Comprehensive Health Benefits for Active Teamsters Members
As an active Teamsters member, you and your family receive premier health benefits, including medical and hospitalization through Blue Cross Blue Shield, pharmacy services through Express Scripts, vision care through Davis Vision, dental care, behavioral health care, and hearing care. You also have access to TeamstersCare in-house clinical services and financial protection through disability, life, and accident insurance.
Complete Coverage
As an active Teamster member, you become eligible for benefits in two ways:
When you start working for an employer already contributing to TeamstersCare, you become eligible after meeting initial eligibility and enrollment requirements.
If your employer starts contributing to TeamstersCare while you are employed, you become eligible once your employer contributes the required amount and you meet the initial eligibility requirements.
Continuing Coverage
After becoming eligible for the first time, you remain eligible until the next review date (January 31, April 30, July 31, or October 31). On these dates, your eligibility is reviewed based on the previous three-month work period. If you worked at least 400 hours, you remain eligible for the next three months.
If you worked less than 400 hours, you can maintain eligibility if:
- Your employer contributed at least 1,800 hours in the past 12 months.
- You worked at least one hour in the current period and continue working for a contributing employer.
You may also buy additional hours.
Buying Up Hours
If you fall short of the 400-hour minimum in a three-month period or haven’t accumulated 1,800 hours in the past 12 months, you may continue coverage by “buying up” the required hours. The buy-up rate is your employer’s current hourly remittance rate.
To be eligible for the buy-up option:
- You must have worked at least 400 hours in each of the three preceding quarters.
- You must work at least one hour in the quarter you’re buying up.
- You must provide proof of continued employment.
- You must send payment to TeamstersCare for the shortfall, up to a $1,000 maximum.
After buying up for one quarter, you must work and have remittances paid on your behalf for three consecutive quarters before you can buy up again.
If none of these options apply, you may continue your medical coverage under COBRA.
Enrollment and Family Status Changes
Once eligible for TeamstersCare benefits, you’ll receive an enrollment package from TeamstersCare Member Services. Complete and return the enrollment form with required documentation within 31 days to activate benefits retroactively to your eligibility date. If submitted late, benefits start the first day of the month TeamstersCare receives your form.
- Moving out of the covered area
- Change of address
- Marriage, divorce, or legal separation
- Birth, adoption, or addition of a dependent
- Death of a participant
- Loss of dependent eligibility
- Returning to work after disability
- Changes in employment-related healthcare coverage
- Eligibility for Medicare or Social Security disability
- Coverage under other group benefit plans
Some changes may require written proof. TeamstersCare handles all eligibility and enrollment issues and will notify vendors on your behalf.
Benefits
As an active TeamstersCare member, you’re entitled to a comprehensive package offering various benefits for your family’s health and financial security. Explore the available benefits by clicking on the programs below:
Medical
TeamstersCare provides its members with medical benefits through an HMO and an Out of Area Option:
- HMO Blue New England Option
- Blue Care Elect Preferred Out of Area Option
Whether you will participate in the HMO or Out of Area option will depend on where you live. The HMO Blue New England plan covers members who live in certain geographical service areas, including all cities and towns of Massachusetts, Rhode Island, Connecticut, Maine, New Hampshire and Vermont. If you are a TeamstersCare member living outside of New England, or a member with an eligible dependent living permanently outside of New England, you are covered by Blue Care Elect Preferred.
Both the HMO Blue and Out of Area Option cover a broad range of services, including:
- Doctor’s care, including maternity, pediatric and well-child visits
- Hospital care (both in- and out-patient)
- Surgery and emergency care
- Diagnostic x-rays and laboratory tests
- Authorized services for rehab, acute care, home health and early intervention
- Chiropractic care, podiatry, nutrition and ambulatory transport
- Authorized medical equipment
HMO Blue New England Option
Your Primary Care Physician
When you enroll in HMO Blue New England, you and each family member must select an in-network primary care physician (PCP). Your PCP will direct and monitor your care, and will be the first person you call when you need routine or sick care. They will also guide you through any referrals you may need for specialized services.
