As a benefit of membership, soccer players, coaches, officials and other registered members receive the protection of Bollinger's Soccer Insurance Program for their soccer activities.
Who is Covered?
Under the General Liability policy, the following are covered as Named Insureds: the Association and its member teams and leagues; all registered players and players participating in try-outs; all member coaches and officials; volunteers of the team or league and other participants affiliated with the Association.
The Accident Policy covers: all registered players and players participating in try-outs; member coaches and officials; volunteers and other participants directly affiliated with the Association.
Covered Activities
Registered members and volunteers are covered when participating in the following covered activities:
1 - Scheduled games, team practice sessions and sponsored activities, provided that they are under the direct supervision of a team official; or tournaments sanctioned by the Association, as a member of a contestant team.
2 - Group travel directly to or from such scheduled practices, games or sponsored activities is covered under the Accident policy. The Liability policy provides Hired/Non-owned auto liability only for the official business of the Association.
3 - No coverage is provided under the Liability policy for parents, coaches or volunteers using any automobile to transport team members or volunteers to any practice, game or activity.
1. Accident Medical Expense Coverage under this policy is provided on an Excess Basis, and benefits will only be paid under this plan after your own personal or group insurance (including Health Maintenance Organizations) has paid out its benefits. Please note that you must follow your primary insurance carrier's eligibility criteria (i.e. to be treated in-network, if required by HMO, etc.) in order for this policy to consider your expenses for payment.
2. Claim Guidelines:
You have 90 days from date of injury to submit claim form.
For claims to be eligible for coverage you must seek medical attention within 60 days from date of injury.
Benefit Period: This policy is subject to a 52 week eligibility period from date of injury. Medical or dental expenses that are incurred within 52 weeks of the date of injury are eligible for coverage under this policy. Any expenses or treatments that are rendered after the 52 week benefit period will not be covered by this policy.
3. Please Remember:
A. Advise your Providers/Hospitals of this insurance so they can file claims directly to Bollinger
B. Attach all Explanation of Benefits (EOB) forms that you have received from your Primary insurance carrier or other healthcare plan.
C. Itemized bills are required: You must submit itemized bills; balance due bills will not be processed. See below for forms needed.
1. HCFA-1500- standard form used by Providers
2. UB-04 or UB-92-standard form used by Hospitals
3. Payment of bills will follow the usual and customary guidelines. This means that the basis for payment of specific medical or dental claims is based on the average cost of that service by region. This policy does not automatically pay for services in full; it pays based on the "usual and customary" fee for that service in your area.
D. Dental Bills: All dental bills must be submitted through your primary insurance's medical and dental plans first before submitting the bills to Bollinger.
E. Flex Spending, Health Reimbursement or Health Spending Accounts (HRA, HSA): Please read below and follow the steps appropriately to submit information.
1. Employer contribution to flex account - Primary insurance first, then flex account, then Bollinger
2. Employee contribution to flex account - Primary insurance first, then Bollinger, then flex account. If monies have been paid out of your flex account before Bollinger then those monies will need to be reimbursed to your flex account by your Providers. In order for claims to be processed by Bollinger, proof of reimbursement to your flex account is needed.
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