Forester Athletic Training

Greetings from Lake Forest! We are currently planning for another exciting season of Forester Athletics.

I am writing about an important aspect and concern of our athletic program -- the medical treatment of our student-athletes, your sons and daughters. Enclosed you will find a brochure explaining the procedures for treatment of athletic injuries and the subsequent insurance coverage. You will also find letters from Mike Gilboe, our head athletic trainer, and Dan Buckley, our Koster insurance account representative

It is important that you read this letter and the enclosed brochure carefully, noting that athletic accident insurance is provided by Lake Forest College but that the coverage is offered on an "excess" basis only. Our athletic insurance policy, which we feel fortunate to continue to provide given today's insurance climate, provides coverage for your son/daughter for injuries incurred while participating in official intercollegiate team play or practice, including sponsored and authorized team travel. The coverage, however, applies only to in-season varsity athletic-related injuries and is considered to be excess to all other valid and collectible medical insurance policies . This means that you will be required to submit athletic injury medical claims to your primary health insurance plan first, then if there are remaining balances, this amount is submitted to the excess plan. The Lake Forest policy has a deductible of $2,500, which is considered met if the primary pays that amount, or over. It is your responsibility to insure this primary coverage or an out-of-pocket expense could be incurred. It is also important that you understand that this policy is for in-season injuries only. Injuries incurred in a pre or post season conditioning activities such as weight lifting are not covered under the athletic insurance policy.

In the event that your son/daughter is injured while participating in a covered sport, it is important for us to know about your medical coverage. With that being said, I ask that you and/or your son or daughter please complete and promptly return the enclosed insurance and medical history forms. The details of each form are explained further in the enclosed letter to your son or daughter from our head athletic trainer, Mike Gilboe. I ask, however, that you ensure all the appropriate forms are completed and returned no later than August 1. If your coverage is provided on an HMO or PPO plan, please be sure to include all the information necessary to procure prior authorizations, where applicable, as these programs may not provide benefits if the proper procedures are not followed. Again, please be sure to discuss your insurance coverage with your son or daughter and return the forms as soon as possible . Until we have the completed paperwork, your son/daughter will not be allowed to try out and/or participate in our athletic program.

Thank you in advance for your cooperation and please feel free to call me at (847) 735-5290 if you have any questions or concerns. I look forward to watching your son or daughter participate in our intercollegiate athletic program and I look forward to seeing you in the stands!

Welcome to Lake Forest College. One of my responsibilities as the head athletic trainer here at the College is to ensure the safety and welfare of our student-athletes. An important part of that process begins now. I ask that you go on-line and download the physical forms to take to your physician. The forms can be found at www.lakeforest.edu/foresters/athletictraining.htm. Find Physical Forms, and click on the link. Follow the directions below and send in the forms by mail or fax, or bring them with you when you report to school in August. As a new Student-Athlete and/or Transfer, it is mandatory that you get a complete physical from your physician prior to reporting for your upcoming season participation. If you do not have a complete physical as well as completed paperwork, you will not be able to practice.

HISTORY FORM: Every varsity athlete must complete this form every year. Please include injuries or illness from this summer if necessary. Address all responses by checking yes or no; indicate whether you are taking any medication.

PHYSICAL EXAMINATION/CARDIOVASCULAR SCREENING FORM: Freshmen and transfers need to complete this form with their family doctor prior to coming to Lake Forest College

INFORMED & MEDICAL CONSENT FORM: Every varsity athlete must complete this form every year. If you are not 18 years old, you MUST have your parent/guardian sign the form also.

INSURANCE: Every varsity athlete must complete this form. Are you covered under your parents’ insurance? YOU need to know this! If you have coverage under your parents’ insurance, please provide a legible copy of both sides of the insurance card when you return the enclosed forms. Also, please state whether you have an HMO or PPO policy. If you do not want the LFC Student Insurance you MUST go on-line and complete the waiver form at www.kosterweb.com or they will assume you want the insurance and bill your account. Any student who is not a US citizen is required to purchase the College’s insurance.

It is important for you to understand that the athletic insurance policy covers you ONLY during in-season activity in your sport and therefore does not include captain’s practices, off-season conditioning, intramurals or club sports. In general, when you’re away from home an HMO will cover very little, if anything, unless it is a true life or death emergency. I encourage you to sit down with your parent/guardian to discuss your insurance coverage and the protocol for reporting an injury should one occur.

EMERGENCY CARD: Every varsity athlete must complete this form prior to participation.
This form is placed with your coach during travel competition in case of an emergency. By helping us fill out this form insures us that we have the correct insurance information available and an emergency contact to call in the event of a serious injury.

