NCAA Division I Student-Athlete Insurance Coverage

Transcription

1 NCAA Division I Student-Athlete Insurance Coverage Overall Findings February 2016 The topic of benefits provided to student-athletes has been and continues to be one of the main priorities for the NCAA and its member schools. Not surprisingly, when conversations occur around this topic, injuries and medical insurance are regularly discussed. Up until this point, we have not had the necessary data needed to assist us as we seek to make decisions for the future. With support from the conference commissioners, we have obtained these critical data through a survey sent to head athletic trainers at all NCAA Division I institutions. The goal of this survey was to determine what schools are paying for, what coverage exists and for how long, and what, if anything, student-athletes and their families are paying out of pocket. With this new data we aim to inform future discussions about student-athlete medical insurance issues, both within the membership and with the general public. Response Characteristics Total Respondents: 232 Response Rate Total 70% FBS 77% FCS 66% No FB 67% 0% 25% 50% 75% 1

2 Responses by Subdivision 40% 26% No FB FCS 34% FBS Responses by n % n % America East 5 2% Mid-Eastern Athletic 6 3% American Athletic 11 5% Missouri Valley 8 3% Atlantic % Mountain West 8 3% Atlantic Coast 10 4% Northeast 7 3% Atlantic Sun 7 3% Ohio Valley 9 4% Big % Pac % Big East 8 3% Patriot League 6 3% Big Sky 10 4% Southeastern 14 6% Big South 6 3% Southern 8 3% Big Ten 11 5% Southland 6 3% Big West 7 3% Southwestern Athletic 3 1% Colonial Athletic Association 5 2% Sun Belt 9 4% USA 10 4% The Ivy League 5 2% Horizon League 6 3% The Summit League 9 4% Metro Atlantic Athletic Mid-American 6 3% 7 3% West Coast 4 2% Western Athletic 3 1% 2

3 Insurance Coverage Most insurance programs for student-athletes are managed through the athletics department (93%). Within the athletics department, the following managers of the program were identified: Manager Athletic training staff 77% Dedicated insurance coordinator 37% Athletics administrator 25% Other 7% 68% of schools have a primary insurance requirement. o If a student-athlete does not have primary coverage, 70% of institutions provide insurance for them. The NCAA Catastrophic Injury Insurance Policy contains a $90,000 deductible ($75,000 for institutions participating in the NCAA Group Basic Accident Medical Program) to be met prior to benefits being payable. Institutions are required to ensure student-athletes have coverage for athletic injuries up to the Catastrophic program deductible. How do institutions meet the NCAA requirement? 23% 6% 4% Purchase accident insurance policy Formal self insurance program 67% Require SAs to provide personal coverage Alternative financial arrangement The following are the details of the fulfillments identified by participating institutions. 3

4 Accident Insurance Policy (67% of Institutions) On average, when a Division I institution meets the NCAA insurance requirement by providing an accidental insurance policy, approximately 400+ student-athletes are covered per institution. Most accident insurance policies purchased by Division I institutions are aggregate (47%) or fullyinsured (43%). Nearly 60% of institutions that have an accidental insurance policy annual premium of $100,000 - $500,000 (30% have a $100,001 - $200,000 premium, another 29% have a $200,001 - $500,000 premium). 45% of institutions accidental insurance policies have a deductible between $ Higher policy limits are sporadic. Over three-quarters of institutions with an accidental insurance policy have a benefit period of 104 weeks. Accident Death and Dismemberment Limits vary by institution, but the most common option purchased is a $10,000 limit (27%). 87% of accidental insurance policies purchased by institutions do not include sub-limits. Formal Self-Insurance Policy (23% of Institutions) On average, when a Division I institution meets the NCAA insurance requirement by having a formal self-insurance program, approximately 400+ student-athletes per institution are included in this policy. 72% of institutions indicated that student-athletes or their families are not responsible for any costs under their program. 59% of institutions with a formal self-insurance policy have a benefit period of 104 weeks. 85% of formal self-insurance policies do not include sub-limits. Alternative Financial Arrangement (6% of Institutions) On average, when a Division I institution meets the NCAA insurance requirement by having an alternative financial arrangement, approximately 400+ student-athletes per institution are included in this arrangement. Many of these arrangements include a self-funded program that act as secondary coverage for remaining balances. 4

5 Student-Athlete Provided Coverage (4% of Institutions) For Division I institution that meet the NCAA insurance requirement by mandating that their studentathletes to provide their own insurance coverage as a condition of their sports participation, this most commonly includes all student-athletes at their institution. Approximately 62% of institutions that require student-athletes to provide their own coverage as a condition of participation: o Do not review their policies regarding this plan o Do provide guidance about appropriate deductibles, copays, etc. o Do verify insurance coverage through their institution s accident medical insurance company or outside vendor Costs for Injuries not Covered by Insurance If primary insurance is not available, 84% of institutions indicated that the athletics department will cover 100% of the cost. 60% of institutions track student-athlete insurance coverage by type (i.e. HMO, PPO, Kaisar, military, government). The amount Division I institutions pay out-of-pocket for injuries varies immensely, ranging from a few hundred dollars to millions. For 89% of schools, these costs cover all student-athletes. 86% of institutions indicated that student athletes do not have out-of-pocket expenses for athletics injury. o The number of student-athletes that do have out-of-pocket expenses vary among institution and can be dependent on if they have a scholarship. Some costs mentioned were for prescriptions and for those seeking a second opinion on a diagnosis. For those reasons, the amount some student-athletes pay out-of-pocket can vary. Unrelated Coverage 44% of institutions do not provide coverage for illnesses, injuries or other medical cost not related to athletics (however 34% do and 23% might, they aren t sure). Of the institutions who provide unrelated coverage, they provide it through the following means: Means of Providing Coverage* Student health centers 62% Self-insurance program 43% A formal insurance policy 36% Other funds available 26% *For illness, injuries and other medical costs not related to athletics. 5

6 Institutions provide/pay for the following for student-athletes for issues not related to athletic injuries: Benefit Eye care 56% Prescription medication 56% Mental health services 54% Standard primary medical treatment 53% Dental 52% Musculoskeletal/orthopaedic rehab 40% 31% of institutions provide coverage for costs incurred due to an athletics injury after a studentathlete leaves school or exhausts their eligibility. Another 43% provide coverage under certain conditions. These are the means through which they provide coverage: Means of Providing Coverage** Self-insurance program 61% A formal insurance policy 44% Other funds available 16% Student health centers 13% ** For costs incurred due to an athletics injury after a student-athlete leaves school or exhausts eligibility. Institutions provide this coverage for various amounts of time, most commonly, 104 weeks (45%). 87% of institutions do not provide any enhancements to basic coverage (i.e. additional death benefit, higher policy, etc). Of those that do, the following enhancements are provided: Enhancements Additional death benefit 67% Other 29% Higher limits 13% 90% of institutions do not pay for unauthorized or non-referred expenses. 6