Emergency Care
In an emergency, such as a suspected heart attack, stroke or poisoning, you should go directly to the nearest medical facility or dial 911 (or your local emergency phone number). You’ll pay a $75 copayment for emergency room services, though this copay is waived if you’re admitted to the hospital.
Basic Medical Benefits
| HMO BLUE NEW ENGLAND | |
| Annual Deductible | none |
| Benefit Level | Plan pays 100% Some copays required |
| Annual Maximum out-of-pocket | none |
| Lifetime Maximum per person, all programs combined | none |
| Dependent Child Coverage | Last day of the month in which child turns 26
|
| Inpatient Care including maternity | Plan pays 100% |
| Preventive Care routine adult physical well-child care allergy testing & treatment annual gynecological exam mammogram | $0 copay per visit $0 copay per visit $15 copay per visit $0 copay per visit Plan pays 100% |
| Outpatient Care office visits for specific treatment diagnostic lab and x-ray outpatient surgery preadmission testing home health care skilled nursing facility | $15 copay per visit Plan pays 100% Plan pays 100% Plan pays 100% Plan pays 100% Plan pays 100% |
| Emergency Room Visit | $75 copay (waived if admitted or observation stay) Notify your HMO within 48 hours of delivery of emergency services. Follow-up care must be arranged by your PCP. |
| Behavioral Health Care (Mental Health/Substance Abuse)
| In-network benefit only Out-patient treatment: $15 copay per visit Inpatient: Plan pays 100% |
*Check with HMO Blue New England for (1) limitations that might apply to services listed above or (2) coverage of any items not identified above.
Important Note: This summary is not meant to be a complete description of your TeamstersCare benefits. For eligibility related issues, or if you have any questions, call TeamstersCare Member Services.
Blue Care Elect Preferred Out of Area Option
As a Blue Care Elect Preferred Member, you are not required to select a Primary Care Physician (PCP). Instead, you and your dependents have two basic options for care: (1) you can take advantage of discounted services by using a Blue Care Elect Preferred Provider or (2) you can use a non-network provider.
If you use an in-network provider, the cost of most services (less any copayment) will be covered in full. If you use a non-network provider, most expenses are covered at 80% of reasonable and customary amounts after a $250 individual/$500 family deductible. The out-of-network co-insurance maximum is $1,000 per individual/$2,000 per family.
For more information on the Blue Care Elect Preferred Provider network, call 1-800-810-2583 or visit Teamsters Union 25 HSIP.
Basic Medical Benefits
| Benefit | Blue Care Elect Preferred | Non-network |
| Annual Deductible | none | $250/individual $500/family |
| Benefit Level | Plan pays 100% Some copays required | After the deductible, the Plan pays 80% 1 |
| Lifetime Maximum per person, all TeamstersCare Programs combined | none | |
| Dependent Coverage | Last day of the month in which child turns 26
| |
| Inpatient Care including maternity | Plan pays 100%
| After the deductible, the Plan pays 80%1 |
| Preventive Care routine adult physical2 (see schedule below) well-child care allergy testing & treatment annual gynecological exam mammogram | $0 copay per visit
$0 copay per visit $15 copay per visit $0 copay per visit Plan pays 100% |
After the deductible, the Plan pays 80%1
|
| Outpatient Care office visit (specific treatment) diagnostic lab and x-ray outpatient surgery preadmission testing home health care skilled nursing facility | $15 copay per visit Plan pays 100% Plan pays 100% Plan pays 100% Plan pays 100% Plan pays 100% |
After the deductible, the Plan pays 80%1 |
| Behavioral Health Care (Mental Health/Substance Abuse) | Out-patient treatment: $15 copay per visit; inpatient: Plan pays 100% | After the deductible, the Plan pays 80%1 |
| Emergency Care doctor’s office hospital emergency room | $15 copay per visit $75 copay per visit 3 | After the deductible, the Plan pays 80%1 |
| Calendar Year Coinsurance Maximum | None | $1,000/individual $2,000/family |
(1) of reasonable & customary expenses for covered charges. If the provider’s actual charges are greater than the usual and customary charge, the member will be responsible for the applicable cost sharing amount based on the usual and customary fee, plus the difference between the usual and customary fee schedule and the provider’s actual charges.
