It pays to defend you
against various disciplinary proceedings. These may include:
·
Hospital, HMO/PPO Peer Review
·
Local
and State Society Peer Review
·
State
Licensure and Disciplinary Boards
·
National Practitioner Data Bank
·
Professional Review Organization
·
OBRA
(Omnibus Budget Reconciliation Act)
It has an Annual
Aggregate Limit of Insurance of $50,000 for these legal expenses.
The terms of
the coverage are the same. Previously, a MedGuard limit of $50,000 was
included with higher limits available. MedGuard coverage is now
available with a standard $50,000 limit. This should be adequate for
most anticipated situations.
Q:
Why is the premium of the stand-alone policy more
than the amount my
MEDICAL
MUTUAL
professional liability was reduced when MedGuard was
removed from it?
It is much less
expensive to add a coverage endorsement to an existing policy.
MedGuard formerly was an endorsement to your
MEDICAL
MUTUAL
professional
liability policy.
MEDICAL
MUTUAL must now provide the coverage on a stand-alone basis
through ProAd. The
new MedGuard product requires separate applications, separate
underwriting and separate billing. It requires a separate jacket,
separate declarations pages and separate mailings. It also has to
stand on its own financially. The per unit costs are significantly
increased as expenses are spread among fewer insureds. As a result,
the cost to provide MedGuard coverage as a separate product greatly
exceeds the cost of providing the coverage as an endorsement.
Q:
Can I
purchase MedGuard for my professional
organization as well as for myself?
YES. In Maryland, MedGuard is
available to professional organizations as well as individual
physicians, surgeons, CRNA’s, nurse midwives, physician’s assistants,
surgeon’s assistants and nurse practitioners. In Maryland and Washington, D.C., MedGuard is available to
individual dentists and dental
hygienists and their professional organizations. However, the professional organization may purchase
coverage only when all eligible members also purchase MedGuard.
Q:
How
much does it cost to purchase ProAd MedGuard
coverage?
If you are
a:
Maryland physician,
surgeon, CRNA, nurse midwife, physician’s assistant, surgeon’s
assistant or nurse practitioner |
|
The cost is
$700 EACH. |
|
If you are a:
Maryland
or Washington, D.C.
dentist or dental hygienist
|
|
The cost is
$300 EACH. |
|
If you are a:
Professional Organization
|
|
The premium is 10% of the sum
of the premium for all of the eligible
individuals in the organization. |
For example: A group
that has three physicians and a professional organization would pay
$2,310. That premium includes $2,100 for each individual physician (3
x $700).
PLUS $210 for the
organization (3 x $70).
Important: The
professional organization may purchase coverage only if all of
the eligible individuals in the organization also purchase the
coverage.
Q:
Why is the MedGuard premium for an individual higher
than the premium for a professional organization?
Covered disciplinary proceedings are more likely to be instituted
against an individual. Therefore, premiums are higher for individuals
than professional organizations.
Q:
Why should I
purchase MedGuard for my professional
organization?
A professional
organization can face administrative proceedings. An HMO or PPO that
has a contract with a professional organization, for example, could
name that organization in a covered administrative proceeding.
Q:
If
I don’t purchase MedGuard now, will the option to buy it be open to me
in the future?
YES. MedGuard
will be available in the future to eligible individuals and
professional organizations. You will need to complete an
application if you decide to purchase MedGuard at a later time. This
application will be evaluated in our MedGuard underwriting process.
Q:
Can I include my MedGuard payment with my payment
for my professional liability policy?
MEDICAL
MUTUAL
Physician
policyholders:
NO. Do not include payment for MedGuard with your
payment for your professional liability policy.
Professionals Advocate (ProAd) Dental policyholders:
YES. You can include payment for MedGuard with your payment
for your professional liability policy
Billing and accounting are separate functions between
M
Policies & Coverages
MedGuard --- Frequently
Asked Questions