Medical Professional Liability Premium Data Call

525 St. Paul Place, Baltimore, Maryland 21202-2272 www.mdinsurance.state.md.us Bulletin 7-8 MARTIN O’MALLEY Governor ANTHONY G. BROWN Lt. Governor PEGGY J. WATSON Interim Commissioner JAMES V. MCMAHAN, III Deputy Commissioner P. RANDI JOHNSON Associate Commissioner Property & Casualty DATE: June 18, 2007 TO: Medical Professional Liability Insurers RE: Medical Professional Liability Premium Data Call ********************************************************************************************* Pursuant to §2-303.2 and §19-112 of the Insurance Article, the Maryland Insurance Administration ("MIA") hereby requests each medical professional liability insurer that offers medical professional liability insurance policies in Maryland to provide information related to medical professional liability insurance premiums for the following: • For healthcare professionals (physicians and surgeons); • For hospitals, medical day care centers, hospice care programs, assisted living programs, and freestanding ambulatory care facilities; • For dental healthcare professionals; • For nursing and certain allied health professionals. These premiums should be the base premiums charged by class and by territory for policy limits of $1,000,000/$3,000,000 based upon mature claims-made rates, with a clean claims history. Please provide the premiums as of October 1, 2007. This information is necessary for the MIA to publish a medical professional liability premium comparison guide in accordance with §2-303.2 of the Insurance Article. The comparison guide will be posted on the MIA website and distributed in electronic and printed format. The requested data should be provided in the required format (see attached). Please submit your data via email. Electronic submission is mandatory. No paper documents will be accepted. Data should be submitted to: lglemza@mdinsurance.state.md.us. Property & Casualty Bulletin Medical Professional Liability Premium Data Call Page 2 For technical questions, please contact Mr. Linas Glemza, Actuary, at (410) 468-2044. For general questions, please contact Cathy Ruppel, Insurance Analyst, at (410) 468-2316. In addition, please refer to the Summary of Revision page for a listing of revisions to this premium comparison request. Please provide this information no later than August 17, 2007. Peggy J. Watson Interim Insurance Commissioner By: _____________________________________ P. Randi Johnson Associate Commissioner Property & Casualty Attachments: • Excel File Format • Data and File Requirements Maryland Medical Malpractice Premium Guide Specifications October 2007edition SUMMARY OF REVISIONS TO SPECIFICATIONS The following are new updates to this guide: 1) The MIA supplied spreadsheet has been updated to include pre-filled territory codes. Therefore, each class now has three rows – one for each territory. If you have statewide rates for certain classes, fill these in for each territory. 2) Certain Profit/Non-Profit classes (MIA sort code 600) have been split into Profit and Non- Profit classes, and now will have their own entries. 3) The MIA supplied spreadsheet has been expanded to include the new/renewal request portion of this call. Certain columns have already been filled in. You may delete rows for those classes that are not written. 4) Use “n/a” instead of “N/A” where necessary. The following were revisions to last year’s specifications. We are including them here for your convenience: 1) We are now providing the actual spreadsheet for the company to fill in. Some columns are already pre-filled. Do not change or add any formatting to that which is already provided; 2) New code – MIA Specialty Group code – this is an MIA provided number and is used to sort the data for output purposes. This number should not be altered; 3) MIA Determined Class code – the purpose of this code is to create uniformity between companies. This code is provided by the MIA and should not be altered; 4) The MIA provided spreadsheet lists all the classes that need to be provided. If your company does not write a particular class, enter n/a – do NOT delete the row. If your company feels that a certain specific class does not fall into any of the categories provided, please contact the MIA first. No other class codes are required. October 2007 Excel File Format All data must start in cell A3 of the spreadsheet. PLEASE use headers. Below lists the columns in which the data must be placed. The placement of data must conform to this or the submission will be returned. The data must be placed in the following columns: Column Description (A) NAIC Group Code (B) NAIC Company Code (C) Effective Date of rates (mm/dd/yyyy) for New Business (D) NAIC Company Name (NOT NAIC GROUP NAME) (E) MIA Specialty Group code pre-filled (F) MIA determined class code pre-filled (G) ISO Class code pre-filled (H) Company Class Code number (I) Description/Name of class pre-filled (J) Type of class code (see below) pre-filled (K) Territory Code pre-filled 1 = Baltimore City and Baltimore County 2 = Anne Arundel, Montgomery, Prince Georges and Howard counties 3 = Rest of State (L) Premium ($1M/$3M, mature claims made with no claims, past or pending) Exclude Extended Reporting endorsement premium No Claim – any situation where no surcharge would apply. If company does not have rates for $1M/$3M, provide a premium that has Coverage for $1M per claim and the closest aggregate limit in terms of premium. > > > > > > Types of Classes (include but not limited to): 1) All physicians and surgeons. 2) All Allied health professionals. Allied health includes nurses, technicians and any ancillary classes. 3) All dentists, dental surgeons and ancillary dental healthcare providers; 4) Hospitals, medical day care centers, hospice care program, assisted living programs and freestanding ambulatory care facilities October 2006 DATA and FILE Requirements Requirements: 1) ALL ENTRIES MUST IN NUMERIC FORMAT, except for Columns C, D and I. 2) Fill Column (L) with “n/a” if rates are not available for the scenario. 3) For the Premiums, use numeric format (zero decimal places). Round off to whole numbers. 