Hospital & Nursing Home Insurance

Residential Care & Long Term Care

• Professional Liability
• General Liability
• Workers’ Compensation - will write monoline
• Excess Workers’ Compensation
• Umbrella/Excess
• Commercial Auto
• Directors & Officers - will write monoline
• Property - will write monoline

Who is Covered

• Adult Homes/Personal Care Homes
• Residential Treatment/Social Services Center
• Assisted Living Facilities
• Independent Living Facilities
• Continuing Care Retirement Communities
• Directors & Officers, both past and present

Residential Care & Long Term Care Underwriting Criteria

• Pre-qualify with Rapid Reply by Health Care Planet
• Acord applications
• Supplementary LTC Application
• Supplementary D&O Application
• Business Income Worksheet Application
• Two years state surveys (HCFA 2567)
• Quality Indicator report
• Facility License
• Five Year hard copy loss runs
• Current financial statement
• Minimum Premium $25,000

Hospitals & Health Care Facilities

Coverage’s Available:

• Professional Liability
• General Liability
• Workers’ Compensation - will write monoline
• Excess Workers’ Compensation
• Umbrella/Excess
• Commercial Auto
• Directors & Officers - will write monoline
• Property - will write monoline

Who is Covered:

• Acute Care
• Mental Health
• Rehabilitation
• Teaching
• Multi-Systems
• Clinics
• Blood Banks
• Surgical
• Directors & Officers, both past and present

Hospital Underwriting Criteria:

• Pre-Qualify with Rapid Reply by Health Care Planet
• Acord Applications
• Supplemental Hospital Professional Application
• Supplemental D&O Application
• 7 years loss history with recent valuation date
• 5 years of historical exposure data
• Most recent JCAHO report
• Current financial statement
• Details on risk management and claims management programs
• Brochures
• Minimum Premium $25,000

Health Care
Workers’ Compensation Program

Spain Agency, Inc. has developed Workers’ Compensation Programs specifically designed for hospitals and nursing homes. We have several plans such as Paid Loss Programs and Guaranteed Cost-Dividend Plan.

Paid Loss Program

The program offers hospitals low pay in costs, significant cash flow advantages, a $250,000 cap per claim, and maximum stop loss aggregates. An institution would be responsible for paid claims only, as they are paid (not paid and reserves as is customary with most insurance carriers). This program is ideal for single hospitals and health care delivery networks that have traditional or self-funded Workers’ Compensation plans.

Guaranteed Cost-Dividend Plan

• Guaranteed Cost is a fixed cost plan. Your premium will be determined in advance based on your payroll information and your experience modification factor. Your premium will remain a constant throughout the term of the policy. If your loss experience is favorable, you may be eligible for a dividend which will be determined twelve months after the close of the policy period.
• This plan allows you to budget in advance, and plan your cash flow accordingly. The cost of the plan will not increase or decrease during the term of your policy. You have the potential to recoup a sliding scale dividend that will be based on positive loss experience. The dividend option carries no additional risk since there is no penalty for poor experience. It should be noted that, by law, dividend payments can not be guaranteed and must be approved by the Board of Directors. Any dividend distributions will be calculated twelve months after the close of the policy year.
• Premium discounts are applied based on premium size.

We provide the following services to reduce a Hospital’s and nursing home’s Workers’ Compensation costs:

Our Company’s program has proven claims and loss control services and is considered one of the premier Workers’ Compensation programs in the country.

1. Return to work/modified duty program
2. Drug free workplace credits
3. Claims Management
• Same day phone contact with injured worker
• Visit with injured workers within 24 hours
• Nurse case management for lost time cases
• No reserving for medical claims
• No reserving for lost time claims less than 30 days
• 1-800 # claims reporting service/Internet Reporting
• Rehabilitation nurse services
4. Loss Control Services
• Dedicated claims offices
• Anti-fraud Hotline
• Slip and fall elimination
• Material handling/Ergonomics Analysis
• Active safety committee participation
• Special anti-fraud investigative unit
• 24 hour emergency claims service
• Computer access to all claims information
• Violence prevention program

Risk Management Services

At Health Care Planet, our goal is to effectively and efficiently provide high-quality innovative risk and safety management products and services designed to reduce our customer’s net insurance costs.

We believe that the development of risk management programs within our insured facilities will enhance the quality of patient care and help reduce the number and severity of injuries and claims. The carriers in our program are dedicated to providing our insureds and agents with the tools needed to achieve these very important objectives.

We are committed to helping our insured facilities keep pace with an ever-changing health care environment, so that we can better serve you in identifying areas of potential liability. Our risk management professionals work in concert with our claims, underwriting and finance teams to help you customize a program to help you identify risks and develop a plan to address potential risks.

The following is an outline of the risk management services offered by Health Care Planet:

• Risk Management Process and Systems
• Department Exposures and Controls
• General Liability Risk Assessment
• Safety Management Program
• Pre-Loss and Post-Loss Work Injury Programs
• Managed Care Protection Liability Program
• Education Programs
• Audio-Visual Library
  • More than 80 Topics
• Quality Assurance/Quality Control Programs
• Evaluation of Claims History
• Comprehensive Building Surveys

Claim Services

At Health Care Planet, we strive to maintain a partnership with all our insureds so that if a claim is initiated, we can stand behind you with a full array of programs and services aimed at providing the best defense possible while minimizing expenses. We have a duty to those we insure to investigate, evaluate and resolve each claim in an efficient and effective manner.

Our corporate claim and litigation management philosophy is to vigorously defend our clients against non-meritorious claims. Meritorious claims will be resolved promptly and equitably. Aggressive claim management is crucial because it affects not only the state of your practice or organization, but your bottom line as well.

Our team of dedicated claim specialists conducts prompt and aggressive reviews to assess the merits of every claim. Our clients will have 24-hour emergency access to our claim management staff and we will not settle a claim without your consent.

If the case does go to court, we bring in experienced local attorneys to provide clients with the best possible representation. We also aggressively manage the use of legal resources to control costs, which helps keep the premium down.

We understand the challenges facing today’s health care providers. Our ability to meet the needs of our insureds has earned us a solid reputation as a leader in the insurance industry.

We are here to serve you.

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Hospital & Nursing Home Insurance