Eligibility for in-service members
Who is covered?
Employees of the New York City Department of Education who are “covered” under agreements with the United Federation of Teachers, and for whom the Department contributes monies to the UFT Welfare Fund.
Any other employee who is covered by a collective bargaining agreement in which the employer makes a contribution to the UFT Welfare Fund.
“Covered employees” are hereinafter sometimes referred to interchangeably as “employees” or "members."
Covered Members — In general, subject to the requirements pertaining to the definition of “covered employees,” members in covered categories are eligible for benefits as long as they are considered in-service.
In-service status is determined by, and runs concurrently with, the period for which contributions are appropriately paid, or should have been paid for the member, by the NYC Department of Education or other appropriate entity to the UFT Welfare Fund. Members on leave with pay are considered to have in-service status.
Dependents — Dependents of eligible members as defined below are eligible for all benefits except the death benefit, disability and in some cases supplemental benefits.
- Legally married spouse.
- A "Domestic partner” — is defined as any individual, eighteen years of age or older, who is not married or related by blood to the member in a manner that would bar marriage in the State of New York, who has a close and committed personal relationship with the member, who lives with the member and has been living with same on a continuous basis, and who, together with the member, has registered as a domestic partner of the member and has not terminated the domestic partnership.
Members can obtain details concerning eligibility, enrollment and tax consequences from the New York City Office of Labor Relations Domestic Partnership Liaison Unit 212-306-7605.
- Children under age 19 — The term “children” for purposes of this and the following definitions, includes:
- Natural children;
- Children for whom a court has accepted a consent to adopt and for the support of whom a member has entered into an agreement;
- Children for whom a court of law has made a member legally responsible for support and maintenance;
- Children who live with a member in a regular parent/child relationship and are supported by the member.
The coverage termination date for children reaching age 19 will be the end of the month during which the child reaches age 19.
- Children under age 26 — The term “children” for purposes of this and the following definitions, includes:
- natural children;
- children for whom a court has accepted a consent to adopt and for the support of whom a member has entered into an agreement;
- children for whom a court of law has made a member legally responsible for support and maintenance;
- children who live with a member in a regular parent/child relationship and are supported by the member.
Enrollment Rules (Special Annual Enrollment Period for Adult Children Under Age 26) — If your adult child is currently under age 26 and has lost health benefits through his/her employer or his/her spouse’s employer for reasons other than non-payment of premium (i.e., discontinuance of employer provided health benefits) you may enroll such child in the Fund’s plan.
Eligibility becomes effective the 1st of the month following the enrollment. Additionally, each year during a special thirty (30) day open enrollment period between Sept. 1 and Sept. 30, children under age 26 may be enrolled in the Fund. The child’s coverage will be effective Oct. 1.
This special annual open enrollment period would be applicable for adult children under age 26 who previously "aged out" of Fund coverage or were over the Fund’s age limits when they first became eligible for coverage but did not enroll at that time.
Unmarried children 29 years of age or under — New York State Insurance Law allows unmarried children to be covered by the member's insured health plan, if they so choose, by paying the premium cost of the coverage until the unmarried child reaches his/her 30th birthday. Welfare Fund coverage for unmarried children 29 years of age or under will coordinate with the coverage afforded said children under New York City health plans.
If you wish to purchase the age 29 coverage (for members whose children are between ages 26 – 29), members need to complete the Application for Age 29 Young Adult Coverage UFT Welfare Benefits Only form.
If your child has never been covered by the UFT Welfare Fund in the past, you will need to complete the Update Your Information form with accompanying documentation and a separate application.
For information and to enroll your dependent child in the New York City Health Benefits Program, visit the program’s website at www.nyc.gov.
- Unmarried children who cannot support themselves because of a mental illness, developmental disability, mental retardation, or physical handicap — If the disability occurred before the age at which coverage would otherwise terminate, and the dependent was covered by the City at that time, coverage will be continued, by submitting to the Fund the acceptance of the disability letter from your basic health carrier and a completed “Disabled Dependent Child Affidavit (DDCA)” form. The form is also available by calling the forms hotline at 212-539-0539.
The following procedure must be followed:
- Obtain a “Certificate of Disability” from your basic health carrier. Complete the form and mail it directly to your carrier. Your carrier will send you a letter confirming your dependents’ disability status.
- Request a “Disabled Dependent Child Affidavit (DDCA)" form from the Welfare Fund. The form is also available by calling the forms hotline at 212-539-0539. Complete the Affidavit and return it to the Fund along with a copy of the approval letter from your carrier.