GAO

United States General Accounting Office

Report to Senator Barbara Boxer

September 2000 INTERSCHOLASTIC

ATHLETICS

School Districts

Provide Some

Assistance to

Uninsured Student

Athletes

GAO/HEHS-00-148

Page 1 GAO/HEHS-00-148 Interscholastic Athletics

Contents

Letter 3

Appendixes Appendix I: Scope and Methodology 16

Appendix II: Indianapolis Public Schools Athletic Insurance 19

Appendix III: Fairfax County School District Supplemental Athletic

Accident Insurance 21

Appendix IV: Comments From the Department of Education 24

Appendix V: GAO Contacts and Staff Acknowledgments 25

Bibliography 26

Related GAO Products 27

Tables Table 1: Public High School Districts Reviewed 16

Table 2: Agencies Contacted to Identify Available Data on Uninsured

Student Athletes 17

Figure Figure 1: Percentage of Uninsured Children Ages 14-18 in Selected

States, 1999 8

Abbreviations

CPS Current Population Survey

NCES National Center for Education Statistics

NFHS National Federation of State High School Associations

SCHIP State Children’s Health Insurance Program

SPORT Sport Physiology and Orthopaedic Rehabilitation Treatment
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Page 3 GAO/HEHS-00-148 Interscholastic Athletics

United States General Accounting Office

Washington, D.C. 20548

Health, Education, and

Human Services Division

B-283140 Letr

September 12, 2000

The Honorable Barbara Boxer

United States Senate

Dear Senator Boxer:

Participation in extracurricular activities is considered to be an important

part of a child’s education. Educational research has demonstrated that

students involved in school activities have higher grade point averages and

graduation rates and lower rates of absenteeism and discipline referral. In

addition, this body of research suggests that extracurricular activities help

students develop teamwork skills, self-discipline, and self-confidence.

Sports are thus an important component of high school extracurricular

programs. During the 1998−1999 school year, about 6.5 million boys and

girls participated in high school athletic programs. Unfortunately,

participation in sports carries risks; some students are injured, and a small

number are seriously hurt. Due to the risk of injury and the potential cost of

treatment, some youths may be unable to participate in school-based

athletic programs because they lack health insurance. Moreover, some

youths may participate in sports without the benefit of health insurance.

In your request, you expressed concern that some high school students

may be prevented from participating in their school’s athletic programs

because they lacked health insurance, and you asked us to study this issue.

Specifically, you asked us to determine (1) the number of uninsured high

school students in the United States and the extent to which the lack of

health insurance poses a barrier to participation in high school athletic

programs and (2) the strategies school districts have developed to provide

health insurance and health care to high school sports participants.

To respond to your questions, we contacted federal and state officials and

experts on uninsured populations. To obtain a state-level perspective on

the issue of insurance and high school athletics, we conducted a national

survey of the 51 high school athletic associations (50 states and the District

of Columbia) and several site visits to state and local health and athletic

organizations. In addition, we reviewed 18 large school districts through

on-site visits and telephone interviews to obtain information on how

various school districts address this issue. App. I provides additional

details about our methodology.
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Results in Brief In 1998, an estimated 3.4 million uninsured children were of high school

age. Among highly populated states, there were wide differences in the

percentage of uninsured children of high school age. The range included a

high of about 28 percent in Texas to about 6 percent in Massachusetts. We

were unable to identify any national, state, or local information on the

extent to which these high school students were prevented from

participating in athletic programs because they lacked basic health

insurance. The officials of the 51 athletic associations we surveyed were

unaware of any instance in which a high school student was prohibited

from playing high school sports because he or she lacked health insurance.

However, according to these officials, while 10 states and the District of

Columbia require high school students to have health insurance before

joining a school’s athletic program, the other 39 states leave this decision to

the discretion of local school districts. In 17 of the 18 large school districts

we reviewed, district policy required student athletes to have health

insurance to participate in high school sports. In addition, many of these

districts required student athletes to document insurance coverage before

participating in sports. However, school officials in four of these large

districts reported that they did not have the resources to monitor the

accuracy of health insurance information before or during a sport’s season.

