Written by SportsDayDFW.com
High school student-athletes, families risk financial strife as some Dallas-area school districts lack supplemental insurance
Jacob Allen cut one way, and his left knee went the other.
It was the Arlington Martin freshman’s first high school football game, and he tore his anterior cruciate ligament and meniscus.
Arlington ISD, like more than a dozen school districts across North Texas, doesn’t provide supplemental accident insurance to cover sports injuries.
The surgery for an ACL tear alone can cost up to $15,000.
Jacob, 15, was uninsured when his injury happened this fall. His father, John Allen, who builds airplane parts, was laid off by Lockheed Martin in January. His mother, Shelley Allen, who works for State Farm, said the insurance benefits were not something the couple could afford.
She understands that letting their son play without insurance is their responsibility.
“We know the risks of him being out there,” Shelley Allen said. “Sure, I wish the school had insurance, but I allow him to play. And he wants to play.”
Jacob and his family are hardly the only ones who find themselves in this predicament.
Twenty percent of the kids ages 6 to 17 who live within the Arlington ISD attendance zone are uninsured, according to U.S. census data. In Cedar Hill, that figure is 16 percent. In Mansfield, it’s 13 percent.
Students without coverage from those and other uninsured districts play without financial security. And, as the Allen family learned, an untimely injury can have staggering financial consequences.
“These kids are representing the community,” Arlington Seguin football coach Carlos Lynn said. “If something were to happen to those kids, it would be nice if the district had some sort of supplemental insurance that could defray those costs.”
“You’re taking a big risk not being covered,” he added. “Injuries can happen at any time.”
What is supplemental insurance?
Most Dallas/Fort Worth-area school districts provide a catastrophic insurance policy for injuries that call for extensive hospitalization and lengthy recovery. Premiums for these policies cost only a few thousand dollars, even for large districts. The deductible is high — $25,000 for most — and the policies pay out up to $10 million.
A catastrophic insurance plan, though, only kicks in when the deductible for treatment is reached.
Several districts offer a supplemental or secondary policy in addition to their catastrophic coverage. These supplemental plans tend to have a low deductible and cover injuries up to $25,000. The policy kicks in to cover what the family’s primary policy does not, and it will act as the primary policy if the student is uninsured.
The premiums for supplemental insurance policies are substantially more expensive than catastrophic plans.
Some districts, like Wylie and Argyle, recently sacrificed their supplemental insurance policies to cope with state budget cuts.
Wylie ISD paid a $25,737 premium for a supplemental policy from Texas Monarch Management that it last offered in 2009-10. It still offers a catastrophic plan with an annual premium of $3,679.
Eagle Mountain-Saginaw ISD also dropped its supplemental policy in the last five years, athletic director Tim Daughtrey said.
“We dropped that because it was $150,000 or something like that,” Daughtrey said. “The catastrophic policy was about $10,000 or $20,000, so we kept the catastrophic plan for the kids.”
Dallas ISD pays nearly $1.8 million for its supplemental policy, which includes a $25,000 cap plus a catastrophic plan that covers expenses up to $6 million.
Dallas ISD added catastrophic and supplemental policies in 1991, a year after North Dallas senior Wendell Murphy suffered a paralyzing injury during a football scrimmage.
Phil Francis, the district’s head athletic trainer, said he files between 375 and 450 claims per year for athletes.
“It’s been our experience that the school board is very sensitive to the needs and the health care of student athletes when they participate in sports,” Francis said. “They have been very forthright in managing their budget to support a premium like that to care for their student athletes.”
Fort Worth ISD is paying $437,986 for its supplemental policy this school year. With an operating budget of more than $600 million, its comprehensive supplemental policy represents less than 0.1 percent of its budget.
Texas Kids First and The Brokerage Store are two of the largest accident-insurance providers in the state. Texas Kids First covers 325 districts across the state, and The Brokerage Store covers 270.
Both companies offer a plan that covers students in all University Interscholastic League-sanctioned activities, including athletics.
The Brokerage Store’s “value” plan, which is its most popular plan, will pay out up to $25,000 per injury. It comes with catastrophic coverage up to $7.5 million.
“School insurance is such a teeny, teeny part of a school’s budget,” said David Cates, the owner and president of The Brokerage Store. “It’s not even worth discussing. In a big school district, it’s nothing.”
Ted Evans, the director of student insurance at Texas Kids First, said the company’s most expensive plans covering the largest districts carry premiums up to about $450,000. The smallest districts may pay only a few thousand dollars for a supplemental policy.
What happens to uninsured athletes?
Some states, like Georgia and Florida, mandate that high school athletes be insured before stepping onto the field. Illinois recently passed a law requiring school districts to purchase at least a catastrophic insurance policy.
No such mandates exist in Texas, and athletes at districts without a supplemental policy are left to foot the bill for non-catastrophic injuries.