4) Filing naming convention a) File name should contain NAIC group code (or NAIC Company code if group code is zero). Using company name is an acceptable alternative. b) The file name must also contain the letters “ML”. c) There are no other specific requirements for naming convention. 5) Spreadsheet detail requirements: a) Arial font with font size of 12. Use default color of black; b) Do not use 1000 separator (i.e. comma); c) Premiums must be rounded to ZERO decimal places; d) Do not use currency format; e) Except as noted in 1) above, all other cells must be in numeric format. Do not use all caps for company name; f) Do not submit formulas; g) Row height is 12.75 (Excel default). Company name column width MUST be set to 34.14. Company name must fit within this setting. There are no specific width requirements for the remaining columns; h) Do not activate “Wrap Text”; i) Do not use borders or colored/highlighted cells; For any other formatting issue, use the Excel default parameters. 6) We now allow companies to submit disclaimers to their submissions. Due to space limitations, please keep it brief. Place disclaimers on a separate spreadsheet page from the premiums. Do not place any symbols next to premiums to explain a disclaimer. October 2006 7) On the contact_info spreadsheet page, provide the following information: Column A - Contact Name Column B - Company Name Column C - Company Address 1 (can also be Department name) Column D - Company Address 2 Column E - City/State/Zip Column F - Phone number for contact name Column G - Fax number for contact name Column H - Email address of contact name. DO NOT SUBMIT THIS In HTML format. Text only. Column I - An 800/888/866 (toll free) that your company uses for healthcare professional inquiries. Column J - website address for healthcare professional inquiries. DO NOT SUBMIT in HTML format. Text only. For column I, if your company does not have a phone number for this purpose, please use the phrase “See Yellow Pages”. 8) On the new_renew spreadsheet page, each insurer shall make a list of each healthcare professional, hospital, medical day care center, hospice care program, assisted living program and freestanding ambulatory care facility for which the insurer accepts new and renewal business. Delete rows for those classes that you do not write. The format shall be: Column A Company Name Column B Each class mentioned listed in your submission Column C “Yes” if accepting NEW business, “No” if not. Column D “Yes” if accepting RENEWAL business, “No” if not. Column E Risk Purchasing Group (RPG) “Yes” if class is through an RPG only “No” if class is not through an RPG Both – if class is through either way. Column B shall include the classes mentioned in the Excel File Format section. October 2006 NAIC Grp NAIC Comp Effective Company MIA Special Company Type of Territory Code Code Date Name Sort Code MIA Code ISO Code Code SPECIALTY Class Code Code Premium 100 80178 80178 Administrative Medicine 1 1 100 80230 80133 Aerospace Medicine 1 1 100 80254 80254 Allergy/Immunology 1 1 100 80151 80151 Anesthesiology 1 1 100 80183 80183 Anesthesiology - All Other 1 1 100 80101 80101 Broncho-Esophagology 1 1 100 80255 80255 Cardiovascular Disease · No Surgery 1 1 100 80297 80297 Dermatology 1 1 100 80256 80256 Dermatology · No Surgery 1 1 100 80237 80237 Diabetes · No Surgery 1 1 100 80238 80238 Endocrinology · No Surgery 1 1 100 80423 80423 Fam/Gen Prac (No Ob) · Minor Surg 1 1 100 80420 80420 Fam/Gen Prac(No Ob) · No Surgery 1 1 100 80421 80421 Fam/Gen Practice (Inc Ob)(No Major Sur 1 1 100 80240 80240 Forensic/Legal Medicine (Except Psychia 1 1 100 80241 80241 Gastroenterology · No Surgery 1 1 100 80231 80135 General Preventive Medicine · No Surger 1 1 100 80243 80243 Geriatrics · No Surgery 1 1 100 80244 80244 Gynecology · No Surgery 1 1 100 80245 80245 Hematology · No Surgery 1 1 100 80222 80222 Hospitalist/House Staff 1 1 100 80232 80232 Hypnosis 1 1 100 80246 80246 Infectious Diseases · No Surgery 1 1 100 80283 80283 Intensive Care Medicine 1 1 100 80257 80257 Internal Medicine · No Surgery 1 1 100 80258 80258 Laryngology - No Surgery 1 1 100 80259 80259 Neoplastic Diseases · No Surgery 1 1 100 80260 80260 Nephrology · No Surgery 1 1 100 80299 80299 Neurology - incl child - No surgery - Pain 1 1 100 80261 80261 Neurology (Including Child) · No Surgery 1 1 100 80262 80262 Nuclear Medicine 1 1 100 80248 80248 Nutrition 1 1 100 80233 80233 Occupational Medicine 1 1 100 80263 80263 Ophthalmology · No Surgery 1 1 100 80264 80264 Otology - No surgery 1 1 100 80265 80265 Otorhinolaryngology · No Surgery 1 1 100 80266 80266 Pathology - No surgery 1 1 100 80267 80267 Pediatrics · No Surgery 1 1 100 80234 80234 Pharmacology - Clinical 1 1 100 80437 80437 Phys/Phys med/Rehabilitation(Inc Acupun 1 1 100 80235 80235 Physician Medicine and Rehabilitation 1 1 100 80268 80268 Physicians - N.O.C.· No Surgery 1 1 100 80236 80236 Public Health 1 1 100 80269 80269 Pulmonary Diseases · No Surgery 1 1 100 80425 80425 Radiology - Therapy 1 1 100 80253 80253 Radiology (Diagnostic) · No Surgery 1 1 100 80252 80252 Rheumatology · No Surgery 1 1 100 80247 80247 Rhinology - No Surgery 1 1 100 80304 80304 Urgent Care Med (No Hospital ER) 1 1 110 80166 80166 Abdominal Surgery 1 1 110 80141 80141 Cardiac - Surgery 1 1 110 80150 80150 Cardiovascular Disease - Surgery 1 1 110 80281 80281 Cardiovascular Disease · Minor Surgery 1 1 110 80282 80282 Cardiovascular Disease · Minor Surgery 1 1 110 80115 80115 Colon & Rectal-Surgery 1 1 110 80271 80271 Diabetes · Minor Surgery 1 1 110 80157 80157 Emergency Medicine - Inc. Major Surgery 1 1 110 80102 80102 Emergency Medicine (No Major Surgery) 1 1 110 80103 80103 Endocrinology - Surgery 1 1 110 80272 80272 Endocrinology · Minor Surgery 1 1 110 80117 80117 Family or General Practice - Surgery / No 1 1 110 80274 80274 Gastroenterology · Minor Surgery 1 1 110 80104 80104 Gastroenterology-Surgery 1 1 110 80143 80143 General Surgery - N.O.C 1 1 110 80276 80276 Geriatrics · Minor Surgery 1 1 110 80105 80105 Geriatrics-Surgery 1 1 110 80167 80167 Gynecology - Surgery 1 1 110 80277 80277 Gynecology · Minor