Sixteen of the 18 school districts we reviewed provided free catastrophic

athletic accident insurance to all student athletes regardless of their

insurance status. In most cases, the catastrophic accident policy would

cover all medical costs once a family’s expenses exceeded $25,000. Two of

the 18 school districts are self-insured for catastrophic situations. Further,

in all school districts we reviewed, local schools have adopted strategies to

provide access to low-cost athletic accident insurance to student athletes.

In all but one of these districts, one of two strategies was used to provide

accident insurance to student athletes. First, in eight school districts, free

supplemental athletic accident insurance was automatically provided to all

student athletes. Second, in nine districts, the families of student athletes

were given the opportunity to purchase low-cost athletic accident

insurance. One district’s policy is to cover all medical costs of an athleticrelated injury. School officials in these districts reported that instances of

uninsured student athletes requiring athletic accident care were addressed

through such activities as accident trust funds established at the school

district level and through direct community involvement. Also, private

organizations such as hospitals and clinics assisted local school districts by

offering free medical services to student athletes for sports-related injuries

and other services such as pre-participation physicals or injury evaluation.
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Background For the school year 1998−1999, the National Federation of State High

School Associations (NFHS) reported that there were about 11.8 million

public high school students in the 50 states and the District of Columbia.

School-based sports programs include about 6.5 million participants in

more than 17,850 high schools across the nation. Of the total number of

participants, 3.8 million were boys and 2.7 million were girls. As would be

expected, large states have high numbers of student athletes. Texas, for

example, had the greatest number of participants with 783,751 high school

athletes, followed by California with 584,590 athletes. Among individual

sports, basketball is the most popular high school sport, with 16,763

programs for boys and 16,439 programs for girls. In terms of individual

participants, football is the most popular boys’ sport with 983,625

participants. Basketball is the most popular girls’ sport, with 456,873

students playing on high school teams.

Athletic injuries among high school athletes are common. A 1999 study

conducted for the National Athletic Trainers Association estimates that the

national student athlete population experiences more than 2 million

injuries of varying degree per year, around 500,000 doctor visits, and 30,000

hospitalizations. The study recorded injury data collected on 10 sports

from a national sample of high schools and found that football was

associated with the greatest number of injuries and involved the highest

likelihood that some type of injury would occur. Furthermore, of all injuries

recorded for all sports, 56 percent occurred during practice and 74 percent

restricted the student athlete from participating in a sports program for

fewer than 8 days. Another ongoing study conducted by the National

Center for Catastrophic Sports Injury Research examined serious and fatal

injuries suffered by high school sports participants from 1982 through 1998.

During this period, football players suffered 67 fatalities, 161 nonfatal

injuries, and 175 serious injuries.1 With the exception of these studies,

national injury data are not routinely collected, maintained, or published.

1

The National Center for Catastrophic Sports Injury Research defines nonfatal injuries as

ones in which the athlete suffers “permanent severe functional disability.” Serious injuries

are defined as ones in which the athlete suffers “no permanent functional disability but

severe injury.”
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To help address the health insurance needs of low-income children, which

could include those participating in high school sports, the Congress

established the State Children’s Health Insurance Program (SCHIP).2 From

fiscal year 1998 to fiscal year 2008, this program will provide more than $40

billion to states for the child health system under the federal/state Medicaid

program or other state-established health insurance programs. The

Department of Health and Human Services distributes the funds to states

based on a formula that includes the state’s number of low-income

children, the state’s number of uninsured low-income children, and the

state’s health care costs as compared with other states. States are afforded

a significant level of flexibility in defining the groups of children targeted

for coverage under the new program. Specifically, under SCHIP, states

choose to spend the new funds by (1) expanding Medicaid and building on

the existing program; (2) establishing a separate, stand-alone program; or

(3) combining these two approaches. The program targets funds at

uninsured children in families whose income is too high to qualify for

Medicaid but is at or below 200 percent of the federal poverty level, that is,

$32,900 for a family of four. States also have discretion as to how to

calculate income (gross, net, or countable income). More significantly,

states have flexibility in establishing nonfinancial eligibility criteria. For

example, SCHIP can use criteria such as residency, geographic area, and

access to other health coverage. About 2 million children have been

enrolled to date, but it remains uncertain the extent to which additional

children will enroll in SCHIP.

