Frequently Asked Questions

Need to define a word? Check the Glossary for a list of common healthcare terms.


Coordination of Benefits

Subrogation & Reimbursement

Workers' Compensation

  • Your health plan contains a provision that excludes the payment of medical bills for work-related injuries and illnesses. This means that we will not provide benefits if Workers’ Compensation laws cover, provide or pay for the service, supply or treatment of any work-related accident or illness.

  • Depending on your collective bargaining agreement, your employer may be required to make contributions, providing coverage for you and your family. Coverage is limited to treatment unrelated to the Workers’ Compensation claim. You may also be eligible to make COBRA self-payments. Refer to your Summary Plan Description under My Documents on your Member Dashboard for detailed information.

  • The Plan does not provide benefits for illness or injury that are, in any way, work-related and/or covered by Workers’ Compensation or similar law. If you feel you have a work-related illness or injury, you should:

    • Let your employer know immediately and complete a report; your union steward can typically help with this.
    • Seek medical treatment and inform the doctor that the injury may be work-related.     
    • Notify TeamCare immediately.
  • If Workers’ Compensation denied your claim because it determined your injury or illness was not related to your employment, TeamCare may cover your treatment; however, we may require that you file an appeal with Workers’ Compensation and may further require that you sign an Agreement to Reimburse.

  • In most cases, treatment for complications related to a work-related injury/illness is not covered for a five-year period from the date of injury or illness. After this, related treatment may be payable unless it is still compensable under Workers’ Compensation.