Surgery 1 1 110 80169 80169 Hand &/or Foot - Surgery 1 1 110 80170 80170 Head & Neck Surgery 1 1 110 80278 80278 Hematology · Minor Surgery 1 1 110 80279 80279 Infectious Diseases · Minor Surgery 1 1 110 80284 80284 Internal Medicine · Minor Surgery 1 1 110 80285 80285 Laryngology - Minor Surgery 1 1 110 80106 80106 Laryngology - Surgery 1 1 110 80107 80107 Neoplastic Diseases - Surgery 1 1 110 80286 80286 Neoplastic Diseases · Minor Surgery 1 1 110 80108 80108 Nephrology - Surgery 1 1 110 80287 80287 Nephrology · Minor Surgery 1 1 110 80152 80152 Neurology ( including child) - Surgery 1 1 110 80288 80288 Neurology (Including Child) · Minor Surge 1 1 110 80168 80168 Obstetrics - Surgery 1 1 110 80153 80153 Obstetrics/gynecology - Surgery 1 1 110 80114 80114 Ophthalmology - Surgery 1 1 110 80289 80289 Ophthalmology · Minor Surgery 1 1 110 80154 80154 Orthopedic Surgery 1 1 110 80290 80290 Otology - Minor Surgery 1 1 110 80158 80158 Otology - Surgery 1 1 110 80291 80291 Otorhinolaryngology · Minor Surgery 1 1 110 80155 80155 Otorhinolaryngology · With Plastic - Surge 1 1 110 80159 80159 Otorhinolayngology - Major Surgery - No 1 1 110 80292 80292 Pathology - Minor surgery 1 1 110 80293 80293 Pediatrics · Minor Surgery 1 1 110 80294 80294 Physicians – This is a N.O.C. classificatio 1 1 110 80308 80301 Pulmonary Diseases · Minor Surgery 1 1 110 80449 80253 Radiology - Incl. Dye - minor surgery 1 1 110 80280 80280 Radiology (Diagnostic) · Minor Surgery 1 1 110 80270 80270 Rhinology - Minor surgery 1 1 110 80160 80160 Rhinology - Surgery 1 1 110 80156 80156 Surgeon - Plastic (N.O.C.) 1 1 110 80144 80144 Thoracic Surgery 1 1 110 80171 80171 Traumatic - Surgery (Not E.R.) 1 1 110 80145 80145 Urology - Surgery 1 1 110 80146 80146 Vascular - Surgery 1 1 121 80303 80303 Geneticist 1 1 121 80473 80473 IM-Oncology (No Surgery) 1 1 121 80269 80269 IM-Pulmonary (No Surgery) 1 1 121 80209 80209 Physical Medicine & Rehab (Major Proc) 1 1 121 80208 80208 Physical Medicine & Rehab (Minor Proc) 1 1 121 80208 80208 Physical Medicine & Rehab (Non-Invasive 1 1 121 80252 80252 Rheumatology · No Surgery 1 1 122 80422 80422 Cardiology (Left Heart Cath Only) 1 1 122 80443 80443 Colon&Rectal Surg(Min/Ltd) 1 1 122 80297 80297 Dermatology W/ Liposuction 1 1 122 80117 80117 FGP (With Obstetrics) 1 1 122 80273 80273 FP - Incl. deliveries 1 1 122 80143 80143 General Surgery (Minor Surgery) 1 1 122 80167 80167 Gynecology (w/ In-vitro Fertilization) 1 1 122 80154 80154 Orthopedic (Incl. Back) 1 1 122 80300 80294 Rheumatology · Minor Surgery 1 1 122 80116 80116 Surgical Specialty (Office,Min) 1 1 130 80249 80229 Psychiatry – including child 1 1 130 80250 80250 Psychoanalysis 1 1 130 80251 80251 Psychosomatic Medicine 1 1 130 80431 80431 Psychiatry - Incl Shock 1 1 130 80995 80995 Psychiatry - Extended 1 1 130 80998 Psychotherapy 1 1 100 80178 80178 Administrative Medicine 1 2 100 80230 80133 Aerospace Medicine 1 2 100 80254 80254 Allergy/Immunology 1 2 100 80151 80151 Anesthesiology 1 2 100 80183 80183 Anesthesiology - All Other 1 2 100 80101 80101 Broncho-Esophagology 1 2 100 80255 80255 Cardiovascular Disease · No Surgery 1 2 100 80297 80297 Dermatology 1 2 100 80256 80256 Dermatology · No Surgery 1 2 100 80237 80237 Diabetes · No Surgery 1 2 100 80238 80238 Endocrinology · No Surgery 1 2 100 80423 80423 Fam/Gen Prac (No Ob) · Minor Surg 1 2 100 80420 80420 Fam/Gen Prac(No Ob) · No Surgery 1 2 100 80421 80421 Fam/Gen Practice (Inc Ob)(No Major Sur 1 2 100 80240 80240 Forensic/Legal Medicine (Except Psychia 1 2 100 80241 80241 Gastroenterology · No Surgery 1 2 100 80231 80135 General Preventive Medicine · No Surger 1 2 100 80243 80243 Geriatrics · No Surgery 1 2 100 80244 80244 Gynecology · No Surgery 1 2 100 80245 80245 Hematology · No Surgery 1 2 100 80222 80222 Hospitalist/House Staff 1 2 100 80232 80232 Hypnosis 1 2 100 80246 80246 Infectious Diseases · No Surgery 1 2 100 80283 80283 Intensive Care Medicine 1 2 100 80257 80257 Internal Medicine · No Surgery 1 2 100 80258 80258 Laryngology - No Surgery 1 2 100 80259 80259 Neoplastic Diseases · No Surgery 1 2 100 80260 80260 Nephrology · No Surgery 1 2 100 80299 80299 Neurology - incl child - No surgery - Pain 1 2 100 80261 80261 Neurology (Including Child) · No Surgery 1 2 100 80262 80262 Nuclear Medicine 1 2 100 80248 80248 Nutrition 1 2 100 80233 80233 Occupational Medicine 1 2 100 80263 80263 Ophthalmology · No Surgery 1 2 100 80264 80264 Otology - No surgery 1 2 100 80265 80265 Otorhinolaryngology · No Surgery 1 2 100 80266 80266 Pathology - No surgery 1 2 100 80267 80267 Pediatrics · No Surgery 1 2 100 80234 80234 Pharmacology - Clinical 1 2 100 80437 80437 Phys/Phys med/Rehabilitation(Inc Acupun 1 2 100 80235 80235 Physician Medicine and Rehabilitation 1 2 100 80268 80268 Physicians - N.O.C.· No Surgery 1 2 100 80236 80236 Public Health 1 2 100 80269 80269 Pulmonary Diseases · No Surgery 1 2 100 80425 80425 Radiology - Therapy 1 2 100 80253 80253 Radiology (Diagnostic) · No Surgery 1 2 100 80252 80252 Rheumatology · No Surgery 1 2 100 80247 80247 Rhinology - No Surgery 1 2 100 80304 80304 Urgent Care Med (No Hospital ER) 1 2 110 80166 80166 Abdominal Surgery 1 2 110 80141 80141 Cardiac - Surgery 1 2 110 80150 80150 Cardiovascular Disease - Surgery 1 2 110 80281 80281 Cardiovascular Disease · Minor Surgery 1 2 110 80282 80282 Cardiovascular Disease · Minor Surgery 1 2 110 80115 80115 Colon & Rectal-Surgery 1 2 110 80271 80271 Diabetes · Minor Surgery 1 2 110 80157 80157 Emergency Medicine - Inc. Major Surgery 1 2 110 80102 80102 Emergency Medicine (No Major Surgery) 1 2 110 80103 80103 Endocrinology - Surgery 1 2 110 80272 80272 Endocrinology · Minor Surgery 1 2 110 80117 80117 Family or General Practice - Surgery / No 1 2 110 80274 80274 Gastroenterology · Minor Surgery 1 2 110 80104 80104 Gastroenterology-Surgery 1 2 110 80143 80143 General Surgery - N.O.C 1 2 110 80276 80276 Geriatrics · Minor Surgery 1 2 110 80105 80105 Geriatrics-Surgery 1 2 110 80167 80167 Gynecology - Surgery 1 2 110 80277 80277 Gynecology · Minor Surgery 1 2 110 80169 80169 Hand &/or Foot - Surgery 1 2 110 80170 80170 Head & Neck Surgery 1 2 110 80278 80278 Hematology · Minor Surgery 1 2 110 80279 80279 Infectious Diseases · Minor Surgery 1 2 110 80284 80284 Internal Medicine · Minor Surgery 1 2 110 80285 80285 Laryngology - Minor Surgery 1 2 110 80106 80106 Laryngology - Surgery 1 2 110 80107 80107 Neoplastic Diseases - Surgery 1 2 110 80286 80286 Neoplastic Diseases · Minor Surgery 1 2 110 80108 80108 Nephrology - Surgery 1 2 110 80287 80287 Nephrology · Minor Surgery 1 2 110 80152 80152 Neurology ( including child) - Surgery 1 2 110 80288 80288 Neurology (Including Child) · Minor Surge 1 2 110 80168 80168 Obstetrics - Surgery 1 2 110 80153 80153 Obstetrics/gynecology - Surgery 1 2 110 80114 80114 Ophthalmology - Surgery 1 2 110 80289 80289 Ophthalmology · Minor Surgery 1 2 110 80154 80154 Orthopedic Surgery 1 2 110 80290 80290 Otology - Minor Surgery 1 2 110 80158 80158 Otology - Surgery 1 2 110 80291 80291 Otorhinolaryngology · Minor Surgery 1 2 110 80155 80155 Otorhinolaryngology · With Plastic - Surge 1 2 110 80159 80159 Otorhinolayngology - Major Surgery - No 1 2 110 80292 80292 Pathology - Minor surgery 1 2 110 80293 80293 Pediatrics · Minor Surgery 1 2 110 80294 80294 Physicians – This is a N.O.C. classificatio 1 2 110 80308 80301 Pulmonary Diseases · Minor Surgery 1 2 110 80449 80253 Radiology - Incl. Dye - minor surgery 1 2 110 80280 80280 Radiology (Diagnostic) · Minor Surgery 1 2 110 80270 80270 Rhinology - Minor surgery 1 2 110 80160 80160 Rhinology - Surgery 1 2 110 80156 80156 Surgeon - Plastic (N.O.C.) 1 2 110 80144 80144 Thoracic Surgery 1 2 110 80171 80171 Traumatic - Surgery (Not E.R.) 1 2 110 80145 80145 Urology - Surgery 1 2 110 80146 80146 Vascular - Surgery 1 2 121 80303 80303 Geneticist 1 2 121 80473 80473 IM-Oncology (No Surgery) 1 2 121 80269 80269 IM-Pulmonary (No Surgery) 1 2 121 80209 80209 Physical Medicine & Rehab (Major Proc) 1 2 121 80208 80208 Physical Medicine & Rehab (Minor Proc) 1 2 121 80208 80208 Physical Medicine & Rehab (Non-Invasive 1 2 121 80252 80252 Rheumatology · No Surgery 1 2 122 80422 80422 Cardiology (Left Heart Cath Only) 1 2 122 80443 80443 Colon&Rectal Surg(Min/Ltd) 1 2 122 80297 80297 Dermatology W/ Liposuction 1 2 122 80117 80117 FGP (With Obstetrics) 1 2 122 80273 80273 FP - Incl. deliveries 1 2 122 80143 80143 General Surgery (Minor Surgery) 1 2 122 80167 80167 Gynecology (w/ In-vitro Fertilization) 1 2 122 80154 80154 Orthopedic (Incl. Back) 1 2 122 80300 80294 Rheumatology · Minor Surgery 1 2 122 80116 80116 Surgical Specialty (Office,Min) 1 2 130 80249 80229 Psychiatry – including child 1 2 130 80250 80250 Psychoanalysis 1 2 130 80251 80251 Psychosomatic Medicine 1 2 130 80431 80431 Psychiatry - Incl Shock 1 2 130 80995 80995 Psychiatry - Extended 1 2 130 80998 Psychotherapy 1 2 100 80178 80178 Administrative Medicine 1 3 100 80230 80133 Aerospace Medicine 1 3 100 80254 80254 Allergy/Immunology 1 3 100 80151 80151 Anesthesiology 1 3 100 80183 80183 Anesthesiology - All Other 1 3 100 80101 80101 Broncho-Esophagology 1 3 100 80255 80255 Cardiovascular Disease · No Surgery 1 3 100 80297 80297 Dermatology 1 3 100 80256 80256 Dermatology · No Surgery 1 3 100 80237 80237 Diabetes · No Surgery 1 3 100 80238 80238 Endocrinology · No Surgery 1 3 100 80423 80423 Fam/Gen Prac (No Ob) · Minor Surg 1 3 100 80420 80420 Fam/Gen Prac(No Ob) · No Surgery 1 3 100 80421 80421 Fam/Gen Practice (Inc Ob)(No Major Sur 1 3 100 80240 80240 Forensic/Legal Medicine (Except Psychia 1 3 100 80241 80241 Gastroenterology · No Surgery 1 3 100 80231 80135 General Preventive Medicine · No Surger 1 3 100 80243 80243 Geriatrics · No Surgery 1 3 100 80244 80244 Gynecology · No Surgery 1 3 100 80245 80245 Hematology · No Surgery 1 3 100 80222 80222 Hospitalist/House Staff 1 3 100 80232 80232 Hypnosis 1 3 100 80246 80246 Infectious Diseases · No Surgery 1 3 100 80283 80283 Intensive Care Medicine 1 3 100 80257 80257 Internal Medicine · No Surgery 1 3 100 80258 80258 Laryngology - No Surgery 1 3 100 80259 80259 Neoplastic Diseases · No Surgery 1 3 100 80260 80260 Nephrology · No Surgery 1 3 100 80299 80299 Neurology - incl child - No surgery - Pain 1 3 100 80261 80261 Neurology (Including Child) · No Surgery 1 3 100 80262 80262 Nuclear Medicine 1 3 100 80248 80248 Nutrition 1 3 100 80233 80233 Occupational Medicine 1 3 100 80263 80263 Ophthalmology · No Surgery 1 3 100 80264 80264 Otology - No surgery 1 3 100 80265 80265 Otorhinolaryngology · No Surgery 1 3 100 80266 80266 Pathology - No surgery 1 3 100 80267 80267 Pediatrics · No Surgery 1 3 100 80234 80234 Pharmacology - Clinical 1 3 100 80437 80437 Phys/Phys med/Rehabilitation(Inc Acupun 1 3 100 80235 80235 Physician Medicine and Rehabilitation 1 3 100 80268 80268 Physicians - N.O.C.· No Surgery 1 3 100 80236 80236 Public Health 1 3 100 80269 80269 Pulmonary Diseases · No Surgery 1 3 100 80425 80425 Radiology - Therapy 1 3 100 80253 80253 Radiology (Diagnostic) · No Surgery 1 3 100 80252 80252 Rheumatology · No Surgery 1 3 100 80247 80247 Rhinology - No Surgery 1 3 100 80304 80304 Urgent Care Med (No Hospital ER) 1 3 110 80166 80166 Abdominal Surgery 1 3 110 80141 80141 Cardiac - Surgery 1 3 110 80150 80150 Cardiovascular Disease - Surgery 1 3 110 80281 80281 Cardiovascular Disease · Minor Surgery 1 3 110 80282 80282 Cardiovascular Disease · Minor Surgery 1 3 110 80115 80115 Colon & Rectal-Surgery 1 3 110 80271 80271 Diabetes · Minor Surgery 1 3 110 80157 80157 Emergency Medicine - Inc. Major Surgery 1 3 110 80102 80102 Emergency Medicine (No Major Surgery) 1 3 110 80103 80103 Endocrinology - Surgery 1 3 110 80272 80272 Endocrinology · Minor Surgery 1 3 110 80117 80117 Family or General Practice - Surgery / No 1 3 110 80274 80274 Gastroenterology · Minor Surgery 1 3 110 80104 80104 Gastroenterology-Surgery 1 3 110 80143 80143 General Surgery - N.O.C 1 3 110 80276 80276 Geriatrics · Minor Surgery 1 3 110 80105 80105 Geriatrics-Surgery 1 3 110 80167 80167 Gynecology - Surgery 1 3 110 80277 80277 Gynecology · Minor Surgery 1 3 110 80169 80169 Hand &/or Foot - Surgery 1 3 110 80170 80170 Head & Neck Surgery 1 3 110 80278 80278 Hematology · Minor Surgery 1 3 110 80279 80279 Infectious Diseases · Minor Surgery 1 3 110 80284 80284 Internal Medicine · Minor