Eligible participants and dependents, where the Fund is the primary insurance, can seek reimbursement for FDA authorized, cleared, or approved OTC COVID-19 test on or after January 15, 2022, for their own personal use. The Fund will reimburse a maximum of 8 individual tests per eligible participant/dependent every 30 days. The Fund will not provide reimbursement for additional tests purchased prior to the end of the 30-day period.
Documentation required for reimbursement: (Please complete both sides of the form) DOWNLOAD FORM HERE
- Participant signed reimbursement form;
- An itemized receipt including proof of purchase;
- Date of purchase;
- Price of the OTC COVID-19 test; and
- The product UPC code and number of tests in the pack.
Examples of FDA authorized, cleared, or approved OTC COVID-19 Antigen tests include, but are not limited to:
- BINAXNOW COVID-19 AG SELF TEST
- FLOWFLEX COVID-19 AG HOME TEST
- CARESTART COVID19 AG HOME TEST
- IHEALTH COVID-19 AG RAPID TEST
- QUICKVUE AT-HOME COVID-19 TEST
- ELLUME COVID-19 HOME TEST
Please submit your documentation and reimbursement form to the Central Pennsylvania Teamsters Health and Welfare Fund by mail at P.O. Box 15224 Reading, PA 19612-5224 or by email at firstname.lastname@example.org or by Fax: 610-320-9236.