NJSCU Participation
The following schools participate in the NJSCU Risk Management Program purchase of Intercollegiate Athletic Accident Insurance: Kean University; New Jersey City University; Montclair State University; Ramapo College of New Jersey; Stockton University; The College of New Jersey; and; William Paterson University of New Jersey.
NCAA Requirements and Information
The participating member institutions of the NJSCU Risk Management Program are in Division 3 of the NCAA. NCAA Division 3 legislation requires all institutions to certify that student-athletes have coverage for medical expenses incurred from athletically related injuries within the NCAA Catastrophic Injury Insurance Program deductible, which is currently $90,000. The NJSCU schools with NCAA teams currently meet this compliance requirement by offering an Athletic Accident Insurance Plan.
Plan Design
The NJSCU Athletic Accident Plan is currently managed by CBIZ Borden Perlman Insurance Agency, the Claims Administrator (Third Party Administrator) is currently NAHGA, and the carrier is currently The Hartford.
This Plan is considered a secondary/excess insurance plan that covers athletic injuries sustained solely during official NCAA sanctioned supervised practice or competition. Because the Plan is a secondary/excess plan, claims for athletic-related injuries must first be reported to the student athlete’s primary health insurance plan. The NJSCU Plan will be available to respond as the excess/secondary payer, subject to any coverage exclusions or limitations per the terms and conditions of the insurance policy. The Plan does not cover: injuries sustained prior to the athlete attending the NJSCU member institution; medical expenses incurred due to sickness or illness, unless it is a direct result of a covered injury; or; injury not directly related to supervised and official practice, play, or travel for the sport.
NJSCU’s Plan has a $0 deductible and provides a $90,000 benefit payable over 104 weeks (2 years) from the date of the accident that caused the injury. Please note that any charges incurred for treatment after 104 weeks will not be covered by the Plan. The injury also requires treatment by a physician within ninety (90) days of the date of the injury, otherwise coverage may be denied.
NJSCU’s Plan is designed to satisfy the deductible (currently $90,000) for the NCAA Catastrophic Injury Insurance Program so that the NJSCU’s NCAA intercollegiate student-athletes who sustain a serious injury can be eligible for extended benefits through the NCAA insurance policy without a gap in coverage.
The NJSCU Plan does not provide coverage for club sport or intramural athletic activities at the participating member institutions. Like any insurance policy, it also has certain exclusions and limits, and as such, is not guaranteed to pay any and all out of pocket expenses that may be incurred by student athletes.
Claims
Intercollegiate student-athletes who sustain an injury must immediately report the accident that caused the injury to their coach and the Athletic Training Staff at the NJSCU participating member institution that they attend. While it is the student-athlete’s responsibility to make sure that medical bills are filed properly and in a timely fashion, the Athletic Training Staff at each school manage the submission of a Athletic Injury Claim Form or electronic submission of the claim to the Claims Administrator of the NJSCU Plan. Claim forms should be completed and submitted within 20 days from the date of injury or as soon as reasonably possible. The NJSCU Plan will consider the claim after it has been processed, or denied, by the student-athlete’s primary health insurance carrier. While a claim should be opened right away with the NJSCU Plan, the student-athlete will eventually need to provide an itemized bill or Explanation of Benefits from their primary insurance carrier. Payments in excess of $5,000 also require medical records from the provider.
The student-athlete is responsible for any notification or pre-approval requirements of their personal health insurance plan. Most insurance carriers require that they be notified within 30 days that an injury has occurred. It is the responsibility of the student, or their parent/guardian, to file the claim with the primary insurance carrier.
Additional Information
NJSCU Risk Management Contacts can access policy documents and other Athletic Accident Insurance information here.
Athletic Contacts and Information for each school