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.

1. Legally married spouse.
2. 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.
3. Children under age 26 — The term “children” for purposes of this and the following definitions, includes:
    
   1. Natural children;
   2. Children for whom a court has accepted a consent to adopt and for the support of whom a member has entered into an agreement;
   3. Children for whom a court of law has made a member legally responsible for support and maintenance;
   4. 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 26 will be the end of the month during which the child reaches age 26.
4. 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. 
5. 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:
   1. 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.
   2. Request a “Disabled Dependent Child Affidavit (DDCA)" form from the Welfare Fund. Complete the Affidavit and return it to the Fund along with a copy of the approval letter from your carrier.