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: