Secondary Insurance Coverage Information
University of Colorado at Colorado Springs has purchased a secondary or excess insurance policy on all of its student-athletes participating in intercollegiate athletics at our institution. All student-athletes MUST have some sort of primary insurance to participate at University of Colorado at Colorado Springs. This insurance MUST last for the full academic year (both traditional and non-traditional seasons as well as individual sessions).
Our insurance has a $500 (as of Fall 2008) deductible. All of the student-athlete’s out of pocket payments or primary insurance payments help to satisfy this deductible. Once this deductible is met, then the excess insurance has Medical Maximum of $75,000 that covers "usual and customary" covered expenses incurred. The NCAA also has a catastrophic insurance policy for those injuries that accumulate bills over $75,000.
The following are stipulations provided by the insurance company for appropriate claims:
Covered entities: The plan covers student-athletes, cheerleaders, student managers and student trainers of the University of Colorado at Colorado Springs for bodily injury sustained by any such person while participating in intercollegiate sports including scheduled games, supervised practice sessions, conditioning and authorized group or team travel to and from such events.
Uncovered entities: Injuries or charges resulting from, for or during the following are NOT covered: Pre-existing conditions, Intoxication or otherwise under the influence; criminal activity, brawling, fighting or rioting; Self-inflicted injury; employment related activity; and sickness.
All medical claims must be filed by the Head Athletic Trainer at University of Colorado at Colorado Springs as soon as possible (there is a 180 day window that a proof of loss statement must be filed with carrier), so that filing of the injury may be expedited.
Important notes:
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If a "proof of loss" form is not filed from the University of Colorado at Colorado Springs Athletic Training Staff within 180 days of original injury, it will not be covered under our excess insurance policy.
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A "proof of loss" statement is only filed when a student-athlete or parent/guardian contacts the University of Colorado at Colorado Springs Athletic Training Staff about details on the secondary insurance and their need to utilize it.
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Once a "proof of loss" statement is filed then the policy and procedures for filling claims are as stated on the "Filing Claims Procedure" link located on the left.
Claim Filing Procedures
All billing of injuries sustained from participation in a intercollegiate competition or practice will be send directly to either the parent/guardian or student-athlete’s address unless the college instructs the medical office otherwise. In some instances the college will receive a copy of the bill, however the primary bill will not be sent to the university.
Policy and Procedure
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Submit all bills incurred to you family employer group or plan first. There will be two outcomes:
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The company will honor the claim and pay all or a portion of the bills incurred. An explanation of benefits (EOB) will be mailed to you, please forward a copy of this to the athletic department for filing with other medical records.
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The company will not honor it and send you a letter of denial. Please forward this to the athletic department also.
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If the balance remains after you family employer group insurance or plan has contributed toward the claim, sent the claim sheet from the insurance company and a copy of the itemized bill incurred to the college’s athletic department.
If you receive a letter of denial from you family employer group insurance or plan administrator, send the letter of denial and a copy of the bills incurred to the college’s athletic department. If no coverage is available, a letter from your employer with verification will be necessary. Any claim(s) needs to be submitted to the athletic department within 90 days of the original claim having been denied by your insurance company. -
If the bills incurred are not paid by your family employer group insurance or plan the claim will be sent from the athletic department to our insurance carrier’s office for processing. There will be no payment if the $500 deductible is not met in the billed charges. If they need any additional information, please cooperate with them. And they will process the claim in the least possible amount of time. It is in your best interest to have the claims settled promptly since all the bills incurred are in your name.
Secondary Insurance Letter
This letter will explain most of the information needed when it come to the both the expectations of the student-athlete / guardian as well as the University in regards to insurance policies. If there are ever any questions please let the athletic training room answer them. Don't hesitate to contact them at any time.