2007-08 Athletic Insurance Benefits

George Fox University provides Secondary Athletic Insurance through Combined Insurance Company of America that covers up to $75,000 of accidental medical expenses for all intercollegiate athletes at no cost to the student athlete. All students participating in intercollegiate athletics are automatically enrolled in the plan. The plan carries a $1,000 deductible and is secondary to the athletes' primary insurance. All medical bills must be filed with the athletes' primary insurance company before the secondary insurance will consider a claim. The purpose of the secondary plan is to cover medical costs not covered by the athletes' primary insurance plan. Medical expenses paid by the athletes' primary insurance may contribute to the $1,000 deductible.

Plan Scope

This plan is limited to providing coverage for conditions sustained while participating in NCAA-sanctioned athletic practices or competition for George Fox University. Injured athletes must report injuries to the athletic training staff in order for appropriate documentation to take place. Medical expenses are only covered when an athlete is referred by the team physician or the George Fox University athletic training staff to health care professionals outside of the university community. The plan will not cover medical costs if the athlete does not consult with the George Fox University athletic training staff prior to receiving treatment.</>

The plan does not cover expenses incurred from medications or treatment for injuries or conditions sustained apart from intercollegiate athletic participation at George Fox University; nor does the plan cover expenses incurred from medications or treatment for preexisting general medical conditions which may be exacerbated by physical activity (e.g. asthma).

Student-Athlete Responsibility for Bill Payment

• The processing of a secondary insurance claim is the sole responsibility of the student athlete.
• The athletes' primary insurance card must be provided to the the health care provider in order for you or the insurance policy holder to receive an Explanation of Benefits (EOB) Statement from the primary insurance company.
• The athlete must maintain records of billing from the medical provider and EOB statements from the primary insurance company.
• When there is billing and EOB evidence that medical bills have exceeded the $1,000 per injury deductible, the student athlete should contact the George Fox University head athletic trainer and request the claim form.
• The claim form will only be provided if there is evidence (e.g. George Fox athletic training staff initial injury report, university treatment log) that the athlete sustained the injury while involved in an NCAA-sanctioned practice, game, or travel related to participation in such events.
• The athlete must mail the completed claim form with copies of the providers' billing statements and the primary insurance company's EOB statements to the secondary insurer.
• All claims must be filed within two years of the date of injury.

The secondary insurer will not process the claim until the claim form, EOBs, and medical bills are received, and the $1,000-per-injury deductible has been met.

Medical expenses incurred for diagnoses and/or treatments not referred by the university's athletic training staff or team physician are not covered by the secondary insurer and are the sole responsibility of the policy holder of the student-athletes' primary insurance.