline
January 1, 2022 — $15 Co-Pays Begin
The City and EmblemHealth start charging $15 co-pays for certain medical services in the GHI Senior Care plan.
November 29, 2022 — Retirees Sue
Five retirees and the NYC Organization of Public Service Retirees file Index No. 160234/2022 in New York County Supreme Court.
January 11, 2023 — Co-Pays Halted
Justice Lyle E. Frank grants a preliminary injunction stopping further co-pays. The class period runs through January 31, 2023.
October 20, 2023 — Class Certified
The court certifies a class of Senior Care retirees and appoints Pollock Cohen LLP and Walden Haran Williams LLP as class counsel.
January 1, 2025 — Co-Pays Return
The injunction is vacated after Emblem files a revised Certificate of Insurance that expressly allows $15 co-pays. They are charged again from this date.
July 31, 2026 — Settlement Signed
The parties sign a settlement capped at $53 million. Opt-outs closed October 15, 2026, claims close October 30, 2026, and the final approval hearing is set for March 24, 2027.
Three Things to Watch For
A short deadline, about 246,000 older class members and a claim form keyed to a personal ID make this case an easy target:
“You didn’t get a form, but we can file for you”
Claims run on the Claimant ID printed on the form mailed to you. If you received no form, the notice says you are not eligible for reimbursement. A service promising to file without one, for a fee or a cut, cannot deliver anything.
Calls asking for your GHI member ID
The online claim asks for your Claimant ID and your GHI member ID. No one needs to phone you for them. The administrator is Atticus Administration; check any contact against 800-814-2610 from EmblemHealth’s own notice, not a number in a text message.
“Deadline extended” or “hospital co-pays too”
Messages saying you can claim after October 30, 2026, or claim hospital co-pays, contradict the settlement. Hospital co-pays administered by Anthem/Empire are excluded. Trust only your mailed form and SeniorCareCopaySettlement.com.
Senior Care Co-Pay Settlement — Questions People Actually Ask
Short answers to the questions people ask most about this case.
What is the senior care pay settlement?
It is the class settlement in Bianculli v. City of New York Office of Labor Relations, Index No. 160234/2022. The City of New York and EmblemHealth agreed to reimburse $15 co-pays charged to Medicare-eligible City retirees in the GHI Senior Care plan from January 1, 2022 through January 31, 2023, up to a $53 million cap. The defendants deny wrongdoing.
What is the senior care pay settlement amount per person?
It depends on your own co-pays. With proof of payment you can get up to $15 per co-pay listed on your claim form. Without proof you can get 40% of the listed amounts, capped at $100. All payments shrink pro rata if claims exceed the money left after $9,900,000 in fees, up to $100,000 in costs and up to $25,000 in service awards.
Is this the senior care settlement from 2022?
The co-pays at issue started on January 1, 2022, and the case was filed on November 29, 2022 — which is why people search for “2022.” The settlement itself was signed on July 31, 2026, and the claim period runs through October 30, 2026.
I never got a claim form. Can I still file?
Per the class notice, no. If no claim form was attached to your notice, you are not eligible for reimbursement, but you remain a class member bound by the release. If you think the data is wrong, call the administrator at 800-814-2610 before October 30, 2026.
When will the senior care settlement pay out?
No payment date has been set. The final approval hearing is scheduled for March 24, 2027. Payments go out only after the court grants final approval and any appeal is resolved. Online claimants can choose PayPal, Venmo, Zelle, direct deposit or a check; mailed claims are paid by check.
How do I file a claim, and where do I mail it?
Online at SeniorCareCopaySettlement.com using the Claimant ID on your form plus your GHI member ID, or by mailing the form to Senior Care Co-Pay Settlement, c/o Atticus Administration, PO Box 64053, St. Paul, MN 55164. Mailed claims must be postmarked by October 30, 2026.
What is the amount of the Blue Cross Blue Shield class action settlement?
That is a different case: the nationwide BCBS antitrust settlement, covered on our BCBS settlement amount page. This NYC case pays nothing for Senior Care hospital co-pays administered by Anthem/Empire Blue Cross Blue Shield.
What is the average settlement for nursing home neglect in Texas?
This page cannot answer that: the Senior Care case concerns insurance co-pays for New York City retirees, not care in a facility. For nursing-home claims, see our Texas nursing home abuse calculator and speak with a licensed Texas attorney.
About This Information
- Editorially Reviewed — Content reviewed for accuracy using published legal research, government data, and verified court records. See our methodology. Reviewed by Leonard Goldberg, Editor · Last updated
- $236 billion in real payouts analyzed · See what we found
This page is for general information only and is not legal advice. Lawsuit status, eligibility, and compensation can change. Settlement Insight is not a law firm and does not represent any party. Consult a licensed attorney about your specific situation.
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