2

In August 1997, as a part of the Balanced Budget Act of 1997, P.L. 105-33, the State

Children’s Health Insurance Program (SCHIP) was established as title XXI of the Social

Security Act.
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An Estimated 3 Million

Children of High

School Age Are

Uninsured, But the

Extent to Which This Is

a Barrier to Sports

Programs Is Unknown

Of the 13 million children without basic health insurance, more than 3

million are of high school age (14−18).3 Substantial differences in the

uninsured rate among children of high school age exist across states. For

example, the estimated uninsured rates among the states we either visited

or contacted range from a high of 27.9 percent in Texas to a low of 5.7

percent in Massachusetts (see fig. 1 for uninsured rates among large

states).

3

We used the Current Population Survey (CPS) data to estimate the number of high school

students without insurance. The CPS is a monthly survey of about 50,000 households

conducted by the Bureau of the Census for the Bureau of Labor Statistics. It is designed to

produce reliable estimates at the national level and, to a lesser extent, the regional level.

Due to the potentially small sample taken within small states, we focused our analysis on

selected large states.
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Figure 1: Percentage of Uninsured Children Ages 14−18 in Selected States, 1999

Source: 1999 CPS data.

The extent to which any of these children are prevented from participating

in high school sports is unknown. We found no systematic data collection

efforts or single data sources that document the number of high school

students prohibited from participating in school-based sports due to the

lack of insurance. In our survey of high school athletic associations,

officials were unaware of any instance in which a high school student was

prohibited from playing high school sports due to a lack of health

insurance.

0

5

10

15

20

25

30

California Texas Massachusetts Florida Virginia Indiana

Percentage
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Some states and school districts require high school student athletes to

have basic health insurance prior to and while participating in a sports

program. Our survey of high school athletic association officials found that

only 10 states and the District of Columbia have a statewide requirement

that student athletes have health insurance to participate in a sports

program. However, according to officials of high school athletic

associations, many school districts require health insurance for athletes. Of

the 18 school districts we reviewed, 17 required that their student athletes

have basic insurance to participate in high school sports.4 Within some of

these districts, school officials we spoke to stated that athletic staff at each

school collect information about the status of each student athlete’s private

insurance. For example, Fairfax County District Schools in Virginia collect

insurance information as part of establishing the eligibility of student

athletes, which generally includes a physical examination and a signed

parental consent form.

We found, however, that local schools often do not verify health insurance

information before students participate in sports, nor do they follow up on

this during the school year. High school officials in many of the 18 districts

reviewed pointed out that this information is usually collected only once

during the school year and that schools are unable to verify the accuracy of

the data collected due to time and expense. Further, an expert on

uninsured populations noted that it is not unusual for students to lose their

insurance coverage at some point during the school year due to a change in

their parent’s job status. For example, an athlete’s parent may lose his or

her job at some point during the school year, resulting in lost insurance

benefits for the child. In addition, several school and health care officials

we spoke to suggested that it is not uncommon for students or parents to

misrepresent their current insurance status so that the student can

participate in a school’s sports program.

4

Boston Public Schools have no requirement that student athletes have basic health

insurance to participate in school-based athletic programs. School district officials reported

that the district will routinely cover any costs associated with an injury related to school

athletics.
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Some School Districts

and Other

Organizations Offer

Insurance and Care

Options to All High

School Athletes

School districts and health care organizations in the locations we visited

have developed strategies to make athletic accident insurance available to

student athletes and to provide access to athletic accident-related care.

Most school districts provided catastrophic athletic accident insurance to

all student athletes regardless of their insurance status and also offered

health insurance to student athletes free of charge or at low cost. School

district officials reported that both the school district and local community

organizations addressed instances of uninsured students who required care

due to athletic accidents. In addition, in all 18 school districts we reviewed,

private organizationsincluding hospitals, medical centers, and sports

clinicsassisted local school districts by offering free medical services to

student athletes.

