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What do I do when my coverage terminates?

Depending upon your situation, there are many different ways to continue your coverage. They are as follows:

1. SPECIAL LEAVE OF ABSENCE COVERAGE (SLOAC) -
When on a medically approved Leave of Absence for Restoration of Health (personal illness or pregnancy related leave) which commences immediately following cessation of in-service status.

When a member is off payroll due to illness or accident, the member may be eligible to have his or her City basic health insurance and Welfare Fund benefits continued for up to four (4) months through the Department of Education’s Special Leave of Absence Coverage (SLOAC). As an additional benefit, the Welfare Fund will pay the premiums directly to your health carrier for continuing City basic health insurance, employee deductions and optional rider, for those who have elected these City coverages, for up to eight (8) additional months.

Your payroll office must file Department of Education Form EB1054 with the Bureau of Health and Welfare to activate your SLOAC benefits.

Paraprofessionals: The preceding paragraphs concerning coverage while on a medically approved sick leave without pay (personal illness or pregnancy related leave), or on an approved leave while receiving Workers’ Compensation, which commences immediately following cessation of in-service status, are also applicable to paraprofessionals.

Continuation of coverage, as stated above, is available to a paraprofessional who is on an approved leave while receiving Workers’ Compensation. You must submit the “Application for Leave of Absence for Employees in Paraprofessional Titles,” issued by the Department of Education with “Approval” indicated in the appropriate section by the Medical Director for those on authorized sick leave without pay.

Regularly Assigned Pedagogical Employees and Regular Substitutes: These members may be eligible to continue health and Welfare Fund Coverage through the Family Medical Leave Act (FMLA). Applications are available from your payroll office.

All Others: Other members may be eligible for continuation of Health and Welfare Fund benefits for a period not to exceed one (1) year if the member:

• receives an official leave for restoration of health (personal illness or pregnancy related leave) from the Department of Education which commences immediately following cessation of in-service status and
• is eligible to receive SLOAC through the Department of Education.

2. THE FAMILY AND MEDICAL LEAVE ACT (FMLA)
The Federal Family and Medical Leave Act of 1993 (FMLA) entitles eligible City employees, after twelve (12) months of employment, up to twelve (12) weeks of Family leave in a twelve (12) month period for the following reasons:

• for the serious illness of the member, or
• the birth or adoption of a child during the first twelve (12) months or for pre-natal care, or
• to care for a serious health condition of a covered family member.

Members using this leave may be able to continue their City health coverage through the FMLA provisions for unpaid leave.

Members should contact their payroll or personnel office for details. Upon submission to the Fund of documentation issued by the Department of Education verifying FMLA status, the Fund will provide Welfare Fund benefits during the FMLA period.

3. LAYOFF
Under the terms of the applicable Collective Bargaining Agreement, members may be eligible for ninety (90) days of basic health insurance and UFT Welfare Fund coverage, excluding Disability coverage.

4. COBRA
The Federal Consolidated Omnibus Budget Reconciliation Act of 1985 (COBRA), as amended, requires that the City and UFT Welfare Fund offer members, retirees and their families, the opportunity to purchase continuation of certain health and Welfare Fund benefits at 102% of the group rate (or 150% of the group rate for the 19th through the 29th months in cases of total disability) whereby the coverage would otherwise terminate. The maximum period of coverage is either 18, 29 or 36 months, depending on the reason for termination.

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