Surgery 1 3 110 80285 80285 Laryngology - Minor Surgery 1 3 110 80106 80106 Laryngology - Surgery 1 3 110 80107 80107 Neoplastic Diseases - Surgery 1 3 110 80286 80286 Neoplastic Diseases · Minor Surgery 1 3 110 80108 80108 Nephrology - Surgery 1 3 110 80287 80287 Nephrology · Minor Surgery 1 3 110 80152 80152 Neurology ( including child) - Surgery 1 3 110 80288 80288 Neurology (Including Child) · Minor Surge 1 3 110 80168 80168 Obstetrics - Surgery 1 3 110 80153 80153 Obstetrics/gynecology - Surgery 1 3 110 80114 80114 Ophthalmology - Surgery 1 3 110 80289 80289 Ophthalmology · Minor Surgery 1 3 110 80154 80154 Orthopedic Surgery 1 3 110 80290 80290 Otology - Minor Surgery 1 3 110 80158 80158 Otology - Surgery 1 3 110 80291 80291 Otorhinolaryngology · Minor Surgery 1 3 110 80155 80155 Otorhinolaryngology · With Plastic - Surge 1 3 110 80159 80159 Otorhinolayngology - Major Surgery - No 1 3 110 80292 80292 Pathology - Minor surgery 1 3 110 80293 80293 Pediatrics · Minor Surgery 1 3 110 80294 80294 Physicians – This is a N.O.C. classificatio 1 3 110 80308 80301 Pulmonary Diseases · Minor Surgery 1 3 110 80449 80253 Radiology - Incl. Dye - minor surgery 1 3 110 80280 80280 Radiology (Diagnostic) · Minor Surgery 1 3 110 80270 80270 Rhinology - Minor surgery 1 3 110 80160 80160 Rhinology - Surgery 1 3 110 80156 80156 Surgeon - Plastic (N.O.C.) 1 3 110 80144 80144 Thoracic Surgery 1 3 110 80171 80171 Traumatic - Surgery (Not E.R.) 1 3 110 80145 80145 Urology - Surgery 1 3 110 80146 80146 Vascular - Surgery 1 3 121 80303 80303 Geneticist 1 3 121 80473 80473 IM-Oncology (No Surgery) 1 3 121 80269 80269 IM-Pulmonary (No Surgery) 1 3 121 80209 80209 Physical Medicine & Rehab (Major Proc) 1 3 121 80208 80208 Physical Medicine & Rehab (Minor Proc) 1 3 121 80208 80208 Physical Medicine & Rehab (Non-Invasive 1 3 121 80252 80252 Rheumatology · No Surgery 1 3 122 80422 80422 Cardiology (Left Heart Cath Only) 1 3 122 80443 80443 Colon&Rectal Surg(Min/Ltd) 1 3 122 80297 80297 Dermatology W/ Liposuction 1 3 122 80117 80117 FGP (With Obstetrics) 1 3 122 80273 80273 FP - Incl. deliveries 1 3 122 80143 80143 General Surgery (Minor Surgery) 1 3 122 80167 80167 Gynecology (w/ In-vitro Fertilization) 1 3 122 80154 80154 Orthopedic (Incl. Back) 1 3 122 80300 80294 Rheumatology · Minor Surgery 1 3 122 80116 80116 Surgical Specialty (Office,Min) 1 3 130 80249 80229 Psychiatry – including child 1 3 130 80250 80250 Psychoanalysis 1 3 130 80251 80251 Psychosomatic Medicine 1 3 130 80431 80431 Psychiatry - Incl Shock 1 3 130 80995 80995 Psychiatry - Extended 1 3 130 80998 Psychotherapy 1 3 NAIC Grp NAIC Comp Effective Company MIA Special Company Type of Territory Code Code Date Name Sort Code MIA Code ISO Code Code Description/Name of Class Class Code Code Premium 200 70963 80964 Nurse- RN 2 1 200 70963 80964 Nurse - LPN 2 1 202 72201 80964 Nurse Practitioner - Class A - Employed 2 1 202 72201 80964 Nurse Practitioner - Class A - Self-Employed 2 1 202 72201 80964 Nurse Practitioner - Class B - Employed 2 1 202 72201 80964 Nurse Practitioner - Class B - Self-Employed 2 1 202 72201 80964 Nurse Practitioner - Class C - Employed 2 1 202 72201 80964 Nurse Practitioner - Class C - Self-Employed 2 1 202 72201 80964 Nurse Practitioner - Class D - Employed 2 1 202 72201 80964 Nurse Practitioner - Class D - Self-Employed 2 1 202 72999 72299 Nurse Practitioner (Prescribing) 2 1 202 80964 80964 Nurse Practitioner - Shared Limits 2 1 210 71401 80962 Nurse Midwife (Dir Spvs) 2 1 210 80962 80962 Nurse Midwife (Indir Spvs) 2 1 210 80962 80962 Nurse Midwife (Dir Spvs) - Shared Limits 2 1 210 80962 80962 Nurse Midwife (Indir Spvs) - Shared Limits 2 1 211 71402 71402 Nurse Midwife Assistant 2 1 215 80913 80913 Nurse Anesthetist (Spvs By Ane) 2 1 215 80960 80960 Nurse Anesthetist (Spvs By Sur) 2 1 216 71502 80452 Nurse Anesthetist (Spvs By Ane) - Shared Limi 2 1 216 80452 80452 Nurse Anesthetist (Spvs By Sur) - Shared Limit 2 1 219 79108 72203 Nurse Surgical / Assistant 2 1 230 80116 80116 Physician Assistant - Employed - Class 1 2 1 230 80116 80116 Physician Assistant - Employed - Class 2 2 1 230 80116 80116 Physician Assistant - Employed - Class 3 2 1 230 72998 72298 Physician's Assistant (Prescribing) 2 1 230 80129 80129 Physician's Assistant - Shared Limits 2 1 231 79101 80116 Physician Surgical Assistant 2 1 232 72205 80945 Perfusionist - Employed 2 1 260 71801 79801 Optometrist - self-employed 2 1 260 79801 79801 Optometrist - Employed 2 1 260 71801 71801 Optometry - Shared Limits 2 1 261 72001 59181 Pharmacist - self-employed 2 1 261 72003 59181 Pharmacist - employed 2 1 262 80410 80410 Chiropractor 2 1 264 80993 72301 Podiatrist (No Surgery) 2 1 264 80994 72303 Podiatrist (Maj or Min Surgery) 2 1 264 80950 80950 Podiatric Corporations - no surgery 2 1 264 80950 80950 Podiatric Corporations - surgery 2 1 270 72401 72401 Psychologist - Employed 2 1 500 89701 80211 Dentist - Not Otherwise Classified 3 1 501 89702 80211 Orthodontics (Local Anesthetics Only) 3 1 501 89703 80211 Pedodontist (Local Anesthetics Only) 3 1 501 89704 80211 Periodontist (Local Anesthetics Only) 3 1 501 89705 80211 Prosthodontist (Local Anesthetics) 3 1 501 89706 80211 Endodontics (Local Anesthetics Only) 3 1 501 89707 80210 Oral Pathologist 3 1 501 89708 80211 Public Health Dentist 3 1 501 89709 80211 Dentist - Not Oral Surgeon, Sedation 3 1 501 89710 80210 Oral Or Maxillofacial Surgeon 3 1 501 89711 80210 Dentist - Not Oral Surgeon, Anesthesia 3 1 501 89712 89712 Oral/Maxillofacial Surgeon (Hosp. , Surgi-cente 3 1 501 89713 89713 Specialists In Dental Anesthesia 3 1 501 80208 80208 Host Dentist 3 1 501 80209 80209 Implants (Incl. osseointegration) 3 1 501 80211 80211 Dental Pathologist 3 1 501 80211 80210 Temporomandibular Joint Specialist 3 1 502 89740 80210 Dental Hygienist 3 1 502 80964 80964 Nurse-Student Nurse 3 1 502 80964 80964 Nurse-Dental Assistant 3 1 600 80522 80522 Assisted Living Facility 4 1 600 80522 80522 Extended Congregate Care 4 1 600 80522 80522 Independent Living Facility 4 1 600 80923 80923 Rehabilitation 4 1 600 80923 80923 Skilled Nursing Facility 4 1 600 80923 80923 Intermediate Care Facility 4 1 600 80522 