Connecticut State Soccer Association

1. 2023 COI Processing is now open!
2. Please fill out the COI Request Form completely and accurately. Please make sure email addresses for the Team Manager and Facility Owner are included.
3. Unless you are only going to play on one field, please enter ALL FIELDS in "Facility Name," so you will be covered for all fields in that Town.
4. If there are several teams that play on the same fields, one COI can be issued for all teams, so, please group all teams to make things easier for everyone.
5. Email a copy of the form to the COI Coordinator Julia Connor. Her email address is CSSASecGen@gmail.com and is listed at the top of the form.
6. Do NOT send the form to the U.S.A.S.A. 
7. Please allow for a regular processing time of 7 days. PLEASE PLAN ACCORDINGLY AND SUBMIT WELL IN ADVANCE.

Insurance coverage for CSSA participants is provided by the US Adult Soccer Association (USASA), the primary adult council member of US Soccer.  

USASA Insurance information, including insurance summaries, can be found on the USASA website.

Instructions:

1. *** CLAIMS ARE DUE TO USASA 90 DAYS FROM DATE OF ACCIDENT *** 
2. THEREFORE, SUBMIT YOUR CLAIM TO CSSA AT LEAST 60 DAYS FROM DATE OF ACCIDENT.  
3. Player downloads the USASA Claim Form (in English or Spanish, links below) from the CSSA Website, AND NOWHERE ELSE. Please note that the form is a PDF file and you will need Adobe Reader (a free download from Adobe.com -- look under 'Download') to open and/or print the file:
4. Player fills out the form completely (with help from his team manager/coach, if needed), except section 8. Player signs the form on page 
5. Player then sends the form to his team manager/coach for sign-off. Please make sure that the application form is complete and player’s pass number is added (ADD the player's pass number to Part B.1 , after you fill in Team Name.
6. Team manager/coach signs off and mails the form to the "league verification officer" to have the league verify that the injury is reported in the official USSF match report (referee's report), if applicable. If needed, the league can ask it's assignor or the referee directly to amend the report to include details of the injury (file a supplemental report).
7. League verification officer signs off and sends the claim form to the USASA verification officer for the CSSA for final sign-off.
8. CSSA then sends the completed claim form to USASA's insurance company.
9. *** CLAIMS RECEIVED AFTER 90 DAYS MAY NOT BE HONORED BY USASA ***

Coverage Information:

Please go to the USASA Insurance Overview Website for insurance plan summary information.

The US Adult Soccer Association (USASA) provides CSSA affiliated leagues and clubs ("member organizations") liability insurance.  Please note the following requirements and guidelines regarding the USASA Release Of Liability Agreement (AKA "waiver"), linked below:

1. The below waiver supersedes previous USASA waivers.  Before play, all players must be registered and sign/acknowledge this waiver.   

2.  Electronic signatures are acceptable.

3.  Member organizations are responsible for retaining the waivers on file.  The recommended period to retain them is seven (7) years.

4.  Member organizations should plan to make the waivers available to CSSA and USASA, if requested.

5.  Additional information on USASA liability insurance coverage is here.

RELEASE OF LIABILITY FORM

In addition to the standard insurance coverage provided to all affiliated, registered players, USASA also offers an additional coverage option to our leagues. Member leagues have the option of increasing their coverage to $25,000 Max Medical Benefit, up from the standard $5K coverage, at the cost of $3.65 per player. 

USASA Insurance Forms can be found here.

USASA Insurance information, including insurance summaries, can be found on the USASA website.