FREQUENTLY ASKED QUESTIONS
On August 5th, the NCAA Board of Governors (BOG) released the requirements for holding regulation games and championships for Fall sports. While the document addressed a number of issues, we would like to review some of the most frequently asked questions we have received regarding plans for testing and treatment of COVID-19.
What exactly is required?
The document from the BOG states “Divisions must develop rules providing that member schools will cover COVID-19-related health costs related to infections that local health officials reasonably believe were the result of student-athletes’ sports participation.”
Will our athletic accident insurance policy cover the testing and health costs related to COVID-19?
No. Your policy is an accident policy that covers medical costs related to accidental injuries sustained due to participation as a member of your team. COVID-19 is an illness and is excluded from coverage, similar to any other illness contracted during participation – such as the flu. Therefore, your accident policy will not cover COVID-related testing or treatment.
Can we add illness coverage to our policy?
Unfortunately, the answer again is no. Carriers are required to adhere to language defined in the accident policy which is filed, reviewed, approved, and ultimately enforced by each State’s Department of Insurance. We have reached out to the carriers and they have confirmed they are not able to deviate from the schedule of benefits that defines coverage for accidents only. Therefore, coverage for COVID testing and treatment will need to be provided through another source.
So how will COVID-related illnesses be paid?
While our team is engaged with the carrier markets to identify any new products, currently we have not seen any COVID-specific policies being offered. As a result, the primary source of coverage for a student’s COVID-related illness will be the student’s primary health insurance plan.
This may take the form of a Student Health Insurance Plan (SHIP), coverage through a parent’s employer plan, or a government program such as Medicaid or Medicare, among others. Except for Short-Term Limited Duration (STLD) plans, all other major employer, individual, public, and self-funded plans are required to cover medically necessary testing without preauthorization or cost-sharing. This federal requirement is part of Families First Coronavirus Response Act (FFCRA) and is valid through the current emergency period.2 There is no specific end date. Some carriers are also` waiving preauthorization and cost-sharing for treatment, but others may be subject to their plan’s deductibles, copays, or coinsurance. In some cases, these may leave students with a large out-of-pocket cost share and should be considered in your planning.
What about testing?
FFCRA requires medically necessary testing be covered without cost sharing. However, this does not apply to asymptomatic or voluntary testing needed to screen athletes prior to play. Costs for preventative screening will likely need to be funded by the institution.
We’re here to help!
We’re happy to work with you to evaluate risk exposure and mitigation solutions, such as self-funding the cost of testing or gap coverage. It may be advantageous to utilize network discounts and claim processing services from your athletic policy claims administrator. One can be set up with little difficulty to enable them to pay the bill on your behalf.
More specific rules and information should be coming from the NCAA Divisions. A due date has been set for Friday, August 14th. We will continue to monitor updates as they become available and will keep you informed. Please feel free to contact us to discuss specific areas of concern or individual solutions for your institution.