National Accident and Health General Agency, Inc. (NAHGA) Supplemental Athletic Accident Insurance Plan for Southwestern University

What does it cover?

The plan is a supplemental plan purchased by Southwestern University for all our NCAA athletes. The plan can help cover the costs not covered by your primary insurance coverage following an NCAA athletics related accident. There are limitations to this plan and payment is not guaranteed. All claims are processed and reviewed by NAHGA to determine qualification.

Who does it cover?

This plan only covers Southwestern University student-athletes during an official NCAA sanctioned event where a coach is present. Any new injury that occurs from an accident, when meeting the stated criteria, can be submitted to NAHGA for review of coverage qualification. There are restrictions that apply for pre-existing injuries and overuse injuries.

What are ways to help meet qualification criteria?

1. Athletes must be referred by a Certified Athletic Trainer from Southwestern University. If an athlete sustains an injury, the athlete must see his/her athletic trainer first. Failure to do so could result in denial of payment.

2. All rules and restrictions associated with the primary insurance company must be followed in order to receive the supplemental coverage. For example, if the primary plan is an HMO, the student-athlete must be seen by an approved physician on the HMO plan. Failure to comply with primary insurance regulations could result in denial of claims.

3. Initial injury must be sustained during an NCAA sanctioned activity. Captains' practices, weight lifting sessions without a coach's supervision, and other non-sanctioned activities are not covered by this supplemental policy.

4. If making a claim, please contact the medical provider and request medical records. These medical records can significantly expedite the claims process when submitted with the claim form.

5. When receiving bills from the medical providers, please ensure they are itemized bills and have been submitted to the primary insurance company. You can do this by contacting the providers and the primary insurance company.

What steps need to be taken following a qualifying injury?

1. First and foremost, the athlete needs to speak to the referring Certified Athlteic Trainer or go online to our insurance website listed on the back of this handout. The athlete will then meet with Southwestern University's Athlete Insurance Coordinator, Abbey Petrecca. The athlete will fill out necessary release forms and be given the claim form. Following this meeting, a letter will be sent to the parents or guardian explaining the claims process.

2. The claim form is to be completed and set to NAHGA claims services. Once the claim form has been submitted, all itemized bills from providers and explanation of benefits (EOBs) from the primary insurance company should be copied and sent to NAHGA claims services.

Insurance Page:
http://www.eiia.org/southwestern/StudentInformation.asp

Insurance Brochure:
http://www.eiia.org/documents/studentprograms/2010-11/SOUTHWESTERN_UNIVERSITY/ICS.pdf

How to file a claim:
http://www.eiia.org/documents/studentprograms/2010-11/Common/How_to_file_a_claim_DOM.pdf

Claim Form:
http://www.eiia.org/documents/studentprograms/2010-11/Common/Claim_Form.pdf

Questions for EIIA:
https://www.eiia.org/southwestern/studentcontact.asp

Southwestern University Insurance Contact Person:
Ms. Abbey Petrecca
Assistant Athletic Trainer
512-863-1768
petrecca@southwestern.edu