For forms needing Fund validation such as optical and hearing aid, members should call the Forms Hotline at 212-539-0539. UFT Chapter Leaders have panelist listings, dental forms and other Welfare Fund literature. Current panel listings and some forms are also available online. Fund representatives are available to members who request assistance with specific health plan related problems. In any correspondence members should include their full name, address, Welfare Fund alternate ID number or social security number, and telephone number. Members should always include photocopies of appropriate documentation such as the Health Benefits Application or the claim rejection notice from the health plan and a Protected Health Information Authorization Form (PHI) giving the Health Plan permission to discuss your claims. Note: Health Insurance claim forms are available directly from the carrier and are not supplied through the Fund.
*Direct reimbursement means that a member has not utilized the services of a panel provider. When using the services of a participating provider (panelist), the panelist will submit the claim.
If a covered member or dependent is injured through the acts or omissions of a third party, the Fund shall be entitled -- to the extent it pays out benefits -- to reimbursement from the covered member or dependent from any recovery obtained from the responsible third party. Fund benefits will be provided only on the condition that the covered member or dependent agrees in writing:
To reimburse the Fund, to the extent of benefits paid by it, out of any monies recovered from such third party, whether by judgment, settlement or otherwise;
To take all reasonable steps to effect recovery from the responsible third party and to do nothing after the injury to prejudice the Fund's right to reimbursement.
In the event you receive an overpayment of Welfare Fund benefits, on your behalf or on behalf of your dependent, you are obligated to refund this overpayment to the Fund immediately. In the event you fail to refund this overpayment, the Fund can offset the overpayment against future benefits until the overpayment is fully recouped, or suspend your benefits until the said overpayment is paid in full. Such offset and/or suspension can be applied to the member’s and eligible dependents’ benefits.