Search
Welfare Fund Green Apple benefits booklet for in-service members
View or download the Green Apple guide to UFT Welfare Fund health benefits for in-service members and their families.
Instructions to download W-2 tax forms from NYCAPS Employee Self Service (ESS)
See instructions with screenshots to download and print your W-2 tax form from the DOE's NYCAPS Employee Self Service (ESS) platform.
Enrolling and updating
Learn how to enroll in the UFT Welfare Fund or update your coverage as your family changes.
Application for seniority credit for prior paraprofessional service - DOE form
This form is to be used to receive seniority credit for prior paraprofessional service by pedagogical personnel who have received a regular appointment.
Benefit description
All eligible members and dependents are covered for optical benefits. Learn more about eligibility and obtaining benefits.
UFT Incident Report
Use this confidential form to notify the UFT School Safety Department if you have been the victim of an incident and/or injury. Or fill out the online incident report form.
Legal Referrals Form
Legal referrals injury claim form
Child Care Provider Attestation of Costs Form OCFS-6060
This form is used to request a Market Rate increase if you serve only children receiving child care assistance.
Teacher's Choice Request for Non-Participation form (opt-out)
Eligible DOE employees who choose not to participate in the Teacher's Choice Program must complete this form and submit it to the Teacher's Choice Unit at the DOE by the due date indicated .
OP160.E1 - Material change/extenuating circumstances exception request
Members currently on a leave may use this form to request an extenuating circumstance for missing the deadline to submit your intention for the next school year or to modify your intention due to a material change.
PD-19 Application for Leave of Absence with Pay for Administrative Employees
PD19 form for Leave of Absence with Pay for Administrative Employees - including nurses and therapists
What is the HCFSA Program/Flexible Spending Account and how can it help with medical expenses? What is this?
The HCFSA is a flexible spending account for health care expenses. Here is how the HCFSA Program works: First, you contribute before-tax dollars into your HCFSA account via automatic payroll deductions. Next, in order to receive reimbursement, you...
Teachers Choice Accountability Form
Teacher's Choice participants use this form to inform their school principal of purchases made with Teacher's Choice funds. Once completed, attach all original receipts/invoices and submit to your school principal for review.
Who is General Vision Services (GVS)?
For years, GVS has served as the third-party administrator for the Welfare Fund’s optical program, providing services such as claim processing. GVS will now also maintain new resources such as the program's website and mobile app. Their dedicated UFT...
Durable Medical Equipment Deductible Reimbursement Form - NYCE PPO in-service subscribers only
For NYCE PPO in-service members only, the Welfare Fund will reimburse up to $100/year of the deductible for the purchase or rental of durable medical equipment, with this form and an original Explanation of Benefits (EOB).
Your Health & Wellness
Members of the Family Child Care Providers chapter have access to a wide range of health and wellness benefits and services at no additional cost. See each health program below for more details.
DOE form to receive salary credit for prior work experience
DOE form to receive salary credit for prior work experience
UFT increases Welfare Fund benefits
The UFT is enhancing its Welfare Fund optical benefit and hearing aid benefit for in-service members and retirees effective March 1, 2022.
Participating Panelist Program
Information on your eligibility for benefits will be available not only to you and your eligible dependents, but also to optical service providers, making it easier to schedule appointments and use your benefits for covered services.
Plan details and coverage
Coverage for eligible members begins on their first day of employment, provided the member has enrolled in a timely manner.
Join the Union!
Enroll online to become a member of the UFT and tap into powerful support and benefits.
Rate Increase Request Form for Providers NYC FS-023
This form is used to request a Market Rate increase if you serve both children receiving child care assistance and children who do not receive child care assistance (private pay).
Market Rate Application Form – Registered Family and Licensed Group Providers
Registered family and licensed group providers whose rates listed on file with ACS are not already higher than the 2007 market rate should use this form to apply to receive the new market rate moving forward and retroactively.
Retiree Toolkit: TDA Deferral Status Election Form
Retiring members should complete this form if they are filing for retirement under the Qualified Pension Plan (QPP) and are Tax-Deferred Annuity (TDA) Program participants who want to defer distribution of their TDA funds past the date on which they...
Membership Application (all DOE titles except paraprofessionals)
UFT membership application for all DOE titles except paraprofessionals. Print, complete and submit this application form only if you are not able to use the UFT's online enrollment form.
Can I go to an optician not listed on the UFT Welfare Fund panel?
Yes, however it is to your advantage to use a participating provider. First, you can take advantage of additional discounts our panelists provide. Second, if you have a problem, the UFT Welfare Fund will help resolve any issues. If you use a non...
Hazardous Chemical Exposure Incident Report
Use this form to document a hazardous chemical exposure incident in your school. Parts I, II, and III of the form are included.
Direct Reimbursement Program
Under direct reimbursement, which can only be used if you utilize a non-participating provider, you are required to pay for the full cost of the service at the optician and submit to the Fund for payment.
T-Bank Stop Payment Request Form
This form is for payroll secretaries.
OP 175: Application for per session employment & retention rights
This form must be completed and submitted to the per session supervisor prior to commencement of employment in a per session activity. Waivers for per session activities that will exceed 400 hours must be submitted electronically through the DOE's...