Medical Professional Liability Rate Guide

MARTIN O'MALLEY Governor ANTHONY G. BROWN Lt. Governor DATE: TO: RE: INsunexcn BETH SAMMIS Acting Commissioner KAREN STAKEM HORNIG Deputy Commissioner P. RANDI JOHNSON Associate Commissioner Property & Casualty AorvrnrsrRATroN 200 St. Paul Street. Suite 2700 Baltimore. Marvland21202 www.mdinsurance. state.md. us Bulletin 10-11 March 31,2010 Medical Professional Liability Insurers Medical Professional Liabilitv Rate Guide * * , t * * * * * * * ( * * * ; f , l * * , * , t * * * * * * * t * * r < * * * * * ' l * * * * * * , f : f i * * * t < t f t ( * * i < r t < * * * * * * * * * * : * * r f * < , i , i * * * * * , t * : t : f r t : * * r f * * : t * * ' t * * * : t Pursuant to 52-303.2 and $19-l12 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. For certain healthcare technicians and assistants classifications. (NEW) NOTE: If your company did not receive this bulletin directly from the MIA, or your company does not have medical professional liability insurance written premium for the year 2009, NO FURTHER ACTION IS REQUIRED ON YOUR PART. These rates should be the base rates 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 that are effective on or after October 1, 2010, for new business. Property & Casualty Bulletin Medical Professional Liabilitv Premium Data Call Page 2 This information is necessary for the MIA to publish a medical professional liability rate comparison guide in accordance with 52-303.2 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 aocepted. Data should be submitted to : lglemza@mdinsurance.state.md.us. For questions, please contact Mr. Linas Glemza at (al0) 468-2044. In addition, please refer to the Summary of Revision page for a listing of revisions to this request. Please provide this information no later than Monday August 3,2010. Beth Sammis Acting Insurance Commissioner By: P. Randi Johnson Associate Commissioner Property & Casualty Attachments: o Excel File Format o Data and File Requirements Signature On File With Original Maryland Medical Malpractice Rate Guide Specifications October 2010 edition SUMMARY OF REVISIONS TO SPECIFICATIONS These are revisions to the specifications and reporting requirements from the prior edition. The following apply to certain specific classes: 1) OLD MIA Sort Code is being retained this year. 2) Healthcare (tech) classes have been added. Please refer to the spreadsheet 3) Data and File Requirements section has been shortened, and a checklist has been added for submission verification purposes. You are encouraged to print this checklist out. 4) In addition, the Cognitive Care class has been re-instated. 5) The excel file layout has been revised. Please refer to the excel file. October 2010 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 Special Sort code pre-filled (F) OLD MIA Special Sort code pre-filled (temporary) (G) MIA determined class code pre-filled (G) ISO Class code pre-filled (H) Company Class Code number (optional) (I) Description/Name of class pre-filled (J) Territory 1 Premium (K) Territory 2 Premium (L) Territory 3 Premium NOTES for Columns (J), (K) and (L) 1 = Baltimore City and Baltimore County 2 = Anne Arundel, Montgomery, Prince Georges and Howard counties 3 = Rest of State Manual 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 rate that has Coverage for $1M per claim and the closest aggregate limit. (M) Leave blank (N) “Yes” if accepting NEW business, “No” if not. (O) “Yes” if accepting RENEWAL business, “No” if not. (P) Risk Purchasing Group (RPG) NOTES for Column (P) “Yes” if class is through an RPG only “No” if class is not through an RPG Both – if class is through either way. October 2010 DATA and FILE Requirements Requirements: 1) Columns (A), (B), (J), (K) and (L) ENTRIES MUST IN NUMERIC FORMAT. 