Insurance Policies and Procedures July 1, 2018
NOTE: All student-athletes must acknowledge this information by returning this signed and dated form.
Dear Student-Athletes, Parents and Guardians:
Welcome to Indiana State University and a new and exciting year ahead. Please take a few moments to review the following information regarding our policies and procedures for the upcoming season concerning athletic-related injuries and medical insurance.
We have purchased an Insurance Blanket Plan that covers athletic injuries for all our student-athletes. This will assist those parents who have a very high family deductible to meet each year and those on an HMO, State Medicaid plan or a plan specific to the area in which you live.
The Blanket Plan is a secondary policy that has a
$2500 deductible per injury. In accordance with our existing insurance policy, ISU will pay the first portion of $1750 of the deductible, leaving the student-athlete to pay the remaining $750 per athletic related injury until we have reached our balance of $2500. It will not be an issue if you have a high deductible, an HMO or State plan that will not cover the claims submitted.
The most a parent/guardian will have to pay is $750 per injury. After the $2500 deductible has been met the Blanket Plan covers at 100% any remaining balances that are usual and customary charges. We hope that this will be cost effective the the family as well as to ISU Athletics.
This new plan does not cover personal physician or facility visits. If the student-athlete’s primary coverage is a State Medicaid, an HMO or a policy that does not cover them while here at Indiana State University, you may want to consider purchasing an individual policy that would cover him/her in case of an emergency or illness that would not be considered an athletic-related injury. If you need assistance with affordable coverage, please contact me, and I will connect you with a local agent who will be happy to assist you.
In accordance with our Athletic Department Insurance Policy, we still need a copy of your insurance card (front and back), along with a brief summary of your benefits (
this must come from your insurance carrier and cannot be typed or hand written). This summary lets us know what your deductibles, co-pays and co-insurances are for In and Out of Network Providers.
Welcome to Indiana State University. If you have any questions please feel free to contact me.
NOTE: All student-athletes must acknowledge this information by returning this signed and dated form.
All forms must may be sent via fax, mail, or email, to:
Pati Smith
ISU Athletic Department
401 N 4th Street 110D
Terre Haute IN 47809
Fax: 812-237-4041
E-Mail:
pati.smith@indstate.edu
For future reference and an explanation of just exactly how things work, we have supplied the following:
- Policies and Procedures
- Athletic Injury Procedures
