Student-Athlete Insurance Information
Sports-related injuries can occur while participating in athletics at Muskingum University. As an NCAA institution Muskingum University provides required insurance coverage for all student athletes. The coverage is in place for injuries that occur only while a student is participating during the regular and non-traditional seasons.
This document provides an overview of the coverage provided and how that coverage will interact with any additional insurance coverage you might have.
HOW THINGS WORK
If an injury occurs that requires care off campus (emergency room visit, see a specialist, etc.) the injured student should be aware of the following steps:
Your own insurance (though yourself or parents) is used first. This is called "primary coverage".
The college is a "secondary coverage". After your insurance has paid, if a balance remains, the following needs to be sent to the Wellness Center: 1. an itemized bill from your provider and 2. The Explanation of Benefits (EOB) from your insurance company that shows what they paid on the original bill. You can have the medical provider sent the itemized bill directly as well.
Susan Fracker (Wellness Center Director) will file any balance owed through our insurance programs. This will be done in the following sequence:
First, we will claim through the $500 accident policy that covers all full time Muskingum students.
If the $500 dollar policy is exhausted a claim will be filed on the athletic department policy. This policy covers claims up to $90,000.
If a catastrophic injury were to occur, the NCAA has a policy to cover claims beyond $90,000.
WHAT IF I PURCHASED PART 2 OF THE COLLEGE INSURANCE?
Part 2 of the University insurance, purchased by many students, does not apply to any injury that occurs to a student-athlete while participating in-season or in a non-traditional season. Part 2 would apply to injuries that occur outside of varsity athletic participation (for example intramural's, off-season weight training).
WHAT IS THERE IS NO COVERAGE THROUGH PARENTS?
If a student athlete doesn't have coverage other than through the university then bills are filed through the Wellness Center. The university policies become the primary coverage.
AN IMPORTANT EXCEPTION
Some physicians charge beyond what is "usual and customary." The University insurance will not pay beyond the "usual and customary" charge for services. You would be responsible for paying these expense.
WHAT YOU NEED TO DO
If a university policy is to be used the student athlete should contact the Wellness Center to arrange completion of the necessary insurance documents. Our Athletic Training staff will also help facilitate the documentation needed to submit any insurance paperwork.
If you have any questions about how the policies work feel free to contact Susan Fracker at the University Wellness Center. If the medical provider has any questions they can call Susan as well.
IMPORTANT CONTACT INFORMATION
Susan Fracker, Director
Head Athletic Trainer
162 Stormont Street
New Concord, OH 43762
THE EASIEST SOLUTION
When your son/daughter is being seen by a specialist, have the provider list Muskingum University as the secondary coverage. That way after the primary insurance has paid their part the residual balance will automatically be sent to Susan Fracker at the University Wellness Center. By doing this you will not have to collect information and forward it on to the University. The billing information that the provider should use is:
For 2011-12 the Group # is
ID # is the student athlete SSN or Muskingum student ID#
The University files the claims through Pearce & Pearce, Inc.
Providers should provide a bill including appropriate diagnosis and procedure codes and any Explanation of Benefits from primary coverage to:
Muskingum University Wellness Center
163 Stormont Street
New Concord, OH 43762
The provider can call Susan Fracker with any questions.