PRIMARY MEDICAL INSURANCE

All student-athletes at North Central College are REQUIRED to have personal, primary insurance that covers athletic-related injuries before participating in intercollegiate athletics at North Central College. It is the student-athlete’s responsibility to verify that the personal, primary insurance does cover athletic-related injuries. To demonstrate proof of this coverage, the student-athlete must provide a copy of their insurance card, both front and back, to the athletic training staff via submission to ATS (Athletic Training Systems -EMR) prior to any athletics participation.  The student-athlete will need to verify insurance each academic year. We encourage parents/guardians to explain provisions of the student-athlete’s personal insurance plan to the student athlete. If the student athlete is from out of the area or out of state, we recommend that the student athlete finds a primary physician in the area under the primary insurance in case of emergency or medical referral.

PRIMARY MEDICAL INSURANCE FOR PURCHASE

If a student athlete does not have primary insurance, North Central College offers a policy through the Educational and Institutional Insurance Administrators (EIIA) for purchase. This policy only covers accidental injuries sustained through official practice or competition. The plan term is for the academic year and will cover the student athlete from the enrollment date to the last date a student athlete is required to be on campus for participation in a covered event. The cost of the policy is around $800.00 (actually coast is not given to us until August each year), which will be charged to the student athlete’s account. There is no pro-rated cost for this insurance.
  
For more information on this policy, please contact Brittany James, Assistant Athletic Director for Health Care and Director of Sports Medicine, at 630-637-5563. 

EXCESS ATHLETIC ACCIDENT INSURANCE

North Central College provides an excess athletic injury policy for student-athletes participating in intercollegiate athletics. An accident is defined as “a sudden, unforeseeable external event which causes injury and occurs while coverage is in effect for the covered person.”  An injury is defined as “bodily harm resulting, directly and independently of disease or bodily infirmity, from an accident. All injury to the same person sustained in one accident, including all related conditions and recurring symptoms of injury will be considered one injury.” A covered event is a “regularly scheduled game, competition or practice session under the direct and immediate supervision by the institution.” A covered practice or game must be supervised by the institution and required of the entire team. Open gyms/unorganized practices and off season weight training do not qualify as covered events. Student-athletes are provided with excess athletic accident insurance coverage at no cost.  The Athletic Insurance Plan is an EXCESS plan. This means that any other valid and collectible insurance (the student-athlete’s primary insurance) coverage must be used first. In the event an injury is sustained through permissible intercollegiate athletics participation and the student-athlete has received medical attention outside of the NCC Athletic Training Staff (team physician, personal physician), a student-athlete may submit a claim to the policy.
 
The policy has a number of provisions. Failure to adhere to these provisions will result in a delay or non-payment of claims.
 
If an injury/accident does occur, the outlined procedure below must be followed:

• An athletic trainer from North Central College must perform an injury evaluation.
  • Injuries must be cared for by a physician within 90 days of initial injury date to be eligible to file an insurance claim.
• Claims for athletic-related injured must be initiated by the Athletic Training Staff.
• The student-athlete must follow proper provisions required by their primary insurance. Failure to do so may result in a rejected excess claim.
• The excess student-athlete accident insurance policy does not cover injuries sustained through intramurals, camps, non-NCAA leagues, pick-up games, previous injuries, etc.

FILING A CLAIM 

Following an injury, or notification that a student-athlete has seen a physician for an athletic-related injury, the Athletic Training Staff will assist the student-athlete in initiating the claim process. Further information about the Excess Athletic Accident Insurance Plan can be found here.
 
Claim Filing Process
Claim Form: This form is to be completed by the treating athletic trainer within two weeks of the student-athlete appointment with the treating physician. The athletic trainer will utilize the claim filing capabilities of ATS in filing the claim. It is the responsibility of the student athlete to keep the information on ATS up to date and current prior to filing any insurance claim.

All claim paperwork must be submitted within 180 days from the date of the initial injury. Once the claim has been filed through ATS, a copy of the claim form will be retained by ATS in that patients’ online chart. A copy of the claim will also be saved in pdf format in our secured server and stored for 7 years.

Typically, NAHGA requests itemized bills (the specific document is the UB-04 or HCFA1500). This document should be requested from the all medical providers seen for that injury. The student athlete must also submit an explanation of benefits from their primary insurance provider. This can be requested from the primary insurance company by contacting the insurance company’s custom service number. All of these documents should be sent directly to NAGHA or the athletic training staff.  Failure to submit these documents will delay the claim process and potentially result in a denied claim. The Athletic Training Staff will assist the student athlete during this process. It is important to make sure the student athlete communicates with the athletic training staff. Once a claim has been submitted questions, should be directed to NAHGA Claim Services customerservice@naghaclaims.com or 877-497-4980.


IMPORTANT NOTES

1. The coverage afforded by the Excess Athletic Accident Plan may provide benefits in EXCESS of any other coverage the student athlete may have. If so, all eligible charges submitted must be accompanied by an Explanation of Benefits (EOB) from the primary insurance carrier(s).
2. Incomplete Claim Forms will result in a processing delay. Allow up to 4 weeks for processing after all information is received.
3. Please ensure that all bills are itemized, listing the patient’s name, date of service, diagnostic code, service code and the provider’s tax identification number.

If you have questions about the excess athletic accident insurance or the process to access the policy, please contact Brittany James, Assistant Athletic Director and Director of Sports Medicine, at bajames@noctrl.edu.