Insurance Information
This guide was developed to familiarize you with Eckerd College’s policies regarding medical care and insurance issues. You may also refer to the Insurance Process Policy for more information and as always please feel free to contact us with any specific questions or concerns.
· Athletics Secondary Policy
Primary Insurance
· All Eckerd College students are required to have personal health insurance on their own or through EC. All medical bills will be processed by their personal insurance plan first. The EC athletic training staff will make every effort to assure the medical provider accepts the student-athletes personal insurance.
EC Secondary Insurance Coverage
· NCAA regulations state the athletic department may be financially responsible (within the limits of their insurance) for medical care of the student-athlete only when the injury is directly related to the student-athlete's sport and occurs during an EC supervised practice, conditioning session or competition.
· The EC athletic department has a secondary insurance policy to help cover medical expenses not covered by the athlete's primary insurance and is only applicable to athletic related injuries.
· Medical expenses for athletic-related injuries not covered by the student-athletes primary insurance or the EC athletic secondary policy will be the responsibility of the athlete or their parent / guardian.
Getting the Bills Paid
· When a student-athlete is injured and receives treatment from our medical staff, you will begin to receive bills for the injury. Your insurance policy must process the bill completely before EC's secondary insurance will pay any remaining balance. This process can take a significant period of time because the bill has to be processed by two insurance companies. In order to expedite this process, please forward copies of any paperwork regarding the injury to the EC Sports Medicine Staff.
Explanation of Benefits (EOB):
· The EOB is a document that explains what the insurance company has paid the medical provider, the balance, if a claim has been denied and what you owe. Often this document looks like a statement and is marked "this is not a bill". It is not unusual to receive several EOB's with different amounts on them.
· The EC athletic secondary insurance will not consider processing the claim till they receive the EOB. It is important you send a copy of all the EOB's to the athletic trainers so we can track the progress of the claim and help provide any documentation that may be needed to settle the claim. Once all the paperwork is in order they will submit the claim to our insurance company.
· These materials must be submitted within 10 days of receipt. Failure to comply with this requirement will result in possible denial of claims and absolve Eckerd College Athletics from any responsibility.
Frequently Asked Questions
· What if I don’t carry primary insurance on my son or daughter?
o You will be required to purchase a primary policy through the college
· What If my policy is an HMO?
o While emergent care and initial diagnosis may be rendered locally, we will be bound to follow the policies and procedures of the managed care contract. We highly recommend that you change your son or daughters primary care physician to one in St. Petersburg.
· What if I don’t think my insurance policy will pay for a claim or my deductible is high?
o The fact that our coverage is “Secondary” means that claim benefits can only be paid after the student-athletes primary insurance process payment and produces an explanation of benefits. If your policy produces an EOB with 0% paid then the secondary will pay 100% usual and customary; if the charge is beyond the coverage amount the student-athlete or parent will be responsible for the remaining balance.
o If you carry a policy with a high deductible the secondary policy will pay 100% of usual and customary charges after the claim has been processed through the primary carrier. Any remaining balance after the payment by the secondary insurance will be the responsibility of the student athlete or parent.
· What if I want my son or daughter to see a physician closer to home?
o In the event that a student athlete chooses to utilize a physician outside of our network the secondary insurance should provide the same coverage given that injury was sustained while participating at Eckerd College. However no guarantee can be made and processing of the claim and submission of claim materials will be the responsibility of the student-athlete or parent. Any amount not covered by the primary and secondary insurance will be the responsibility of the student athlete or parent.
· What if my son or daughter is sick or ill?
o The sports medicine staff will schedule and coordinate doctor’s appointments for student athletes when they are sick or in need of medical attention.
o The secondary insurance will only cover claims for athletic injuries; this does not include illnesses or other medical conditions.
o The sports medicine staff may require a student athlete to be cleared by a physician due to an illness or medical condition. Although the appointment will be considered mandatory the secondary insurance nor Eckerd College will be responsible for fee’s not covered by the primary insurance carrier.
Travis Irwin
Director of Sports Medicne
727-864-7831
