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UFT Welfare Fund Health Plan Comparison Chart Wall Chart

Summary comparison of health plans for employees and those retirees not eligible for Medicare.

Personnel Memorandum #4: Disability Accommodation Request

This memorandum supersedes Personnel Memorandum #51, 1997-98. It is the policy of the NYC Department of Education to provide equal employment opportunity to all qualified individuals with disabilities. Any current or prospective employee who is a...

Personnel Memorandum #25, 1996-1997: Information For Survivors of a Deceased Pedagogical or Administrative Employee

This directory should be a valuable source of information to survivors or executors designated to handle the estate of a deceased employee.

Special Circular #28, 1990-1991: Lesson Plans

Planning by teachers is a critical element in the educution of our students. This planning provides a blueprint for such educational priorities as the implementation of curriculum, the development of long and short-term expectations for student...

TRS BK11: Account Number Change Form for Electronic Fund Transfer

Please file this form only if you meet one or both of the following conditions: You are receiving Qualified Pension Plan (QPP) and/or Tax-Deferred Annuity (TDA) payments from TRS through Electronic Fund Transfer (EFT); and The account number at your...

TRS BK19: EFT/Direct Deposit Cancellation Request Form

Please complete this form if you would like to cancel the Electronic Fund Transfer (EFT) or Direct Deposit of one or both of the following: a) your monthly retirement allowance under the Qualified Pension Plan (QPP); or b) your monthly annuity...

TRS BK58: EFT Authorization Form

Electronic Fund Transfer (EFT) is a payment system that allows TRS retirees and beneficiaries receiving lifetime benefits to have their monthly Qualified Pension Plan (QPP) and/or Tax-Deferred Annuity (TDA) Program payments electronically transferred...

Request for Payment of Overtime

This form is used by school nurses and occupational and physical therapists.

Chancellor's Regulation C-200: License Terms

This regulation is directed to applicants for positions and those concerned with the administration of the licensing procedure.

Chancellor's Regulation C-240: Teacher License Requirements

This regulation sets forth the requirements for the following licenses: Pre-Kindergarten and Elementary School Teacher, Reading Teacher, Teacher of English as a Second Language, School Media Specialist (Library), Instructional Recorder, Teaching an...

Chancellor's Regulation C-251: License Requirements for Adult Education

The regulation sets forth the requirements for license of Teacher of Basic English as a Second Language to Adults, Teacher of Basic Literacy to Adults and Teacher of Occupational Subject to Adults.

Chancellor's Regulation C-266: Laboratory Specialist in Secondary Schools License Requirements

This regulation prescribes the license requirements for Laboratory Specialists in Secondary Schools.

Chancellor's Regulation C-274: License Requirements for School Psychiatrist

This regulation prescribes the requirements for license for School Psychiatrist.

Anesthesia Benefit Claim Form - HIP Subscribers Only

Although the cost of anesthesia for hospitalization, emergency illness or accidental injury should be covered in full by HIP/HMO, the Welfare Fund will pay 80% of reasonable, usual and customary charges when not covered by HIP/HMO.

Child Care Coverage Request Form

Members on an approved Child Care Leave who are currently covered by the UFT Welfare Fund are eligible to receive extended UFT Welfare Fund benefits for up to a maximum of six (6) consecutive months for the birth or adoption of a child.

Dental Claim Form Instructions

These instructions explain how to fill out your dental claim form either after treatment or for pre-treatment estimates for more complicated procedures such as periodontic surgery, bridges, crowns, inlays, dentures and other procedures that cost over...

Dental Enroll/Transfer Form

As a new member you are automatically enrolled in the Scheduled Benefit Plan. If you wish to enroll in one of the other UFT Welfare Fund dental options use this form. All other members and retirees who wish to transfer from one UFT Welfare Fund...

Dependent Child Affidavit

Fill out and have this form notarized for your dependent child to ensure coverage by the UFT Welfare Fund benefit plan.

Direct Access Dental Plan

This fully explains the benefits available under the UFT Welfare Fund Direct Access Dental Plan (SIDS – Self-Insured Direct Services) and includes a subscription form at the end.

Disabled Dependent Child Affidavit

Fill out and have this affidavit notarized to cover unmarried children over age 26 who cannot support themselves because of a mental illness, developmental disability, mental retardation or physical handicap under the UFT Welfare Fund Benefit Plan....

Drug Reimbursement Form for In-Service Members

Include all original pharmacy receipts with prescription detail clearly noted which must include the name, strength, quantity and price. Please attach to this form. Receipts must be mailed within 90 days from date of service. Reimbursement will be in...

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).