Long Beach State Policies on Athletically Related Medical Expenses
In compliance with NCAA Bylaw 126.96.36.199 insurance benefits are provided to all LBSU student-athletes. Coverage is for athletic related injuries and illnesses that occur during sanctioned athletic activities with Long Beach State. Medical illnesses, pre-existing conditions and injuries that occur outside of athletic activities are not covered by this policy.
Insurance Provisions for Athletes
The Athletics Department has a secondary or excess insurance policy, thru the AIME program, for injuries that occur while participating in Long Beach State athletic activities. The insurance policy requires that if an athlete has personal insurance it must pay first and the remaining balances and deductibles will be paid by the Athletic Department's insurance. Benefits are payable only on an excess basis over and above any benefits or services provided by the primary insurance. If there is an out-of-pocket expense to the student-athlete or parents (co-pays, medications, deductibles) they will receive reimbursement for all costs by our secondary insurance.
If an athlete has no insurance, the Athletic Department will pay all expenses up to the limits of its insurance policy. If a claim involves more than this amount ($90,000), the NCAA catastrophic insurance policy will then provide coverage. It provides up to $20 million in lifetime benefits to varsity student-athletes (including student coaches, student managers, student trainers and student cheerleaders).
- Travel accident benefits for staff and players are covered by this policy.
- Another stipulation of the coverage is that if an athlete is covered by an HMO organization he/she is required to utilize that insurance. The HMO/PPO provision requires that treatment be denied by that entity before the risk pool will cover the expenses. The athletic department has no choice in this matter.
The first documented treatment for an injury must occur within 120 days of the injury. Expenses are covered for up to 104 weeks (2 yrs) from the onset of injury regardless of remaining eligibility. After this 2 year period, the insurance company will no longer be responsible for payment of claims for the injury2.
Claims must be authorized by and submitted for payment to the athletic medicine staff. This requires that athletes submit any bills and/or receipts immediately to the athletic medicine staff. The athletic department or its insurance provider will not be responsible for late charges or payment of claims that have not been authorized or submitted for payment in a timely manner.
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