Secondary Insurance Policies & Procedures

1.  All student-athletes participating in intercollegiate athletics are required to carry medical accident insurance which provides coverage for injuries incurred while participating in the play or practice of intercollegiate sports.  This primary policy must have a maximum benefit equal to or exceeding $75,000.00 for the coverage of intercollegiate athletic injuries (Beginning August 1, 2010, the policy must have a maximum benefit equal to or exceeding $90,000.00).  It is suggested your policy have a minimum deductible of $2,500.00.  Each student-athlete must also complete their insurance information online through ATS with all the necessary information and turn in a front and back copy of their insurance card prior to participation in intercollegiate athletics.  It is the student-athlete's responsibility to update their insurance information through ATS if any changes due occur in their personal insurance plans as well as returning an updated copy of their insurance card to the Sports Medicine Staff.  The University of Scranton will not be responsible for expenses incurred if the student-athlete changes insurance plans or drops their personal insurance. 

2.  In the event an injury does occur, all bills must go through the primary insurance policy first.  All benefits and stipulations from the primary insurance policy must be followed (i.e. staying in-network).  The University operates as an excess insurance carrier for student-athletes.  This coverage is secondary to any other collectible medical insurance that the student-athlete has.  The student-athlete's health insurance information must be provided to the individual rendering medical services (i.e. Emergency Room, etc.) to the injured student-athlete.  Coverage is limited to injuries incurred during an official, supervised practice or game, and team travel to and from a scheduled event.  Illnesses such as common colds, sore throats, respiratory infections, gastrointestinal disorders, and pre-existing conditions are not covered by this policy.  Additional coverage is also provided by the NCAA Catastrophic Insurance plan.
 
3.  Any claim for benefits must first be filed with the insurance company providing medical insurance to the student-athlete under his/her own insurance policy or that of a parent or guardian.  This would include Blue Cross/Blue Shield, any private accident and health coverage, including union plans, HMO policies, or group policies through the employer of a parent or guardian.  If there are any balances due after payment has been made by the student-athlete's primary insurance, an initial claim form must be filled out by the student-athlete and and the Head Athletic Trainer.  This can only be completed by the Head Athletic Trainer.  Along with this claim form, the official insurance bills called "UB-04/UB-92" and "HCFA" forms (these must be requested directly from the Provider, these are not the bills typically received by mail) and the Explanation of Benefits (EOB) must also be submitted to the Head Athletic Trainer within 90 days of the loss.  The University and/or its athletic insurance company will consider paying the balance based on usual and customary charges and the student-athlete's compliance with the INJURY REPORTING PROCEDURES.

4.  All special requirements (i.e. HMO or PPO policies, etc.) for the student-athletes' primary medical insurance must be followed unless prior approval is obtained from the Head Athletic Trainer.  Prior approval can be obtained by contacting the Head Athletic Trainer by email or phone and setting up a meeting.

5.  The University's secondary insurance coverage for injuries sustained during an official practice or game includes a $2,500.00 disappearing deductible.  All student-athletes/parents are responsible for the $2,500.00 disappearing deductible included in this policy.  Other insurance payments, as well as personal payments, can be used to satisfy this deductible which applies to each separate injury.  After all claims for benefits have first been filed with your primary medical insurance carrier, any remaining bill may be submitted to the Athletic Training Office along with official insurance bills (called "UB-04/UB-92" and "HCFA") and the Explanation of Benefits (EOB) indicating previously paid amounts within 90 days of the loss.  Once the $2,500.00 deductible has been met, the University's insurance carrier will consider the remaining balance based on usual and customary charges and the student-athlete's compliance with athletic injury procedures.