2) Fill Column (J), (K) and (L) with “n/a” if rates are not available for the class. 3) For the Premiums, round off to whole numbers, unless the rating base requires otherwise. 4) Spreadsheet detail requirements – please use the spreadsheet provided by the MIA. Do not add any formatting features. 5) We allow companies to submit disclaimers to their submissions. Keep it brief. Place disclaimers on a separate spreadsheet page. Do not place any symbols next to the rates to explain a disclaimer. 6) On the contact_info spreadsheet page, please follow the instructions as provided. October 2010 Submission Verification Checklist. Do not submit this checklist at all. Cell Completion ____ a) All cells for Columns A to D are filled for all listed classes, even if your company has no rates for any particular classes. Do not leave any blank. ____ b) Premium cells – Do not use dollar signs and commas. Round to the nearest whole number, except for certain facilities classes where the need to retain dollars and cents is needed. ____ c) When a premium cell is not applicable, use “n/a”, not “N/A”. ____ d) Verify that there are NO formulas. Use CTRL - ~ to verify. ____ e) Do not delete any rows that show a class description Territorial verification ___ a) Make sure the rates correspond to the correct territories. Territories are defined in the Excel File Format documentation. Other ___ a) Make sure file name is under 20 characters ___ b) Make sure the 800/888 number is a general/customer service number. ___ c) Make sure website is in form of www.(name).com (or .net). Do not include http:// October 2010 Changes to MPL rate guide spreadsheet 1) Rates by territory - this is overhauled. Each territory has its own column for rates. Instead of having 3 rows per specialty (one for each territory), there is only one row for each specialty. 2) The following columns have been deleted: a) Old MIA sort code 3) The new_renew tab has been deleted. All new_renew information will now be contained within each respective tab. 4) New tab - tech - is added. This contains new classes for the rate guide. 5) Facilities tab - Cognitive Care classes have been re-instituted. This class was inadvertantly deleted for 2009 guide. Refer to MIA Special Sort codes 6020 and 6021 6) The alliedhealth and facilities tabs have been "sub-grouped" for completion of data purposes. RULES FOR COMPLETING THE SPREADSHEETS (reporting requirements) 1) If your company has no rates for all classes listed in a particular tab, leave blank and do nothing. 2) If your company has at least one rate in a particular tab (or a subgroup within a tab), the following rules apply: a) Columns A to D, I to K AND M to O MUST BE COMPLETED for those classes where you supply rates. b) For those classes where no rates are supplied (within the tab or subgroup), the following apply: Column A Group code is required Column D Group or Company name is required Columns I, J and K Use n/a for all three columns All other columns can be left blank c) NOTE - only alliedhealth and facilities have sub-groups. Refer to Special Instructions in these tabs, located at the bottom of each spreadsheet. d) Hint - it maybe helpful to treat/view sub-groups has tabs within a tab. NAIC Grp NAIC Comp Effective Company MIA Special ISO Company Terr 1 Terr 2 Terr 3 leave Accepts Business Risk Purchasing Code Code Date Name Sort Code MIA Code Code Code SPECIALTY Premium Premium Premium blank NEW RENEWAL Group 1001 80178 80178 Administrative Medicine 1002 80230 80133 Aerospace