Health and Welfare

 The 2021 Medicare Part B IRMAA Reimbursement Form has been released by the City Office of Labor Relations.  It is available by clicking here or going to our website, www.csawf.org, and clicking on the MEDICARE REIMBURSEMENT tab on the left, then clicking on the form.

IRMAA is the Income Related Monthly Adjustment Amount that many retirees must pay based on their Medicare adjusted gross income.  As a result of past negotiations between the Municipal Labor Committee, representing all workers, and the City,  Medicare eligible retirees are entitled to full reimbursement of their Part B premiums.

The standard Part B premium in 2021 was $148.50 per person per month,  $1,782.00 for the entire year, which was deposited to the account where you receive your pension (or sent by paper check if you still receive a pension check) on Aptil 15th.

At this time you may apply for any applicable IRMAA amount for Part B that you, and/or a covered dependent, paid in 2021.  Once again the CSA Retiree Welfare Fund extends an offer to review the forms for completeness for you.  If all is correct we will deliver electronically to the Office of Labor Relations.  You may email the forms to dhathaway@csawf.org or mail to our office.  If you would like confirmation that all is in order please include your email address.

If you and your spouse/domestic partner are each New York City retirees, and each have your own health plan, you each must submit your own reimbursement form.  We will review your spouse/partner's submission as a courtesy.

We will need the following documents to complete your submission to the City.  Please select the situation that best fits your submission status

If you received Social Security Benefits in 2021

• Completed 2021 IRMAA Application.  - signed and dated

• First page of the NOVEMBER 2020 Social Security Letter showing 2021 payments.  (The letter needed for 2021 was received before the year, and shows what you were to pay.  Do not send the November 2021 letter - that is for the 2022 reimbursement)

• Copy of SSA-1099 form for 2021 showing what you paid for Part B in 2021.  DO NOT SEND TRS 1099 FORM

If you DID NOT receive Social Security Benefits in 2021

• Completed 2021 IRMAA Application.  - signed and dated

• First page of the NOVEMBER 2020 Social Security Letter showing 2021 payments.  (The letter needed for 2021 was received before the year, and shows what you were to pay.  Do not send the November 2021 letter - that is for the 2022 reimbursement)

• Copy of the monthly billing statements and proof of payment ( Cancelled check, page from bank statement / credit card statement showing payment )

If you began receiving Social Security Benefits mid-year

• Completed 2021 IRMAA Application.  - signed and dated

• First page of the NOVEMBER 2020 Social Security Letter showing 2021 payments.  (The letter needed for 2021 was received before the year, and shows what you were to pay.  Do not send the November 2021 letter - that is for the 2022 reimbursement)

• Copy of the monthly billing statements and proof of payment ( Cancelled check, page from bank statement / credit card statement showing payment ) for the months before receiving social security benefits and the SSA-1099 Form showing payments deducted from your social security benefits.