School Districts Offer Free

or Low-Cost Accident

Insurance

Sixteen of the 18 school districts we reviewed offered free catastrophic

coverage to high school athletes. The other two school districts are selfinsured for catastrophic situations. Catastrophic injury insurance is meant

to cover the medical costs for serious injury, such as a fractured vertebra or

paralysis. In most of the school districts we contacted, this insurance

coverage commences when the athlete’s medical bills reach $25,000. The

maximum amount of coverage ranges from $1 million to $5 million

depending on the district. School officials we spoke to stated that

catastrophic injuries within their districts are rare but that catastrophic

insurance is nonetheless important. For example, one school official from

the El Paso Independent School District in Texas said that one student had

experienced head trauma in a football game and had been hospitalized for 6

months. The school districts we visited emphasized that the premiums they

pay for catastrophic insurance are relatively low. For example, the Austin

Independent School District in Texas pays approximately $13,000 to

provide catastrophic insurance coverage to all 10,000 students

participating in school sports.

In addition to catastrophic injury insurance, 17 of the 18 school districts we

reviewed either provide free supplemental athletic accident insurance to

student athletes or offer athletic accident insurance to student athletes for

a fee. Eight of the public school districts we contacted purchased

supplemental athletic accident insurance for their student athletes. These

plans are blanket policies purchased for a specific number of student

athletes at a set rate. For example, the San Antonio Independent Schools in

Texas pay approximately $260,000 to cover about 17,000 sports
B-283140

Page 11 GAO/HEHS-00-148 Interscholastic Athletics

participants. Other examples of similar strategies are in effect across the

nation.

• The El Paso Independent School District in Texas insures all high school

athletes at no charge to the student. The policy provides secondary

insurance coverage to most student athletes and acts as a primary plan

for student athletes who are injured during a sports activity and do not

have other insurance coverage.

• The District of Columbia insures high school students participating in

sports at no charge to the student. Although the policy has a $100

deductible should the student athlete file a claim for needed care, very

seldom is the deductible fee charged for low-income students.

• The Indianapolis School District in Indiana provides for and pays the

insurance premiums for high school students participating in sports.

The policy is intended to be a supplemental policy. However, if a student

does not have basic health insurance coverage, the school policy

becomes the primary insurance if the student is injured during athletics.

App. II presents an example of a supplemental athletic accident

coverage plan that is provided to student athletes’ parents or guardians.

Nine school districts we reviewed offer students the opportunity to

purchase low-cost athletic accident insurance. In these districts, the

student athlete may purchase an athletic accident policy through the

school. These policies cover only accidents occurring during authorized

events such as games or formal practices. App. III, provided by Fairfax

County School District of Virginia, is an example of such a policy.

While most of the districts that offer these accident policies require them

only when the student athlete does not have insurance, some school

districts require that all student athletes—regardless of insurance status—

purchase a policy through the district. For example, the Hillsborough

County Public Schools in Florida require all student athletes to purchase a

policy through the district regardless of whether the athlete has private

insurance. The cost to the student is one-half of the total cost to the district.

For instance, if the cost to the district for football insurance is $90 to $95,

the student pays $45 to $48. One Hillsborough County school official cited

the fact that many families do not have a steady source of insurance.

School officials believe that having a policy for the mandatory purchase of

insurance is the best way to protect the school district from liability. These

officials also believe that the policy protects the athlete and his or her

family from the financial burden of paying for health care out of pocket.
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In addition, some school districts have implemented methods to provide

insurance to students of low-income families on a case-by-case basis. For

example, the Hillsborough County Public School District in Florida has an

annual “Football Jamboree.” The proceeds of this event go into a trust fund

designed to help poor families pay the cost of the district’s mandatory

insurance. In cases of financial hardship, the principal of each school can

obtain funds from the trust to cover an athlete’s insurance costs.

