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Insurance Information

Secondary Insurance Information

POLICY
LVC provides Intercollegiate Sports Accident Insurance through Bob McCloskey Insurance and BMI Benefits (bobmccloskey.com) to assist our student-athletes if injured when participating in supervised intercollegiate sports activities (club sports are NOT considered intercollegiate).  Under the terms of the policy, the coverage is considered a secondary payer to all other valid and collectable medical insurance policies.  Most notable would be parental primary insurance coverage through place of employment under which the student-athlete is covered as an eligible dependent.  All LVC student-athletes are required to have an active primary insurance policy.

The Sports Accident Insurance plan has standard limitations:

  • Injuries must occur during supervised intercollegiate practices, games, or training sessions during the traditional or non-traditional season as specified by the NCAA.  Out-of-season injuries are not covered by this policy.
  • The insurance policy is an excess insurance plan, which means benefits are provided after any other valid and collectible insurance has processed the medical claims.
  • There is no Deductible under this plan.
  • This plan will pay a maximum limit of $90,000 at 100% of the Usual, Reasonable, & Customary (UR&C) for eligible athletic accidents.
  • Initial medical treatment must be received by a doctor within 180 days from the date of the Accident causing Injury.
  • Claim forms must be submitted within 90 days from the date of Injury, however as soon as possible up to one year from the date of accident.
  • All covered expenses must be submitted within 12 months from the date of service or charges will be denied.
     
CLAIM FILING INSTRUCTIONS
In order for a medical bill to be considered for payment, you as the student-athlete must follow the below steps:
  1. Report your injury to the LVC Athletic Training Staff immediately.  Once your injury has been reported, the Athletic Training Staff is then responsible for submitting your injury claim form to BMI; however, you may be asked to assist with this process.
  2. When visiting any medical provider where treatment is being received for your injury, present the BMI secondary insurance card, in addition to your primary insurance card, during check-in for your appointment (BMI insurance card information can be obtained from the LVC Athletic Training Staff).  Your medical providers should then bill BMI directly after initially billing your primary insurance.
  3. If you forget to share the BMI secondary insurance information with your medical providers during your visit, YOU are then responsible for contacting each provider where treatment was received and providing the BMI insurance card information. The LVC Athletic Training Staff will not be responsible for doing this.
 
If the above steps were missed or not followed and you have already paid the medical provider and wish to be reimbursed directly from BMI, you must submit, in addition to the injury claim form:
  1. a paid receipt or statement that verifies the payment, along with
  2. the Itemized bills, and
  3. the primary Explanation of Benefits (EOBs).
 
Please be aware, balance due statements are NOT itemized bills and cannot be processed and paid by BMI Benefits.  The Itemized bills, known as HCFA 1500s (physician billing form) and UB-04s (hospital billing form), should show the ICD-10 and CPT codes for the services provided, as well as other necessary information for insurance processing.  Claims paid via an HSA or FSA are reimbursable; however, claims paid via an HRA are not reimbursable.
 
Submit the completed injury claim form, itemized bills, and primary insurance EOBs to BMI Benefits, LLC.  Claims can be submitted via mail, fax, or e-mail. You may contact BMI Benefits to discuss your claim.  Please be aware that settlement of your claim may take several weeks to process.
 
Mail                                                                Assigned Claims Examiner
BMI Benefits, LLC                                          Examiner Name: Heidi Piskin
PO Box 511                                                    Examiner Email: heidi@bobmccloskey.com
Matawan, NJ 07747                                       Examiner Fax: 732.210.9738
                                                                       Examiner Phone: 800.445.3126 x 56045
 
NOTE: When BMI processes a submitted claim, an Explanation of Benefits (EOB) will be mailed to the medical provider of service with any check payment.  A second copy is also mailed to the address on file for the claimant/student explaining the claim payment details.  If any information is missing that is needed for BMI to process and pay an outstanding claim, an EOB will be mailed stating what needs to be submitted to BMI for reprocessing and payment of the medical claim.  All submitted claims are subject to the policy terms, conditions, and benefits as outlined in the coverage.
 
Lebanon Valley College will not be responsible for paying any medical bills not covered by secondary insurance.  It is important for you to be knowledgeable of your health benefits and be aware of which medical providers are considered in-network or out-of-network when seeking treatment.  If you choose to seek treatment with out-of-network providers, you may have a higher likelihood of incurring out-of-pocket expenses, which will then become your responsibility.