Medicine 1003 80254 80254 Allergy/Immunology 1004 80151 80151 Anesthesiology 1005 80183 80183 Anesthesiology - All Other 1006 80101 80101 Broncho-Esophagology 1007 80255 80255 Cardiovascular Disease · No Surgery 1008 80256 80256 Dermatology · No Surgery 1009 80237 80237 Diabetes · No Surgery 1010 80238 80238 Endocrinology · No Surgery 1011 80423 80423 Fam/Gen Prac (No Ob) · Minor Surg 1012 80420 80420 Fam/Gen Prac(No Ob) · No Surgery 1013 80421 80421 Fam/Gen Practice (Inc Ob)(No Major Surg) 1014 80240 80240 Forensic/Legal Medicine (Except Psychiatry) 1015 80241 80241 Gastroenterology · No Surgery 1016 80231 80135 General Preventive Medicine · No Surgery 1017 80303 80303 Geneticist 1018 80243 80243 Geriatrics · No Surgery 1019 80244 80244 Gynecology · No Surgery 1020 80245 80245 Hematology · No Surgery 1021 80222 80222 Hospitalist/House Staff 1022 80232 80232 Hypnosis 1023 80473 80473 IM-Oncology (No Surgery) 1024 80269 80269 IM-Pulmonary (No Surgery) 1025 80246 80246 Infectious Diseases · No Surgery 1026 80283 80283 Intensive Care Medicine 1027 80257 80257 Internal Medicine · No Surgery 1028 80258 80258 Laryngology - No Surgery 1029 80259 80259 Neoplastic Diseases · No Surgery 1030 80260 80260 Nephrology · No Surgery 1031 80299 80299 Neurology - incl child - No surgery - Pain Mgmt 1032 80261 80261 Neurology (Including Child) · No Surgery 1033 80262 80262 Nuclear Medicine 1034 80248 80248 Nutrition 1035 80233 80233 Occupational Medicine 1036 80263 80263 Ophthalmology · No Surgery 1037 80264 80264 Otology - No surgery 1038 80265 80265 Otorhinolaryngology · No Surgery 1039 80266 80266 Pathology - No surgery 1040 80267 80267 Pediatrics · No Surgery 1041 80234 80234 Pharmacology - Clinical 1042 80437 80437 Phys/Phys med/Rehabilitation(Inc Acupuncture) 1043 80209 80209 Physical Medicine & Rehab (Major Proc) 1044 80208 80208 Physical Medicine & Rehab (Minor Proc) 1045 80208 80208 Physical Medicine & Rehab (Non-Invasive) 1046 80235 80235 Physician Medicine and Rehabilitation 1047 80268 80268 Physicians - N.O.C.· No Surgery 1048 80236 80236 Public Health 1049 80269 80269 Pulmonary Diseases · No Surgery 1050 80425 80425 Radiology - Therapy 1051 80253 80253 Radiology (Diagnostic) · No Surgery 1052 80252 80252 Rheumatology · No Surgery 1053 80247 80247 Rhinology - No Surgery 1054 80304 80304 Urgent Care Med (No Hospital ER) NAIC Grp NAIC CompEffective Company MIA Special ISO Company Terr 1 Terr 2 Terr 3 leave Accepts Business Risk Purchasing Code Code Date Name Sort Code MIA Code Code Code SPECIALTY Premium Premium Premium blank NEW RENEWAL Group 1101 80166 80166 Abdominal Surgery 1102 80141 80141 Cardiac - Surgery 1103 80422 80422 Cardiology (Left Heart Cath Only) 1104 80150 80150 Cardiovascular Disease - Surgery 1105 80281 80281 Cardiovascular Disease · Minor Surgery 1106 80115 80115 Colon & Rectal-Surgery 1107 80443 80443 Colon&Rectal Surg(Min/Ltd) 1108 80282 80282 Dermatology · Minor Surgery 1109 80297 80297 Dermatology W/ Liposuction 1110 80271 80271 Diabetes · Minor Surgery 1111 80157 80157 Emergency Medicine - Inc. Major Surgery 1112 80102 80102 Emergency Medicine (No Major Surgery) 1113 80103 80103 Endocrinology - Surgery 1114 80272 80272 Endocrinology · Minor Surgery 1115 80117 80117 Family or General Practice - Surgery / No OB 1116 80117 80117 FGP (With Obstetrics) 1117 80273 80273 FP - Incl. deliveries 1118 80274 80274 Gastroenterology · Minor Surgery 1119 80104 80104 Gastroenterology-Surgery 1120 80143 80143 General Surgery - N.O.C 1121 80143 80143 General Surgery (Minor Surgery) 1122 80276 80276 Geriatrics · Minor Surgery 1123 80105 80105 Geriatrics-Surgery 1124 80167 80167 Gynecology - Surgery 1125 80167 