In Mansfield and Arlington, two of the largest area school districts that carry no supplemental policy, one medical option for uninsured athletes is the JPS Health Network — an $800 million tax-supported health care system for residents of Tarrant County.
JPS has 19 school-based health centers in Tarrant County that can provide X-rays, diagnoses and treatments at a discounted price. The school-based health centers work alongside the JPS primary care sports medicine fellowship. Nonsurgical treatments often come with only a $15 to $20 co-pay, said Dr. Michele Kirk, a sports medicine physician at JPS.
If surgery is required, JPS will often refer families to Children’s Medical Center Dallas, to the JPS orthopedic department, or to orthopedic surgeons in the area who are willing to work on a sliding scale for cash patients.
The cost of surgery for, say, a torn ACL, ranges between $10,000 to $15,000, Kirk said, and families are on their own to shop around for a price they can afford.
A JPS clinic provided Jacob Allen with an MRI and a diagnosis for roughly $200 on the Saturday after his injury. Dr. James Bothwell of the Bone & Joint Clinic in Fort Worth performed the surgery about a month later, on Oct. 4, and Jacob’s family negotiated a fee of about $8,600.
Shelley Allen said she had to pay half of that up front, and the rest is being paid in monthly installments of about $365.
“My husband cashed in his IRA and that was the only thing that saved us,” Shelley Allen said.
She bears no grudge toward the Arlington school district or Jacob’s coaches. She couldn’t afford the physical therapy Jacob needed, so he’s seeing the Martin athletic training staff every day for free treatment.
“Martin cares about these kids,” Shelley Allen said. “Coach [Bob] Wager, coach [Chris] Lemoine, coach [Kellen] Monreal, they’ve all gone to bat for Jacob over and over to help us. I have a great support system and I wouldn’t change it for anything.”
For athletes and families attending school in districts without a supplemental policy, Kirk stressed the need for education.
Families need to know what benefits are available to them, and families who qualify for benefits need to continue to renew their plans every year, she said.
“One of the most frustrating things to me,” Kirk said, “is that a lot of these kids qualify for insurance programs in Texas, and the families haven’t applied or they’ve let the coverage lapse. Other families make just a bit too much to qualify for certain programs, and that’s particularly hard for those families.”
Kirk added that while she would like to see schools provide at least a discounted insurance that families could buy into, she also places some of the responsibility on parents.
“I’m always blown away by the fact that parents let their kids play something like football without insurance,” she said. “It blows my mind. I’m not going to say it’s just the responsibility of the school districts. I think there’s a parental responsibility involved here.”
Mandating insurance coverage for student-athletes is a difficult sell for area coaches, and it’s not something Kirk favors, either.
Lynn said mandating athletes to have insurance would hurt too many kids — particularly those from low-income homes.
“Some people can’t afford insurance, and you can’t make them have insurance,” he said. “Financially it could put the family in a bind. But sports and other extra-curriculars, those things help keep families afloat.”
The Allen family will be making monthly payments on Jacob’s injury until midway through his sophomore football season.
But there’s no doubt in mom’s mind that Jacob will be playing again next fall.
“Are you kidding me?” Shelley Allen said. “Absolutely. It killed him to miss this season.”
Staff writers Kyle Fredrickson, Daniel Lathrop and Corbett Smith contributed to this report.
Follow David Just on Twitter at @DavidJustDMN.
Are you covered?
Here’s a look at some of the school districts in North Texas that do not carry a supplemental insurance policy to cover athletic injuries:
District -- Average daily attendance
Argyle ISD -- 1,781
Arlington ISD -- 59,602
Carroll ISD -- 7,357
Coppell ISD -- 10,620
*Birdville ISD -- 22,376
*Burleson ISD -- 9,990
*Cedar Hill ISD -- 7,712
Eagle Mountain-Saginaw ISD -- 16,712
Hurst-Euless-Bedford ISD -- 20,544
*Mansfield ISD -- 31,206
Pilot Point ISD -- 1,399
*Richardson ISD -- 35,463
Sanger -- 2,513
Stephenville -- 3,432
Weatherford ISD -- 7,164
Wylie ISD -- 12,731
*Denotes districts that also do not carry catastrophic coverage
Know the facts
Here are some quick facts regarding sports injuries in the United States:
•Approximately 8,000 children are treated in emergency rooms each day for sports-related injuries.
•Among children, those aged 15-17 experience the highest emergency room visits for sports injuries.
•Rates of sports injury visits to ERs were highest in remote, rural settings.
•High school athletes suffer two million injuries, 500,000 doctor visits and 30,000 hospitalizations each year.
•There are three times as many catastrophic football injuries among high school athletes as college athletes.
•Sixty-two percent of sports-related injuries occur during practices.
Data compiled by the National Athletic Trainers’ Association.