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For Members

2025 Plan Documents

  • 2025 Evidence of Coverage – HealthTeam Advantage Plan I (PPO) (Coming Soon)
  • 2025 Evidence of Coverage – HealthTeam Advantage Plan II (PPO) (Coming Soon)
  • 2025 Evidence of Coverage – HealthTeam Advantage Eagle Plan (PPO) (Coming Soon)
  • 2025 Evidence of Coverage – HealthTeam Advantage Vitality Plan (PPO) (Coming Soon)
  • 2025 Evidence of Coverage – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) (Coming Soon)
  • 2025 Evidence of Coverage – HealthTeam Advantage Cardinal Plan (HMO) (Coming Soon)
  • 2025 Enrollment Online Form (Coming Soon)
  • 2025 Enrollment Book (Coming Soon)
  • 2025 Plan-to-Plan Change Form – PPO (Coming Soon)
  • 2025 Plan-to-Plan Change Form – HMO (Coming Soon)
  • 2025 Prior Authorization Forms – HealthTeam Advantage Plan I (PPO), Plan II (PPO), Vitality Plan (PPO), & Cardinal Plan (HMO) (Coming Soon)
  • 2025 Prior Authorization Forms – HealthTeam Advantage Diabetes & Heart Care Plan (HMO C-SNP) (Coming Soon)
  • 2025 Low Income Subsidy – HealthTeam Advantage Plan I (PPO) (Coming Soon)
  • 2025 Low Income Subsidy – HealthTeam Advantage Plan II (PPO) (Coming Soon)
  • 2025 Low Income Subsidy – HealthTeam Advantage Eagle Plan (PPO) (Coming Soon)
  • 2025 Low Income Subsidy – HealthTeam Advantage Vitality Plan (PPO) (Coming Soon)
  • 2025 Low Income Subsidy – HealthTeam Advantage Diabetes & Heart Care (HMO C-SNP) (Coming Soon)
  • 2025 Low Income Subsidy – HealthTeam Advantage Cardinal Plan (HMO) (Coming Soon)
  • 2025 Comprehensive Formulary Addendum – HealthTeam Advantage Plan I (PPO), Plan II (PPO), Vitality Plan (PPO), and Cardinal Plan (HMO) (Coming Soon)
  • 2025 Comprehensive Formulary Addendum – HealthTeam Advantage Diabetes & Heart Care Plan (HMO C-SNP) (Coming Soon)
  • 2025 Dental Coverage Certificate with Covered Code List – HealthTeam Advantage PPO I, PPO II, Vitality PPO, Eagle PPO and Cardinal HMO (Coming Soon)
  • 2025 Dental Coverage Certificate with Covered Code List – HealthTeam Advantage Diabetes & Heart Care HMO CSNP (Coming Soon)
  • Activate and Manage your OTC Card
  • 2025 OTC Product Catalog (Coming Soon)
  • 2025 PPO OTC Benefit Flyer (Coming Soon)
  • 2025 Cardinal Flexible Benefit (Coming Soon)
  • 2025 Cardinal OTC Benefit (Coming Soon)
  • 2025 CSNP OTC Benefit (Coming Soon)