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Dependent Verification Form
Domestic Partner/Common Law Spouse Affidavit
Spousal Surcharge Form
Request for Accommodation Medical Exemption from Vaccination
Tuition Reimbursement Request Form
– Inframark can help cover your tuition for accredited coursework – up to $3,000/year!
Critical Illness –
Health Screening Benefit Form
– Claim your $50/$100 Reward!
TeamCare Benefit Enrollment Materials
(for Bridgeport Union use only)
TeamCare Enrollment form
TeamCare Plan MH Benefit Summary
2023 & 2024 TeamCare Coverage Rates
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