(2) one routine visit every five calendar years from age 19 through 29, one routine visit every three calendar years from age 30 through 39, one routine visit every two calendar years from age 40 to 54 and one routine visit per calendar year when age 55 or older.
(3) copay waived, if emergency room visit results in immediate hospitalization
Important Note: This summary is not meant to be a complete description of your TeamstersCare benefits. For a detailed listing of Blue Care Elect Preferred providers and facilities in your area, call 1-800-810-2583.
For more information on specific coverage under the Blue Care Elect Preferred option, claims-related questions, limitations that might apply to services listed above and coverage of any items not identified in this chart, call 1-800-241-0803.
Blue Cross Blue Shield Behavioral Health Benefit
Your Blue Cross Blue Shield medical benefit includes counseling and treatment for emotional difficulties, mental illness, substance abuse, family and marital problems and childhood concerns. You also have access to a variety of programs and services to help with chronic behavioral conditions.
To access outpatient behavioral health services, you simply make an appointment with an in-network provider and pay a $15 copay at the time of your visit. No referral or pre-authorization is necessary.
For new episodes of outpatient care, the first 12 visits are automatically authorized. If more than 12 visits are needed, your in-network provider will contact Blue Cross Blue Shield for additional authorizations on your behalf.
If you or your dependents have questions, you may call the Blue Cross Behavioral Health Coordination line at 1-800-444-2426
Important Note: As a TeamstersCare member, you also have access to behavioral health services through our in-house Employee Assistance Program.
Pharmacy
As an Active Member of the TeamstersCare plan, you and your family members may obtain your pharmacy benefits in one of the following ways:
Option #1: Walk-in Service
You and your dependents can get up to a 90-day supply of your prescription drug at either the Charlestown or Stoughton TeamstersCare in-house pharmacies. The cost per prescription is $5 for generic and $15 for brand name medications (if no generic is available).
To fill a new prescription, you may walk in during pharmacy hours or have your doctor phone, fax or e-prescribe your medication.
To refill a prescription, you have three options:
- Phone: Call the Charlestown or Stoughton pharmacy and use the automated Telemanager to request a prescription refill.
- Online: click the link and submit the required information.
- PocketRx App: Download the PocketRx app on iTunes or Google Play to refill your prescription on the go.
Note: Make sure you have your prescription available, as you’ll need the six-digit refill number.
Option #2: Mail-Order Service
Obtain up to a 90-day supply of your prescription drug through the Express Scripts mail order program. The cost per prescription is $5 for generic and $15 for brand name medications (if no generic is available).
To fill a mail-order prescription, mail in your prescription and copay along with the Prescription Order Form. This form is available by calling Express Scripts at (877) 543-7097 or by going to www.Express-scripts.com.
To refill a mail-order prescription, you may either:
- Log on to www.Express-scripts.com and click “Order Status.”
- Call the Express Scripts automated phone service at 1-877-543-7097.
- Mail a Refill Request Form, along with a refill slip or prescription label, to Express Scripts.
Option #3: Retail Pharmacy
You may obtain up to a 30-day supply of your prescription drug through a retail pharmacy. If the pharmacy participates in the Express Scripts TeamstersCare network, you will pay a $15 copay for generic prescriptions. For brand name prescriptions, you will pay $25 (plus the cost difference between the brand name and generic drug if generic is available). Note that Walgreen’s, Walmart and Sam’s Club are not in the Express Scripts TeamstersCare network.
If you choose to use an out-of-network pharmacy, you will be responsible for paying the full cost of the prescription (including the copay) and submitting a claim to Express Scripts for reimbursement. You will receive a check based on the network rates for the drug, less the amount of your copay. Click here to download claim form.