Local School Districts and

Community Groups

Respond to Athletic

Accidents Among the

Uninsured

School officials acknowledge that in some instances high school athletes

participate in sports without the benefit of health insurance. As we

indicated earlier, school officials cited a number of factors that contribute

to this situation, including the lack of resources to verify students’

insurance status, a family member’s loss of insurance coverage during the

sport season, or parents who misrepresent their insurance status at the

beginning of a season. Although student athletes who lose or have no

insurance would be covered by the district’s free catastrophic accidental

insurance policy, their families would be at risk for medical expenses up to

the catastrophic threshold. However, school officials also reported that

instances of uninsured students requiring athletic accident care were

infrequent. The school districts we reviewed had various measures to meet

the health care needs of an injured athlete when the school district does

not know that the student is participating in sports without health

insurance.

According to school officials, the school and community actively respond

to athletic accidents among uninsured students to address health care

needs and minimize costs to the family. School district efforts included

fundraising drives, booster club contributions, and the provision of free

care by health care providers such as physicians and clinics. In some

locations, school districts rely on their health care partners to provide free

medical service to the injured student athlete. For example, districts such

as the Los Angeles Unified School District in California benefit from

athletic trainers provided by the University of Southern California Center

for Athletic Medicine Foundation and the West Coast Sports Medicine

Foundation. The athletic trainers, who are present at games and often

during practices, provide on-the-spot free care for many less serious

injuries. School officials also told us that, for more severe injuries, local

hospitals and community and school organizations such as booster clubs

help ease the financial burden on the athlete’s family. These athletic

accident plans and medical services are limited to sports-related injuries

incurred by students with no basic health insurance.
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Schools Partner With Health

Care Organizations to

Provide Athletic Accident

Services

Many high school districts we reviewed have developed partnerships with

local health care organizations to provide a range of health-related services

to student athletes. These organizations provide student athletes with free

pre-participation physicals, injury evaluation services, access to

physicians, and rehabilitation services. More specifically,

• The West Coast Sports Medicine Foundation, a nonprofit charitable

organization, provides approximately 12,000 high school students at 25

Los Angeles area schools with the opportunity to participate in schoolbased sports. The foundation provides student athletes with (1) free (no

cost to the athlete or family) athletic accident insurance coverage, (2)

athletic training to reduce and mitigate injuries, and (3) access to sports.

• The Sport Physiology and Orthopaedic Rehabilitation Treatment

(SPORT) Clinic in Riverside, California, has contracted with area high

schools to provide a program for the care and prevention of athletic

injuries. Health care officials at the SPORT Clinic educate student

athletes to prevent or reduce athletic injuries, advise athletes on the

care and treatment of their injuries, and provide treatment of minor

athletic injuries. In addition, the clinic’s facilities are available for use by

high school athletes. Medical consultation, treatment, and facilities are

available free of charge for each injury, for two weeks from the initial

visit.

• The Methodist Sports Medicine Center at the Methodist Hospital and St.

Vincent’s Medicine in Indianapolis have had informal agreements with

the Indianapolis Independent School District for more than15 years.

These medical providers furnish athletic trainers and doctors free of

charge for all games and tournaments. In addition, athletic trainers visit

each high school within the Indianapolis School District twice a week.

Finally, some districts use local health providers to conduct preparticipation exams. The Healthsouth Doctor’s Hospital of Coral Gables,

Florida, has an arrangement with Dade County Public Schools to provide

physicals free of charge to all high school athletes within the county.

Agency Comments and

Our Evaluation

We provided the Department of Education with the opportunity to

comment on a draft of this report. Education concurred with our findings

(see app. IV).
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We will send copies of this report to The Honorable Richard W. Riley,

Secretary of Education, and to school officials in the states we visited. We

will also make copies available to others on request.

If you have any questions regarding this report, please contact me at (202)

512-7215. Key contacts and staff acknowledgments for this report are listed

in app. V.

Sincerely yours,

Marnie S. Shaul

Associate Director, Education, Workforce,

and Income Security Issues
Page 15 GAO/HEHS-00-148 Interscholastic Athletics
Page 16 GAO/HEHS-00-148 Interscholastic Athletics

Appendix I

Scope and Methodology ApApenednxidexiIs

We designed our study to collect data on whether high school students are

prevented from participating in sports because they lack health insurance.

