From key acquisitions by Coverys to the announcement of a new MGA formed by Cooper Gay, the past month has seen some important developments in the world of insurance for healthcare providers. HRMR reports.
Coverys, a provider of medical professional liability insurance and related services, has made a number of significant changes in recent weeks.
“Our emphasis on underwriting discipline has enabled us to address a broad array of classes and attract domestic and international paper.”
Coverys Custom Accounts (CCA), a new account underwriting division, was formed to support Coverys’ strategic plan and further its expansion into the large account underwriting and services arena.
CCA is at the forefront of Coverys’ continuing strategy to respond to the needs of hospitals, health systems and physician groups as they navigate changes resulting from the Affordable Care Act. Clinical and financial integration of the healthcare delivery system is posing challenges for providers on all levels and is bringing with it a trend towards structuring delivery of care on a larger and broader scale.
CCA will offer solutions to large providers to address the unique risks associated with these new and often complex structures.
“Establishing CCA demonstrates our commitment to expanding our services in the large account underwriting arena. CCA will be an integral part of our strategy to become the market leader in medical professional liability program underwriting and design wherever these services are needed,” said Gregg Hanson, CEO and president of Coverys.
CCA will have a dedicated large account underwriting unit responsive to producer needs featuring capabilities that embrace alternative risk financing structures, excess coverage and reinsurance programs. In addition, CCA clients will have access to the Coverys suite of comprehensive risk management and patient safety educational programs, as well as online and in-person educational programs that provide continuing medical education credits for physicians and nurses.
Key acquisitions
Coverys has also made some strategic acquisitions. Last month Medical Professional Mutual Insurance Company (ProMutual), a Coverys company, finalized the acquisition of Preferred Professional Insurance Company (PPIC), located in Omaha, Nebraska.
PPIC was formerly owned by 18 Catholic healthcare systems, seven of which are in the top 25 largest non-profit hospital systems in the US. The transaction had previously received unanimous shareholder support before regulatory approval was obtained.
Through the acquisition of PPIC, Coverys will expand its presence across the country and as a leading medical professional liability insurer in the US. The acquisition also supports its strategy to broaden delivery of innovative products and services within the medical professional liability insurance marketplace on a national basis.
“Coverys shares PPIC’s long-standing commitment to our policyholders. We are pleased that this acquisition will allow us to offer our policyholders access to the enhanced services and products for which Coverys is recognized as well as its financial strength and stability,” said Lynnette Matza, CEO and president of PPIC.
“We view the acquisition of PPIC as a critical pivot point in our growth strategy providing additional scale on a national level in our marketplace,” said Hanson. “We are excited to finalize the acquisition of PPIC and to have its dedicated staff join the Coverys team.”
Coverys also finalized an agreement to acquire ELM Exchange (ELM), headquartered in Rockville, Maryland.
Coverys is the eighth largest medical professional liability provider in the country based on direct written premium and provides medical professional liability insurance protection to physicians, hospitals, dentists and other healthcare providers from coast to coast.
ELM provides customized online educational programs that give healthcare providers the knowledge and tools to minimize clinical risk and maximize patient safety and satisfaction. Their programs currently service more than 95 client organizations representing approximately 1,000 hospitals, office practices and healthcare facilities throughout the country.
The acquisition supports Coverys’ continuing commitment to offer healthcare providers with solutions to increase patient safety, improve patient outcomes and decrease medical malpractice claims. In addition, ELM will increase opportunities for Coverys to provide fee-based education and clinical risk management services to a variety of individuals and entities in the medical provider community.
“ELM is an acknowledged leader in the development and distribution of online accredited medical and nursing education. This acquisition provides Coverys the ability to expand our current healthcare provider education and medical risk management programs by reaching a diverse market encompassing insured and self-insured hospitals, health systems and academic medical centers, as well as other insurance carriers,” said Hanson.
“Joining forces as a Coverys company gives ELM a real push in the healthcare provider education space,” said Rick Fiscina, CEO and co-founder of ELM. “We are confident that through this acquisition, ELM will further enhance its professional reputation for providing unique medicolegal education services on a flexible and scalable delivery platform to an ever-growing number of healthcare providers and facilities served by Coverys.”
“There are tremendous synergies gained by combining the vast educational resources of Coverys and ELM, all for the benefit of healthcare providers across the country,” said Tara Gibson, vice president of risk management of Coverys.
