Date: August 1, 2015

To: Johnson & WalesUniversity Student-Athletes

From: Alan Segee, ATC, Director of Sports Medicine

Subject: Insurance Coverage for the 2015-2016 Academic Year

Johnson & Wales University requires all registered, undergraduate day students, both domestic and international, and all international graduate and doctoral students carry health insurance that is accepted in the United States. This includes all student athletes, regardless of program of study. If students have medical insurance through their parent’s or a personal plan, they may waive out of the Johnson & Wales University student health plan. If students do not waive out, they will automatically be enrolled in the University health insurance plan which is underwritten by United Healthcare with University Health Plans acting as the broker.

The insurance policy through University Health Plans coversinjuries related to athletics. However, coverage is subject to specific policy terms and conditions and includes certain restrictions and exclusions of which you should be aware. All students are encouraged to read the insurance brochureonline at to become familiar with the policy details concerning coverage, limitations, co-pays and exclusions. Brochures are also available in the JWU student health centers.

Should you, as a student athlete, opt out of the Johnson & Wales student healthinsurance plan, there is a supplemental insurance policy covering athletic injuries provided by the University. THIS POLICY HAS A $10,000 DEDUCTIBLE WHICH YOU AS THE STUDENT ATHLETE ARE RESPONSIBLE FOR. Further, it is your responsibility as a student to be familiar with your personal insurance and its coverage. Students who are enrolled in the Johnson & Wales student insurance plan have this $10,000 covered through the University Health Plans’ policy.

Please note that Johnson & Wales University assumes no responsibility whatsoever for any uninsured expenses, and we strongly recommend that the student-athlete have coverage through a primary health insurer to avoid possible and significant out-of-pocket expenses in the event of an injury.

In addition, it is the student athlete’s responsibility to take care of all co-pays regardless of whether they are generated through the institution’s insurance policy or their own.

If you should have any questions or concerns regarding insurance, please contact me at 401-598-1626.

I have read the above information on insurance and acknowledge it. I understand that I may have to pay some out of pocket costs for medical care.

______Signed Print Name Date