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Secondary Insurance

Baker University Student-Athlete Secondary Athletic Accident Insurance

The secondary athletic accident insurance policy is effective only after the student-athlete’s (S-A) primary health care insurance has paid its full portion and after the S-A has paid incurred charges to meet the secondary insurance disappearing deductible of $750.00 per accidental incident. A disappearing deductible is defined as follows: the covered person may use covered expenses paid under another health care plan to satisfy the deductible under this policy. See examples below.

Please note that athletics requires all S-A to document health care insurance coverage, through parent, spouse, or personal policy, and must be primary coverage when an athletic accident occurs. Baker University does not pay medical bills or out of pocket expenses. Also, note that this is insurance and insurance is not designed to cover all services in full, such as devices (braces) used by the S-A to play post-injury. Please, be aware that secondary insurance will not pay everything in full.

Upon referral to a physician, S-A provides the physician’s office with his/her health care insurance. In most cases, insurance will be directly billed by the physician’s office. After primary insurance has paid the provider, any remaining balance is sent to the home address of the S-A and not the school address. This comes as an explanation of benefits (EOB) and an invoice. These two documents should be presented to Cathy McDonald, Director of Human Resources, Constant 3. If the physician’s office is already aware of the secondary insurance, they will file the secondary claim directly with Cathy, before billing the S-A for any balance. Once the secondary athletic accident insurance deductible, up to $750.00, has been paid by the responsible party or the S-A, the athletic accident insurance will provide excess payment as long as the proper documentation is presented.

EXAMPLES

S-A incurs a $1,000.00 charge and S-A health care insurance pays $0.00, because of a $1,500 deductible on the health care insurance. Once the S-A has paid the $750.00 deductible, the remaining balance can be filed with the secondary accident insurance.

S-A incurs a $2,000.00 charge and S-A health care insurance pays 50% or $1,000.00. The $750.00 secondary insurance deductible has disappeared in the $1,000.00 paid by the primary. The remaining balance of $1,000.00 will be filed with the secondary accident insurance.

S-A incurs $12,000.00 charge and S-A primary health care insurance pays 80% of $9,600.00. The $750.00 secondary insurance deductible has disappeared in the $9,600.00 paid by the primary. The remaining balance of $2,400.00 will be submitted to secondary accident insurance.

S-A incurs a $500.00 charge and the S-A primary health care insurance pays a portion or denies payment. The secondary accident insurance deductible has not been met and payment is the responsibility of the S-A.

If you have any questions, please contact Cathy McDonald (cathy.mcdonald@bakeru.edu | 785-594-8362) in Human Resources.

The way health care insurance works for your athletic injury:

  • Present your driver’s license and health care insurance card to the physician’s office.
  • Your health care insurance is primary or used first.
  • Any insurance co-pay or deductible may need to be paid at the time of services; so secure receipts.
  • Some physician offices submit the claims directly to your insurance and if so, your permanent address (parents) will receive an explanation of benefits (EOB) from your primary insurance and an invoice for the remaining balance from the physician’s office. Secure the EOB and invoices/receipts.
  • Some physician offices require you to file directly with your health care insurance and insurance sends you a check to pay the physician. Then, you must pay the physician directly. Again, secure receipts.
  • In either case, once your insurance has paid its portion, the remaining balance can be submitted to the secondary athletic accident insurance company who provides secondary athletic accident insurance for Baker University Athletics, so bring the EOB and invoices to Baker University Human Resources, Constant Hall #4 or fax to 785-594-8374.
  • Our secondary athletic accident insurance has a $750.00 deductible, thus you or your insurance, or a combination of both must pay the first $750.00 before our secondary athletic accident insurance becomes effective.
  • If for any reason the physician’s office denies your insurance or your insurance denies you coverage, you’ll have to secure “denial documentation” from the physician’s office or from the insurance company and pay the deductible of $750.00 before our secondary athletic accident insurance becomes effective.
  • If a bill is paid in full by your primary insurance Baker University Human Resources still needs the bill and EOB as proof toward your secondary deductible.