Reminder:  This information about insurance coverage is a general guide only. It in no way replaces or supercedes the information provided in the coverage policy.
 

Name of Insurance Company: Student Athletic Protection, Inc.

Address of Insurance Company: 3207 Stadium Drive, Suite #7
                                                   Kalamazoo, MI 49008-1500

Name of Policy Holder: Wabash College Athletics Department

 Insurance Information

 1. How is a student-athlete covered by the athletic insurance policy?
If the student is on the NCAA eligibility roster of the sport when the injury occurred, then that student is coverd by Student Athletic Protection, Inc.
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 2. Who will file a claim with Student Athletic Protection, Inc.?
Athletic injury claims should be directed to Nurse Carol Lamb in the Wabash Health Center, after primary insurance is paid.  All injury care and referral should be initiated through the Athletic Trainer and/or the College Physician.  This procedure has been established by Wabash College in collaboration with Student Athletic Protection, Inc.  Failure to follow these established procedures may forfeit coverage for that injury.  Obviously, this does not pertain to emergencies or emergency room situation where immediate medical care is required.
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 3. Whose insurance will be the primary carrier?
If your son is covered by any type of personal insurance, that company will serve as the Primary Insurance Coverage.  This is not an option, your personal coverage will always serve on a primary basis.  The Student Athletic Insurance Policy is an “Excess” or “Secondary” policy.  They will only consider bills that have been processed through your Primary Insurance Carrier first.
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 4. What is covered by the athletic policy?
Generally, the policy covers athletic related injuries that occur during supervised and scheduled athletic practices and games.  All of the following will be considered by Student Athletic Protection.
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 5. What does Student Athletic Protection require to process medical bills?
1. An injury claim must already be filed.

2. An Itemized Bill from each service provider.  An Itemized Bill details the charges for each item that makes up the total bill.  A bill that only shows a “total charge” is not acceptable to process a claim.

3. Explanation of Benefits (EOB) from your primary insurance carrier for each medical bill.  An EOB explains what your insurance carrier covered or denied from each medical bill.  Your primary insurance carrier will normally mail you an EOB after they have considered any medical bills.  A claim must be filed before you will receive an EOB from your primary insurance company.
**Unless Student Athletic Protection has all three of these items, a bill will not be considered.
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 6. What if we have an HMO?
An HMO requires a referral from your primary care physician before any medical care is received (other than emergencies).  If these procedures are not followed your HMO will deny all medical bills.  If your HMO denies your bills for this reason, Student Athletic Protection will also deny these bills.  It is imperative to follow the procedures established by your HMO.

HMO’s are the most restrictive type of medical insurance.  You are limited to physicians and medical care that is within the HMO’s network.  They also usually lengthen the time it takes for an athlete to initially see an orthopedist because a referral must be obtained before the athlete is seen for an injury.  And its also possible the primary care physician will want to see the athlete first, before a referral is made.
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 7. What if we have a PPO?
There are several types of PPO’s, but all of them provide more liberal coverage than HMO’s.  Some PPO’s do not require a referral as long as the physician who is seen is in their network of providers.  For full benefits, some PPO’s require a referral from your primary care physician.  Most PPO’s we have come in contact with provide coverage for “out of network” services.  This means if a referral is not obtained or a network physician is not used they still provide partial coverage then Student Athletic Plan will consider all unpaid balances, when the proper paperwork is received.
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 8. What if we have a “Traditional Plan”?
The “Traditional Plan” with an insurance company provides the best of all possible worlds.  Referrals are not required and coverage is open to any physician, hospital, or medical facility.  These plans normally have a deductably and Student Athletic Protection will consider all unpaid balances, when the proper paper work is received.
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 9. What is our responsibility in this process?
1. For emergency room visit, make sure your insurance company is contacted, if they require this for coverage.

2. Make sure a claim has been filed with your primary insurance company for each medical service provider (many times hospitals do not do this for you, especially with emergency room visits).

3. Obtain all of the required itemized bills, receipts, and EOB’s required by Student Athletic Protection.

**We suggest you make a folder and keep any and all of the information you receive regarding the athletic injury here for future reference.
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 10. Where do we send bills and EOB’s?
Carol Lamb
Student Health Center
Wabash College
PO Box 352
Crawfordsville, IN  47933

We will then forward the paperwork on the Student Athletic Protection with the identifiers they require for claim processing.  We will also keep a copy of all paperwork in the athletes file for future reference.
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 11. Who can we contact with questions or problems?

From Student Athletic Protection:
Claims Adjustor
Casey
1-800-232-1579

Agent
Rick Russel
1-800-232-1579

From Wabash:

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