Get Teamcare Enrollment Form

Filling out the Teamcare Enrollment Form online is essential for ensuring that your adult child's insurance information is accurately processed. This guide will walk you through each section of the form, providing detailed instructions to assist you in completing it correctly.

Follow the steps to efficiently fill out the Teamcare Enrollment Form.

1. Click ‘Get Form’ button to obtain the form and open it for completion.
2. Enter the participant's ID number. This is a required 9-digit number found on the medical ID card. Ensure accuracy in this field.
3. Provide the participant's name. This name should match the one on the medical ID card.
4. Read the certification statement and confirm your understanding of the requirements regarding informing Teamcare of any changes in the adult child's insurance status.
5. Sign and date the form. Your signature certifies that the information is accurate and that you choose to elect coverage for the adult child.
6. Fill out the adult child's information, including their name, social security number, and relationship to the participant. Indicate if the adult child has any other insurance coverage from various sources.
7. If you answer 'YES' to any of the previous questions about additional insurance, provide the policyholder's name, employer name, insurance carrier name, effective date of coverage, group policy number, and insurance carrier's telephone number!
8. Review the entire form for accuracy and completeness. Ensure all required fields are filled.
9. Once the form is complete, save your changes. You can download, print, or share the form as needed before submitting it.

Complete your Teamcare Enrollment Form online today for seamless processing of your adult child's insurance coverage.