General Information Medical Clearance Forms Insurance Page Meet the Staff Resources
Primary Insurance Qualification
A Qualifying primary insurance plan has the following criteria:
- Should provide coverage in the State of Washington
- Should be primary for any injuries (not only only Emergency Care)
- Deductible should be $5000 or less
- Not be a Medical sharing plan. (They do not qualify as insurance)
If your primary insurance does not meet this criteria there will be an option to purchase a sports insurance on the day you check in with the Athletic Training Staff.
Individual Sports Plan Enrollment
On behalf of the entire Athletic Department, I would like to welcome you to Pacific Lutheran University. We are excited and proud to have your family member join the Lute family.
It’s extremely important that you have a clear understanding of the insurance program covering student-athletes at Pacific Lutheran University. Medical health insurance is required for all student-athletes. PLU provides accidental medical coverage for student-athletes for sports related injuries. PLU pays the premium for this secondary (excess) coverage. Parental, or guardian, insurance is primary coverage. This means that the student-athlete or family’s applicable medical insurance policy will be used first in covering any accident occurring in athletics.
Coverage is subject to specific policy terms and conditions and includes certain restrictions and exclusions of which you should be aware. Note that PLU assumes no responsibility whatsoever for any uninsured expenses. The student must have coverage through a primary health insurer to avoid possible, significant out-of-pocket expense in the event of an injury.
Please also note that the NCAA’s Catastrophic Injury Insurance Program covers student-athletes who are catastrophically injured while participating in a covered intercollegiate athletic activity (subject to all policy terms and conditions). The policy has a $90,000 deductible and is supplemental coverage in the event of a catastrophic injury. More information on this program can be found on the NCAA’s website at http://www.ncaa.org/about/resources/insurance/ncaa-catastrophic-injury-insurance-program.
If you have any questions, please contact the PLU athletic training staff, at (253) 535-7366. We look forward to another year of continuing our history of athletic and academic excellence. Welcome to PLU!
Go Lutes!
EIIA: Intercollegiate Sports Plan
Pacific Lutheran University provides athletic accident coverage to full time intercollegiate-athletes while participating in regularly scheduled games, competitions, practice sessions, or team strength/conditioning workouts under the direct and immediate supervision of Pacific Lutheran University’s Athletic Department. The athletic accident coverage is a SECONDARY insurance and CAN NOT be used as primary insurance coverage. Please click on the links below for detailed information about this insurance coverage.
EIIA: Intercollegiate Sports Full Plan
EIIA: Intercollegiate Sports Plan Summary
EIIA: Primary Sports Plan
CLAIM FILING PROCEDURES:
1. An accident must be reported to the Student Insurance Coordinator within 24 hours following the accident. Accidents incurred during supervised practice or play should be reported to the Athletic Trainer or Athletic Department Official immediately following the injury.
2. If you are insured by an HMO, PPO or similar arrangement, they must be contacted for proper instruction or authorization on covered health care. HMO & PPO Plans must be utilized. If you do not use the facilities or services of the HMO, PPO or similar arrangement, medical benefits may be reduced.
3. The coverage afforded by the Student Plan may provide benefits in EXCESS of any other coverage the student may have. If so, all eligible charges submitted must be accompanied by an Explanation of Benefits (EOB) from the primary insurance carrier(s). The Insurance Section in Part 1 of this Claim Form must include insurance information for BOTH parents if the student is 26 years of age or under. Blank lines or N/A are not acceptable.
4. Incomplete Claim Forms will result in a processing delay. Allow up to 4 weeks for processing after all information is received.
5. Please ensure that all bills are itemized insurance bills, listing the patient’s name, date of service,
diagnostic code, service code and the provider’s tax identification number. (HCFA and UB forms are preferable.)
6. File only one Claim Form per loss (Accident or Sickness). Once the initial Claim Form has been filed, additional information submitted should be identified with the school’s name, the student’s name, ID# and the initial date of loss.
IMPORTANT INFORMATION: ♦ Initial medical treatment must take place within 90 days from the date of Accident or Sickness. ♦ Written notice of a claim must be given within 180 days after a covered loss occurs. ♦ All eligible expenses must be submitted within one year from the date of service.
If you have any questions about filing your claim, please contact your school's Student Insurance Coordinator or NAHGA Claim Services at 1-877-497-4980.
Any questions of the insurance coverage should be directed to:
Kelsey Bunker at kbunker@plu.edu
