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TABLE OF CONTENTS

Letter from The Board of Trustees

I. Overview
Overview: Emergencies   Go
What Should I Do in an Emergency? Go
Overview: Important Questions Go
Important Questions: Medical Benefit Go
Important Questions: Other Benefits Go
Important Questions: Eligibility Go
Important Questions: “Life Events” Go

 


II. Participation

United Parcel Service (UPS) Part-time Benefit Members Go
UPS Part-time Benefits Go
UPS Part-time Eligibility Go
TeamstersCare Membership: Full Benefits Go
How You First Become Eligible Go
How You Continue to Remain Eligible Go
Information You Must Provide to Remain Eligible Go
Reinstating Lost Eligibility Go
General Guidelines that Apply to Reinstatement Go
When Your Eligibility EndsGo
Dependent Eligibility Go
When Your Dependents Are Eligible Go
Defining “Eligible Children” Go
Defining “Disabled Children” Go
Defining “Full-Time Student” Go
When a Dependent’s Eligibility Ends Go
Other Participation Notes Go
Family Medical Coverage in Case of Your Death Go
Continuing Medical Coverage if You’re DisabledGo
Continuing Health Coverage under COBRA Go
Continuing Coverage for Your Spouse after Legal Separation or Divorce Go
Coverage on Returning from Military Duty Go

 


III. Medical Benefit Overview

TeamstersCare Medical Benefit Options: General Information Go
TeamstersCare HMO’s: General Information Go
 TeamstersCare Tufts Out of Area Option: General Information Go
 Choice of Medical Option for the Calendar Year Go
 TeamstersCare Clinical Services Benefits: General Information Go
 TeamstersCare Coverage: Lifetime Maximum Go
 Coordinating TeamstersCare Health Benefits with Other Medical Benefits Go
 Medical Benefits for Motor Vehicle and Motorcycle Accidents Go
Continuing Medical Coverage under COBRA Go
Health Benefits TeamstersCare Doesn’t Cover Go

 

IV. TeamstersCare Basic Medical Benefit Options

The TeamstersCare HMO’s: Overview Go
Your TeamstersCare HMO Options Go
How the TeamstersCare HMO’s Work Go
Benefits HMO’s Do Not Cover Go
Knowing Your HMO Go
When to Contact Your HMO & Charlestown Member Services Go
The TeamstersCare Tufts Out of Area Option: Overview Go
PHCS Network Medical Coverage Go
Non-PHCS Network Medical Coverage Go
Clinical Benefits from TeamstersCare Facilities Go
About the TeamstersCare Tufts Out of Area Option Go
How the TeamstersCare Tufts Out of Area Option Works Go
Hospital Admissions Go
Benefits the TeamstersCare Tufts Out of Area Option Does Not Cover Go
When to Contact Tufts, PHCS, & Charlestown Member Services Go

 

V. Clinical Services Benefit

Pharmacy Benefit Go
Prescription Drug Costs Go
TeamstersCare Pharmacies Go
RESTAT Network Pharmacies Go
Non-Network Pharmacies Go
What Prescriptions Are Covered Go
What Prescriptions Are Not Covered Go
Dental Benefit Go
Option #1: TeamstersCare Dentists Go
Option #2: DeltaPreferred Network Dentists Go
Option #3: Non-Network Dentists Go
Your Costs for DeltaPreferred and Non-Network Dental Services Go
Dental Treatment in the Hospital Go
Orthodontic Benefit Go
Dental Expenses Not Covered Go
Pre-Treatment Dental Estimates Go
Filing a Dental Claim Go
Coordinating with Other Dental Plans Go
Vision Benefit Go
Davis Vision Network Go
Your TeamstersCare Vision Benefit Go
Eyewear You Can Select Go
Making an Appointment Go
Mental Health & Substance Abuse Benefit Go
TeamstersCare Mental Health & Substance Abuse Benefit: In-House Resources Go
TeamstersCare Mental Health & Substance Abuse Benefit: Covered Services Go
Chart: Mental Health Benefit Go
Chart: Substance Abuse Benefit Go
R.A.F.T. Go
Mental Health & Substance Abuse Benefit: Individual Maximum Coverage Go
Wellness Benefit Go
Wellness Screening Services for Members & Spouses Go
Other Specialized Wellness Benefits Go
Health Information Services Go
Health Services Not Included in Screenings Go
Scheduling Screenings 54
Hearing Care Benefit Go
Hearing Care Benefits Outside of New England Go

 

VI. Other Benefits

Weekly Disability Benefit Go
Your Disability Coverage Go
Disability Waiting Period Go
More Than One Period of Disability Go
Continuing TeamstersCare Medical Coverage While Disabled Go
Continuing Life Insurance While Disabled Go
Disability TeamstersCare Does Not Cover Go
Disability Resulting from Motor Vehicle and Motorcycle Accidents Go
Other Disability Settlements Go
Filing a Weekly Disability Claim Go
Information You Must Provide to be Eligible for Weekly Disability Benefits Go
Life Insurance Benefit Go
Your Life Insurance Benefit Amount Go
Naming Your Beneficiary Go
Living Benefits Option Go
Dependent Life Insurance Benefit Go
Converting TeamstersCare Life Insurance to an Individual Policy Go
Life Insurance Benefits If You’re Disabled Go
Filing a Life Insurance Claim Go
Accidental Death & Dismemberment Benefit Go
AD&D Benefit Go
Additional Coverage for Using Seat Belts Go
Special Benefit for Your Spouse Go
Special Coverage for Felonious Assault Injuries Go
Special Benefit for Military Reserve or National Guard Go
Naming Your Beneficiary Go
Losses AD&D Does Not Cover Go
How to File an AD&D Claim Go

 

VII. COBRA, HIPAA, Privacy, Newborns’ Act, and WHCRA
Continuing Your Health Coverage under COBRA Go
Types of Coverage Go
The Period for Making Your Decision About COBRA Coverage Go
Cost of Continued Coverage Go
Qualifying Events Go
When COBRA Continued Coverage Ends Go
If You Don’t Elect Cobra Coverage Go
If You Have Questions about COBRA Go
Your Rights under HIPAA Go
Privacy & Notice of TeamstersCare Privacy Policies Go
Your Rights Under the Newborns’ and Mothers’ Health Protection Act Go
Your Rights Under the Women’s Health and Cancer Rights Act Go


VIII. AdministratioN

Coordination of Benefits Go
General COB Guidelines Go
Exceptions to General COB Guidelines Go
Coordinating Coverage for Children Go
Coordinating Coverage with Medicare Go
Third Party Liability Go
No-Fault Auto Insurance Go
Workers’ Compensation Go
Your Rights as a Plan Member Under ERISA Go
Information About Teamsters Union 25 Health Services & Insurance Plan Go
Plan Administrator/Named Fiduciary Go
The Board of Trustees Go
Plan Year Go
Employer and Plan Identification Numbers Go
Plan Contributions Go
Benefit Payment Go
Eligibility for Benefits Go
Financial Information Go
Agent for Service of Legal Process Go
Plan Authority Go
Claims and Appeals Go
Submitting a Claim Go
Responding to Your Claim Go
Appealing a Claim Go
Final Notes Go
Important Addresses and Phone Numbers Go