Ascent changes CyberPro
Ascent Underwriting, a managing general agent (MGA) specializing in emerging and professional risks, has made changes to its medical billings errors and omissions product and increased limit availability to $5 million.
CyberPro, which was launched in December 2013 to offer financial protection against US healthcare billing and coding regulation violations, will now include coverage for qui tam investigations and reputational harm. In addition, coverage for full prior acts is available.
As well as the placement of individual risks, Ascent can now offer reinsurance solutions for other insurance carriers looking to offer medical billings and cyber coverage as part of their own offerings.
Gareth Tungatt, chief underwriting officer of Ascent Underwriting, said: “We launched our medical billings product at the end of last year to protect US healthcare professionals on an individual risk basis. We are, however, already receiving frequent requests for tailored reinsurance facilities and structured programs from companies wishing to take advantage of Ascent’s proprietary products and incorporated risk management solutions.
“Although most practitioners have invested heavily in new technology and revised business procedures, they are still at risk of fines and prosecutions resulting from incorrect healthcare claims billing, coding or processing. In answer to this growing threat we have enhanced our cover and increased its flexibility while maintaining the vital reimbursement for billing audit investigations and regulatory fines elements.”
Medical Billings is part of Ascent’s portfolio of insurance solutions for professional and non-tangible risks. It provides a solution combining protection for both healthcare data protection risk and the business risks associated with patient billing and coding exposures.
Amendments to billings regulations over the last few years has seen a tightening of the billing and coding process for all healthcare providers when submitting claims for reimbursements for medical services to insurance companies and government-led Medicare.
Cooper Gay forms new healthcare MGA
Broker Cooper Gay Swett & Crawford (CGSC) has launched an underwriting management agency specializing exclusively in the healthcare industry.
Pro-Praxis Insurance will be led by Robert Allen and will be based in New York.
The MGA will bring domestic business to the London market, the company said. It plans to build a suite of proprietary insurance products in conjunction with Lloyd’s of London and US market underwriters.
Toby Esser, CEO of CGSC, said: “US domestic markets have traditionally dominated the US healthcare insurance space. Between Pro-Praxis, the experience of Bob Allen and the well established distribution platform of Swett & Crawford, we have here a mechanism for producing a superior healthcare insurance product and business for the Lloyd’s of London and US markets.”
Through underwriters at Lloyd’s, Pro-Praxis has also launched a new healthcare and clinical research underwriting facility which will offer primary professional liability, general liability and standalone umbrella coverage for classes ranging from air ambulances to zoonotic disease centers.
For clinical research liability, the team will offer primary professional liability, general liability and standalone umbrella coverage for classes such as trial sponsors, contract research organizations, independent research sites and institutional review boards. All eligible classes have capacity up to $10 million per claim.
Allen said: “Our aim with Pro-Praxis is to build an underwriting platform that will introduce capacity and underwriting complexity rarely seen in the MGA arena.
“Our emphasis on underwriting discipline has enabled us to address a broad array of classes and attract domestic and international paper.”
Ironshore offers first Medicare Set-Aside policy
IronHealth, the specialty healthcare unit of Ironshore, will offer the first insurance Medicare Set-Aside liability policy.
The policy is designed to protect self-insured employers and workers’ compensation insurance carriers that opt not to seek approval by the Federal Centers for Medicare and Medicaid Services (CMS) for workers’ compensation Medicare Set-Aside Arrangements (MSA).
The coverage is designed to remove the uncertainty of future Medicare enforcement actions from the workers’ compensation settlement process. Coverage will substitute Ironshore insurance protection for CMS assurances on both an individual and aggregate claims basis.
Matt Dolan, president of IronHealth, said: “Ironshore is very comfortable assuming the long-term risk of insurance for a non-CMS approved settlement, and pleased to help make the MSA process more efficient for our insureds. The new MSA product demonstrates an ongoing commitment to working with those employers who choose to self-insure their liability, employee health benefits or workers’ compensation programs.”
“Seeking CMS approval of an MSA has been a decade-long challenge when settling workers’ compensation insurance claims. The Ironshore Medicare Set-Aside Liability Policy is an alternative program now available in the marketplace, designed to adhere to the letter and spirit of the law, while eliminating CMS’ review as part of the settlement process.”
Coverys, Cooper Gay, ProMutual, Ascent Underwriting, CyberPro, Pro-Praxis Insurance, IronHealth, US