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PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM SERFF Tracking Number: MDPC-126061025 State: District of Columbia Filing Company: The Medical Protective Company State Tracking Number: Company Tracking Number: 09-HCPA-02 TOI: 11.0 Medical Malpractice - Claims Made/Occurrence Sub-TOI: 11.0024 Physicians Assistants Product Name: Health Care Professionals - Physician Assistants Project Name/Number: NP/PA Filings /09-HCPA-02 Filing at a Glance Company: The Medical Protective Company Product Name: Health Care Professionals - Physician Assistants SERFF Tr Num: MDPC-126061025 State: District of Columbia TOI: 11.0 Medical Malpractice - Claims Made/Occurrence SERFF Status: Closed-APPROVEDState Tr Num: Sub-TOI: 11.0024 Physicians Assistants Co Tr Num: 09-HCPA-02 State Status: Filing Type: Rate/Rule Reviewer(s): Robert Nkojo Authors: Melissa Millican, Christopher Cole Disposition Date: 07/14/2009 Date Submitted: 03/11/2009 Disposition Status: APPROVED Effective Date Requested (New): 07/01/2009 Effective Date (New): Effective Date Requested (Renewal): 07/01/2009 Effective Date (Renewal): State Filing Description: General Information Project Name: NP/PA Filings Status of Filing in Domicile: Pending Project Number: 09-HCPA-02 Domicile Status Comments: Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed: Deemer Date: Created By: Christopher Cole Submitted By: Melissa Millican Corresponding Filing Tracking Number: 09-HCPA-02 Filing Description: The Medical Protective Company is pleased to introduce new Physicians Assistants rates, rules and forms for individual Healthcare Professionals. Where applicable we have separated the forms from the rates and rules and have submitted a separate filing under a separate submission. We respectfully request an effective date of July 1, 2009 for this submission. The enclosed Memorandum and exhibits detail the rate development of this filing and provide brief descriptions of the manual rate and rule pages included in the package. In addition to the aforementioned pages, please find specimen copies of the proposed policies and endorsements.

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Page 1: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Filing at a Glance

Company: The Medical Protective Company

Product Name: Health Care Professionals -

Physician Assistants

SERFF Tr Num: MDPC-126061025 State: District of Columbia

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

SERFF Status: Closed-APPROVEDState Tr Num:

Sub-TOI: 11.0024 Physicians Assistants Co Tr Num: 09-HCPA-02 State Status:

Filing Type: Rate/Rule Reviewer(s): Robert Nkojo

Authors: Melissa Millican,

Christopher Cole

Disposition Date: 07/14/2009

Date Submitted: 03/11/2009 Disposition Status: APPROVED

Effective Date Requested (New): 07/01/2009 Effective Date (New):

Effective Date Requested (Renewal): 07/01/2009 Effective Date (Renewal):

State Filing Description:

General Information

Project Name: NP/PA Filings Status of Filing in Domicile: Pending

Project Number: 09-HCPA-02 Domicile Status Comments:

Reference Organization: N/A Reference Number: N/A

Reference Title: N/A Advisory Org. Circular: N/A

Filing Status Changed: 07/14/2009

State Status Changed: Deemer Date:

Created By: Christopher Cole Submitted By: Melissa Millican

Corresponding Filing Tracking Number: 09-HCPA-02

Filing Description:

The Medical Protective Company is pleased to introduce new Physicians Assistants rates, rules and forms for individual

Healthcare Professionals. Where applicable we have separated the forms from the rates and rules and have submitted

a separate filing under a separate submission. We respectfully request an effective date of July 1, 2009 for this

submission.

The enclosed Memorandum and exhibits detail the rate development of this filing and provide brief descriptions of the

manual rate and rule pages included in the package. In addition to the aforementioned pages, please find specimen

copies of the proposed policies and endorsements.

Page 2: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

If you should have any additional questions related to this filing, please let me know.

