Forms for health benefits

This form is for retired members who have elected a New York City optional rider or New York City health plan, or are covered under their spouse’s/domestic partner’s NYC health plan.

This form is for retired members who have elected a non-New York City optional rider for health insurance or prescription plan, or are covered under their spouse’s/domestic partner’s non-NYC health plan.

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

For HIP subscribers only, includes a section for member and physician to fill out. Please attach original, itemized, paid bill showing date and item purchased.

For UFT Chapter Leaders: Do you and your co-workers want to understand your Welfare Fund benefits better? By filling out this form you can request a Welfare Fund representative to come to your school and provide an overview of the benefits, with a question and answer period.

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

Step Therapy is a program especially designed for people who take prescription drugs regularly to treat ongoing medical condition(s). The program is a new approach to getting you and your family the prescription drugs you need.

The Affordable Care Act requires group health plans to provide a Summary of Benefits and Coverage (SBC) to plan participants so they may better understand their coverage. In compliance with this law, the UFT Welfare Fund has completed an SBC regarding the essential benefit we provide, our prescription drug plan.