File a claim for GHI Senior Care copays

As you know, a recent class action settlement with the city and EmblemHealth will give Medicare-eligible retirees in GHI Senior Care a reimbursement for copays they paid between January 2022 and February 2023. We wanted to follow up with you to let you know more about how to file a claim to get your reimbursement.

What to look for:

You should have received an email and a paper claim in your postal mail from Atticus Administration. Atticus Administration is the third-party company that EmblemHealth is using to process the reimbursement claims.

What to do:

You must either fill out the paper claim or use the electronic claim form that was sent to you via email. You must submit your claim by Oct. 30, 2026.

If your spouse or domestic partner is on your GHI Senior Care plan, they may also file a claim for reimbursement for the copays they made between January 2022 and February 2023.

What is needed on the claim form:

• Provide your correct name and address if the pre-populated information on the claim form is incorrect.
• If necessary, indicate whether you are submitting proof of legal name change or evidence of authority to act on behalf of the class member (if, for example, the class member is deceased) and, if so, specify the type of proof you are submitting.
• Provide your contact information, such as an email address and/or telephone number.
• For each copay listed on the pre-populated form, confirm whether you did in fact pay the copay.
• For each copay listed, indicate whether you are submitting proof that you paid the copay and, if so, specify the type of proof you are submitting.
• Sign the affirmation at the bottom of the claim form. Signature is required to receive reimbursement.

You must submit the completed, signed claim form and any supporting documents by Oct. 30, 2026.

What documentation is needed:

To be eligible for up to full reimbursement for any or all of the copay(s) listed on your claim form, you must submit proof of payment of each copay. Acceptable proof includes:

• a receipt
• a canceled check
• a bank statement
• a credit card statement
• a written letter from the provider confirming that you paid the copay (use the provider form letter attached to your claim form)

Please do not send original documents. Redact — blacken out or otherwise make unreadable — any sensitive information from the documents. The documents you submit will not be returned to you.

What to do if you do not have documentation:

If you do not have proof of payment for any or all of the copay(s) listed on the claim form, you can still be eligible for a partial reimbursement. You must submit the completed claim form and sign the section affirming that you actually paid the copay(s). All claim forms will be reviewed by the claims administrator. If the claims administrator approves the claim as eligible for a partial reimbursement, any reimbursement for copays for which you do not have proof of payment will be limited to up to 40% of the copay amount, up to a maximum of $100.

More information:

You can find more information in the email and postal mail that you received from Atticus Administration. You can also visit their website for complete details and frequently asked questions.

Need help?

If you need assistance, you can reach out to the UFT Welfare Fund at 212‑539‑0500.