Pay for Pain: Schools pitch in to help families cover athletic injury costs

Aysia Taylor poses for portrait on Tuesday, June 4, 2019, at Manton Consolidated High School, in Traverse City. Taylor injured her shoulder playing basketball last season. Manton High School carries supplemental insurance coverage for athletes, through Kalamazoo-based 1st Agency, which covers students should they be injured at school or while competing in or traveling to and from scheduled athletic events. This coverage has helped cover the cost of her surgery and recovery.

MANTON — A hard foul sent Manton's Aysia Taylor spilling to floor.

The Rangers sophomore reached out, searching for balance. She found an unyielding wall instead, jamming her right shoulder in the opposite direction of her fall. Her shoulder weighed considerably more, stuck at her waist like a ship anchored at sea as she stood to approach the free-throw line.

She tried to shoot her free throws. She air-balled the first, missed the second off iron.

The damage to the rim of Taylor's ball-and-socket shoulder joint simply wouldn't permit a shooting motion, or as Manton softball's starting catcher would eventually discover, a throwing motion either.

"I was scared," Aysia said. "It was my throwing shoulder and softball is my priority sport."

Taylor's mother, Angie Taylor, was concerned for her daughter. As the school's softball coach, she was concerned for her team's upcoming season.

But the biggest question was whether or not to take Aysia to see a doctor.

"Her injury wasn't a broken bone," Angie said. "We didn't know what happened until she had an MRI. Do we just wait for a while?"

The reason for pause was one many families might consider. Health care costs have increased dramatically over the years, as have insurance premiums. Without threat of life-altering injury, perhaps patience would pay off — literally. The pain might recede. The injury might heal. There might be no reason to see a doctor, and subsequently write a check, at all.

Thanks to decisions made by the Manton school district over the years, the Taylor family didn't need to weigh all those factors.

Manton Consolidated Schools is one of several area districts to carry a supplemental insurance policy through Kalamazoo-based 1st Agency, which covers students should they be injured at school or while competing in or traveling to and from scheduled athletic events.

Coverage plans vary by district. Some, like Manton, have blanket policies that cover all students or all student-athletes. Others, like Kingsley, provide voluntary insurance plans that families may purchase on an individual basis. Traverse City Area Public Schools is another district that employs the services of 1st Agency.

All provide a safety net for student-athletes and their families should injury occur.

John Griesbach, Area Vice President of 1st Agency, said schools opt for supplemental insurance for a variety of reasons. Peace of mind, moral obligation and improved public relations all factor in to why a district may decide to provide coverage.

"It's a philosophy," Griesbach said. "Schools feel the obligation to purchase a blanket policy. It's a wonderful thing they can do for students and parents."

When provided a list of the 40 schools in the Record-Eagle's sports coverage area, Griesbach said 1st Agency works with about 40 percent of those schools. The company covers schools in 20 states and averages 10,000 claims per year, he said.

The blanket policies help those with or without insurance and stem the tide of rising deductibles. Some family's health insurance plans may carry deductibles of $6,000 to $12,000. Particularly in cases like those, a bill for a doctor visit, MRI or surgery could all prove costly.

If a district offers supplemental insurance, many or all out-of-pocket costs may be covered. Claims always go through parent's insurance first, but if the deductible isn't met, those uncovered costs get kicked to 1st Agency, where 80-90 percent of 1st Agency's schools have a policy that covers those bills in full, Griesbach said.

"Mom and dad won't be burdened with that full medical bill going forward," he added.

For families, the help can be immeasurable — within the pocketbook or on the mind. For the Taylors, their own $2,500 deductible wouldn't have been impossible to reach, but they're thankful for not having to worry about it.

"(Aysia's injury) was something I probably would have waited a month before taking her to see if it would get better," Angie said. "This let me take Aysia in the next day."

Aysia tried physical therapy for weeks, but on June 5, she had surgery to repair a torn labrum, adding to the potential expense the Taylors might have incurred. She'll require 6-9 months of recovery to fully heal and hopes to be back behind home plate next softball season. She'll miss volleyball season this fall, but has a chance to return to the court for a portion of next basketball season.

