2006 New York Code - Health Insurance Coverage For City Employees, Persons Retired From City Employment, And Dependents Of Such Employees And Retirees.

 
    § 12-126 Health insurance coverage for city employees, persons retired
  from  city employment, and dependents of such employees and retirees. a.
  Definitions. As used in this section, the following terms shall have the
  meaning hereinafter stated:
    i. "City employee." A person: (1) who is employed by a  department  or
  agency of the city; and (2) is paid out of the city treasury; and (3) is
  employed  under  terms  prescribing  a work week regularly consisting of
  twenty or more hours during the fiscal year; and (4) is not employed  by
  the board of education.
    ii.  "City  retiree."  A  person  who:  (1)  is receiving a retirement
  allowance, pension or other retirement  benefit  from  a  retirement  or
  pension  system  either  maintained by the city or to which the city has
  made contributions on behalf of such person pursuant to subdivision  (g)
  of  section  80-a  of  the  retirement  and social security law; and (2)
  immediately prior to such  person's  retirement  as  a  member  of  such
  system,  was  a  city  employee,  or  was  an  employee  of the board of
  education  employed  under  terms  prescribing  a  work  week  regularly
  consisting  of  twenty or more hours during the fiscal year; and (3) had
  at the time of retirement, at least five years of credited service as  a
  member  of  such  retirement  or  pension  system,  except that (A) such
  requirement of credited service shall not apply in cases  of  retirement
  for accident disability, and (B) the requirement of credited service for
  vested retirement and service retirement shall be at least ten years for
  a  person  who was not an employee of the city or the board of education
  on or before the effective date of the local law that added this clause.
    iii. "Dependent." The spouse of a city employee or city retiree or any
  child  of  a  city  employee  or  city  retiree  during  the  period  of
  eligibility  of  such  child  for  coverage under the insurance contract
  applicable to such employee  or  retiree;  provided,  however,  that  no
  spouse  or  child  of  any  such  employee  or retiree shall be deemed a
  dependent after the death of such employee or retiree.
    iv.     "Health     insurance     coverage."     A     program      of
  hospital-surgical-medical   benefits   to  be  provided  by  health  and
  hospitalization insurance contracts entered into between  the  city  and
  companies providing such health and hospitalization insurance.
    b.  Payment of health insurance costs. Except as otherwise provided in
  section  12-126.1  and  section  12-126.2  of  this  chapter,  for  city
  employees, city retirees and their dependents:
    * (1)  The  city will pay the entire cost of health insurance coverage
  for city employees, city retirees, and their dependents, not  to  exceed
  one  hundred  percent  of  the  full cost of H.I.P.-H.M.O. on a category
  basis.   Where such health  insurance  coverage  is  predicated  on  the
  insured's  enrollment  in  the hospital and medical program for the aged
  and disabled under the Social Security Act, the city will pay the amount
  set forth in such act under 1839 (a) as added by title XVIII of the 1965
  amendment to the Social Security Act; provided that  such  amount  shall
  not  exceed  the sum of nineteen dollars and fifty-three cents per month
  per individual for the period beginning January first, nineteen  hundred
  eighty-eight   and   ending   December  thirty-first,  nineteen  hundred
  eighty-eight, and provided further however that such  amount  shall  not
  exceed  the  sum  of twenty-seven dollars and ninety cents per month per
  individual for the period  beginning  January  first,  nineteen  hundred
  eighty-nine   and   ending   December   thirty-first,  nineteen  hundred
  ninety-one, and provided further that such amount shall not  exceed  the
  sum  of  twenty-nine  dollars  per  month  per individual for the period
  beginning January first, nineteen hundred ninety-two and ending December
  thirty-first, nineteen hundred ninety-five. Provided further, that  such
  amount  shall  not  exceed  the  sum of thirty-two dollars per month per


