Introduction
Point Loma Nazarene University requires all undergraduate and graduate students to have
valid comprehensive health insurance coverage. For each year of enrollment, proof of valid insurance coverage is required through the University student portal
AND through the PLNU Sports Medicine Electronic Medical Record system: Healthy Roster.
How am I covered?
As explained above, every Student-Athlete is required to have a valid insurance plan prior to each academic year and participation in PLNU athletics. This insurance plan will function as your
primary insurance, thereby operating as the primary method for medical billing for any injury or illness regardless of whether the injury or illness was sustained while participating in a PLNU athletics sponsored activity.
In addition to your primary insurance, the PLNU Department of Athletics provides a
secondary insurance plan to the Student-Athlete to assist with payment of medical expenses that you may incur as a direct consequence of participating in a PLNU athletics sponsored activity or event. However, there is NEVER a guarantee of payment from the secondary insurance. In order for an injury to qualify for coverage under the PLNU secondary athletic injury insurance policy, the Student-Athlete must have been injured while participating in supervised practice, training, or competition for PLNU, exhausted primary insurance, and have their medical care coordinated and authorized by our Sports Medicine staff. Any medical bills resulting from an unauthorized visit to a medical provider will not be covered by the secondary policy, even if the provider is listed as a team physician or had treated the athlete in the past for a different injury. The PLNU secondary insurance policy will only cover authorized expenses during the 2 years (104 weeks)
following the date of injury. It is very important to understand that this is not a comprehensive insurance policy nor is PLNU responsible for injuries occurred while training without direct supervision by a PLNU coach, Certified Athletic Trainer, or Strength and Conditioning Coach.
For further information regarding the PLNU secondary insurance, please refer to the
Student-Athlete Insurance Information and Contract. This will also be available to you as part of the completion of your forms and documentation within HEALTHY ROSTER.
What do I need to know?
With the exception of emergencies, all Student-Athletes must seek the advice or notify their team Athletic Trainer prior to receiving services from a physician. Secondary insurance coverage may be nullified if the Student-Athlete does not adhere to this policy. The Sports Medicine staff is dedicated to the care of each Student-Athlete and it is imperative that they be involved in the evaluation and treatment of every individual.
In the event of an injury requiring treatment from a medical provider outside of the PLNU Sports Medicine Clinic, the Student-Athlete MUST communicate with the Sports Medicine Head Athletic Trainer Alice Davis-Winkel, prior to receiving secondary insurance benefits.
What do I need to do before I play?
It is imperative that you have a valid primary insurance plan prior to participating in PLNU athletics. As previously mentioned, proof of your insurance plan must be provided within HEALTHY ROSTER. However, it is also important that you plan ahead regarding your medical care while in San Diego.
If you have an
HMO and you are not from San Diego, please change your primary care physician to a San Diego physician before the school year begins. If you would like help finding a provider contact the Head Athletic Trainer, Alice Davis-Winkel.
Kaiser Permanente functions much like an
HMO. If you are not from Southern California/San Diego, you must switch your coverage to San Diego and find a local provider prior to the start of the school year. If you would like help finding a provider contact the Head Athletic Trainer, Alice Davis-Winkel.
If you have an HMO from another state besides California, then you must transfer your coverage to California for it to be valid.
If you are an international student: The University provides a competitive, affordable international student health insurance plan through
WellFleet Student- Point Loma Nazarene. International students (undergraduate, graduates and student-athletes) are automatically enrolled into the program for each semester of study at PLNU. Visit
Wellfleet Insurance Services - PLNU to download brochures, ID cards, review plan benefits and more. For questions about the international student health insurance plan contact
with "Wellfleet Student Benefits- Customer Service for Colleges & Universities: (877) 657-5030 (Monday-Thursday, 8:30 a.m.-7:00 p.m. EST, Friday, 9:00 a.m.-5:00 p.m. EST).
PLEASE thoroughly read all of the information provided to you in the
Student-Athlete Insurance Information and Contract. If you have any questions, please contact Head Athletic Trainer,
Alice Davis-Winkel.
Definitions
Primary Insurance: Any medical coverage you hold privately, through your job or parent(s), which covers illness and/or injury.
Secondary Insurance: Athletic injury insurance policy that PLNU provides for each Student-Athlete. This policy is used after your primary insurance has paid the maximum allowed per injury. The secondary policy is free of charge to the Student-Athlete.
PPO: Preferred Provider Organization plans provide more flexibility when picking a doctor or hospital. They also feature a network of providers, but there are fewer restrictions on seeing non-network providers. In addition, your PPO insurance will pay if you see a non-network provider, although it may be at a lower rate
HMO: Health Maintenance Organization gives you access to certain doctors and hospitals within its network. A network is made up of providers that have agreed to lower their rates for plan members and also meet quality standards. But unlike PPO plans, care under an HMO plan is covered only if you see a provider within that HMO’s network. There are few opportunities to see a non-network provider. There are also typically more restrictions for coverage than other plans, such as allowing only a certain number of visits, tests or treatments.
HSA: Health savings accounts are not typical savings accounts, and they’re available only to people who have a high-deductible health plan, or HDHP. Every year the government determines the minimum deductible amount a plan can have to qualify as an HDHP, as well as the maximum amount an individual can contribute to an HSA. When you withdraw funds to use for qualified medical expenses, you don’t pay taxes on the money. If you use the money for other expenses, you must pay a penalty tax.
FSA: Flexible spending accounts come only as part of a benefits package from an employer — you can’t get one on your own — but the medical expenses you can use them for are the same as HSAs. The rule for the money is “use or lose,” meaning you lose any amount you haven’t spent at the end of the year, unless your employer has selected a rollover option.
