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Student Accident Insurance Plan

Enrollment/Eligibility

Who is eligible?

All students enrolled in classes or in a practicum program and/or other recognized student groups approved by the college are eligible for the Wisconsin Technical Colleges Mandatory Accident Only Insurance Plan, and will be defined as a "Covered Person". Non-credit, avocational, and distance learning online students are not eligible. However, online students who physically attend the college for academic purposes are eligible.

How do I enroll?

Eligible students do not need to submit an enrollment form. All colleges participating in the Mandatory Accident Only Plan for the Wisconsin Technical College System will submit student information to Gallagher Student to enroll students.

Accident Insurance Plan Benefits

View detailed plan information:

  • When an accident occurs while on campus, attending a practicum program, or other recognized student group approved by the College or during travel to and from a program, the plan offers comprehensive benefits that include hospital room and board, inpatient and outpatient surgical procedures, labs and x-rays, physician office visits, ambulance, durable medical equipment, emergency care, and prescription drugs.
  • Services are covered at 100% of Reasonable and Customary Charges.
  • Please refer to gallagherstudent.com/blackhawk for complete details regarding coverage, limitations, and exclusions.

Eligible students are covered while on campus, attending or participating in a college-sponsored or recognized activity, including practicums. This includes traveling to or from the Covered Person's home, and campus, within the entire state of Wisconsin. The covered travel time includes the period before the Covered Person's required attendance time and the period after their dismissal or when they complete any extra duties.

International travel is covered, but cannot exceed two hours each way.

Coverage is in place while on school premises, during school hours, and on school days.

Coverage is in place to and from a school sponsored event within the entire state of Wisconsin.

Yes, the student with blended courses is covered when required to be on campus, as long as the premium has been paid for that student.
Blended online courses are a mix of online and regular in-person courses. Online courses don't necessarily require students to physically attend class while regular courses do.
ID cards are available online. To print an ID card, students should complete the following steps:
  1. Visit gallagherstudent.com/blackhawk, click on "College & University Students and Scholars," and select your school from the dropdown menu.
  2. Log-in using your existing account information (first time visitors will need to create an account).
  3. Select “Authorize Account” located to the left of your screen under Account Information and enter your Student ID number along with your date of birth.
  4. Once your account has been authorized, select ‘Account Home’ and click on ‘Generate ID Card’.

No, the 2020-2021 Wisconsin Technical Colleges Accident Only Insurance Plan does not have a deductible. Deductible means the amount for which you are responsible before payment is made by the claims company.

Students who provide documentation of equivalent coverage that will remain in effect the entire semester may submit a request for waiver from this program.

Download Icon Waiver Request Form

Yes, you can go to any licensed provider.

Physicians should bill the claims administrator. The billing information is on the back of your accident insurance ID card that you print off the website. However, if you do receive a bill, or you paid for a service and need to be reimbursed, you should submit your bill (and proof of payment if seeking reimbursement) and completed claim form, which can be found at gallagherstudent.com/blackhawk, selecting your school from the dropdown menu and clicking, "Claims Company". Make sure your name, insurance ID number, and school name are on the bill and make a copy for your records.

Submissions should be sent to:
Health Special Risk, Inc. (HSR)
HSR Plaza II, 4100 Medical Parkway
Carrollton, TX 75007

You can go to https://www.hsri.com/, create a User Name and Password, and look up a specific claim or view a list of all claims submitted.

No, there is no option to continue coverage after this policy terminates.

Please visit gallagherstudent.com/blackhawk to view optional additional products available including personal property, dental, vision, and more.

Contact Information

Questions about what's covered, how to access benefits, enrollment concerns, or replacement ID cards?

Gallagher Student Health and Special Risk
500 Victory Road
Quincy, MA 02171
1 (877) 449-7938 or 1 (617) 769-6073

Questions about a specific claim or claims payment?

Health Special Risk, Inc. (HSR)
HSR Plaza II, 4100 Medical Parkway
Carrollton, TX 75007
General HSR Toll-Free Number: 1 (800) 328-1114
HSR-Markel Claims Toll-Free Number: 1 (888) 765-7223
 
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