We also sought to determine the number of uninsured high school students

in the United States, the extent to which the lack of health insurance posed

a barrier to participation in high school athletic programs, and the

strategies health care organizations and school districts have developed to

assist student athletes with health insurance or health care. We interviewed

education, health, and athletic officials at the national, state, and local

levels and contacted 18 large public school districts. We visited 8 public

school districts and conducted telephone interviews with officials at 10

public school districts.

We also administered a survey to high school athletic association officials

in all 50 states and the District of Columbia to help determine whether

students participate in sports without the benefit of health insurance. For

our statistical analysis of uninsured children and school districts, we used

the 1999 Current Population Survey (CPS) and the National Center for

Education Statistics’ (NCES) database, respectively. We performed our

work between July 1999 and July 2000 in accordance with generally

accepted government auditing standards.

School District Reviews We visited 8 school districts and telephoned officials at another 10 school

districts that used a variety of methods to provide assistance to student

athletes. All districts were among the largest in the nation. Within each

school district we interviewed athletic directors, business and insurance

managers, athletic health care service coordinators, and other relevant

staff involved with student athletes (see table 1).

Table 1: Public High School Districts Reviewed

State School Districts

CA Los Angeles Unified School District

San Francisco Unified School District

DC District of Columbia Public Schools

FL Dade County Public Schools

Hillsborough County Public Schools

Orange County Schools

Palm Beach County School District
Appendix I

Scope and Methodology

Page 17 GAO/HEHS-00-148 Interscholastic Athletics

Athletic Association Survey We designed and mailed a data collection instrument to representatives of

the interscholastic athletic associations of the 50 states and the District of

Columbia. The survey focused on five areas: insurance requirements for

student athletes, insurance plans available to student athletes, premiums

and types of coverage offered to the student athletes, instances of students

participating in sports without health insurance, and innovative methods to

provide student athletes with health insurance. We received 49 completed

questionnaires.

National, State, and Local

Education and Health

Agencies

We interviewed education and health officials at the national, state, and

local levels to identify federal, state, and local health insurance

requirements for student athletes. We also collected information on

whether any of these agencies had data on uninsured student athletes (see

table 2).

Table 2: Agencies Contacted to Identify Available Data on Uninsured Student

Athletes

Pinellas County School District

Polk County School District

IN Indianapolis Public School District

MA Boston Public Schools

TX Austin Independent School District

Dallas Independent School District

El Paso Independent School District

Houston Independent School District

Northside Independent School District

San Antonio Independent School District

VA Fairfax County Public Schools

(Continued From Previous Page)

State School Districts

Agency contacted Data No data Anecdotal

U.S. Department of Education X

U.S. Department of Education, State of Massachusetts X

U.S. Department of Health and Human Services X
Appendix I

Scope and Methodology

Page 18 GAO/HEHS-00-148 Interscholastic Athletics

a

Data have limitations.

Children’s Defense Fund X

Center on Budget and Policy Priorities X

National Parent Teachers Association X

Council of Chief School Officers X

Robert Wood Johnson Foundation X

President’s Council on Physical Fitness X

National Alliance for Health and Physical Education X

National Center for Health Statistics X

National Assembly on School-Based Health Care X X

USC Center for Athletic Medicine X X

Health Care for All (Coaches Campaign, Mass.) X X

National Federation of State High School Associations X

Coaches Campaign, Penn. X

National Federation Officials Association X

West Coast Sports Medicine Foundation X X

Healthsouth Doctor’s Hospital, Coral Gables, Fla. X

The SPORT Clinic X X

California Athletic Trainers Association X X

National Federation Coaches Association X

National Youth Sports Safety Foundation, Inc. X

California Interscholastic Foundation X

Massachusetts Interscholastic Athletic Association

(MIAA)

