Student Accident Insurance
USD 231 is pleased to offer student accident insurance coverage at no cost to all K-12 students. This group insurance covers both athletic related injuries and student-related injuries for the following:
- attending regular school sessions,
- participating in or attending school-sponsored and supervised extracurricular activities,
- participating in school-sponsored and supervised KSHSAA interscholastic sports and activities, and
- traveling by way of biking or walking directly to and from school for regular school sessions; and while traveling in school provided transportation to or from any school-sponsored and supervised activity. Excludes non-school provided motorized transportation of any kind.
Medical benefits under the student accident insurance policy helps cover out of pocket medical costs up to $10,000 per injury (typically 80 percent of usual and customary charges). Please refer to the medical benefits summary for coverage explanation.
Steps for Filling a Claim (Claim Form Below):
- One claim form for each accident needs to be submitted. However, this is not a guarantee of benefits but only an explanation that is subject to all applicable terms, conditions, limitations, and exclusions of the plan.
- A school official must complete Part A for all school-related accidents. The parent or guardian must complete all questions in Part B – Parent Statement. Only if the accident is non-school related and the family has purchased additional insurance coverage (24- Hour Coverage, Extended Dental Coverage), the parent or guardian may complete Part A. Print a copy of the claim form to present to the treating physician or facility so they might understand what is needed from them to process your claim. Do NOT depend on the medical provider to submit the claim form. You should submit the claim directly to claims office within 90 days from the date of injury.
- You will need to send copies of itemized bills. These are the original billings you receive, not monthly statements. These itemized bills often called UB04 or CMS 1500 provide the Address, Procedure Code, Diagnosis Code, and the Provider's Tax ID Number.
- You will need to submit copies of all bills to your family and/or group insurance, even if you have a large deductible. This plan is supplemental to all other valid coverage. You must file a claim with your other insurance first. This plan does not cover penalties imposed for failure to use providers preferred or designated by your primary coverage. After you have received payment or copies of “Explanation of Benefits” (EOB) from your family insurance company or insurance administrator (Blue Cross, Group Health, Prudential Insurance, etc.), send copies of itemized bills and your other insurance E.O.B.'s to: (Does not apply to our primary plans)
STUDENT ASSURANCE SERVICES, INC.
P.O. BOX 196
STILLWATER, MN 55082-0196
NO CLAIM CAN BE PROCESSED UNTIL ALL OF THE FOLLOWING DOCUMENTS HAVE BEEN PROVIDED BY YOU OR THE MEDICAL PROVIDER.
- Completed Claim Form
- Itemized Bills (UB04) (CMS 1500)
- Explanation of Benefits from primary insurance (EOB)
For a local USD 231 contact regarding general questions on how to file a claim, contact Candace Moorehouse at 913-856-2046.
For specific questions regarding covered medical benefits or the status of a claim, contact Student Assurance Services (SAS) at 1-800-328-2739.