N/A Resident Care - For Profit 4 1 600 80522 N/A Resident Care - Not for Profit 4 1 600 80522 N/A Independent Care - For Profit 4 1 600 80522 N/A Independent Care - Not for Profit 4 1 600 80923 N/A Skilled Care - For Profit 4 1 600 80923 N/A Skilled Care - Not for Profit 4 1 600 80923 N/A Intermediate Care - For Profit 4 1 600 80923 N/A Intermediate Care - Not for Profit 4 1 600 80926 80926 Hospice For Profit - In-Patient Care - Per Licens 4 1 600 80926 80926 Hospice Not for Profit - In-Patient Care - Per Lic 4 1 600 80953 80953 Palliative Care - Non-Hospice Patients - Not for 4 1 600 80954 80954 Palliative Care - Non-Hospice Patients - For Pro 4 1 601 89648 N/A Dialysis Center 4 1 601 89643 N/A Surgicenter - Endoscopy 4 1 601 89644 N/A Surgicenter - Eye Clinic 4 1 601 89646 N/A Surgicenter - Urology 4 1 601 89645 N/A Surgicenter - Multi - Specialty 4 1 602 80601 80601 Chemical Dependency & Rehabilitation Beds 4 1 602 80610 80610 ER Visits - Employed Physicians 4 1 602 80610 80610 ER Visits - Contracted Physicians 4 1 602 80610 80610 All Other Outpatient Visits 4 1 602 80611 80611 Acute Care Beds, Bassinets, Maternity Beds 4 1 602 80611 80611 Neo Natal Beds 4 1 602 80613 80613 Clinic Visits 4 1 602 80923 80923 Long Term Care Beds 4 1 602 80990 80990 Psychiatric Visits 4 1 602 80997 80997 Psychiatric Beds 4 1 602 89640 N/A Inpatient Surgeries 4 1 602 89641 80453 Outpatient Surgeries 4 1 602 N/A N/A Births (Birthing Centers) 4 1 200 70963 80964 Nurse- RN 2 2 200 70963 80964 Nurse - LPN 2 2 202 72201 80964 Nurse Practitioner - Class A - Employed 2 2 202 72201 80964 Nurse Practitioner - Class A - Self-Employed 2 2 202 72201 80964 Nurse Practitioner - Class B - Employed 2 2 202 72201 80964 Nurse Practitioner - Class B - Self-Employed 2 2 202 72201 80964 Nurse Practitioner - Class C - Employed 2 2 202 72201 80964 Nurse Practitioner - Class C - Self-Employed 2 2 202 72201 80964 Nurse Practitioner - Class D - Employed 2 2 202 72201 80964 Nurse Practitioner - Class D - Self-Employed 2 2 202 72999 72299 Nurse Practitioner (Prescribing) 2 2 202 80964 80964 Nurse Practitioner - Shared Limits 2 2 210 71401 80962 Nurse Midwife (Dir Spvs) 2 2 210 80962 80962 Nurse Midwife (Indir Spvs) 2 2 210 80962 80962 Nurse Midwife (Dir Spvs) - Shared Limits 2 2 210 80962 80962 Nurse Midwife (Indir Spvs) - Shared Limits 2 2 211 71402 71402 Nurse Midwife Assistant 2 2 215 80913 80913 Nurse Anesthetist (Spvs By Ane) 2 2 215 80960 80960 Nurse Anesthetist (Spvs By Sur) 2 2 216 71502 80452 Nurse Anesthetist (Spvs By Ane) - Shared Limi 2 2 216 80452 80452 Nurse Anesthetist (Spvs By Sur) - Shared Limit 2 2 219 79108 72203 Nurse Surgical / Assistant 2 2 230 80116 80116 Physician Assistant - Employed - Class 1 2 2 230 80116 80116 Physician Assistant - Employed - Class 2 2 2 230 80116 80116 Physician Assistant - Employed - Class 3 2 2 230 72998 72298 Physician's Assistant (Prescribing) 2 2 230 80129 80129 Physician's Assistant - Shared Limits 2 2 231 79101 80116 Physician Surgical Assistant 2 2 232 72205 80945 Perfusionist - Employed 2 2 260 71801 79801 Optometrist - self-employed 2 2 260 79801 79801 Optometrist - Employed 2 2 260 71801 71801 Optometry - Shared Limits 2 2 261 72001 59181 Pharmacist - self-employed 2 2 261 72003 59181 Pharmacist - employed 2 2 262 80410 80410 Chiropractor 2 2 264 80993 72301 Podiatrist (No Surgery) 2 2 264 80994 72303 Podiatrist (Maj or Min Surgery) 2 2 264 80950 80950 Podiatric Corporations - no surgery 2 2 264 80950 80950 Podiatric Corporations - surgery 2 2 270 72401 72401 Psychologist - Employed 2 2 500 89701 80211 Dentist - Not Otherwise Classified 3 2 501 89702 80211 Orthodontics (Local Anesthetics Only) 3 2 501 89703 80211 Pedodontist (Local Anesthetics Only) 3 2 501 89704 80211 Periodontist (Local Anesthetics Only) 3 2 501 89705 80211 Prosthodontist (Local Anesthetics) 3 2 501 89706 80211 Endodontics (Local Anesthetics Only) 3 2 501 89707 80210 Oral Pathologist 3 2 501 89708 80211 Public Health Dentist 3 2 501 89709 80211 Dentist - Not Oral Surgeon, Sedation 3 2 501 89710 80210 Oral Or Maxillofacial Surgeon 3 2 501 89711 80210 Dentist - Not Oral Surgeon, Anesthesia 3 2 501 89712 89712 Oral/Maxillofacial Surgeon (Hosp. , Surgi-cente 3 2 501 89713 89713 Specialists In Dental Anesthesia 3 2 501 80208 80208 Host Dentist 3 2 501 80209 80209 Implants (Incl. osseointegration) 3 2 501 80211 80211 Dental Pathologist 3 2 501 80211 80210 Temporomandibular Joint Specialist 3 2 502 89740 80210 Dental Hygienist 3 2 502 80964 80964 Nurse-Student Nurse 3 2 502 80964 80964 Nurse-Dental Assistant 3 2 600 80522 80522 Assisted Living Facility 4 2 600 80522 80522 Extended Congregate Care 4 2 600 80522 80522 Independent Living Facility 4 2 600 80923 80923 Rehabilitation 4 2 600 80923 80923 Skilled Nursing Facility 4 2 600 80923 80923 Intermediate Care Facility 4 2 600 80522 N/A Resident Care - For Profit 4 2 600 80522 N/A Resident Care - Not for Profit 4 2 600 80522 N/A Independent Care - For Profit 4 2 600 80522 N/A Independent Care - Not for Profit 4 2 600 80923 N/A Skilled Care - For Profit 4 2 600 80923 N/A Skilled Care - Not for Profit 4 2 600 80923 N/A Intermediate Care - For Profit 4 2 600 80923 N/A Intermediate Care - Not for Profit 4 2 600 80926 80926 Hospice For Profit - In-Patient Care - Per Licens 4 2 600 80926 80926 Hospice Not for Profit - In-Patient Care - Per Lic 4 2 600 80953 80953 Palliative Care - Non-Hospice Patients - Not for 4 2 600 80954 80954 Palliative Care - Non-Hospice Patients - For Pro 4 2 601 89648 N/A Dialysis Center 4 2 601 89643 N/A Surgicenter - Endoscopy 4 2 601 89644 N/A Surgicenter - Eye Clinic 4 2 601 89646 N/A Surgicenter - Urology 4 2 601 89645 N/A Surgicenter - Multi - Specialty 4 2 602 80601 80601 Chemical Dependency & Rehabilitation Beds 4 2 602 80610 80610 ER Visits - Employed Physicians 4 2 602 80610 80610 ER Visits - Contracted Physicians 4 2 602 80610 80610 All Other Outpatient Visits 4 2 602 80611 80611 Acute Care Beds, Bassinets, Maternity Beds 4 2 602 80611 80611 Neo Natal Beds 4 2 602 80613 80613 Clinic Visits 4 2 602 80923 80923 Long Term Care Beds 4 2 602 80990 80990 Psychiatric Visits 4 2 602 80997 80997 Psychiatric Beds 4 2 602 