Specialty Medications
If you have a prescription for a specialty medication (certain high-cost drugs which treat complex conditions), you must fill your prescription through either of our in-house TeamstersCare pharmacies (walk-in service) or through Accredo, the Express Scripts Specialty Pharmacy (mail-order only). The copayment per prescription is $15 for up to a 30-day supply.
Dental
As an Active member of the TeamstersCare benefits plan, you and your dependents have two basic options when you need dental care:
Option 1: TeamstersCare Dental Offices
The dental offices in Charlestown, Chelmsford and Stoughton provide basic dental services such as:
- Preventative care including dental exams, x-rays, fluoride treatment, cleaning and scaling
- Sealants
- Fillings, root canals for certain teeth and simple extractions
- Full or partial dentures, including denture repair and reline
- Mouth guards
- Second opinions
- Emergency care (office hours only)
There is no cost for preventative care visits. There is a $5 fee for filling visits and a $10 fee for denture, root canal and extraction visits.
Option #2: Dental Blue Freedom Network
Dental Blue Freedom gives you the flexibility to choose from three networks, Dental Blue PPO, Dental Blue, or the Dental Blue National network. You’ll receive the greatest discounts by selecting a Dental Blue PPO dentist. You may also choose a Dental Blue network dentist which includes 90% of the dentists in Massachusetts. And you have the option of using the Dental Blue National network which includes dentists throughout the United States. You may even select an out-of-network dentist, though your share of the costs will generally be higher.
To view the current Fee Allowance Schedule click here.
To determine whether a particular dentist is in one of the Dental Blue Freedom networks, go to www.bcbsma.com or call BCBS’s Member Service at 1-800-241-0803.
Cost of Services
With the exception of preventative services, any dental treatment you receive from an in-network or out-of-network dentist is subject to a $50 per person/$100 per family calendar year deductible. There is also a calendar year maximum benefit of $2,500 per person.
Vision
TeamstersCare has contracted with Davis Vision to provide you and your family with benefits to protect your vision and eye health. With a national network of participating providers, you may visit any Davis Vision eye specialist for a broad range of eye care services and supplies – often at no cost to you.
For a list of participating providers, call Davis Vision at 1-800-999-5431 or visit www.davisvision.com. You may also contact TeamstersCare Member Services for a list of New England providers.
To view vision benefits please click here.
Important Note: When choosing either eyeglasses or contact lenses, you must make your full selection at the time of your examination. If you go to a provider who only provides an exam, you must order glasses through another provider within 30 days of your vision exam.
Hearing Care
Once every year, you and your family members are eligible to receive a comprehensive hearing test at our Charlestown Audiology Office. Ordinarily, hearing care services and equipment are covered only when they are provided at our Charlestown Audiology Office.
All routine hearing examinations, diagnostic evaluations and middle ear analyses are provided at no cost to you. Services include:
- Ear examinations
- Diagnostic hearing evaluations
- Middle ear analysis
- Hearing aid analysis, fitting and follow-up, as appropriate
To schedule an appointment for a hearing exam for you or your eligible dependents (ages 3 and up), contact the Charlestown Audiology Office.
Out of Area Benefit
If you or your family members live outside of New England, you can be authorized to receive certain hearing care services from a private audiologist, provided our TeamstersCare audiologist conducts a pre-treatment review. For more information, see your Active Members Summary Plan Description or call the Audiology Office directly.
Employee Assistance Program
TeamstersCare provides an Employee Assistance Program (EAP) benefit for our members and their dependents who are in need of advice and guidance for a behavioral health issue. This confidential service is provided at no cost to you and is available in person or by phone.
Services include:
- Short-term counseling sessions (up to 3 visits)
- Assessments and referrals
- Case management
- Addiction issues
- Advice or guidance with personal problems, family and relationship issues, financial and legal concerns, anxiety, grief counseling, job stress, etc.
Call TeamstersCare EAP at 1-800-851-8326 to speak to a clinical provider or to schedule an appointment.