Thank you for your time,

Melissa Coker

Company and Contact

Filing Contact Information

Melissa Millican, Paralegal [email protected]

5814 Reed Road 260-486-0838 [Phone]

Fort Wayne, IN 46835 260-486-0733 [FAX]

Filing Company Information

The Medical Protective Company CoCode: 11843 State of Domicile: Indiana

5814 Reed Road Group Code: Company Type:

Fort Wayne, IN 46835 Group Name: State ID Number:

(260) 486-0838 ext. [Phone] FEIN Number: 35-0506406

---------

Filing Fees

Fee Required? No

Retaliatory? No

Fee Explanation:

Per Company: No

COMPANY AMOUNT DATE PROCESSED TRANSACTION #

The Medical Protective Company $0.00

Page 3: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Correspondence Summary

Dispositions

Status Created By Created On Date Submitted

APPROVED Robert Nkojo 07/14/2009 07/14/2009

Filing Notes

Subject Note Type Created By Created

On

Date Submitted

status of the filing Note To Reviewer Melissa Millican 05/04/2009 05/04/2009

Effective Date Note To Reviewer Christopher Cole 03/19/2009 03/19/2009

Page 4: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims Made/Occurrence Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Disposition

Disposition Date: 07/14/2009

Effective Date (New):

Effective Date (Renewal):

Status: APPROVED

Comment:

Company Name: Overall %

Indicated

Change:

Overall % Rate

Impact:

Written

Premium

Change for

this

Program:

# of Policy

Holders

Affected for this

Program:

Written

Premium for

this Program:

Maximum %

Change (where

required):

Minimum %

Change (where

required):

The Medical Protective

Company0.000% 0.000% $0 0 $0 0.000% 0.000%

Percent Change Approved:

Minimum: % Maximum: % Weighted Average: %

Page 5: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Schedule Schedule Item Schedule Item Status Public Access

Supporting Document Cover Letter All Filings Yes

Supporting Document Consulting Authorization Yes

Supporting Document Actuarial Certification (P&C) Yes

Supporting Document District of Columbia and Countrywide

Experience for the Last 5 Years (P&C)Yes

Supporting Document District of Columbia and Countrywide

Loss Ratio Analysis (P&C)Yes

Rate OCC Rate Pages Yes

Rate OCC Class Plan Yes

Rate OCC Aggregate Credit Rule Yes

Rate OCC Deferred Premium Payment Plan

RuleYes

Rate OCC Full Time Equivalency Rating Rule Yes

Rate OCC Group Rating Rule Yes

Rate OCC Leave of Absence Credit Rule Yes

Rate OCC Military Leave of Absence Credit

RuleYes

Rate OCC Minimum Premium Rating Rule Yes

Rate OCC Part Time Practice Rule Yes

Rate OCC Renewal Rating Rule Yes

Rate OCC Risk Management Credit Rule Yes

Rate OCC Schedule Rating Plan Yes

Rate OCC Membership Association Credit Yes

Rate OCC New to Practice Credit Yes

Rate OCC Shared Entity Vicarious Liability

CoverageYes

Rate OCC Partnership or Corporation

CoverageYes

Rate SCM Rate Pages Yes

Rate SCM Class Plan Yes

Rate SCM Tail Factors Yes

Rate SCM Aggregate Credit Rule Yes

Rate SCM Deferred Premium Payment Plan

RuleYes

Rate SCM Full Time Equivalency Rating Rule Yes

Page 6: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Rate SCM Group Rating Rule Yes

Rate SCM Leave of Absence Credit Rule Yes

Rate SCM Military Leave of Absence Credit

RuleYes

Rate SCM Minimum Premium Rating Rule Yes

Rate SCM Part Time Practice Rule Yes

Rate SCM Renewal Rating Rule Yes

Rate SCM Risk Management Credit Rule Yes

Rate SCM Schedule Rating Plan Yes

Rate SCM Membership Association Credit Yes

Rate SCM New to Practice Credit Yes

Rate SCM Shared Entity Vicarious Liability

CoverageYes

Rate SCM Partnership or Corporation

CoverageYes

Rate SCM Accelerated Extension Contract

RuleYes

Rate SCM Extension Contract Rating Yes

Rate SCM Prior Acts Coverage Yes

Rate SCM Slot Rating Rule Yes

Rate SCM Convertible Coverage Rating Plan Yes

Rate OCC Moonlighting Rule Yes

Rate SCM Moonlighting Rule Yes

Rate OCC Student Resident Rule Yes

Page 7: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Note To Reviewer

Created By:

Melissa Millican on 05/04/2009 07:30 AM

Last Edited By:

Melissa Millican

Submitted On:

05/04/2009 07:30 AM

Subject:

status of the filing

Comments:

I wanted to check the status of the filing, is there any additional information needed at this time.