89640 N/A Inpatient Surgeries 4 2 602 89641 80453 Outpatient Surgeries 4 2 602 N/A N/A Births (Birthing Centers) 4 2 200 70963 80964 Nurse- RN 2 3 200 70963 80964 Nurse - LPN 2 3 202 72201 80964 Nurse Practitioner - Class A - Employed 2 3 202 72201 80964 Nurse Practitioner - Class A - Self-Employed 2 3 202 72201 80964 Nurse Practitioner - Class B - Employed 2 3 202 72201 80964 Nurse Practitioner - Class B - Self-Employed 2 3 202 72201 80964 Nurse Practitioner - Class C - Employed 2 3 202 72201 80964 Nurse Practitioner - Class C - Self-Employed 2 3 202 72201 80964 Nurse Practitioner - Class D - Employed 2 3 202 72201 80964 Nurse Practitioner - Class D - Self-Employed 2 3 202 72999 72299 Nurse Practitioner (Prescribing) 2 3 202 80964 80964 Nurse Practitioner - Shared Limits 2 3 210 71401 80962 Nurse Midwife (Dir Spvs) 2 3 210 80962 80962 Nurse Midwife (Indir Spvs) 2 3 210 80962 80962 Nurse Midwife (Dir Spvs) - Shared Limits 2 3 210 80962 80962 Nurse Midwife (Indir Spvs) - Shared Limits 2 3 211 71402 71402 Nurse Midwife Assistant 2 3 215 80913 80913 Nurse Anesthetist (Spvs By Ane) 2 3 215 80960 80960 Nurse Anesthetist (Spvs By Sur) 2 3 216 71502 80452 Nurse Anesthetist (Spvs By Ane) - Shared Limi 2 3 216 80452 80452 Nurse Anesthetist (Spvs By Sur) - Shared Limit 2 3 219 79108 72203 Nurse Surgical / Assistant 2 3 230 80116 80116 Physician Assistant - Employed - Class 1 2 3 230 80116 80116 Physician Assistant - Employed - Class 2 2 3 230 80116 80116 Physician Assistant - Employed - Class 3 2 3 230 72998 72298 Physician's Assistant (Prescribing) 2 3 230 80129 80129 Physician's Assistant - Shared Limits 2 3 231 79101 80116 Physician Surgical Assistant 2 3 232 72205 80945 Perfusionist - Employed 2 3 260 71801 79801 Optometrist - self-employed 2 3 260 79801 79801 Optometrist - Employed 2 3 260 71801 71801 Optometry - Shared Limits 2 3 261 72001 59181 Pharmacist - self-employed 2 3 261 72003 59181 Pharmacist - employed 2 3 262 80410 80410 Chiropractor 2 3 264 80993 72301 Podiatrist (No Surgery) 2 3 264 80994 72303 Podiatrist (Maj or Min Surgery) 2 3 264 80950 80950 Podiatric Corporations - no surgery 2 3 264 80950 80950 Podiatric Corporations - surgery 2 3 270 72401 72401 Psychologist - Employed 2 3 500 89701 80211 Dentist - Not Otherwise Classified 3 3 501 89702 80211 Orthodontics (Local Anesthetics Only) 3 3 501 89703 80211 Pedodontist (Local Anesthetics Only) 3 3 501 89704 80211 Periodontist (Local Anesthetics Only) 3 3 501 89705 80211 Prosthodontist (Local Anesthetics) 3 3 501 89706 80211 Endodontics (Local Anesthetics Only) 3 3 501 89707 80210 Oral Pathologist 3 3 501 89708 80211 Public Health Dentist 3 3 501 89709 80211 Dentist - Not Oral Surgeon, Sedation 3 3 501 89710 80210 Oral Or Maxillofacial Surgeon 3 3 501 89711 80210 Dentist - Not Oral Surgeon, Anesthesia 3 3 501 89712 89712 Oral/Maxillofacial Surgeon (Hosp. , Surgi-cente 3 3 501 89713 89713 Specialists In Dental Anesthesia 3 3 501 80208 80208 Host Dentist 3 3 501 80209 80209 Implants (Incl. osseointegration) 3 3 501 80211 80211 Dental Pathologist 3 3 501 80211 80210 Temporomandibular Joint Specialist 3 3 502 89740 80210 Dental Hygienist 3 3 502 80964 80964 Nurse-Student Nurse 3 3 502 80964 80964 Nurse-Dental Assistant 3 3 600 80522 80522 Assisted Living Facility 4 3 600 80522 80522 Extended Congregate Care 4 3 600 80522 80522 Independent Living Facility 4 3 600 80923 80923 Rehabilitation 4 3 600 80923 80923 Skilled Nursing Facility 4 3 600 80923 80923 Intermediate Care Facility 4 3 600 80522 N/A Resident Care - For Profit 4 3 600 80522 N/A Resident Care - Not for Profit 4 3 600 80522 N/A Independent Care - For Profit 4 3 600 80522 N/A Independent Care - Not for Profit 4 3 600 80923 N/A Skilled Care - For Profit 4 3 600 80923 N/A Skilled Care - Not for Profit 4 3 600 80923 N/A Intermediate Care - For Profit 4 3 600 80923 N/A Intermediate Care - Not for Profit 4 3 600 80926 80926 Hospice For Profit - In-Patient Care - Per Licens 4 3 600 80926 80926 Hospice Not for Profit - In-Patient Care - Per Lic 4 3 600 80953 80953 Palliative Care - Non-Hospice Patients - Not for 4 3 600 80954 80954 Palliative Care - Non-Hospice Patients - For Pro 4 3 601 89648 N/A Dialysis Center 4 3 601 89643 N/A Surgicenter - Endoscopy 4 3 601 89644 N/A Surgicenter - Eye Clinic 4 3 601 89646 N/A Surgicenter - Urology 4 3 601 89645 N/A Surgicenter - Multi - Specialty 4 3 602 80601 80601 Chemical Dependency & Rehabilitation Beds 4 3 602 80610 80610 ER Visits - Employed Physicians 4 3 602 80610 80610 ER Visits - Contracted Physicians 4 3 602 80610 80610 All Other Outpatient Visits 4 3 602 80611 80611 Acute Care Beds, Bassinets, Maternity Beds 4 3 602 80611 80611 Neo Natal Beds 4 3 602 80613 80613 Clinic Visits 4 3 602 80923 80923 Long Term Care Beds 4 3 602 80990 80990 Psychiatric Visits 4 3 602 80997 80997 Psychiatric Beds 4 3 602 89640 N/A Inpatient Surgeries 4 3 602 89641 80453 Outpatient Surgeries 4 3 602 N/A N/A Births (Birthing Centers) 4 3 Risk Company Accepts Business Purchasing Name SPECIALTY NEW RENEWAL Group Administrative Medicine Aerospace Medicine Allergy/Immunology Anesthesiology Anesthesiology - All Other Broncho-Esophagology Cardiovascular Disease · No Surgery Dermatology Dermatology · No Surgery Diabetes · No Surgery Endocrinology · No Surgery Fam/Gen Prac (No Ob) · Minor Surg Fam/Gen Prac(No Ob) · No Surgery Fam/Gen Practice (Inc Ob)(No Major Surg) Forensic/Legal Medicine (Except Psychiatry) Gastroenterology · No Surgery General Preventive Medicine · No Surgery Geriatrics · No Surgery Gynecology · No Surgery Hematology · No Surgery Hospitalist/House Staff Hypnosis Infectious Diseases · No Surgery Intensive Care Medicine Internal Medicine · No Surgery Laryngology - No Surgery Neoplastic Diseases · No Surgery Nephrology · No Surgery Neurology - incl child - No surgery - Pain Mgmt Neurology (Including Child) · No Surgery Nuclear Medicine Nutrition Occupational Medicine Ophthalmology · No Surgery Risk Company Accepts Business Purchasing Name SPECIALTY NEW RENEWAL Group Otology - No surgery Otorhinolaryngology · No Surgery Pathology - No surgery Pediatrics · No Surgery Pharmacology - Clinical Phys/Phys med/Rehabilitation(Inc Acupuncture) Physician Medicine and Rehabilitation Physicians - N.O.C.