  individual  effective  January  first,  nineteen   hundred   ninety-six.
  Provided  further,  that  such  amount  shall  not  exceed  the  sum  of
  thirty-eight dollars and  seventy  cents  per  month  effective  January
  first,  two thousand and provided further that each year thereafter, the
  City shall reimburse covered employees in an amount equal to one hundred
  percent of the Medicare Part-B premium rate applicable to that year.
    * NB The validity of local law 39 of 2001 is currently  a  subject  of
  disagreement  between the Mayor and the City Council. This certification
  is not intended as a legal opinion as to the validity of the local  law,
  other than certifying the truth of the facts presented herein.
    (2)  Health  insurance  coverage for surviving spouses and children of
  police officers, firefighters and certain other city employees:
    (i) Where the death of a member of the uniformed forces of the  police
  or  fire  departments  is  or was the natural and proximate result of an
  accident or injury sustained while  in  the  performance  of  duty,  the
  surviving  spouse  or  domestic  partner,  until he or she dies, and the
  children under the age of nineteen years  and  any  such  child  who  is
  enrolled  on a full-time basis in a program of undergraduate study in an
  accredited degree-granting institution of higher  education  until  such
  child  completes  his  or  her educational program or reaches the age of
  twenty-three years, whichever comes first, shall be afforded  the  right
  to  health  insurance  coverage,  and health insurance coverage which is
  predicated on the insured's  enrollment  in  the  hospital  and  medical
  program  for  the aged and disabled under the social security act, as is
  provided for city employees, city retirees and their dependents  as  set
  forth in paragraph one of this subdivision. The mayor may, in his or her
  discretion,  authorize  the  provision of such health insurance coverage
  for the surviving spouses, domestic partners and children  of  uniformed
  correctional  and  sanitation  employees  who  died on or after November
  first, nineteen hundred  ninety-six  and  before  February  eighth,  two
  thousand  five, the surviving spouses, domestic partners and children of
  employees of the fleet services division of the  police  department  who
  died on or after October first, nineteen hundred ninety-eight and before
  April   thirtieth,  nineteen  hundred  ninety-nine,  and  the  surviving
  spouses, domestic partners and children  of  employees  of  the  roadway
  repair  and maintenance division of the department of transportation who
  died on or after September first, two thousand five and before September
  twenty-eighth, two thousand five, as a natural and proximate  result  of
  an  accident  or  injury  sustained  while  in  the performance of duty,
  subject to the same terms, conditions and limitations set forth  in  the
  section.  Provided,  however, and notwithstanding any other provision of
  law to the contrary, and solely for the purposes of this subparagraph, a
  member otherwise covered by this subparagraph shall be  deemed  to  have
  died  as  the  natural  and  proximate  result  of an accident or injury
  sustained while in the  performance  of  duty  upon  which  his  or  her
  membership  is  based,  provided  that such member was in active service
  upon which his or her membership is based at the time that  such  member
  was  ordered  to active duty, other than for training purposes, pursuant
  to Title 10 of the United States Code, with  the  armed  forces  of  the
  United States, and such member died while on active duty on or after the
  effective  date  of  the  chapter of the laws of two thousand five which
  amended this subparagraph while serving on such active military duty.
    (ii) Where a retired  member  of  the  fire  department  dies  and  is
  enrolled  in  a  health  insurance  plan,  the surviving spouse shall be
  afforded  the  right  to  such  health  insurance  coverage  and  health
  insurance  coverage  which  is predicated on the insured's enrollment in
  the hospital and medical program for the aged  and  disabled  under  the
  social  security act as is provided for retirees and their dependents as


  set forth in subparagraph (i) of this paragraph, provided such surviving
  spouse pays one hundred two percent of the group rate for such coverage,
  with two  percent  intended  to  cover  administrative  costs  incurred,
  provided  such  spouse  elects such health insurance coverage within one
  year of the death of his or her spouse.
    (iii) Where a retired  member  of  the  police  department,  including
  premerger  retirees  who  were  police officers employed by the New York
  city housing authority or the New York city transit authority, dies  and
  is  enrolled  in  a health insurance plan, the surviving spouse shall be
  afforded  the  right  to  such  health  insurance  coverage  and  health
  insurance  coverage  which  is predicated on the insured's enrollment in
  the hospital and medical program for the aged  and  disabled  under  the
  social  security act as is provided for retirees and their dependents as
  set forth in subparagraph (i) of this paragraph, provided such surviving
  spouse pays one hundred two percent of the group rate for such coverage,
  with two  percent  intended  to  cover  administrative  costs  incurred,
  provided  such  spouse  elects such health insurance coverage within one
  year of the death of his or her spouse.
    c. Any amount paid by the city  pursuant  to  subdivision  b  of  this
  section  shall  not be deemed to be salary, wages or compensation within
  the meaning of any law relating to any retirement or pension system  and
  shall  not  be  considered  or  included for the purpose of computing or
  determining employee or city contributions or the rights, allowances and
  benefits  to  which  a  city  employee  or  such  employee's  heirs   or
  beneficiaries  shall  become  entitled  under  any retirement or pension
  system;  and  shall  not  be  construed  as  a  change   of   grade   or
  classification or as a promotion to higher grade or position.
    d.  Such  health  insurance coverage as is provided under this section
  shall be administered by office of labor relations.