Athletics

⬇️ Download Original PDF: AD-FY26 Parent packet - all sports.pdf

Dear PARENT AND/OR LEGAL GUARDIAN,

RE: Student Insurance - All Sports Excluding Fall Football 2025

Attached you will find an Enrollment Form and Schedule of Benefits outlining what coverages are available through K&K Insurance Company for your student[cite: 540]. [cite_start]This policy provides **Accident Only Coverage** and is not meant to replace full medical coverage, but rather to act as a supplement to your personal health insurance[cite: 543, 544]. [cite_start]This policy provides a maximum benefit of $25,000 for each covered injury[cite: 541]. [cite_start]Both Low and High Options are available, so read the options and choose the policy that best fits your student's needs.

Please sign the attached form to document your request to either **purchase or waive** the insurance coverage for your student[cite: 545].

Sincerely,

Dawn Jones
Assistant Director, Risk Management

Acceptance/Waiver Form

Student Insurance, All Sports Excluding Fall Football 2025

Student Name: ________________________________

I have read the Student Accident Coverage information and understand the coverages available and provided by K&K Insurance for my student.

Signature of Parent and/or Guardian: _______________________________ Date: _________________

I choose to waive the Student Accident Coverage through K&K Insurance Group as I already have medical coverage for my student.

Signature of Parent and/or Guardian: _______________________________ Date: _________________

FORM must be completed and signed.

⬇️ Download Original PDF: English.pdf

2025-2026 Student Accident Coverage (English)

Serviced by: K&K Insurance Group, Inc. Phone: 855-742-3135

Remember to visit our website for faster enrollment: www.studentinsurance-kk.com. [cite_start]Secured Accident Coverage can be purchased online any time throughout the year[cite: 888].

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ACCIDENT ONLY COVERAGE: The policy provides benefits for a loss due to a covered injury up to a maximum benefit of **$25,000 for each injury**[cite: 889]. [cite_start]This is a brief summary of benefits, not a contract[cite: 896]. [cite_start]The Master Policy, which contains all provisions, limitations, and exclusions, is on file at your school district and will govern benefit payments.

This insurance **does not provide major medical or comprehensive medical coverage** and is not designed to replace major medical insurance.

SCHEDULE OF BENEFITS: Maximum Benefits Paid As Specified Below

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Compare and Choose	Low Option Accident Only	High Option Accident Only
Maximum Benefit:	$25,000 (For Each Injury) [cite: 891]	$25,000 (For Each Injury) [cite: 891]
Deductible:	$0 [cite: 891]	$0 [cite: 891]
Inpatient Hospital Services
Room & Board Expenses:	Up to $150 per day/ Semi-private room rate [cite: 891]	80% of Usual and Customary Charges/ Semi-private room rate [cite: 891]
Miscellaneous Expenses:	$600 maximum per day [cite: 891]	$1,200 maximum per day [cite: 891]
Emergency Room Treatment: (Treatment must be rendered within 72 hours from the time of the injury)	$150 maximum [cite: 891]	$300 maximum [cite: 891]
Dental Services:	$10,000 max with extended dental; [cite_start]$200 per tooth without [cite: 891]	$10,000 max with extended dental; [cite_start]$500 per tooth without [cite: 891]
Prescription Drugs:	$75 maximum [cite: 891]	$200 maximum [cite: 891]

Choose Your Coverage Plan: One-Time Payment For Accident Coverage

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Coverage is effective when the completed enrollment form and premium are received by the company, or on the policy's effective date, whichever is later[cite: 906]. [cite_start]Coverage terminates on the earlier of one year from the effective date or the first day of the next school year[cite: 907].

