North Carolina State University Athletics Department
Summary of Student-Athlete Insurance
As your student-athlete prepares for the upcoming year of school and competition, we ask that you take a moment to review the
following statements regarding student-athlete injuries and medical insurance protocol. The Athletics Department has acquired
Supplemental Athletic Accidental Insurance for all student-athletes at no cost to the individual (this is NOT a health
insurance policy – but rather an athletic accident policy). To insure your son or daughter’s enrollment in this plan you must
complete and return the enclosed forms by _____________**. We have all become increasingly aware of spiraling medical costs
over the last several years. At North Carolina State University we strive to provide the best possible medical care for each of our
student-athletes. Our department provides excellent preventative conditioning programs and routine medical care through our
Athletic Training Staff and Team Physicians. However, there is risk of injury in athletic participation and diagnostic test(s) or
medical treatment may require referral to specialist(s) off campus. Accurate information will minimize unnecessary delays in
treatment for your son or daughter.
When an athlete becomes ill or injured, any group or personal insurance must be considered primary insurance. Our health care
providers are required to file claims directly with the primary insurance carrier. North Carolina State University will process balances
of properly processed claims for athletic injuries. The Athletic Department will not automatically assume responsibility for nonathletic conditions.
Assumption of Risk
By participating in intercollegiate athletics, a student assumes certain risk and responsibilities in addition to those assumed by the
institution. These include an obligation to safe conduct during practice and competition and a strict adherence to the rules of the sport
which are designed to safeguard the well-being of all participants. Each student-athlete has an obligation to inform the athletic
trainers and team physician of any medical problems encountered on or off the field of play.
Some General Notes About Insurance Coverage
• Occasional claims on your medical insurance generally do not affect the premiums. Therefore, if you currently have coverage
on your son or daughter that will meet the University’s Hard Waiver Student Health Insurance Plan requirement for Creditable
Coverage for Intercollegiate Athletic Participation **, we highly recommend that you maintain that coverage as long as the policy
permits for full-time student dependents.
•
Your insurance company may require verification of "full-time enrollment". We will be more than happy to assist you in
obtaining this certification.
•
Filing an insurance information form is a Condition of Eligibility in the Supplemental Injury Insurance Program. Please
understand that some type of personal medical insurance is highly recommended: it is not mandatory. FILING THE
INSURANCE FORM IS MANDATORY.
On the following page are some commonly asked questions regarding insurance issues. Please read this information carefully and
retain this packet for your personal records and future reference. Complete and sign the enclosed forms and be sure to return them by
_________________ in the enclosed envelope.
Your cooperation in this matter is greatly appreciated. Your time and effort will determine how smooth your son's or daughter's
transition is into their upcoming season. Please feel free to contact our Athletic Training Staff or the Insurance Administrative
Coordinator with questions you have, or if you need assistance completing the necessary paperwork.
Commonly Asked Questions Regarding Athletic Injuries
and Insurance Coverage
What expenses can be paid by the Athletic Department?
N. C. State will pay all expenses resulting from any athletically related injury during NCAA sanctioned practices or games. After primary and secondary insurances
have paid, N. C. State will pay any additional expenses for pre-approved care and treatment. This coverage extends to all NCAA sanctioned athletic activities,
regardless of whether they occur during the academic year or during the summer.
When will North Carolina State University pay the bills?
AFTER your group or personal insurance has processed the claim the North Carolina State University Sports Medicine Department will pay balances due for the above
described situations (including deductibles and copayments). Proof of no insurance is required for the Athletic Department to make immediate payment. N. C. State
will cover up to two years from the date of injury for any medical expenses incurred, when following N. C. State policies.
Who does North Carolina State University pay?
We make payment directly to the health care provider. You should not make personal payments to a health care provider for treatment of an athletically related injury.
What do I do if I receive a bill for medical services for an athletic injury?
Forward the bill immediately to the Administrative Coordinator in the Sports Medicine Department at the address below. Our department will review the bill in
question and consider it for immediate payment or request that the health care provider file a claim with your personal or group insurance company.
How will I know if and how my insurance company made payment?
You should receive a letter advising you that your son or daughter has reported an injury and that he or she may be referred to an off campus provider. When your
insurance company has processed the claim, you will receive an Explanation of Medical Benefits (EOB) which will define exactly how the claim was calculated and to
whom payment was made. DO NOT THROW THIS EOB AWAY!
What should I do with the EOB I receive from the insurance company?
Always forward a copy to us at the address below. The Sports Medicine Administrative Coordinator will make payment of any approved care and balance direct to the
health care provider.
What do I do if I receive a check from my insurance company with the EOB?
If you receive a check from your insurance company for care related to your son or daughter, call the Administrative Coordinator IMMEDIATELY. You can assume
that the health care provider has not been paid by your insurance company, but you have - and you will need to made immediate arrangements to forward that EXACT
amount to the health care provider. Some insurance companies will only make payments to you (the subscriber). Often times this situation can be confusing because
you may not know the exact name of the provider or you may not recognize the physician's name. Note: The Sports Medicine Administrative Coordinator will need a
copy of this EOB also.
Why do I have to complete a new form every year?
Your release is good for one school year. We have found that the information is subject to change. Each student-athlete's insurance status is required before they can
be cleared for participation.
How do I fill out the form if my son/daughter does NOT have Health Insurance?
You will need to go to www.ncsu.edu/student-health/ web sight for more information regarding the Hard Waiver Student Health
Insurance Requirement.
If you find that you have additional questions now or in the future, please contact the Administrative Coordinator below.
Administrative Coordinator
Glenda J. May
Phone 919-515-3065
Fax 919-515-6056
E-mail address: Glenda_May@NCSU.EDU
North Carolina State University
Sports Medicine Office
2500 Warren Carroll Dr/Box 8502
Raleigh, NC 27695-8502
Signing and returning the required forms by _________________ automatically enrolls your son or
daughter in the Supplemental Athletic Insurance at North Carolina State University.
Summary of North Carolina State University's Secondary coverage of Athletic Injuries**
Injuries sustained and reported by a student-athlete during NCAA sanctioned official practice or games are evaluated by the Sports
Medicine Staff. After evaluation the athlete may be referred to a specialist in the local medical community. If an athlete wishes to
seek other medical attention, prior written approval must be obtained from the Director of the Sports Medicine Office. Unapproved
consultations or treatment are NOT covered under our secondary insurance policy.
Limitations of Coverage
Our secondary coverage is an accident policy and does NOT cover:
• an injury sustained in an activity which is not associated with the athlete's sport in a supervised intercollegiate practice or
competition or outside the academic school year
• a chronic or recurrent injury which was sustained prior to or outside of participation in athletics at North Carolina State
University
• any sickness or illness
Conditions Required
eligible medical bills must be received and processed by NCSU within two years from the date of injury. NCSU may not be
responsible for any expenses occurring or submitted after this date.
the required insurance information form must be complete and on file with the Sports Medicine Office.
primary health insurance must be submitted and processed prior to any submission to the Sports Medicine Office.
**This is a summary and is informational only, and is subject to the terms and conditions of the applicable insurance policy.
A Final Word
Items to return by ________________________________
Student Insurance Information & Forms Packet – this is a stapled packet
Enlarged Copy of Insurance Card(s) (front & back side) – Health-Dental-Prescription
Medical History (Incoming Freshmen only)
We are grateful for your cooperation in this important matter and welcome any questions or comments you may have.
The Athletics Department of North Carolina State University will strive for excellence in making this a great year for your son or
daughter.