Insuring Physicians:

Are commercial insurers competitors or partners?

Charles KolodkinCleveland Clinic

Jack MeyerThe Doctors Company

Larry SmithMedStar HealthDec. 3, 2014

Employed Physicians:Captive v. Carrier

Traditional Liabilities Cost Claims Control Risk Management

Regulatory Considerations Risk Tolerance Underwriting expertise Claims Management Educational offerings Portability

Employed Physicians:Captive v. Carrier

Tail Liabilities Cost Claims Control Expectation of clinician

Wall off liabilities Risk Tolerance Claims Management Operational Management / Control

Employed Physicians:Captive v. Carrier

Prior Acts Liabilities Cost Recruiting Tool Claims Control

Third Party Business Linkage with Hospital Risk Certainty Claims Management

Insuring Independent Physicians:Captive v. Carrier

Captive

Assures Availability Assures Affordability Linkage with Hospital Claims Control Lower Costs

Insuring Independent Physicians:Captive v. Carrier

Carrier

Regulatory Underwriting Expertise Claims Management Risk Management expertise Time / Resource efficiencies Broader Coverages Linkage with Hospital

Insuring Independent Physicians:Captive v. Carrier

Hybrid Captive as Reinsurer

Underwriting Expertise Claims Management Risk Management expertise Promote issues Time / Resource efficiencies Broader Coverages Linkage with Hospital

Insuring Independent Physicians:Captive v. Carrier

Hybrid Carrier as Reinsurer

Underwriting Expertise Claims Management Risk Management expertise Promote issues Time / Resource efficiencies Broader Coverages Linkage with Hospital

WHAT DO PHYSICIANS WANT?

• Affordability• Claims Management• Flexibility• Supplemental Coverages• Physician Governance• Dividends