AISA STUDENT INSURANCE 2009

2010-2011 AISA Student Insurance: The following schools are covered under the AISA Student Insurance Base Plan which became effective on July 15, 2010. Coverage has expired for schools that had the 2009-2010 AISA Base Plan and have not submitted the 2010-2011 Base Plan Participation form. If you have any questions concerning student catastrophic or base plan insurance coverage, please call David Larson at 334-395-8000 or toll free 1-888-636-7272. The due date for catastrophic and base coverage insurance fees is September 3, 2010. There is a $25.00 per month late fee for payments received after this due date.

The AISA State Board of Directors has approved the following Student Group Insurance Programs for the 2010-11 school year. All AISA members must participate in the catastrophe coverage and are strongly encouraged to participate in the base plan. An association brochure outlining the complete program will follow. To expedite implementation, some of the program highlights are listed below. Coverage becomes effective on July 15, 2010. Schools will be billed in September.

Excess Group Catastrophe Plan

(Required for all AISA member schools)

$1,000,000 Accident Medical Maximum - Excess Payment

25,000 Deductible

100,000 Catastrophic Cash Benefit

Premium: Grades 7-12 $ 5.00 per student

Grades K5-6 $ 3.00 per student

All AISA members must participate in the above Group Catastrophe Insurance Program and all students in K5-12 must be included in the count. Four year olds and under may be covered at the Grades K5-6 rate. Faculty and staff may be covered at the Grades 7-12 rate.

Excess Group Base Plan

(Optional)

0-$25,000 Accident Medical Maximum - Excess Payment

Premium: Grades 7-12 $21.00 per student

Grades K5-6 $16.00 per student

Four year olds and under may be covered at the Grades K5-6 rate. Faculty and staff may be covered at the Grades 7-12 rate.

AISA members are strongly encouraged to participate in the AISA Excess Group Base Plan Coverage. All AISA sports and school activities are covered under this special program. All students must be included in the count.

Note: AISA all-star participants are not covered unless the school carries the base plan coverage.

One of the requirements for membership into the Alabama Independent School Association is for each member school to participate in the Association’s Group Accident Catastrophe Plan of excess medical, accidental death & dismemberment and disability benefits. This covers every enrolled child at the school for all Association/school sponsored and supervised activities; including all sports, and has a $25,000 deductible. Your plan will remain as it was last year: same price, benefits, and administrators.

If you have a seriously injured student/athlete and you think the price of the medical bills could approach $25,000, call our office to receive a catastrophe claim form (334-395-8000). Also, if you have an accidentally disabled child or an accidental death call our office for the appropriate claim form.

The Association also offers an excess accident group Base Medical Plan which is optional school by school, covers $0-$25,000, and fills the Catastrophe deductible gap. This is so important because more and more of your students, and/or athletes are underinsured or uninsured. We welcome the opportunity to talk to those of you not on the Base Plan about these excellent benefits and much needed coverage.

As always, if you have any questions or comments, please call our office. We appreciate your business and value working with you.

TO: Schools participating in the Association Excess Accident Group Medical BASE PLAN

** Enclosed find new 2010-2011 Notification of Injury Form. THROW AWAY ALL OTHER FORMS & COPIES. Use these new forms and this procedure memo to copy from.

** Upon accidental injury to an insured, a school official should obtain the Notification of Injury Form from your School or PBS office. Only one form per injury is needed. To be a covered accident, injury must happen during an Association/school sponsored and supervised activity, treatment must commence within 30 days of injury by a legally qualified medical doctor, and Injury Form must be submitted within 90 days of the injury. There is a one year benefit period.

** A school official(coach, principal, etc.) must read the claim instructions on top of the form.

** The school official should complete Part I-School Report of the injury form answering every question, keep a copy and notify the parent or guardian to come and get the injury form. (It has been suggested that the parent sign another form stating they received the injury form completed by school official). Give the parent or guardian of the injured student/athlete the partially completed Notification of Injury Form.

** Parent or guardian must read the claim instructions on top of the Notification of Injury Form. It is the parent/guardian's responsibility, not medical providers, to submit their form completed properly.

** Parent or guardian must understand that this is an excess and secondary plan with a one(1) year benefit period and that they should first file on and follow procedures of any other individual or family medical plans(private, All-Kids, Champus, Medicare, or Medicaid). They should complete Part II of our plan’s Notification of Injury Form, keep a copy, and send the injury form to the address on the top left of the form. Then send copies of itemized provider bills and corresponding explanation of benefits(EOB'S) from the other insurance plans when they arrive .

** The parent, not a provider, must submit: the Injury Form, EOB’s, and provider balance bills