Retired Firefighter Security Benefit Fund
Retired Firefighter Security Benefit Fund
Retiree Forms & Resources
Healthcare Resources
Health & Safety Programs
Military Forms
NYC Fire Pension Forms & Info
- December 2024 NYC Fire Pension Fund Mailing: Updating Beneficiaries
- Change of Address Form
- Check Affidavit
- Electronic Fund Transfer Form
- Pension Fund Manual
- Retirement Checklist
- Telephone Directory
- Tier II Vesting Info
- Tier III Vesting Info
- Vested Application
- Virtual Retirement Seminar Schedule 2025
- W-4P Form
WTC Related Forms & Info
- WTC Application Addendum
- WTC Disability Application
- WTC Disability Application for Reclassification
- WTC Counseling Services
- WTC Health Impacts
- WTC Pharmacy Benefit Manager
- WTC Physical Health Satellite Locations
- WTC Prescription Plan Fact Sheet
- WTC Medical Monitoring
- WTC Notice of Participation
- WTC Presumptive Illness Registration Form
- WTC Workers Compensation
Security Benefit Fund Forms
SBF Checklists
Beneficiaries & Enrollment
Dental
Effective January 1, 2024, UFA Members receive dental coverage through MetLife.
Health Benefits Program
- NYC OLR Health Benefits Program
- NYC Health Plans
- Health Benefits Application for Retired UFA Members
- October 2024 Rate Change Notice
- October 2024 Rate Chart - Retirees Only*
- October 2024 COBRA Package
- October 2024 Rate Chart for Young Adult Option (Dependents under 29)
- Senior Care Court Decision August 2024
- Senior Care Copay Notice 2025
Medical
- Elderly Pharmaceutical Insurance Coverage Program (EPIC)
- GHI Urgent Care Participating Providers 2023
- Medicare IRMAA Reimbursement Form
- For more information on IRMAA Reimbursements, visit: https://www1.nyc.gov/site/olr/health/retiree/health-retiree-medb-irmaa.page
- Medicare Part B Reimbursement Application
- For more information regarding Medicare Part B, please visit: https://www1.nyc.gov/site/olr/health/retiree/health-retiree-medb-irmaa.page
- Medicare Part D Plan Creditable Coverage Letter 2022
Optical
Retirees (and their eligible spouse/dependents) can submit a claim once every other year. The UFA allows retired members to claim up to $130 for optical benefits every other year. Claims go by calendar year. For example, a retired member can use their optical coverage in August 2024, then again in January 2026. See UFA SBF Optical Benefits for more details.
Prescriptions
Optical Provider
Retirees (and their eligible spouse/dependents) can submit a claim for up to $130 for optical benefits every other year.
Claims go by calendar year. For example, a retired member can use their optical coverage in August 2024, then again in January 2026. See UFA SBF Optical Benefits for more details.
The reimbursement rate is as follows:
$30 for exam
$50 for frames
$50 for lenses
or $100 for contact lenses (instead of glasses)