Thank you,

Melissa

Page 8: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Note To Reviewer

Created By:

Christopher Cole on 03/19/2009 09:54 AM

Last Edited By:

Christopher Cole

Submitted On:

03/19/2009 09:54 AM

Subject:

Effective Date

Comments:

We ask to modify the effective date from 7/1/2009 to 6/1/2009.

Thank you.

Page 9: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims Made/Occurrence Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Rate InformationRate data applies to filing.

Filing Method: file and use

Rate Change Type: %

Overall Percentage of Last Rate Revision: %

Effective Date of Last Rate Revision:

Filing Method of Last Filing: n/a - this is the initial filing

Company Rate InformationCompany Name: Company

Rate

Change:

Overall %

Indicated

Change:

Overall % Rate

Impact:

Written

Premium

Change for

this

Program:

# of Policy

Holders

Affected for

this Program:

Written

Premium for

this Program:

Maximum %

Change

(where

required):

Minimum %

Change

(where

required):

The Medical Protective

CompanyN/A 0.000% 0.000% $0 0 $0 0.000% 0.000%

Page 10: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Rate/Rule Schedule

Schedule Item

Status:

Exhibit Name: Rule # or Page

#:

Rate Action Previous State Filing

Number:

Attachments

OCC Rate Pages RTS-xxx; ST-09-

1

New dc occ.pdf

OCC Class Plan NPRC-CW;

7/1/2009

New dc pa oc cp.pdf

OCC Aggregate Credit

RuleACR-CW;

7/1/2009

New dc pa occ agg.pdf

OCC Deferred

Premium Payment

Plan Rule

DPP-CW;

7/1/2009

New dc pa occ dpp.pdf

OCC Full Time

Equivalency Rating

Rule

FTE-CW;

7/1/2009

New dc pa occ fte.pdf

OCC Group Rating

RuleGRR-CW;

7/1/2009

New dc pa occ group.pdf

OCC Leave of

Absence Credit RuleLOA-CW;

7/1/2009

New dc pa occ loa.pdf

OCC Military Leave of

Absence Credit RuleMLOA-CW;

7/1/2009

New dc pa occ mloa.pdf

Page 11: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

OCC Minimum

Premium Rating RuleMPR-CW;

7/1/2009

New dc pa occ mpr.pdf

OCC Part Time

Practice RulePTP-CW;

7/1/2009

New dc pa occ ptp.pdf

OCC Renewal Rating

RuleRRR-CW;

7/1/2009

New dc pa occ renewal.pdf

OCC Risk

Management Credit

Rule

RMC-CW;

7/1/2009

New dc pa occ rmc.pdf

OCC Schedule Rating

PlanSRP-CW;

7/1/2009

New dc pa occ srp.pdf

OCC Membership

Association CreditMAC-CW;

7/1/2009

New dc pa occ mac.pdf

OCC New to Practice

CreditNTP-CW;

7/1/2009

New dc pa occ ntp.pdf

OCC Shared Entity

Vicarious Liability

Coverage

SVL-CW;

7/1/2009

New dc pa occ entity.pdf

OCC Partnership or

Corporation CoveragePCC-CW;

7/1/2009

New dc pa occ pc.pdf

SCM Rate Pages RTS-xxx; ST-09-

1

New dc scm.pdf

Page 12: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

SCM Class Plan NPRC-CW;

7/1/2009

New dc pa cm cp.pdf

SCM Tail Factors ECF-xxx; ST-09-

1

New dc pa scm ecf.pdf

SCM Aggregate Credit

RuleACR-CW;

7/1/2009

New dc pa scm agg.pdf

SCM Deferred

Premium Payment

Plan Rule

DPP-CW;

7/1/2009

New dc pa scm dpp.pdf

SCM Full Time

Equivalency Rating

Rule

FTE-CW;

7/1/2009

New dc pa scm fte.pdf

SCM Group Rating

RuleGRR-CW;

7/1/2009

New dc pa scm group.pdf

SCM Leave of

Absence Credit RuleLOA-CW;

7/1/2009

New dc pa scm loa.pdf

SCM Military Leave of

Absence Credit RuleMLOA-CW;

7/1/2009

New dc pa scm mloa.pdf

SCM Minimum

Premium Rating RuleMPR-CW;

7/1/2009

New dc pa scm mpr.pdf

SCM Part Time

Practice RulePTP-CW;

7/1/2009

New dc pa scm ptp.pdf

Page 13: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

SCM Renewal Rating

RuleRRR-CW;