Disability
(Full-time members only)
If you have a disability that prevents you from working (including pregnancy), the TeamstersCare Weekly Disability Benefit will pay you a benefit each week, for up to 26 weeks. The disability must be caused by a sickness or injury that is not related to your job. Benefits begin on the 8th day of the disability, after a 7-day waiting period.
Your weekly disability benefit equals 75 percent of your regular weekly base pay, for a minimum of $300 per week to a maximum of $600 per week. This benefit is available for the member only and is calculated based on your hourly rate of pay and the number of hours worked during your most recent eligibility determination period.
To be eligible for benefits, you must submit the appropriate form, which is available from TeamstersCare Member Services. This form must be filled out by you, your employer and your doctor.
For more information on weekly disability benefits, the Active Members Summary Plan Description.
Life Insurance
(Full-time members only)
The TeamstersCare Life Insurance Benefit provides financial protection for your family or beneficiaries in the event of your death.
Benefit Amounts
If you die from any cause (on or off the job), TeamstersCare pays your beneficiaries a benefit of $50,000. You will also receive a life insurance benefit for your eligible spouse and dependents in the following amounts:
- $5,000 for your spouse
- $2,000 for each eligible dependent child
Accelerated Death Benefit
If you are diagnosed by a doctor as being totally or permanently disabled, and your disability will likely result in your death within the next 24 months, you are eligible to receive up to 75 percent of your total $50,000 life insurance benefit while you are living. The remaining benefit is payable to your beneficiary upon your death.
For additional information call TeamstersCare Member Services at 617-241-9220, ext. 2.
For more information on your life insurance benefit, see the Active Members Summary Plan Description.
Accidental Death & Dismemberment
(Full-Time members only)
The TeamstersCare Accidental Death & Dismemberment (AD&D) Insurance Benefit provides you with additional life and accident insurance protection. This coverage is available for the member, only.
If the member dies as a result of an accident, the AD&D benefit is paid to the beneficiary in addition to the normal life insurance benefit.
The maximum AD&D benefit is $50,000 for one accident.
Basic Benefits
If a member dies within 365 days of an accident, or suffers one of the injuries below, TeamstersCare will pay the following benefits:
| Loss | Benefit |
| Loss of Life | 100% |
| Loss of Both Hands | 100% |
| Loss of Both Feet | 100% |
| Loss of Entire Sight of Both Eyes | 100% |
| Loss of One Hand and One Foot | 100% |
| Loss of One Hand and Entire Sight of One Eye | 100% |
| Loss of One Foot and Entire Sight of One Eye | 100% |
| Loss of Speech and Hearing (both ears) | 100% |
| Loss of Entire Sight of One Eye | 50% |
| Loss of Speech or Hearing (both ears) | 50% |
| Loss of One Hand or One Foot | 50% |
| Loss of Thumb and Index Finger of same Hand | 25% |
| Quadriplegia (Paralysis of both upper and lower limbs) | 100% |
| Triplegia (Paralysis of three limbs) | 75% |
| Paraplegia (Paralysis of both lower limbs) | 75% |
| Hemiplegia (Paralysis of an upper and a lower limb) | 50% |
| Uniplegia (Paralysis of a limb) | 25% |
In addition, members may be eligible to receive an airbag benefit, seatbelt benefit, childcare benefit, child education benefit, coma benefit or felonious assault benefit. You can learn more about these benefits, and other AD&D Insurance details, please see your Active Members Summary Plan Description.
Dental, Vision & Audiology Coverage
As a member of the TeamstersCare Vision & Dental program, you and your eligible dependents will receive comprehensive dental and vision benefits through Dental Blue Freedom and Davis Vision. Members may also visit TeamstersCare’s three in-house dental offices for basic services such as cleanings, fillings, dentures and emergency care (during office hours).
Eligibility
As a Vision & Dental Member, your eligibility is determined by your collective bargaining agreement.
Enrollment
Once you are eligible for TeamstersCare benefits, you will receive an enrollment package. Within this package is an enrollment form that you must complete and return to Member Services (with the required documentation) within 31 days. If your documentation is received within this timeframe, your benefits will be activated retroactively to your eligibility date.
