Eligibility

I just got hired with a company that has TeamCare healthcare. When do I become eligible for Plan Benefits?

Your coverage begins the Sunday after your employer has made Plan contributions to TeamCare for eight weeks on your behalf within a 52-week period. In other words, coverage begins on the 9th week of contributions within a 52-week period.

Your Collective Bargaining Agreement (CBA) explains when your employer is required to begin making contributions. Note: the eight week contribution requirement is waived for new Employer Groups that join TeamCare.

If I die before I retire, what benefits are available for my family?

If you die while still working, your beneficiaries may be entitled to Life Insurance and Accidental Death. In addition, your family may be eligible for continued health coverage up to 5 years. Survivors should contact us to discuss eligibility.

When am I eligible for my next dental appointment?

If your plan includes dental benefits, members and their covered dependents may receive oral exams once every six months. Oral exams are covered under the preventative services portion of your dental plan. For more information, review My Benefits on your dashboard.

When am I eligible for benefits after my return to work from layoff?

If you’re out of work for less than 52 weeks, coverage is in effect the first week Health Plan contributions on your behalf are made to TeamCare. If you’re out of work more than 52 weeks, your coverage begins the Sunday after Health Plan contributions have been made to TeamCare on your behalf for eight weeks within a 52-week period.

Why did my coverage terminate?

Generally, your coverage ends when your Employer has reported you in an inactive status (i.e. layoff, terminated, quit, etc.).

If your claim was denied stating you were not covered for this date of service, check with your employer first. If the issue isn’t resolved, please send us a message through our Message Center

When am I eligible for glasses?

If your plan includes vision benefits, participants and their covered dependents may receive an eye examination and glasses or contact lenses once every 12 months. For more information, review My Benefits on your dashboard.

Why don’t I have coverage the first eight weeks my employer pays into the Plan?

TeamCare rules require an initial contribution period (your establishing period) before active coverage begins.

Are my parents or boyfriend/girlfriend eligible for benefits?

No. Under TeamCare rules, parents, boyfriends, and girlfriends do not meet the definition of an eligible dependent.

Am I eligible for benefits if I need treatment outside the United States?

Yes.  You are eligible for services covered under TeamCare when treatment is received outside the United States. Treatment received must be considered Standard Medical Care, Services, or Supplies. 

When does my coverage end?

Generally, your coverage ends when your employer reports you in an inactive status. For more information, see Participating in TeamCare.

When does coverage end for my spouse?

Coverage for your spouse ends on the date when:

  • Your coverage ends
  • You get divorced
  • Your spouse enters the military.

For more information, see Participating in TeamCare.

When does coverage end for my child?

Coverage for your child ends on the date when your coverage ends or your child reaches age 26.

Coverage for an adult child ends when:

  • Your coverage ends
  • The adult child reaches age 26
  • The adult child enters the military

Children who are mentally or permanently physically disabled may be eligible for some benefits after the age of 26.

How do I add my spouse to my plan?

To add your new spouse to your plan, you must notify the Plan within 60 days. You must also submit a completed Member Enrollment Form listing your spouse’s name and birthdate and include a copy of the marriage certificate. If he/she is approved coverage for your spouse will begin on the day you were married.

How do I add my children or stepchildren to my plan?

To add your children or stepchildren to your plan, you must notify the Plan within 60 days. You must also submit a completed Member Enrollment Form listing your children or stepchildren’s names, birthdates, and in the cases of stepchildren, a copy of your spouse’s divorce decree. If there is no divorce decree, please submit the children’s birth certificates along with the court order that shows which natural parent is to provide coverage.

If your children or stepchildren are approved, coverage begins at birth or in cases of stepchildren, the date of marriage.