AMGA Risk Purchasing Group FAQ

What is a Risk Purchasing Group?
A Risk Purchasing Group is a legal entity that allows a group of unassociated professionals to join together to take advantage of a joint purchase. The program was established under the Federal Risk Retention Act of 1986.

Is a Risk Purchasing Group an insurance company?
No, a risk purchasing group is not an insurance company, it is a pool of like business that buy insurance as a group from an insurance company. There is no additional risk assumed by the physicians’ insured (above what they might accept in their individual purchase of insurance). Further, it allows the group to gather purchasing strength to continue buying at the best dollar due to their size and demographics.

For the AMGA program, who is the insurance company?
The insurance company is Oceanus Risk Retention Group. We selected Oceanus because it is designed for AMGA ’s large physician groups. Oceanus retains the first $250,000 of each and every claim with reinsurance with an A. M. Best A rated company including assets in excess of $2 billion over and above the $250,000. retention. Further, excess limits of up to $ 5million can be quoted at substantially reduced rates over and above the primary offering of $1 million / $ 3 million.

Is the policy any different than a standard coverage policy?
Yes, this is a policy that is being developed just for you, a valued AMGA member. We will offer the broadest coverage options at dramatically reduced premium dollars.

Do I have to purchase "Tail" coverage from my existing insurance carrier when I move to the new program?
No, Full Prior Acts Coverage will be offered to all AMGA members and applicants. When switching to Oceanus from your current carrier, there will be no need to look into purchasing an extended reporting endorsement (known as a “tail”). This full prior acts coverage will also be extended to any pre-existing entities which the applicant may have been legally a part of should that pre-existing entity ever be involved in a lawsuit.

What attorneys will we have for our defense if a claim is filed against us?
Oceanus will allow the insured a choice of legal counsel. We will develop a choice panel of local and highly qualified legal firms for our AMGA physicians to choose from. We will also entertain requests for other legal representation should the insured wish not to choose from the firms within our panel. Oceanus will allow Separate Counsel Provision within your policy. This means that should it be strategically appropriate, we will pay for separate representation for both the physician and the group’s entity should they request it.

What is your policy on settlements?
Oceanus MUST obtain the insured’s written consent to settle any and all claims on their behalf. Period. There is no hammer clause within the policy.

What type of service can we expect in this program?
PMIS is the administering broker for the program. The expertise within the confines of our broker is dedicated to the needs of all AMGA members. They are in excess of $ 100 million in sales and have 90 highly trained employees located in 13 offices throughout the country. Our main contact, Jeffrey Combs has 27 years of experience and has developed these types of exclusive physician programs for, BJC Health System, St. Louis, St. John's Mercy Health System, St. Louis, Baylor Medical System, Dallas, TX, Saint Francis Health System, Tulsa, OK, etc.

We have a long-standing relationship with our broker. What if we want to continue to work with him/her?
We think your broker will agree that this program is unique and extremely beneficial for you. Your broker will not lose his/her commission if your group changes to the AMGA Risk Purchasing Group.

How did I get selected for the program?
As a member of AMGA, you will have exclusive access to this program. We can do this because AMGA physicians typically enjoy an exceptional medical malpractice loss history that is largely a part of their dedication to quality, professional management, and commitment to risk management.

What happens if I have a large claim? Will I be asked to leave the group?
Absolutely not, as the size of the program will virtually guarantee all enrollees that they are secure for at the very least 3 years.

What happens if I leave AMGA?
If your group drops its AMGA membership, you will not be eligible for the Risk Purchasing Group Program Credit unless you purchase the Risk Management Educational Program for $15,000/yr. The underwriting carrier will offer you a standard policy and pricing or you may seek coverage from another insurance carrier.

What pricing will we expect in the future?
Guaranteed Renewals and Rate Freezes will be offered to all AMGA insureds should they maintain a loss ratio of 50% or less. This has become extremely important with the recent marketplace upheaval and uncertainties you all have experienced.

If I leave the program do I have to purchase tail coverage? If yes, how is the premium calculated?
Tail Coverage is offered, should an insured wish to move on and select Oceanus to continue to cover an insureds prior acts. This extended reporting endorsement will only cost 150% of the insureds current annualized premium. The industry norm is 200% or greater.

How is the billing of the policy premium going to work?
You will be offered payment options directly from our agent, Jeffrey Combs. There will be several options offered.

What if I'm in a state that Oceanus is not licensed in? Will my rate be the same or possibly higher?
Oceanus will request through your State government to be licensed in that state, and we do not anticipate problems in this area. The rating for each state will differ from one another due to climate of claims.

What if I have mid-level office staff (PA, NP's etc) in my group? Will they be covered under this policy?
Yes, we will be able to insure all employees and any exposure you have within your operation.

What if I have a Locum Tenens covering for me? Will the locum be covered under the coverage?
Locum Tenens coverage is provided. The physician providing the locum tenens must be approved by Oceanus prior to acting as locum tenens.

Will I have a separate set of limits under this policy or all the physician members share in one limit of liability?
Yes, each physician will have his own limits, and separate from the others.

What if I only work on a part time basis, does this rate still apply to me?
Part-Time Physicians who work less than 20 hours per week will have their premiums modified to half of the appropriate annual premium of a full-time physician.

What happens if I or another physician retires?
A Free Unlimited Retirement Tail will be offered to all AMGA insureds after being insured within the program for 3 years. The industry standard is either 5 consecutive years or no free tail offered at all. Retirement is defined as leaving the practice of medicine in its entirety.

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