UCCS Athletics

Dear Parent(s), Guardian(s) and Student-Athlete:
 
As the Athletic Medicine Staff at University of Colorado Colorado Springs (UCCS), we are very excited about the upcoming athletic season and your Student-Athlete’s interest in Mountain Lion Athletics. We wish the best for your Student-Athlete and hope that the upcoming years at UCCS are successful both academically and athletically.
Our Athletic Department goes to great lengths to provide the best medical coverage possible for our Student-Athletes However, we realize that the risk of a Student-Athlete suffering an injury in competition or practice is a possibility. This letter explains the procedures that are in place for insurance claims that are associated with these injuries.
 
UCCS Secondary / Excess Insurance Policy
UCCS carries a secondary / excess insurance policy (“Secondary Policy”) for our Student-Athletes to help defray the cost of a major injury. However, this Secondary Policy applies ONLY if four criteria are met:
 

1. The Student-Athlete must be covered on a primary insurance plan either under a parent/guardian’s name or their own name (“Primary Policy”).
2. The Primary Policy must NOT exclude participation in intercollegiate athletics (for example, the general student insurance plan offered by UCCS DOES NOT cover participation in intercollegiate athletics).
3. The Primary Policy must cover the entire school year, and any additional time frames that are sport-specific (like championship season, out of season, or non-traditional season).
4. If the Primary Policy is an HMO, then the rules and regulations for the Primary Policy must be followed.

 
Should the Student-Athlete fail to meet these criteria, then the Student-Athlete forfeits the right to claim benefits under the Secondary Policy.
 
            What the Secondary Policy Is:
The Secondary Policy covers UCCS Student-Athletes, cheerleaders, student managers, and student trainers for bodily injury sustained by any such person while participating in intercollegiate sports including scheduled games, supervised practice sessions, conditioning and authorized group or team travel to and from such events. 
 
The Secondary Policy has a deductible of $500, which can be met through payments under the Primary Policy and/or out-of-pocket expenses. The NCAA also has a catastrophic insurance for all of its member institutions that provides coverage when medical expenses exceed over $90,000. UCCS’ Secondary Policy is intended to assist for medical expenses exceeding the $500 deductible (or an applicable deductible from a primary insurance high deductible plan per below) up to the $90,000 coverage threshold of the NCAA catastrophic insurance.
 
UCCS team physicians must be consulted.  If a Student-Athlete seeks treatment from an outside provider for an injury or illness that directly affects the Student-Athlete’s participation in athletics, the Student-Athlete must inform the UCCS Athletic Medicine Staff prior to the appointment with the outside provider.  This ensures that the Secondary Policy will cover those visits and any follow-up care. 
 
What the Secondary Plan Is Not:
The Secondary Plan does not cover a Student-Athlete’s injuries or charges resulting from, or during: documented pre-existing conditions; intoxication or impairment from substances; criminal activity, brawling, fighting or rioting; self-inflicted injury; employment related activity; and sickness.
 
Because the deductible for the Secondary Policy is $500, the Secondary Policy will not support a high deductible primary insurance policy until the higher of the two deductibles is met.  For example, if a Student-Athlete’s Primary Policy has a $2,500 deductible, the Secondary Policy will not provide support until that $2,500 deductible has been met at the Student-Athlete’s expense.
 
Should a Student-Athlete not be eligible for coverage under the Secondary Policy for any reason, we will assist the Student-Athlete in identifying local insurance brokers that are able to advise on the appropriate medical coverage.
 
Secondary / Excess Insurance Claim Procedures
All billing of injuries sustained from participation in an intercollegiate competition or practice will be sent directly to either the parent/guardian or Student-Athlete’s address, unless UCCS instructs the medical provider’s office otherwise. Although in some instances it will receive a copy of the bill, UCCS should not receive the primary bill. To receive support under the Secondary Policy, you should:

1. Submit all bills incurred to the appropriate recipient under the Primary Policy. There will be two possible outcomes:
   1. The Primary Policy insurance company will honor the claim and pay all or a portion of the bills incurred. An explanation of benefits (EOB) will be mailed to you. Please forward a copy of this to the Athletic Department.
      • If a balance remains, send the claim sheet from the insurance company and a copy of the itemized bill incurred to the Athletic Department as soon as possible: UCCS has 90 days to file a claim with its secondary insurance provider.
   2. The Primary Policy insurance company will not honor the claim and will send you a letter of denial. Please forward this letter and a copy of the bills incurred to the Athletic Department.. This information must be submitted to the Athletic Department within 90 days of the denial of the original claim.

2. If the bills incurred are not paid under the Primary Policy insurance or plan and are instead paid out-of-pocket by the Student-Athlete, the Student-Athlete must submit a copy of the bills incurred to the Athletic Department.  The Athletic Department will forward the claim to our insurance carrier’s office for processing. However, there will be no reimbursement if the $500 deductible and/or the deductible from a high-deductible Primary Policy is not met in the billed charges.

 
Please Note:
If the Primary Policy is through an HMO (health maintenance organization), you must follow the proper procedures required under the Primary Policy in order for the Secondary Policy to satisfactorily complete its portion of the claim. This is especially important if the Primary Policy requires pre-authorization to have your Student-Athlete treated out of the Primary Policy’s service area.
 
UCCS must have a current copy of the Primary Policy’s insurance card in its records for your Student-Athlete, so your Student-Athlete should bring it to any medical appointments for a physical.
 
If you have any questions or concerns about these procedures, please do not hesitate to contact UCCS at the information below.  Insurance information is sometimes difficult to work through, and UCCS is committed to help its Student-Athletes and their families. 
 
 
Sincerely,

Brian Hardy, MSc, ATC
Assistant Athletic Director, Athletic Medicine
University of Colorado Colorado Springs
Office: (719) 255-3004
Fax: (719) 255-3131
Email: bhardy@uccs.edu