CSA Conference
Thank you all those who attend our annual Conference, last Saturday, November 1, 2025. The turnout was the largest CSA conference in history with more than 1,850 members registered to attend. In the coming weeks we will share photos and videos celebrating our collective work.
Election Results
CSA congratulates Mayor-elect Zohran Mamdani and all those elected last night to serve our city and state. As always, our union pledges to work collaboratively with all elected officials and stakeholders to keep our schools safe and ensure that every child receives a high-quality education that meets their social, emotional, and academic needs. As we collectively prepare for the transition in leadership in 2026, we look forward to building strong partnerships that lift up the voice of school leaders and support your daily service to our public schools.
City Health Care Benefits Update CHALLENGED IN COURT- COURT DATE DEC.1, 2025
As we previously shared, the city’s NYCE PPO Plan was recently challenged in court with the plaintiffs seek a temporary restraining order to halt the open enrollment and transfer period. A Manhattan Supreme Court judge rejected the petition for a temporary restraining order and set a court date for Dec. 1 to hear additional arguments in the case. Please be reminded that the plaintiffs’ objection concerns the city’s funding structure, not its coverage details, and we are closely monitoring these developments within the courts. The plan is slated to be implemented on Jan. 1 after it was approved by the MLC. This plan will cover in-service members, pre-Medicare retirees, and their dependents. The court challenges will not impact Medicare retirees regardless of any decision from the judge. Medicare retirees will be receiving updates from Emblem by mail outlining the change in prescription coverage from Express Scripts to Prime Therapeutics.
We will share updated information as we are able. In the meantime, we will continue to provide details about the plan, so that you rest easy knowing any steps you will need to take by January 1st.
City Health Plan Benefits - Annual Fall Transfer Period
The Fall 2025 Annual Health Benefits Program Transfer Period for both in-service member and retirees began November 1, 2025 and will extend to November 30, 2025.
During the Annual Transfer Period, employees may:
· Transfer into any health plan for which they are eligible
· Add or drop the Optional Rider
· Add or drop dependent(s)
· Waive benefits
Please review the Transfer Period Notices for detailed information about the transfer period and how to make changes:
In-Service members with access to HR Connect will be directed to make make changes to their health benefits online by logging into the ESS through NYCAPS.
Retired members will submit changes through the Office of Labor Relations.
Click here for detailed instructions on how to make changes.
To learn more about the Health Plans offered, please click here to visit the Summary of Plans & Rates page for the following information:
· Health Plan Rate Chart for Employees and Retirees
· Summary Program Description (SPD)
· Summary of Benefits and Coverage (SBC)
· Links to the Health Plans’ websites for additional health plan
NOTE: The NYCE PPO plan is subject to finalization and approval through the city’s contracting process.
Please note the provider directory on the NYCE PPO site was updated on October 3rd. If you could not find a provider in a search prior to that, we encourage you to try again.
CSA News
Please click here for the most recent issue of the CSA News, which includes comprehensive information on the city’s updated health care plan. Paper copies are also being mailed to the address on file.
City Health Care Plan ON HOLD UNTIL FURTHER NOTICE
On September 30, the Municipal Labor Committee (MLC), a coalition of over a hundred unions, voted to approve the City’s updated health plan. The NYC Employees PPO Plan passed with almost 90% support from MLC members.
As we previously shared, this plan will cover in-service members, pre-Medicare retirees and their dependents.
According to the City, the NYCE PPO Plan will take effect January 1, 2026, and the open enrollment and transfer period will begin November 1, 2025. (We will provide more information about next steps in the coming days.)
Nothing is more important to us than the health and well-being of you and your family. From the moment this plan was first raised a couple of years ago, our goal has been to ensure our union is among the best-informed to strategically advocate on your behalf. The NYCE PPO Plan locks in a five-year agreement to provide you with high-quality, premium-free health care with expanded access and mental health services.
Last week, CSA Welfare Fund’s director Susan Barone delivered a virtual presentation to highlight the improvements from our current plan and address members’ questions.
