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Form 1095-B, Health Coverage, is a tax form that reports the type of health coverage you have, any dependents covered by your insurance policy and the period of coverage for the prior year.

In accordance with the federal Patient Protection and Affordable Care Act, the UFT Welfare Fund annually files a return with the IRS showing that covered members and their families had health coverage for the prior calendar year. 

If you wish to receive a copy of your Form 1095-B for coverage received in 2019, you may request it in one three ways:

  • By sending an email to 
  • By mailing a request to UFT Welfare Fund, 52 Broadway, 7th Floor, New York, New York 10004, Attention: 1095 Requests
  • By filling out the online form below.

Your form will be sent within 30 days of the date your request is received. If you have questions, please call SHIP at 212-228-9060.

Fill out my online form.