Thank you for your time. If you have any questions, please don’t hesitate to call me at 847-735-5296. Have a safe and enjoyable remainder of the summer.

Michael Gilboe, MS, ATC
Head Athletic Trainer
Lake Forest College
555 N. Sheridan Rd.
Lake Forest, IL 60045
T 847.735.5296
F 847.735.6290

Letter from Koster Insurance

To: Parents of Lake Forest College Intercollegiate Athletes
From: Athletic Training/Koster Insurance
Re: Athletic Insurance Information

Dear Parent/Participant:

On behalf of the Lake Forest College Athletic Department, I would like to take this opportunity to explain the type of Excess Athletic Sports Insurance Policy purchased by the Institution for the students that are participating in one of our sports programs. The plan is underwritten by AIG, an A (excellent) rated by AM Best, an Insurance Financial Rating Company.

The Policy provides coverage for an injury, which occurred as a result of participating in a regularly scheduled, supervised, sponsored play or practice.

The coverage is offered on an "excess" basis to the participant primary health insurance policy, such as their parent's plan or any other heath insurance plan. Under the provision the plan will always pay secondary to any other valid and collectible health insurance plan. Therefore in the event of an injury, the participant will be required to submit the medical claims directly to his/her primary insurance plan first and then if there are any remaining balances, this amount is submitted to the excess plan. Should the participant not have any other health insurance, this plan will cover the claim up to the plan maximum.

The Lake Forest Policy has a deductible of $2,500, which is considered met if the primary pays up to that amount or over. It is your responsibility to ensure that the student athlete is responsible for this amount either through primary insurance coverage or an out of pocket expense could be incurred.

If you have any questions or concerns, please feel free to contact our office.

Sincerely,

Dan Buckley
Sports and Special Risk Account Representative
Koster Insurance

Insurance Q & A

Lake Forest College
Intercollegiate Athletic Insurance - Secondary Coverage

This information about insurance coverage is a general guide only. It in no way replaces or supercedes the information provided in the coverage policy.

Koster Insurance Company
500 Victory Road
Quincy, MA 02171
Tel. # 617.770.9889
Fax # 617.479.0860
Email: STUDENTCARE@KOSTERINS.COM

How is a student-athlete covered by the athletic insurance policy?

In order to be covered by the athletic insurance, the student-athlete must be enrolled in the Lake Forest College Student Insurance program and/or have their own personal insurance, and be a member of an intercollegiate athletics team at Lake Forest College (LFC).

Who will file a claim with LFC Athletic Insurance?

All Athletic injury claims will be filed by the Head Athletic Trainer at LFC. All injury care and referral should be initiated through the LFC Athletic Training Staff and/or the Team Physician. This does not pertain to emergencies or emergency room situations where immediate medical care is required.

Whose insurance will be the primary carrier?

Your son's/daughter's personal insurance, will serve as the Primary Insurance Coverage. This is not an option; your personal coverage will always serve on a primary basis. The Lake Forest College Athletic Insurance Policy is an "Excess" or "Secondary" policy. They will only consider bills that have been processed through your Primary Insurance Carrier first.

What is covered by the LFC Athletic Insurance Policy?

The athletic insurance policy provides coverage for injuries incurred while participating in official team play or practice of intercollegiate sports, including sponsored and authorized team travel. The coverage applies only to "in-season" varsity athletic-related injuries. It is important to note that an injury incurred in a pre or post season conditioning activity such as weight lifting will not be covered under the athletic insurance policy.

What does the LFC Athletic Insurance require to process medical bills?

An injury claim must already be filed.
An Itemized Bill from each service provider. An Itemized Bill details the charges for each item that makes up the total bill. A statement that only shows a "total charge" is not acceptable to process a claim.
Explanation of Benefits (EOB) from your primary insurance carrier for each medical bill. An EOB explains what your insurance carrier covered or denied from each medical bill. Your primary insurance carrier will normally mail you an EOB from your primary insurance company.

** Unless the LFC Athletic Insurance has all three of these items, a bill will not be considered.

What if we have an HMO?

An HMO requires a referral from your primary care physician before any medical care is received (other than emergencies). If these procedures are not followed your HMO will deny all medical bills. If your HMO denies your bills for this reason, LFC Athletic Insurance will also deny these bills. It is imperative to follow the procedures established by your HMO.

