On Tuesday, September 30, 2025, the Municipal Labor Committee met at District Council 37 for the purpose of discussing and voting upon the proposed NYC Employee PPO Health Benefit Plan.
The voting structure at the MLC is a “weighted vote” that requires 66.67% of the weighted votes to be in favor of a motion to pass. After a discussion, a vote was taken and the motion passed by a margin of 87.6% in favor of the new plan, and 12.4% not in favor.
The DEA joined the PBA, SBA, UFA, and UFOA in voting not in favor. Of major concern to us was the lack of a written commitment from the City to continue to fund prescription, dental, and optical union benefits for line of duty families and the uncertainty about future funding of the PICA Program (chemotherapy and injectables).
Since the MLC has now approved the new NYC Employee PPO Health Benefit Plan, active members and pre-Medicare retirees can expect to receive literature from the City of New York explaining the new program in early October.
Here’s the backstory:
After a lengthy Request for Proposal (RFP) process, which commenced in 2022, the City of New York has proposed United HealthCare (UHC) to administer the basic health benefits package for all active employees and non-Medicare eligible retirees. The proposed plan is called the NYC Employees PPO Plan.
If adopted, it would replace the current GHI-CBP plan for service for active members and non-Medicare eligible retirees. The term of the proposed plan is five (5) years commencing January 1, 2026, through December 31, 2030, with a provision for annual renewals.
United Healthcare has partnered with Emblem Health to provide hospital and medical coverage nationally through a robust national network of doctors and hospitals acting as one cohesive plan.
The intent of the proposed plan is to do the following:
Preserve premium-free health care;
Expand access to in-network doctors for retirees residing outside of New York State;
Maintain the current network of doctors so that members can keep their current doctors;
Prevent co-pay increases;
Reduce the need for prior authorizations by 50% for certain covered services;
Vastly improve access to behavioral and mental health providers nationally;
And, maintain copay-free care at Memorial Sloan Kettering and the Hospital for Special Surgery.
The proposed plan must be ratified by the Municipal Labor Committee (MLC) and is scheduled for a vote on Tuesday, September 30, 2025. The MLC is expected to approve the proposal.
If ratified, UHC would become the new carrier for hospitalization and medical coverage for non-Medicare retirees residing outside of New York State and in certain areas of New York State, except in the counties noted below. The current Emblem network consists of 120,000 doctors nationally which would expand to approximately 1.6 million in-network doctors nationally under the proposed UHC Choice Plus Network.
Emblem Health would administer hospitalization and medical coverage for all active employees and non-Medicare retirees residing in what will be known as the “Down State Thirteen Counties (DS-13).” The DS-13 consists of the five Boroughs, Nassau, Suffolk, Westchester, Putnam, Rockland, Orange, Dutchess, and Ulster counties. Participating physicians in the DS-13 will increase from the current 64,000 in-network doctors to 78,000 in-network doctors under the Emblem Bridge Network. No disruption for hospital coverage is expected as all the current hospitals will remain in-network, including Memorial Sloan Kettering and the Hospital for Special Surgery.
More information will be forthcoming pending ratification by the MLC.