7/1/2009

New dc pa scm renewal.pdf

SCM Risk

Management Credit

Rule

RMC-CW;

7/1/2009

New dc pa scm rmc.pdf

SCM Schedule Rating

PlanSRP-CW;

7/1/2009

New dc pa scm srp.pdf

SCM Membership

Association CreditMAC-CW;

7/1/2009

New dc pa scm mac.pdf

SCM New to Practice

CreditNTP-CW;

7/1/2009

New dc pa scm ntp.pdf

SCM Shared Entity

Vicarious Liability

Coverage

SVL-CW;

7/1/2009

New dc pa scm shared

entity.pdf

SCM Partnership or

Corporation CoveragePCC-CW;

7/1/2009

New dc pa scm pc.pdf

SCM Accelerated

Extension Contract

Rule

AEC-CW;

7/1/2009

New dc pa scm acc.pdf

SCM Extension

Contract RatingECR-CW;

7/1/2009

New dc pa scm ecr.pdf

SCM Prior Acts PAC-CW; New dc pa scm prior.pdf

Page 14: Filing at a Glance - | disb · Reference Organization: N/A Reference Number: N/A Reference Title: N/A Advisory Org. Circular: N/A Filing Status Changed: 07/14/2009 State Status Changed:

PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Coverage 7/1/2009

SCM Slot Rating Rule SRR-CW;

7/1/2009

New dc pa scm slot.pdf

SCM Convertible

Coverage Rating PlanCCR-CW;

7/1/2009

New dc pa scm conv.pdf

OCC Moonlighting

RuleMRR-CW;

7/1/2009

New dc pa occ moon.pdf

SCM Moonlighting

RuleMRR-CW;

7/1/2009

New dc pa scm moon.pdf

OCC Student

Resident RuleSRE-CW;

7/1/2009

New dc pa occ student.pdf

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Edition Date: 07/01/09 SVL-CW

DISTRICT OF COLUMBIA

HEALTHCARE PROFESSIONALS

PHYSICIAN ASSISTANT

OCCURRENCE PROGRAM

SHARED ENTITY VICARIOUS LIABILITY COVERAGE

A SCHEDULED HEALTHCARE PROFESSIONAL ENTITY MAY BE MADE AN ADDITIONAL INSURED ON A HEALTHCARE PROFESSIONAL’S PRIMARY INDIVIDUAL POLICY AT NO ADDITIONAL CHARGE. COVERAGE IS LIMITED TO VICARIOUS LIABILITY BASED SOLELY ON PROFESSIONAL SERVICES RENDERED, OR WHICH SHOULD HAVE BEEN RENDERED BY THE NAMED INSURED PHYSICIAN ASSISTANT. THIS ADDITION WILL NOT OPERATE TO PROVIDE ADDITIONAL LIMITS OF LIABILITY PER CLAIM FILED OR ANNUAL AGGREGATE BEYOND THE STATED LIMITS OF THE INDIVIDUAL POLICY.

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Edition Date: 07/01/09 LOA-CW

DISTRICT OF COLUMBIA

HEALTHCARE PROFESSIONALS

PHYSICIAN ASSISTANTS

STANDARD CLAIMS MADE PROGRAM

LEAVE OF ABSENCE CREDIT RULE

A HEALTHCARE PROVIDER WHO IS ON A LEAVE OF ABSENCE FOR A CONTINUOUS PERIOD OF 45 DAYS OR MORE MAY BE ELIGIBLE FOR RESTRICTED COVERAGE AT A DISCOUNT OF 100% OF THE APPLICABLE RATE FOR THE PERIOD OF THE LEAVE OF ABSENCE. THIS WILL APPLY RETROACTIVELY TO THE FIRST DAY OF THE LEAVE OF ABSENCE, IF REPORTED TO THE COMPANY WITHIN 30 DAYS. ONLY ONE APPLICATION OF THIS CREDIT MAY BE APPLIED TO AN ANNUAL POLICY PERIOD. LEAVE OF ABSENCE MAY INCLUDE THE FOLLOWING:

• THE BIRTH OF INSUREDS NEWBORN, PLACEMENT OF FOSTER CHILDREN OR INSURED ADOPTS A CHILD, PROVIDED THE LEAVE IS COMPLETED WITHIN 12 MONTHS OF THE BIRTH, PLACEMENT OR ADOPTION.

• TO CARE FOR A SPOUSE, CHILD OR PARENT WHO HAS A SERIOUS HEALTH CONDITION.

