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  2007-08 insurance policy / medical claims information
Insurance Policy / Medical Claims Information

While at Gannon University we want you to have an enjoyable athletic experience.  Injuries do occur and we attempt to provide our athletes with the very best possible care.  Medical bills are incurred when the athlete is treated, whether it be locally, during a road trip, or by a medical provider in his/her own home area.
 
We do require that each year all athletes and parents fill-out and sign a parental information/insurance form, and submit a copy of their insurance card (front and back) for our records.  If at any time there is a change in the primary insurance coverage for an athlete during his/her competitive season, it is the responsibility of the parents/guardians and athlete to inform Gannon University’s athletic training staff of this and to fill out a new parental information/insurance form.
 
NOTE: ALL INJURIES must be brought to the attention of the athletic training staff immediately.  The athletic training staff, or in the absence of an athletic trainer in the event of an emergency the head coach of the sport, will refer the athlete to the appropriate medical provider.  Any non-referred treatment is not covered under Gannon University’s insurance policy.  All bills incurred will be the financial responsibility of the athlete and his/her parents/guardians.  The team physician or athletic training staff also makes the final decision on when an athlete may return to competition after an injury.
 
Insurance Information:
  • Gannon University provides an athletic accident insurance policy for coverage of its student-athletes for ACCIDENTS WHICH OCCUR WHILE PARTICIPATING IN GAMES OR OFFICIAL PRACTICES OF THEIR INTERCOLLEGIATE ATHLETIC TEAMS.  It does not cover illnesses or routine dental care.
  • The NCAA does not permit us, or any college or university, to provide coverage or pay the bills incurred for expenses related to illnesses or conditions which are not the direct result of an accident in our intercollegiate athletics program.
  • This athletic accident insurance policy is a SECONDARY coverage insurance policy.  It takes effect only after a primary insurance policy has honored or denied payment on a claim.
  • Pre-existing injuries or conditions, or aggravation due to athletic participation are not covered benefits.
  • The University’s insurance policy does not cover the cost of braces or orthotic devices.
  • Once the attending physician has released the athlete for further competition, all subsequent medical procedures related to the same injury are the sole responsibility of athlete, parents, or guardians unless written approval from Gannon University’s designated medical personnel has been obtained.
  • All ELECTIVE SECOND OPINIONS will not be the financial responsibility of the Gannon University Athletic Department.  They are the responsibility of the athlete and his/her parents or legal guardians.
  • In an effort to eliminate as many problems as possible, please acquaint yourself with the guidelines set forth by your insurance carrier while attending Gannon University – especially if your coverage is through a HMO or PPO plan.  Many plans require that you contact them and let them know you are attending college and that you may be out of state/network.
  • Please know if your insurance carrier requires a SECOND OPINION or PRE-CERTIFICATION before surgery.  Proper procedures are necessary to assure there will be no reduction in your benefits.
Claims Procedure:
  • All medical bills incurred by an athlete as a result of injury occurring in a designated intercollegiate practice or game will be sent directly to the primary insurance company or to an athlete’s home address.  Occasionally, the athletic training department will receive a copy of bill(s), but in no case will the athletic training department be the primary place for the bill(s) incurred to be sent.
  • Please follow the procedure listed below for all athletic medical claims:
    • Submit the bills incurred to your family or employer group insurance coverage plan first.  They will do one of two things:
      • Honor the claim and pay all or a portion of the bills incurred.  You will be provided with an explanation of benefits (EOB).
      • Not honor the claim and send you a letter of denial.  An example might be that the athlete is no longer part of the group policy because he/she has reached the age of 23.
    • If there remains a balance after the family or employer group insurance plan has contributed toward the claim, please send the explanation of benefits and a copy of the itemized bills to the Gannon University Athletic Training Department.
      • If you receive a letter of denial from your family or employer group insurance plan, please send the letter of denial along with the explanation of benefits and copies of the itemized bills.
      • If there is no coverage, a letter from you/your employer with verification may be necessary.
    • If the bills incurred have a remaining balance that is large enough, the claim will be sent to our main insurance carrier office in Kalamazoo, Michigan for processing.  If they need any additional information, please cooperate with them, and they will process your claim as soon as possible.  It is in your best interest to have the claim settled promptly since all bills incurred are in your name.  All claims must be filed within 15 months from the date of the accident.
Gannon University~University Square ~ Erie, PA 16541-0001
Toll Free: 1-800-GANNON-U
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updated 9/12/06 by: drt