"For us, it's been very helpful with a $2,500 deductible," Angie said. "The MRI is almost the cost of that. Now we're still looking at surgery."

Angie said a friend's daughter suffered a similar injury that ran the family roughly $5,000 to fix. When that friend, whose school district does not offer a similar insurance policy, heard about Aysia's injury, she simply wished Angie "good luck."

"It's not like we couldn't do it, but for some people, that can be a deal breaker," Angie said. "I have not had to pay anything so far out of pocket. I'm just sending the bill and they're paying it, so that's very awesome.

"I had a call from a doctor in Cadillac. They didn't get the 1st Agency information. It was going to be a $149 bill. I had to send it (to 1st Agency). It's huge for me. It's not like we wouldn't do it or couldn't afford it, but it definitely eases my mind."

As family budgets grow ever tighter, so to do school districts.

Manton Schools superintendent Len Morrow said the district made a "personal decision" to ensure it continued to carry a policy through 1st Agency even in tough times. The district pays for the policy through its general fund.

"What it allows is all of our kids an equal footing," Morrow said. "Varying degrees of insurance. We want all of our kids to play sports, not just ones able to have insurance. An injury could be devastating to someone financially. We don't want anyone to say they don't want their kids to participate because they don't have the means to do so."

The MHSAA plays its part

The Michigan High School Athletic Association (MHSAA) also aims to ease the financial burden of some injuries sustained by student-athletes in the forms of catastrophic injury and concussion insurance.

The MHSAA adopted concussion coverage beginning with the 2015-16 school year.

Student-athletes are provided with "first dollar" coverage, meaning there is no deductible for concussion assessment or treatment. The program has no co-pays or restrictions on specific doctors and no referrals required as long as an incident report was filed. Neurological follow-up care is covered if medically necessary.

Coverage is maxed at $25,000 per injury.

The MHSAA had 11,990 head injuries reported from the 2015-18 school years — that is less than 2% of participants — which resulted in 727 gap insurance claims. Total payout for those claims exceeded $485,000.

The catastrophic injury coverage has been provided since 1970 and is at no cost to the eligible athletes of MHSAA member schools or registered officials. The policy will pay up to $1,000,000 in medical expenses after a deductible of $25,000 in paid medical expenses per claim has been met. It has rarely been used.

Other schools, other options

While Manton Consolidated Schools and others provide blanket supplemental insurance policies to its student-athletes, others provide different options through different means.

Grand Traverse Area Catholic Schools, including Traverse City St. Francis, is provided supplemental insurance by the Diocese of Gaylord through Student Assurance Services.

The benefits are similar to 1st Agency in that the policy covers most or all of out-of-pocket expenses.

Claims are typically processed through parent insurance first, but St. Francis does not require its students to have insurance in order to participate in athletics.

"We don't want any costs or fear of our students not being covered," TC St. Francis athletic director Aaron Biggar said. "That's pretty important to us."

Kingsley Schools, which does require insurance to participate in athletics, provides supplemental insurance opportunities through 1st Agency. However, it differs in the fact that families purchase a year-long policy on a case-by-case basis.

Individual plans cost $105 for the sport, plus the time while the student-athlete is in school. An injury sustained in physical education class would be covered, for example. Football is the lone exception in that it costs more for coverage at $375.

Elk Rapids, Johannesburg-Lewiston and Onekama offered similar options for the 2018-19 school year.

"It's very reasonable, especially if you don't play football," Kingsley athletic director Mitch Miggenburg said.

There is an option to add a dental plan as well. Miggenburg estimated only 10-12 Kingsley students purchase individual plans each year.

Glen Lake superintendent Sander Scott said a board of education subcommittee has been tasked with discussing whether the district should join the other schools that offer some form of supplemental insurance.

"We want to make sure we take care of kids. That's our job." Scott said. "But we also are making sure the district is thoughtful of how far it extends itself. Ultimately it will be a decision for our board of education."

Scott believed the decision would be made in time for the 2019-20 school year

Senior Sports Reporter

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