• TO CARE FOR INSUREDS OWN HEALTH CONDITION WHICH PREVENTS INSURED FROM WORKING.

• TIME TO ENHANCE THE INSUREDS EDUCATION OR OTHER REASON WHILE NOT PRACTICING.

THIS CREDIT IS NOT AVAILABLE TO AN INSUREDS LEAVE OF ABSENCE FOR VACATION PURPOSES. THE MINIMUM PREMIUM RATING RULE APPLIES TO INSUREDS ELIGIBLE FOR THE LEAVE OF ABSENCE CREDIT.

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Edition Date: 07/01/09 NTP-CW

DISTRICT OF COLUMBIA

HEALTHCARE PROFESSIONALS

PHYSICIAN ASSISTANTS

STANDARD CLAIMS MADE PROGRAM

NEW TO PRACTICE CREDIT

A PRACTITIONER IN THEIR FIRST YEAR OF PRACTICE, AFTER GRADUATION, WILL RECEIVE A 25% CREDIT APPLIED TO CURRENT FILED RATES. THE NEW TO PRACTICE CREDIT WILL NOT BE APPLIED IN COMBINATION WITH PART-TIME CREDITS.

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Edition Date: 07/01/09 MRR-CW

DISTRICT OF COLUMBIA

HEALTHCARE PROFESSIONALS

PHYSICIAN ASSISTANT

OCCURRENCE PROGRAM

MOONLIGHTING RATING RULE

ANY HEALTHCARE PROFESSIONAL WHO REQUESTS COVERAGE FOR

MOONLIGHTING ACTIVITIES, WHILE WORKING FULL TIME AT A PRACTICE

EXCLUDED BY THE MEDICAL PROTECTIVE COMPANY, AND AVERAGES LESS

THAN 500 HOURS DURING THE TERM OF AN ANNUAL POLICY FOR SUCH

MOONLIGHTING ACTIVITIES, WILL BE CONSIDERED A MOONLIGHTING

PRACTITIONER AND WILL BE ELIGIBLE FOR A REDUCTION IN THE OTHERWISE

APPLICABLE RATE BASED ON THE FOLLOWING SCHEDULE.

THE RATE SHALL BE CALCULATED AS 0.325 OF THE APPLICABLE

STATE/TERRITORY OCCURRENCE CLASS P1 RATE. THE PREMIUM SHALL BE

FULLY EARNED AT THE INCEPTION DATE OF THE POLICY.

TO QUALIFY, THE MOONLIGHTING PRACTITIONER MUST BE CLAIM FREE FOR A

MINIMUM OF THE PRECEDING FIVE YEARS. PART TIME APPLICANTS OR

INSUREDS ARE NOT ELIGIBLE FOR MOONLIGHTING COVERAGE.

THE COMPANY, AT OUR DISCRETION, MAY AUDIT THE PRACTITIONER TO VERIFY

COMPLIANCE WITH THE TERMS OF THIS MOONLIGHTING RULE.

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PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Supporting Document Schedules

Item Status: Status

Date:

Satisfied - Item: Cover Letter All Filings

Comments:

Please find cover letter attached

Attachment:

dc coverletter.pdf

Item Status: Status

Date:

Satisfied - Item: Consulting Authorization

Comments:

n/a - this company is being made by the company

Item Status: Status

Date:

Satisfied - Item: Actuarial Certification (P&C)

Comments:

Please find attached the DC Memo and Exhibits.

Attachments:

dc pa ex.pdf

DC PA Memo.pdf

Item Status: Status

Date:

Satisfied - Item: District of Columbia and

Countrywide Experience for the

Last 5 Years (P&C)

Comments:

This is an initial filing.

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PDF Pipeline for SERFF Tracking Number MDPC-126061025 Generated 03/17/2011 09:25 AM

SERFF Tracking Number: MDPC-126061025 State: District of Columbia

Filing Company: The Medical Protective Company State Tracking Number:

Company Tracking Number: 09-HCPA-02

TOI: 11.0 Medical Malpractice - Claims

Made/Occurrence

Sub-TOI: 11.0024 Physicians Assistants

Product Name: Health Care Professionals - Physician Assistants

Project Name/Number: NP/PA Filings /09-HCPA-02

Item Status: Status

Date:

Satisfied - Item: District of Columbia and

Countrywide Loss Ratio Analysis

(P&C)

Comments:

This is an initial filing.

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