The University of New Haven provides excess insurance coverage to protect all of our intercollegiate athletes against medical claims from accidental injury during your participation in all school sponsored and supervised athletic events. This coverage is administered by claims payer, BMI Insurance. Any changes to this policy will be available on our website at the beginning of the fall academic semester. Please share this information between parent/guardian and student-athlete. All parties need to understand the benefits of this policy as well as the claim administration process.
Sports Medicine / Athletic Training Excess/Secondary Insurance Policy Information
Policy details:
-Â Â Â Â Â $90,000 medical maximum per injury (NCAA catastrophic policy includes $90,000 deductible).
-Â Â Â Â Â 24 month benefit period from date of injury.
-Â Â Â Â Â Coverage is based on usual customary and reasonable fee (UCR).
-Â Â Â Â Â Covers acute accidents during university sponsored athletic practices and events only (does not cover recreational, club or intramural sports accidents).
-Â Â Â Â Â Although this coverage is very broad, there are restrictions, limitations, and exclusions in any insurance policy. In some situations, medical bills are not guaranteed to be covered in full.
-     This is an excess/secondary insurance policy. Claims will be paid immediately upon receipt of an itemized bill from the medical care provider (CMS 1500, CMS 1450 or UB 92 form) and an explanation of benefits (EOB) from the student-athlete’s primary insurance.
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Claims processing instructions:
-     Accidents must be immediately reported to a member of the University’s Athletic Training staff.
-     Claims can only be submitted by the University’s Athletic Training staff.
-Â Â Â Â Â Claims must be submitted and treatment must commence within 90 days of the date of injury.
-Â Â Â Â Â If you receive a form from your primary insurance or BMI Insurance requesting further information, please complete the form immediately in order to accelerate claims processing.
-Â Â Â Â Â If there are problems with claims processing, please contact BMI Insurance immediately. Identify yourself as a parent/guardian of a University of New Haven Student-Athlete or as a New Haven Student-Athlete and you will be assisted immediately.
-Â Â Â Â Â Due to federal HIPPA regulations, members of the New Haven Athletic Training staff cannot contact primary insurance companies or provider billing departments without written permission. You may be asked to communicate with your insurance company in order to accelerate claims processing.
-     If you choose to use a provider outside of the New Haven’s network of physicians:
o  Student-Athletes that prefer to seek coverage through physicians outside of our network must seek approval through the Director of Sports Medicine PRIOR to incurring any treatment.
o  Student-Athletes that prefer to seek coverage through physicians outside of our network must have primary insurance coverage and must verify that coverage includes the chosen provider.
o  Itemized bills (CMS 1500, CMS 1450 or UB 92) must be collected from provider(s) and submitted to BMI Insurance at the address listed below.
o  Primary insurance explanation of benefits (EOB) forms must be collected and submitted to BMI Insurance at the address listed below.
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Contact information:Â
All insurance policy questions can be directed to Andrea Harmon, Director of Sports Medicine, 203-479-4890
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All claims information and questions can be directed to:
BMI Benefits, LLC P.O. Box 511, Matawan, NJ 07747.
(P) 1-800-445-3126 (F) 732-583-9610
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Sports Medicine / Athletic Training Insurance/Billable Services Process
In order for New Haven Athletic Department’s excess/secondary insurance to assist in bill payment for athletic injuries sustained, (x-ray, MRI, MD visit, injection…) please follow the below instructions.Â
1.         In case of an athletic related injury (associated with competition through New Haven Athletics), your Athletic Trainer will submit a claim form on your behalf to BMI.Â
2.         During your visit, give your primary insurance information AND athletic excess/secondary insurance information to service provider. (All medical facilities that you go to -Doctor’s office, x-ray office, MRI office…) Excess/secondary information will be provided by your Athletic Trainer prior to your visit.Â
3.         Bring in any bills from the service(s) and appropriate explanation of benefits (EOB) from your insurance company and deliver it directly to your Athletic Trainer. (You may need to call your insurance company and have them send you that EOB, and then bring it in.)Â
4.         Bring in ANY subsequent bills / EOB’s you get pertaining to this athletic injury to your Athletic Trainer as soon as possible.
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Examples of needed documentation:
Itemized Bill
Explanation of Benefits (EOB)
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