The zoom webinar can be accessed by clicking here (Password: if2$bJuQ)
This webinar is only the start of how we will support and protect you. We will continue to address your questions in the coming weeks and months, so please continue to share with sbarone@csawf.org.
We will also provide comprehensive details in emails, on our website, in webinars, and in the CSA news, so that you rest easy knowing any steps you’ll need to take by January. We’ll monitor the rollout of the update plan, flag any concerns, and hold the City accountable to provide the health care you deserve and have earned.
Medicare Retirees - Prescription Manager (DOE-Based)
Beginning January 1, 2026, Emblem Health has decided to update the prescription benefit manager (PBM) for all DOE-based retirees from Express Scripts to Prime Therapeutics. Before then, you will receive a new ID card and important communications directly from Prime.
Please review all mailings carefully, as they may include steps you’ll need to take—such as selecting a new in-network pharmacy if your current one is not included, reviewing updates to the drug formulary, or confirming information if you use home delivery services. The process of transferring your current medications will be automatic, and you do not need your doctor to call in new prescriptions. If any medication you take is affected by formulary changes, Prime will notify you, and temporary transition supplies may be available while you and your doctor determine alternatives. You will be notified if the pharmacy you currently use is not in-network.
Medicare Retirees will remain on Medicare with the current Emblem/GHI Supplemental plan with no change to medical coverage.
For questions about the plan email Susan Barone, CSA Welfare Fund Administrator at sbarone@csawf.org
IRMAA Reimbursement Payment for 2025 for DOE Retirees
For those who submitted your IRMAA reimbursement forms in a timely manner, (the Office of Labor Relations considers timely – before July 1, 2025) the first round of payments should have landed in the same bank account you receive your pension, this past Friday October 11th. Note that OLR will continue making payments over the next several weeks. Also note, if you submitted one document with your partner or spouse included, some members received reimbursement for one person. The second reimbursement should also appear within six weeks. It is not too late to submit your IRMAA reimbursement form for 2025 as OLR allows a three-year look back.
Social Security Benefit Increase for 2026
Social Security benefits and Supplemental Security Income (SSI) payments for 75 million Americans will increase 2.8 percent in 2026. On average, Social Security retirement benefits will increase by about $56 per month starting in January. Over the last decade the cost-of-living adjustment (COLA) increase has averaged about 3.1 percent. The COLA was 2.5 percent in 2025.
Nearly 71 million Social Security beneficiaries will see a 2.8 percent COLA beginning in January 2026. Increased payments to nearly 7.5 million people receiving SSI will begin on December 31, 2025. Those who have a personal my Social Security account can view their COLA notice online, which is secure, easy, and faster than receiving a letter in the mail. You can set up text or email alerts when a new message–such as your COLA notice–is available in your my Social Security account. You will need to have a personal my Social Security account by November 19 to see your COLA notice online.
To get started, visit www.ssa.gov/myaccount.
Turning 65 Webinar
Susan Barone and Mark Brodsky will be hosting a Turning 65 Webinar for all members turning 65 who will be transitioning to Medicare in 2026. Members are welcome to join the zoom with dependents who are covered by the NYC Health Plan and would like to learn how to apply for Medicare, coordinate benefits with the NYC Health Plan and apply for Medicare Part B Reimbursement.
When: Jan 22, 2026 at 4:00 PM
Register in advance for this webinar:
https://us06web.zoom.us/webinar/register/WN_DANjCjZDTEWkBq2_K7ueSA
After registering, you will receive a confirmation email containing information about joining the webinar.
Teachers Retirement System - On Line Programs
Members who would like to attend an online educational program must register in advance for and submitting the registration form. Visit www.trsnyc.org Resources - Educational Programs.
Retired Members
Monday, December 8, 2025
TDA Options After Retirement (3:00 pm to 5:00 pm)
Tuesday, December 23, 2025
TDA Options After Retirement (3:00 pm to 5:00 pm)
Tuesday, January 6, 2026
Death Benefits After Retirement (11:00 am to 12:30 pm)
Tuesday, January 13, 2026
Advance Planning for Retirees (11:00 am to 12:30 pm)
Tuesday, January 20, 2026
Reviewing Your Benefits Letter (11:00 am to 12:30 pm)
Tuesday, January 27, 2026
Retiree Website Tour (11:00 am to 12:30 pm)
AFSA Scholarship
Up to $4,500 for Children of AFSA Members Attending College for the First Time in 2026. The 2026 Diann Woodard Scholarship online application and guidelines are now open. If you have a graduating high school senior planning to attend college in 2026, now is the time to encourage them to apply!
