Since we started in 1992, we have been solely dedicated to providing Student Insurance solutions for secondary schools. This is all we do! Please feel free to contact your peers at any of the schools we currently serve to see what they have to say about our products and service.
INJURY AND SICKNESS PLAN FAQ’S
Who underwrites the policy?
The plan is underwritten by United Healthcare, an Insurance Company rated A(excellent) by AM Best and a leader in the Student Insurance field.
What do I do if I have questions regarding a claim?
A student’s detailed claims history and individual explanation of benefits (EOB’s) are available 24/7 on a secure website called Partner Center. In addition, there is a customer team dedicated to serving schools only that can be reached via a toll free number. Finally, you can always contact our office with any specific concerns.
How are pre-existing conditions treated?
There are no limitations or waiting periods for pre-existing conditions.
Are there any deductibles or copayments under the plan?
There are no deductibles or copayments under the plan.
How are prescription drug claims handled?
Prescription claims are filed electronically using OptumRX.
Is coverage mandatory?
No, coverage is not mandatory. Most schools use a “hard waiver” approach meaning that students must provide proof of acceptable/sufficient coverage through a USA Insurance company. If they do not, then the school enrolls them in the plan. Many schools have now made this part of their enrollment agreement.
Can we cover students for short periods of time?
Yes. You can cover students for any period of time, whether that is for a 2 week trip overseas, a summer camp, a mid-term enrollment or for the academic year (up to 10 months). We have a daily rate, or 10 month-12 months rate.
How do we add/remove students?
All enrollments are handled through our secure website which keeps all information private. In addition, this provides you with an ongoing track record or your enrollment requests.
Is this a Network Plan?
That is up to you. We have both “Usual & Customary” (Non-network) and Network plans available. Network plans can help keep costs down and reduce the problem of balance billing. We utilize the United Healthcare Options PPO Network plan.
What types of materials/communications do you provide your schools so they can understand the policies and communicate the information to students and families?
We have developed a host of materials to help communicate with your families. All of these materials are available electronically and can be edited to meet your needs.
Are physicals and immunizations covered?
Preventative Care Services are covered, which include physicals and immunizations.
ACCIDENT ONLY FAQ’S
Are the plans primary or excess?
The Accident Only plans are excess. Any claim would first be submitted to the student’s primary plan. The Explanation of Benefits from the primary along with any remaining balances would then be submitted to this plan.
Are the plans voluntary or mandatory?
We offer both mandatory and voluntary plan options.
Are the plans 24 hour or during school hours?
The mandatory Accident Only plan offers coverage for students during school hours and at all school sponsored activities (including International travel). The voluntary Accident Only plan offers 24 hour coverage.
Is coverage included for all interscholastic sports, including football?
Yes, the mandatory plan offers coverage for all interscholastic, intramural and club sports, including football. The voluntary plan offers coverage for all interscholastic, intramural and club sports with an option for football coverage.
What is the duration of the policy?
The policy starts at the beginning of your school’s first athletic practice (prior to the start of the new school year) and runs for one year. You provide the start date for your policy.
Who underwrites the policy?
The mandatory basic policy is underwritten by The Hartford Insurance Company (up to $25,000) The voluntary basic policy is underwritten by Nationwide Insurance Company (up to $25,000) The mandatory catastrophic policy is underwritten by Nationwide Insurance Company (up to $1,000,000) Both companies are A rated companies by AM Best.
What are the coverage limits?
$25,000 primary coverage and $975,000 catastrophic coverage
Are there any deductibles, co-insurance or co-pays?
No. Coverage is 100% up to $1,000,000 per student.
How is enrollment handled?
On the mandatory application you will be asked to fill in the number of students attending the school and camp (if applicable). That’s it. No lists or separate forms are required. On the voluntary application you will submit individual student information for enrollment.
Are your Accident Only plans available in all states?
The mandatory Accident Only plan is offered in all states except DC, NH, NM, NY and OH. The voluntary Accident Only plan is offered in all states except NH and NY.