DATE: 2018-2019 School Year
TO: Parents/Guardians of Buckeye Local Schools Students
FROM: Patrick Colucci, Superintendent
The Buckeye Local School District has made arrangements with STUDENT PROTECTIVE AGENCY
to provide student accident insurance for those wishing to purchase coverage this year. Please note the coverage shown on the application. Covered losses less than $250.00 are paid without regard to other insurance.
Senior High football requires an additional premium. All other school supervised sports are covered under the plan. On claims over $250.00, this is an excess coverage policy for which benefits are payable only for that part of the loss not covered by other collectible insurance. If a person has no other insurance, the Company will pay the covered medical expenses incurred within one year, up to the specified limits of the policy.
Please note that the student application will be available on our website under the "Parents" tab, "Student Insurance Program."
Complete the application and check the boxes for coverage desired. Tear off and keep the rest of the application, as it shows not only the coverage but also the exclusions and limitations of the policy.
Mail the application directly to STUDENT PROTECTIVE AGENCY, 300 COSHOCTON AVENUE, MOUNT VERNON, OH 43050 along with a money order or check payable to STUDENT PROTECTIVE AGENCY.
The school will be notified as to who takes out coverage. You can call Student Protective Agency at 1-800-278-2544 for more information.
In case of an accident, the student or parent should immediately go to the building principal who will sign and provide the claim form if only school time coverage is taken out. 24 hour coverage needs no signature. The policy number shall be provided by the school for the claim or you can call 1-800-278-2544. You may give that policy number to the doctor or hospital but the bills should be sent to the parent or guardian who then should attach them to the claim form.
Once completed, mail the claim form (and attachments) to the claims office at GUARANTEE TRUST LIFE INSURANCE, PO BOX 1148, GLENVIEW, IL 60025.
If you have any further questions regarding a claim, please call 1-800-622-1993. It is the responsibility of the parent or guardian to file the claim.
Please click on the links below for more information and Enrollment Form.
2018-2019 Student Accident Insurance Program Brochure