The program helps students continue their education by awarding five one-time $2,500 college tuition scholarships to outstanding high school seniors. This year, there will be a supplemental $2,000 award added to each scholarship courtesy of M3 Technology.
Every year, AFSA takes pride in celebrating the achievements of our members’ families through the Scholarship Program. The AFSA General Executive Board will select five awardees this year based on academic excellence, passion for volunteerism and display of exceptional work ethic.
Students who apply must clearly express their goals for the future and appropriately tie these goals to their higher education aspirations.
The Deadline is January 16, 2026.
Informational Update Vol 16 #9
1. Acupuncture – On January 1, 2017, the CSA Welfare Fund first covered acupuncture (only 18 visits) through its supplemental medical benefits. In 2019, the coverage was expanded to 36 per year. Medicare offered no coverage for this service until 2021 when it covered 12 visits in a 90-day period for chronic lower back pain
Medicare will cover the 12 visits in a 90-day period for chronic lower back pain providing:
· The pain lasts 12 weeks or longer
· The pain is not related to spreading cancer, inflammatory or infectious disease
· The pain is not associated with pregnancy or surgery.
Medicare also covers an extra 8 sessions if your doctor indicates that your chronic back pain shows improvement. If the doctor indicates there is no improvement or your condition is getting worse, then Medicare will not cover the additional sessions.
Medicare covers no more than 20 treatments yearly. These treatments may only be used for chronic lower back pain.
Once you have used your allotted 20 treatments (12 + 8), or if you are not eligible for Medicare reimbursement—either because you do not meet its requirements or are not Medicare-eligible—you may turn to the CSA Retiree Welfare Fund and the CSA Retiree Chapter for additional coverage.
v CSA Retiree Welfare Fund – You are allowed a maximum of 36 visits a year. The maximum allowable charge for reimbursement is $100 per visit, although the acupuncturist may charge more than the $100. After an annual $100 deductible you will be reimbursed 80% of the cost.
The provider must be legally certified to practice acupuncture under the provider’s state license. If the provider is not state licensed or lives in a state that does not have a state license, then he or she must have a certificate from the National Certification Commission for Acupuncture and Oriental Medicine (NCCAOM).
To file a claim, submit the bill, proof of payment, and on the first claim, the provider’s state license or certification.
v CSA Retiree Chapter – You will get an additional 20%
reimbursement of whatever the Fund reimburses you. You do not have to apply for it as the process is a seamless operation. The reimbursement should come about 2 weeks after the Fund reimbursement.
2. 2026 Medicare Handbook –The 2026 Medicare is now available for your use. It contains valuable information about Medicare’s benefits and costs. You can obtain either a hard copy or an electronic one. The advantage of the electronic copy is that the information is most up to date.
If you want to order a hard copy, you need to have a Medicare account. If you don’t have an account, go to www.Medicare.gov and follow the prompts. Once you have an account, login and click on the link, Get my Medicare Summary Notices electronically. You will then see a box labeled, “Medicare & You” handbook. Click on the link, “paper” in the box and Medicare will eventually mail you the handbook.
3. Question of the Month
Q. I am eligible for 2024 IRMAA but have not yet applied. Am I too late to do so?
A. No, you can still apply. Just make sure to check the 2024 box and sign the application. You can mail the application along with the proper documents to the Office of Labor relations. The address is:
NYC Office of Labor Relations
Health Benefits Program
22 Cortlandt Street, 12th Floor
New York, NY 10007
You can also submit the application electronically. Instructions on how to do it on OLR’s website, https://www.nyc.gov/olr.
Norm Sherman
Florida CSA Retiree Chapter Liaison & Outreach Coordinator
nshermzie@aol.com