X

National Association of Insurance Commissioners X

National Athletic Trainers Association (NATA) X

National Interscholastic Athletic Administrators

Association

X

Texas University Interscholastic League X

Texas Department of Health X

Texas Healthy Kids Corporation X

American Association of School Administrators X

Bureau of Labor Statistics (Current Population Survey)a X

(Continued From Previous Page)

Agency contacted Data No data Anecdotal
Page 19 GAO/HEHS-00-148 Interscholastic Athletics

Appendix II

Indianapolis Public Schools Athletic

Insurance ApendxiI

The Indianapolis Public Schools pay for health insurance that covers high

school students for injuries suffered in sports. The policy is intended to be

a supplemental athletic accident policy; however, if a student does not have

other insurance coverage, the school policy becomes the primary

insurance. Also, if a student is covered by Medicaid or SCHIP, the district’s

supplemental policy becomes the primary coverage.

Only accidents that occur while the student is involved in an athletic event

or practice are covered. This policy defines an accident as an unexpected,

sudden, and definable event that is the direct cause of a bodily injury,

independent of any illness, prior injury, or congenital predisposition.

Coverage is only for care not covered by any family or employer group

coverage or plan. This policy has no deductible.

The following page gives an example of a letter that the Indianapolis Public

Schools send to parents and guardians explaining the insurance coverage

provided to student athletes.
Appendix II

Indianapolis Public Schools Athletic

Insurance

Page 20 GAO/HEHS-00-148 Interscholastic Athletics
Page 21 GAO/HEHS-00-148 Interscholastic Athletics

Appendix III

Fairfax County School District Supplemental

Athletic Accident Insurance ApendxiI

Ten of the school districts we reviewed offer students the opportunity to

purchase low-cost supplemental accident insurance. The specifics of the

policies offered vary from district to district. Generally, such a policy would

cover only accidents that occur during school-sponsored and -supervised

sporting events, practices, or transportation in a school-furnished vehicle

to such an event. The policies act as primary coverage for student athletes

without insurance and as secondary coverage for those with insurance.

Additional coverage, such as 24-hour accident coverage, may be obtained

for an additional charge. The following pages are an illustration of the

supplemental accident insurance policy offered to student athletes of the

Fairfax County School District.
Appendix III

Fairfax County School District Supplemental

Athletic Accident Insurance

Page 22 GAO/HEHS-00-148 Interscholastic Athletics
Appendix III

Fairfax County School District Supplemental

Athletic Accident Insurance

Page 23 GAO/HEHS-00-148 Interscholastic Athletics
Page 24 GAO/HEHS-00-148 Interscholastic Athletics

Appendix IV

Comments From the Department of

Education ApendxiIV
Page 25 GAO/HEHS-00-148 Interscholastic Athletics

Appendix V

GAO Contacts and Staff Acknowledgments ApendxiV

GAO Contacts David D. Bellis, (202) 512-7278

Christine M. Shine, (617) 565-7547

Staff

Acknowledgments

In addition to the individuals named above, Christopher Galvin and Kevin

Murphy made key contributions to this report.
Page 26 GAO/HEHS-00-148 Interscholastic Athletics

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School Sports: A Review of the 1995−1997 Season.” Journal of Athletic

Training, Vol. 34, No. 3 (1999): pp. 277−284.

Smith, Madeleine. Health Insurance Coverage: Characteristics of the

Insured and Uninsured Populations in 1998. Washington, D.C.:

Congressional Research Service, updated October 6, 1999.

—. Health Insurance Coverage of Children. Washington, D.C.:

Congressional Research Service, updated January 12, 2000.

—. Health Insurance: Uninsured Children by State, 1996−1998. Washington,

D.C.: Congressional Research Service, updated October 28, 1999.

—. Health Insurance: Uninsured by State, 1998. Washington, D.C.:

Congressional Research Service updated October 6, 1999.

Young, Beth Aronstamm. Characteristics of the 100 Largest Public

Elementary and Secondary School Districts in the United States: 1997−98.

Washington, D.C.: U.S. Department of Education, National Center for

Education Statistics, July 1999. NCES 1999−318.
Page 27 GAO/HEHS-00-148 Interscholastic Athletics

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