Richard Stockton College Athletic Training

Intercollegiate Athletic Insurance- Secondary Coverage
2010-11
Reminder:  This information on insurance coverage is a general guide only, it in no way
 replaces or supersedes the information provided in the coverage policy.

Name of Insurance Company: United HealthCare (Student Resources)
Address of Insurance Co:  PO Box 809025: Dallas, TX 75380-9025
Phone Number 1800-505-4160
Name of Policy Holder:  Richard Stockton College-- Athletic Injury Policy
Policy Number: 2010-201945-8
Copy of the Policy Web Version
NCAA Catastrophic Injury Insuracne Webcast Policy
 
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1.  How is my son or daughter covered by the athletic insurance policy?  
In order to be eligible for coverage each athlete must pass their athletic physical at Stockton College.  Once cleared medically to participate, every intercollegiate athlete is covered automatically. Back to questions. 


2.  Who will file a claim with United HealthCare?
 
All athletic injury claims must be filed through Athletic Training Services.  Therefore, injured athletes should report their injury to the Athletic Training Staff and discuss their injury situation before seeing a physician.  Failure to do so may forfeit coverage for that injury.  Obviously this does not pertain to emergency or emergency room situations where immediate medical care is required. 



3. Whose insurance will be the primary carrier?
 
If your son/ daughter 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 United HealthCare Policy is an "Excess" or "Secondary" policy.  They will only consider bills that have been processed through your Primary Insurance Carrier first. 



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 Bollinger with the proper paper work (this is not a complete list, however): 
1. Deductables 
2. Co-Pays 
3. Prescriptions 
4. Hospital Bills 
5. MRI/ Diagnostic Testing Bills 
6. Emergency Room Bills 
7. Physician Bills 
8. Knee Braces 
***You should obtain a receipt & itemized bill for any bills you pay directly yourself (including co-pays). 



5. 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, United HealthCare 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 it's also possible the primary care physican will want to see the athlete first, before a  referral is made.



6. 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.  But all 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 (usually reduced benefits, with a deductable).  As long as the PPO provides partial coverage then United HealthCare will consider most unpaid balances, when the proper paperwork is received.    



7.  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 physican, hospital, or medical facility.  These plans normally have a deductable and United HealthCare will consider all unpaid balances, when the proper paper work is received.  



8. How are bills processed?
Each medical provider should bill your primary insurance first and then United HealthCare as your secondary insurance.



9 .  What is our responsibility in this process? 
 
1. For emergency rooms visits, 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. Maintain copies of all of the required itemized bills, receipts, and EOB's required by Bollinger. 

***We suggest you make a folder and keep any and all of the information you receive regarding the athletic injury here for future reference.

Receipts for co-pays should be sent to:
Richard Stockton College
Athletic Training Services- Sports Center 309
PO Box 195
Pomona NJ, 08240



10. Who can we contact with questions or problems? 

From Stockton: 
Chris Klenk, MEd, ATC, CSCS- Assistant Athletic Trainer/ Email: klenkc@stockton.edu
Jessica Spencer, MA, ATC- Athletic Trainer/ Email: spencerj@stockton.edu
Jon Heck, MS, ATC- Associate Director of Athletics and Recreation/ Email: heckj@stockton.edu 

609-652-4952 

   
 
Questions or comments regarding the Athletic Training Pages should be directed to 
Jon Heck at:

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