ESBD_File_352335_Insurance Q&A Addendum.pdf
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- Attached to
- 737-24 Intercollegiate Sports Accident Insurance
- Solicitation number
- 737-24IntercollegiateSportsAccidentInsurance
- Issued by
- Travis County, Savannah CDP, Texas
About this file
This document is an Addendum to a Request for Proposal (RFP) issued by Angelo State University (ASU) for Intercollegiate Sports Accident Insurance. The RFP seeks to procure accident insurance coverage for all student-athletes, student managers, trainers, and coaches registered as ASU students. The Addendum provides detailed responses to questions regarding the current insurance policy, including information on loss runs, premiums, administrative fees, and claims data for the past five policy years. The RFP states that approximately 380 athletes and an additional 20 staff members would need to be covered under the insurance plan.
The current insurance policy has an aggregate deductible of $94,525, a stop loss of $14,175, and a claims administration fee of $12,500. The university has a $60,000 cap per facility for medical bills, with the facility billing the student-athlete's primary insurance first and the university paying any remaining balance. Once the $60,000 cap is reached, the facility continues to bill the student-athlete's insurance but does not bill the university for the remainder of the policy period.
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Text version
737-24-Intercollegiate Sports Accident Insurance
Questions and Answers Addendum
• Could you please provide a copy of the in-force insurance policy? attached here
• Could you please provide up to date loss runs for the 2019, 2020, 2021, 2022, and 2023 policy years?
o
Policy Year Aggregate Deductible
Stop Loss Premium
Claims Administration Fee
Total Paid Claims As of 3/1/24
2023-2024 $94,525 $14,175 $12,500 $60,000 2022-2023 $94,525 $14,175 $12,500 $60,000 2021-2022 $94,525 $14,175 $12,500 $67,955.64 2020-2021 $94,525 $14,175 $12,500 $74,720.72 2019-2020 $107,000 $15,000 $12,500 $80,746.77 o
• Could you please provide the current premium and any administrative fess associated with this plan? $14,175
• Is the $60,000 cap for the facility referenced on page 5 paid out of the aggregate plan?
Currently, no. Possibly looking to change this in the future.
• Is the $60,000 paid to the health care facility referenced on page 5 a lump sum payment made to the provider? Or is the expense accrued during the year and once the cap is hit then payments made to this provider stop for the remainder of the policy period? Expense accrued through the year and once the cap is hit, billing stops for the remainder of the fiscal year.
• What is the name of the facility referenced on page 5 that is paid $60,000? Shannon Clinic and Shannon Medical Center
• Can you confirm in 2022-2023 and 2023-2024 there have been no claims paid outside of the main facility that is paid the $60,000? As of 3/1/24, that is correct.
• The RFP states that 80% of student-athletes have collectible insurance. Does the University utilize verification services to verify insurance? Our healthcare provider verifies insurance at the beginning of each year as part of our pre-participation physical process.
• Is there a specific or per injury deductible? If so, can you please provide that for the current and prior 4 policy periods? No per injury deductible.
• What is the “as of” date or what date was the claims data generated on? 3/1/24
• Is there an exclusion on the current policy for Physical Therapy and/or Rehab? No
• If it takes some time to put together the responses to ours and anyone else’s questions, would the University be able to extend the due date for 10 days from whenever the responses are provided? As posted in RFP our plan is to get responses to these questions out by March 11.
• What is the Premium for the last three policy years?
Policy Year Aggregate Deductible
Stop Loss Premium
Claims Administration Fee
Total Paid Claims As of 3/1/24
2023-2024 $94,525 $14,175 $12,500 $60,000 2022-2023 $94,525 $14,175 $12,500 $60,000 2021-2022 $94,525 $14,175 $12,500 $67,955.64 2020-2021 $94,525 $14,175 $12,500 $74,720.72 2019-2020 $107,000 $15,000 $12,500 $80,746.77
• Can you provide more details on the contractural agreement with the local health care facility:
o Is there a no-balance provision once the cap has been met?
o It appears that the agreement is Primary, then reverts to the Policy to pay on the remaining balance?
o Is there a Catastrophic policy in place in the event the claim exceeds the cap in the agreement? No, if a claim exceeds the cap in the agreement, the claim would be paid up to $60,000.
o Basically, how does the contract specifically nwork with the local healthcare provider?
The facility will bill the student athlete’s primary insurance first (if applicable). Whatever balance is remaining is billed to the school. Currently, the school pays that balance through our business office. Once the school has paid $60,000 in medical bills, the facility continues to bill the student athlete’s primary insurance (if applicable) but does not bill the school.
• I see in the proposal that about 380 athletes would need to be included in this overall quote.
How many additional people would need to be included as well (student managers, trainers and coaches)? Roughly 20 additional people would be included to cover other staff and student athletic trainers.
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