· No Surgery Public Health Pulmonary Diseases · No Surgery Radiology - Therapy Radiology (Diagnostic) · No Surgery Rheumatology · No Surgery Rhinology - No Surgery Urgent Care Med (No Hospital ER) Abdominal Surgery Cardiac - Surgery Cardiovascular Disease - Surgery Cardiovascular Disease · Minor Surgery Cardiovascular Disease · Minor Surgery Colon & Rectal-Surgery Diabetes · Minor Surgery Emergency Medicine - Inc. Major Surgery Emergency Medicine (No Major Surgery) Endocrinology - Surgery Endocrinology · Minor Surgery Family or General Practice - Surgery / No OB Gastroenterology · Minor Surgery Gastroenterology-Surgery General Surgery - N.O.C Geriatrics · Minor Surgery Geriatrics-Surgery Gynecology - Surgery Gynecology · Minor Surgery Risk Company Accepts Business Purchasing Name SPECIALTY NEW RENEWAL Group Hand &/or Foot - Surgery Head & Neck Surgery Hematology · Minor Surgery Infectious Diseases · Minor Surgery Internal Medicine · Minor Surgery Laryngology - Minor Surgery Laryngology - Surgery Neoplastic Diseases - Surgery Neoplastic Diseases · Minor Surgery Nephrology - Surgery Nephrology · Minor Surgery Neurology ( including child) - Surgery Neurology (Including Child) · Minor Surgery Obstetrics - Surgery Obstetrics/gynecology - Surgery Ophthalmology - Surgery Ophthalmology · Minor Surgery Orthopedic Surgery Otology - Minor Surgery Otology - Surgery Otorhinolaryngology · Minor Surgery Otorhinolaryngology · With Plastic - Surgery Otorhinolayngology - Major Surgery - No Plastic Pathology - Minor surgery Pediatrics · Minor Surgery Physicians – This is a N.O.C. classification Pulmonary Diseases · Minor Surgery Radiology - Incl. Dye - minor surgery Radiology (Diagnostic) · Minor Surgery Rhinology - Minor surgery Rhinology - Surgery Surgeon - Plastic (N.O.C.) Thoracic Surgery Traumatic - Surgery (Not E.R.) Risk Company Accepts Business Purchasing Name SPECIALTY NEW RENEWAL Group Urology - Surgery Vascular - Surgery Geneticist IM-Oncology (No Surgery) IM-Pulmonary (No Surgery) Physical Medicine & Rehab (Major Proc) Physical Medicine & Rehab (Minor Proc) Physical Medicine & Rehab (Non-Invasive) Rheumatology · No Surgery Cardiology (Left Heart Cath Only) Colon&Rectal Surg(Min/Ltd) Dermatology W/ Liposuction FGP (With Obstetrics) FP - Incl. deliveries General Surgery (Minor Surgery) Gynecology (w/ In-vitro Fertilization) Orthopedic (Incl. Back) Rheumatology · Minor Surgery Surgical Specialty (Office,Min) Psychiatry – including child Psychoanalysis Psychosomatic Medicine Psychiatry - Incl Shock Psychiatry - Extended Psychotherapy Nurse- RN Nurse - LPN Nurse Practitioner - Class A - Employed Nurse Practitioner - Class A - Self-Employed Nurse Practitioner - Class B - Employed Nurse Practitioner - Class B - Self-Employed Nurse Practitioner - Class C - Employed Nurse Practitioner - Class C - Self-Employed Nurse Practitioner - Class D - Employed Risk Company Accepts Business Purchasing Name SPECIALTY NEW RENEWAL Group Nurse Practitioner - Class D - Self-Employed Nurse Practitioner (Prescribing) Nurse Practitioner - Shared Limits Nurse Midwife (Dir Spvs) Nurse Midwife (Indir Spvs) Nurse Midwife (Dir Spvs) - Shared Limits Nurse Midwife (Indir Spvs) - Shared Limits Nurse Midwife Assistant Nurse Anesthetist (Spvs By Ane) Nurse Anesthetist (Spvs By Sur) Nurse Anesthetist (Spvs By Ane) - Shared Limits Nurse Anesthetist (Spvs By Sur) - Shared Limits Nurse Surgical / Assistant Physician Assistant - Employed - Class 1 Physician Assistant - Employed - Class 2 Physician Assistant - Employed - Class 3 Physician's Assistant (Prescribing) Physician's Assistant - Shared Limits Physician Surgical Assistant Perfusionist - Employed Optometrist - self-employed Optometrist - Employed Optometry - Shared Limits Pharmacist - self-employed Pharmacist - employed Chiropractor Podiatrist (No Surgery) Podiatrist (Maj or Min Surgery) Podiatric Corporations - no surgery Podiatric Corporations - surgery Psychologist - Employed Dentist - Not Otherwise Classified Orthodontics (Local Anesthetics Only) Pedodontist (Local Anesthetics Only) Risk Company Accepts Business Purchasing Name SPECIALTY NEW RENEWAL Group Periodontist (Local Anesthetics Only) Prosthodontist (Local Anesthetics) Endodontics (Local Anesthetics Only) Oral Pathologist Public Health Dentist Dentist - Not Oral Surgeon, Sedation Oral Or Maxillofacial Surgeon Dentist - Not Oral Surgeon, Anesthesia Oral/Maxillofacial Surgeon (Hosp. , Surgi-center) Specialists In Dental Anesthesia Host Dentist Implants (Incl. osseointegration) Dental Pathologist Temporomandibular Joint Specialist Dental Hygienist Nurse-Student Nurse Nurse-Dental Assistant Assisted Living Facility Extended Congregate Care Independent Living Facility Rehabilitation Skilled Nursing Facility Intermediate Care Facility Resident Care - For Profit Resident Care - Not for Profit Independent Care - For Profit Independent Care - Not for Profit Skilled Care - For Profit Skilled Care - Not for Profit Intermediate Care - For Profit Intermediate Care - Not for Profit Hospice For Profit - In-Patient Care - Per Licensed Bed Hospice Not for Profit - In-Patient Care - Per Licensed Bed Palliative Care - Non-Hospice Patients - Not for Profit - Per patient visit Risk Company Accepts Business Purchasing Name SPECIALTY NEW RENEWAL Group Palliative Care - Non-Hospice Patients - For Profit - Per patient visit Dialysis Center Surgicenter - Endoscopy Surgicenter - Eye Clinic Surgicenter - Urology Surgicenter - Multi - Specialty Chemical Dependency & Rehabilitation Beds ER Visits - Employed Physicians ER Visits - Contracted Physicians All Other Outpatient Visits Acute Care Beds, Bassinets, Maternity Beds Neo Natal Beds Clinic Visits Long Term Care Beds Psychiatric Visits Psychiatric Beds Inpatient Surgeries Outpatient Surgeries Births (Birthing Centers) CONTACT Company Name as you would like to be NAME shown on the rate guide Address 1 Address 2 City, State Zip Contact name Contact name 800 number for insureds to call website name for insureds and others phone number fax number contact email for assistance/questions to visit to obtain info