HMO's are the most restrictive type of medical insurance. You are limited to physicians and medical care that is within the HMO's network. HMO's generally lengthen the time it takes for an athlete to initially see an orthopedist because a referral must be obtained before the athlete is seen for an injury. And it's also possible the primary care physician will want to see the athlete first, before a referral is made.

What if we have a PPO?

There are several types of PPO's, but all of them provide more liberal coverage than HMO's. Some PPO's do not require a referral as long as the physician who is seen is in their network or providers. For full benefits, some PPO's require a referral from you primary care physician. But all PPO's we have come in contact with, provide coverage for "out of network" services. This means if a referral is not obtained or a network physician is not used they will still provide partial coverage then the LFC Athletic Insurance will consider all unpaid balances, when the proper paperwork is received.

What if we have a "Traditional Plan"?

The "Traditional Indemnity Plan" with an insurance company provides the best of all possible worlds. Referrals are not required and coverage is open to any physician, hospital, or medical facility. These plans normally have a deductible and LFC Athletic Insurance will consider all unpaid balances, when the proper paperwork is received.

What is our responsibility in this process?

For emergency room visits, make sure your insurance company is contacted. Make sure a claim has been filed with your insurance company for each medical service provider (many times hospitals do not do this for you, especially with emergency room visits).
Obtain all of the required itemized bills, receipts, and EOB's required by the LFC Athletic Insurance.

** We suggest you make a folder and keep any and all of the information you receive regarding the athletic injury here for future reference.

Where do we send bills and EOB's?

Koster Insurance Company
500 Victory Road

Quincy, MA 02171

Please make a copy of all documents you send to Koster for your records .

Who can we contact with questions or problems?

Lake Forest College:

Michael Gilboe
Head Athletic Trainer
847.735.5296
Email: gilboe@lfc.edu

Linda Alaimo
Insurance Coordinator-SHS
847.735.5050
Email: alaimo@lfc.edu

From: Koster Insurance Company:

Koster Insurance
Dan Buckley
800.457.5599

Dear Forester Student-Athlete,

I hope you are enjoying your summer thus far. Once again the athletic physical forms are on-line. The forms can be found at www.lakeforest.edu/foresters/athletictraining.htm. Find Physical Forms, and click on the link. Follow the directions below and send in the forms or bring them in with you when you report to school in August.

1. Returning Fall Athletes, if you were not cleared by Student Health Services prior to leaving for the summer you must complete the forms necessary in order to be cleared for participation (See chart below).

2. Returning Winter/Spring Athletes, we will have weeks/times available for you when you return to be cleared by SHS when you arrive back on campus. If you would like to visit with your own doctor for your physical, please do so by completing the necessary forms (See chart below).

HISTORY FORM: Every varsity athlete must complete this form every year. Please include injuries or illness from this summer if necessary. Address all responses by checking yes or no; indicate whether you are taking any medication.

PHYSICAL EXAMINATION/CARDIOVASCULAR SCREENING FORM: Freshmen and transfers need to complete this form with their family doctor prior to coming to Lake Forest College.

INFORMED & MEDICAL CONSENT FORM: Every varsity athlete must complete this form every year. If you are not 18 years old, you MUST have your parent/guardian sign the form also.

INSURANCE: Every varsity athlete must complete this form every year. Are you covered under your parents’ insurance? YOU need to know this! If you have coverage under your parents’ insurance, please provide a legible copy of both sides of the insurance card when you return the enclosed forms. Also, please state whether you have an HMO or PPO policy. If you do not want the LFC Student Insurance you MUST go on-line and complete the waiver form at www.kosterweb.com or they will assume you want the insurance and bill your account. Any student who is not a US citizen is required to purchase the College’s insurance.

It is important for you to understand that the athletic insurance policy covers you ONLY during in-season activity in your sport and therefore does not include captain’s practices, off-season conditioning, intramurals or club sports. In general, when you’re away from home an HMO will cover very little, if anything, unless it is a true life or death emergency. I encourage you to sit down with your parent/guardian to discuss your insurance coverage and the protocol for reporting an injury should one occurs.

EMERGENCY CARD: Every varsity athlete must complete this form prior to participation, every year!

YEAR	Pages to be Completed
Freshman	1, 2, 3, 4, 5
Soph/Jr/Sr	1, 3, 4, 5
First Time Athlete/ Transfer	1, 2, 3, 4, 5

Thank you for your time. If you have any questions please, don’t hesitate to call me at 847-735-5296. Have a safe and enjoyable remainder of the summer.

Sincerely,

Michael Gilboe, MS, ATC
Lake Forest College
Head Athletic Trainer