insurance claim

All registered playing members of CSA are provided with a secondary medical insurance coverage. Payment will not be made for any expenses incurred after 52 weeks of the accident date. If you need to submit a claim for an injury, please click the appropriate link below.

For dates of injury occurring on or after September 1, 2022

Please use this link to submit your claim: https://app.playershealthclaims.com/landing/colorado-soccer-association

For dates of injury occurring between September 1, 2021 to August 31, 2022

Please use this CSA Youth Insurance Claim Form and follow the step by step process below:

1. Injured individual, guardian, or parent completes the above mentioned claim form & submits it to Colorado Soccer Association at insurance@coloradosoccer.org for review & signature.

2. Colorado Soccer reviews the completed form to verify that the injury occurred during a sanctioned activity. Once signed off on, Colorado Soccer Association sends it to the insurance carrier.

3. A claim is set up by Mutual of Omaha & they will send out a letter of acknowledgement within 30 days of receipt of the claim in their office. The letter will outline that they will need the following items to completely process the claim:

- Itemized bills with procedure & diagnosis codes

- Primary Insurance Explanation of Benefits (EOBs)

- Paid Receipts for items paid out of pocket (not required but nice to have)

4. Mutual of Omaha pays claims per the policy provisions. EOBs will be sent out to claimants notifying them of the actions taken by Mutual of Omaha.

To read more about what is covered and more information regarding the secondary insurance, click the button below based upon when the injury occurred.