If the enrollment form is not received within this 31 day timeframe, your benefits will be activated on the first day of the month that TeamstersCare receives your form and documentation.
Dental Benefits
As a member of the TeamstersCare Vision and Dental benefits plan, you and your dependents have two basic options when you need dental care:
Option 1: TeamstersCare Dental Offices
The dental offices in Charlestown, Chelmsford and Stoughton provide basic dental services such as:
- Preventative care including dental exams, x-rays, fluoride treatment, cleaning and scaling
- Sealants
- Fillings, root canals for certain teeth and simple extractions
- Full or partial dentures, including denture repair and reline
- Mouth guards
- Second opinions
- Emergency care (during office hours)
There is no cost for preventative care visits. There is a $5 fee for filling visits and a $10 fee for denture, root canal and extraction visits.
Option 2: Dental Blue Freedom Network
Dental Blue Freedom gives you the flexibility to choose from three networks: Dental Blue PPO, Dental Blue, or the Dental Blue National network. You’ll receive the greatest discounts by selecting a Dental Blue PPO dentist. You may also choose a Dental Blue network dentist which includes 90% of the dentists in Massachusetts. You also have the option of using the Dental Blue National network which includes dentists throughout the United States. You may even select an out-of-network dentist, though your share of the costs will generally be higher.
To view the current Fee Allowance Schedule click here.
To determine whether a particular dentist is in one of the Dental Blue Freedom networks, go to www.bcbsma.com or call BCBS Member Service at 1-800-241-0803.
Cost of Services
With the exception of preventative services, any dental treatment you receive from an in-network or out-of-network dentist is subject to a $50 per person/$100 per family calendar year deductible. There is also a calendar year maximum benefit of $2,500 per person.
Orthodontic services are covered at 50% of cost, up to a $2,000 lifetime maximum per person. This coverage is available for the member, spouse and dependents.
Vision Benefits
TeamstersCare has partnered with Davis Vision to offer comprehensive vision benefits to protect you and your family’s eye health. With a national network of participating providers, you can access a wide range of eye care services and supplies, often at no cost.
To find a participating provider, call Davis Vision at 1-800-999-5431 or visit www.davisvision.com. You can also contact TeamstersCare Member Services for a list of New England providers.
Vision Benefits Overview and Costs
TeamstersCare has contracted with Davis Vision to provide you and your family with benefits to protect your vision and eye health. With a national network of participating providers, you may visit any Davis Vision eye specialist for a broad range of eye care services and supplies – often at no cost to you.
For a list of participating providers, call Davis Vision at 1-800-999-5431 or visit www.davisvision.com. You may also contact TeamstersCare Member Services for a list of New England providers.
To view vision benefits please click here.
Important Note: When choosing either eyeglasses or contact lenses, you must make your full selection at the time of your examination. If you go to a provider who only provides an exam, you must order glasses through another provider within 30 days of your vision exam.
UPS Part-Time Benefits
For eligible part-time United Parcel Service (UPS) employees, your TeamstersCare coverage varies in benefits and eligibility criteria.
If you work 225 or more hours for UPS in a three-month eligibility period, but fewer than 400 hours, you qualify for:
- Medical care and hospitalization
- Behavioral health
- Pharmacy and prescription drugs
- Dental care
- Vision care
- Hearing care
- Employee Assistance Program (EAP)
However, you are not eligible for weekly disability, life insurance and AD&D Insurance.
UPS Part-Time Eligibility
As a part-time UPS employee, you follow the same eligibility rules as full-time employees, except you must work 225 hours, not 400, in a three-month eligibility period.
If you do work 400 or more hours in a fixed eligibility period, you receive the same benefits as full-time employees for the corresponding three-month coverage period.
Access Essential Member Forms On-line
Explore our collection of commonly requested forms and documents for TeamstersCare members. From essential TeamstersCare/Dental Blue Freedom forms to pharmacy-related documents and beyond, we’ve got you covered.
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