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	With Extended Dental	Without Extended Dental
24-Hour Accident (Around-the-clock. Before, during and after school. Weekends, vacation and all summer.)	Low Option: $83.00 High Option: $122.00 [cite: 909]	Low Option: $75.00 High Option: $114.00 [cite: 909]
At-School Accident (During regular school term and direct travel to/from home/school)	Low Option: $26.00 High Option: $34.00 [cite: 909]	Low Option: $18.00 High Option: $26.00 [cite: 909]
High School Football (Play or practice of regularly scheduled football)	Low Option: $136.00 High Option: $208.00 [cite: 909]	Low Option: $128.00 High Option: $200.00 [cite: 909]
High School Football (Spring Only)	Low Option: $58.00 High Option: $88.00 [cite: 909]	Low Option: $50.00 High Option: $80.00 [cite: 909]

⬇️ Download Original PDF: Spanish.pdf

Cobertura de accidentes para estudiantes 2025-2026 (Español)

Prestada por: K&K Insurance Group, Inc. Teléfono: 855-742-3135

Recuerde visitar nuestro sitio web para una inscripción más rápida: www.studentinsurance-kk.com. La Cobertura asegurada de accidentes puede adquirirse en línea en cualquier momento del año.

COBERTURA SOLO ACCIDENTES: La Póliza ofrece beneficios por siniestros causados por una lesión cubierta hasta un Beneficio máximo de **$25,000 por lesión**[cite: 139]. [cite_start]El tratamiento debe ser iniciado por un médico con licencia en los 60 días posteriores a la fecha de la lesión, y los beneficios se pagarán por los gastos médicos cubiertos incurridos durante las 52 semanas posteriores a la fecha de la lesión[cite: 140]. [cite_start]Este es un breve resumen de los beneficios y no un contrato[cite: 146]. [cite_start]La póliza maestra es el contrato que regirá y controlará el pago de las prestaciones.

Este seguro **no proporciona cobertura médica mayor ni cobertura médica integral** y no ha sido diseñado para sustituir un seguro médico mayor.

PROGRAMA DE BENEFICIOS: Beneficios máximos pagados según lo especificado a continuación

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Compare y elija	Solo accidentes con opción baja	Solo accidentes con opción alta
Beneficio máximo:	$25,000 (por lesión) [cite: 139]	$25,000 (por lesión) [cite: 139]
Deducible:	$0 [cite: 1]	$0 [cite: 1]
Servicios hospitalarios para pacientes internos
Gastos de alojamiento y comida:	Hasta $150 por día/ Tarifa de habitación semiprivada [cite: 1]	80% de los Gastos usuales y habituales/ Tarifa de habitación semiprivada [cite: 1]
Gastos varios:	Máximo de $600 por dia [cite: 1]	Máximo de $1,200 por día [cite: 1]
Tratamiento en sala de emergencias:	Máximo de $150 [cite: 1]	Máximo de $300 [cite: 1]
Servicios odontológicos:	$10,000 max con ampliación de la cobertura odontológica; [cite_start]$200 por diente sin [cite: 1]	$10,000 max con ampliación de la cobertura odontológica; [cite_start]$500 por diente sin [cite: 1]
Medicamentos recetados:	Máximo de $75 [cite: 1]	Máximo de $200 [cite: 1]

Elija su plan de cobertura: Pago único por la cobertura de accidentes

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La cobertura entra en vigencia cuando la compañía recibe el formulario de inscripción y la prima[cite: 20]. [cite_start]La cobertura finaliza en la fecha en que su cobertura cumpla doce meses de vigencia o el primer día del año lectivo siguiente[cite: 21].

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	Con ampliación de la cobertura odontológica	Sin ampliación de la cobertura odontológica
Accidente 24 horas (Las 24 horas. Antes, durante y después de la escuela. Fines de semana, vacaciones y todo el verano.)	Opción baja: $83.00 Opción alta: $122.00 [cite: 24]	Opción baja: $75.00 Opción alta: $114.00 [cite: 24]
Accidente en la escuela (Durante el período lectivo normal, en las instalaciones del centro escolar y en viajes directos de ida y vuelta a casa)	Opción baja: $26.00 Opción alta: $34.00 [cite: 24]	Opción baja: $18.00 Opción alta: $26.00 [cite: 24]
Fútbol americano de la escuela secundaria (Jugar o practicar fútbol americano programado regularmente)	Opción baja: $136.00 Opción alta: $208.00 [cite: 24]	Opción baja: $128.00 Opción alta: $200.00 [cite: 24]
Fútbol americano de la escuela secundaria (solo primavera)	Opción baja: $58.00 Opción alta: $88.00 [cite: 24]	Opción baja: $50.00 Opción alta: $80.00 [cite: 24]