Insurance

CSSA offers its member leagues, teams, and players insurance coverage’s purchased on behalf of the members as part of the annual registration fees. This comprehensive plan protects players, teams, leagues, and CSSA in the event of claims arising out of soccer activities organized by CSSA member organizations. The accident policy covers medical and dental expenses during sanctioned amateur soccer activities. The general liability policy protects members and CSSA in the event they are sued for incidents involving bodily injury or property damage resulting from an amateur soccer activity.

PLAYER ACCIDENT INSURANCE

Participant Accident Insurance (PAI) is intended to act as a secondary policy to a CSSA member's primary insurance. If no primary insurance exists, claims may be paid through this policy. The standard PAI premium is $9.50 per year and is included in each member's $25 annual CSSA registration fee. This policy covers up to $5,000 in medical/dental coverage associated with a legitimate injury sustained by a CSSA member during a CSSA sanctioned soccer activity.

Excess Participant Insurance (EPI), up to $25,000 in medical/dental coverage, is available, at the league level, for an additional fee. For a player to be eligible to enroll for this coverage, the league in which the CSSA member is registered must fully opt in (i.e., all players within the league must elect and pay the required premium). The EPI premium is an additional $3.80 per player.

PLAYER ACCIDENT CLAIMS

If a CSSA member is injured during a sanctioned activity and desires to submit a claim for potential reimbursement of medical costs, download and thoroughly read the claim filing instructions and the accident claim form:

INSURANCE CLAIM FORMS

(click on the appropriate link)

2011-2012 PAI Claim Form (English)

2011-2012 PAI Claim Form (Spanish)

PLAN DESCRIPTIONS

2011-2012 Player Accident Plan ($5k)

2011-2012 Player Accident Plan ($5k) (Spanish)

In addition to the Claim Form, primary health insurance provider information (if applicable), and any receipts, obtain a copy of the Game Report prepared by the referee that substantiates the injury.

ALL PLAYER ACCIDENT CLAIMS MUST BE SUBMITTED TO CSSA FOR VERIFICATION

Submit your fully completed Accident Claim Form and supporting documents to CSSA via drop off or mail to:

Colorado State Soccer Association
5555 W Evans Ave
Denver, CO 80227

or e-mail to

insurance@coloradostatesoccer.com

If you have questions, call the CSSA office at 303-456-0666 or send an e-mail to insurance@coloradostatesoccer.com