Athletics

July 1, 2006

Dear Parent/Guardian/Student-Athlete:

The Athletic Department at Suffolk University would like to welcome you. As your son/daughter prepares to join us, we would wish to share some information regarding insurance coverage.

Effective July 1, 2006, all Suffolk University student-athletes must provide evidence of insurance that includes coverage for athletically-related injuries. This is a pre-requisite for practice and competition.

The student-athlete at Suffolk University is provided Athletic Accident and Injury Insurance, as a separate policy within the Athletic Department from the University Health Plan. Please note: This coverage is offered on an “excess” basis. Under the terms of the provision, this coverage is considered to be secondary to all other valid and collectible medical insurance policies. All claims must be initially sent through the primary health insurance coverage of the student-athlete. The most notable source being the family health insurance coverage through your employer under which the student-athlete is an eligible dependent.

Please note: The Student-Athlete policy covers medical expenses related to ATHLETIC INJURIES ONLY. The injuries covered must be sustained during the academic year and result from their participation in an intercollegiate sport. Any illness or injuries not directly resulting from athletic participation will not be covered under this policy. The university’s student health plan and/or your primary health insurance would incur those illness/injury expenses.

Massachusetts State law mandates that all students who are enrolled in 9 credits or more per semester must have health insurance. Suffolk University offers student health insurance through University Health Plans. Each year eligible students must choose to enroll or waive the student health insurance on-line. Students wishing to waive the insurance must have comparable health insurance. If students do waive the insurance, they will be AUTOMATICALLY enrolled in the Suffolk insurance plan, and are charged the premium.

For more information, go to http://www.universityhealthplans.com

(Please be advised that the student health plan through our supplier, University Health Plans, does not cover injuries sustained while participating in intercollegiate athletics at Suffolk University.) As mentioned above, athletic injuries are covered through the University’s athletic insurance policy on an excess basis.

If, covered by an HMO, and your son/daughter will be out of the network area while attending school, it is recommended that you change your primary care physician to one in the Boston area. Your insurer should be contacted for information and physician listings. This is particularly true for all students who reside outside of Massachusetts and have out-of state health care plans.

In the event that your son/daughter is injured while participating in intercollegiate athletics at Suffolk, it is vital for us to know about any medical coverage you may have. We appreciate the time you have spent to ensure this information is completed and returned with your student-athlete upon their return to campus this fall. If you have any questions or concerns, please feel free to contact me at (617) 573-8772.

Sincerely,
Jeff Stone, M. Ed., ATC
Head Athletic Trainer- Suffolk University
41 Temple St.
Boston, MA 02114
jstone@suffolk.edu

ATHLETIC INSURANCE CLAIM FILING PROCEDURES

Suffolk University provides secondary (“excess”) insurance for all participating student-athletes. This insurance is in excess of all other valid and collectable insurance policies. All medical bills generated from an athletic injury, sustained during participation in intercollegiate athletics, must first be filed with the student’s primary health insurance carrier, as well as copies to the University’s Head Athletic Trainer.

DEDUCTIBLE: There is a $250.00 deductible to each individual claim.

CLAIMS PROCEDURES:

1. File all medical bills with the primary insurance carrier upon immediate receipt.

2. Upon completion of payments, bring itemized bills with the corresponding explanation of benefits statements (E.O.B) or denial of benefits statements (Denials) from the primary insurance carrier to the athletic department office. Insurance will only process claims with these forms, they will not accept balance forward bills.

3. The athlete department will submit the claim to the insurance carrier
*NOTE: The benefits period for each injury is 24 months from the date of the accident. It is essential that all injuries be reported in a timely manner to the designated university athletic trainer or physician. This will ensure appropriate documentation and treatment for the student-athlete.

REMINDERS:

* The University’s Insurance Carrier does not permit Suffolk University or any college or university to provide coverage or pay the bills incurred for expenses related to illnesses or conditions which are not sustained as the direct result of an accident or injury in our intercollegiate sports program.

* The athletic accident insurance provides coverage for your son/daughter for accidents while participating in play or official practice, on an excess basis only.

* With the exception of emergency room treatment, an injured athlete is obligated to be evaluated by the University’s designated physician and/or athletic trainer for appropriate treatment or referral.

* The final decision on physical qualifications or reason for rejection is the responsibility of the Team Physician, Athletic Trainer or Athletic Director. The Team Physician, Athletic Trainer or Athletic Director (in consort) will determine the decision on when a student-athlete may return to competition after a previous injury.

* Each student-athlete is required to have a physical examination upon entrance to Suffolk University. In-coming freshmen and transfer students must have a physical dated after July 1, 2006. Upon each successive year, the student-athlete will fill out a medical form updating any health changes from the previous year.