80167 Gynecology (w/ In-vitro Fertilization) 1126 80277 80277 Gynecology · Minor Surgery 1127 80169 80169 Hand &/or Foot - Surgery 1128 80170 80170 Head & Neck Surgery 1129 80278 80278 Hematology · Minor Surgery 1130 80279 80279 Infectious Diseases · Minor Surgery 1131 80284 80284 Internal Medicine · Minor Surgery 1132 80285 80285 Laryngology - Minor Surgery 1133 80106 80106 Laryngology - Surgery 1134 80107 80107 Neoplastic Diseases - Surgery 1135 80286 80286 Neoplastic Diseases · Minor Surgery 1136 80108 80108 Nephrology - Surgery 1137 80287 80287 Nephrology · Minor Surgery 1138 80152 80152 Neurology ( including child) - Surgery 1139 80288 80288 Neurology (Including Child) · Minor Surgery 1140 80168 80168 Obstetrics - Surgery 1141 80153 80153 Obstetrics/gynecology - Surgery 1142 80114 80114 Ophthalmology - Surgery 1143 80289 80289 Ophthalmology · Minor Surgery 1144 80154 80154 Orthopedic (Incl. Back) 1145 80154 80154 Orthopedic Surgery 1146 80290 80290 Otology - Minor Surgery 1147 80158 80158 Otology - Surgery 1148 80291 80291 Otorhinolaryngology · Minor Surgery 1149 80155 80155 Otorhinolaryngology · With Plastic - Surgery 1150 80159 80159 Otorhinolayngology - Major Surgery - No Plastic 1151 80292 80292 Pathology - Minor surgery 1152 80293 80293 Pediatrics · Minor Surgery 1153 80294 80294 Physicians – This is a N.O.C. classification 1154 80308 80301 Pulmonary Diseases · Minor Surgery 1155 80449 80253 Radiology - Incl. Dye - minor surgery 1156 80280 80280 Radiology (Diagnostic) · Minor Surgery 1157 80300 80294 Rheumatology · Minor Surgery 1158 80270 80270 Rhinology - Minor surgery 1159 80160 80160 Rhinology - Surgery 1160 80156 80156 Surgeon - Plastic (N.O.C.) 1161 80116 80116 Surgical Specialty (Office,Min) 1162 80144 80144 Thoracic Surgery 1163 80171 80171 Traumatic - Surgery (Not E.R.) 1164 80145 80145 Urology - Surgery 1165 80146 80146 Vascular - Surgery NAIC Grp NAIC Comp Effective Company MIA Special ISO Company Terr 1 Terr 2 Terr 3 leave Accepts Business Risk Purchasing Code Code Date Name Sort Code MIA Code Code Code SPECIALTY Premium Premium Premium blank NEW RENEWAL Group 1301 80995 80995 Psychiatry - Extended 1302 80431 80431 Psychiatry - Incl Shock 1303 80249 80229 Psychiatry – including child 1304 80250 80250 Psychoanalysis 1305 80251 80251 Psychosomatic Medicine 1306 80998 n/a Psychotherapy NAIC Grp NAIC Comp Effective Company MIA Special ISO Company Terr 1 Terr 2 Terr 3 leave Accepts Business Risk Purchasi Code Code Date Name Sort Code MIA Code Code Code Description/Name of Class Premium Premium Premium blank NEW RENEWAL Group 2001 70963 80964 Nurse - RN 2002 70963 80964 Nurse - LPN 2010 72201 80964 Nurse Practitioner - Class A - Employed 2011 72201 80964 Nurse Practitioner - Class A - Self-Employed 2012 72201 80964 Nurse Practitioner - Class B - Employed 2013 72201 80964 Nurse Practitioner - Class B - Self-Employed 2014 72201 80964 Nurse Practitioner - Class C - Employed 2015 72201 80964 Nurse Practitioner - Class C - Self-Employed 2016 72201 80964 Nurse Practitioner - Class D - Employed 2017 72201 80964 Nurse Practitioner - Class D - Self-Employed 2018 72999 72299 Nurse Practitioner (Prescribing) 2019 80964 80964 Nurse Practitioner - Shared Limits 2030 71401 80962 Nurse Midwife (Dir Spvs) 2031 80962 80962 Nurse Midwife (Indir Spvs) 2032 80962 80962 Nurse Midwife (Dir Spvs) - Shared Limits 2033 80962 80962 Nurse Midwife (Indir Spvs) - Shared Limits 2040 71402 71402 Nurse Midwife Assistant 2060 80913 80913 Nurse Anesthetist (Spvs By Ane) 2061 80960 80960 Nurse Anesthetist (Spvs By Sur) 2062 71502 80452 Nurse Anesthetist (Spvs By Ane) - Shared Limits 2063 80452 80452 Nurse Anesthetist (Spvs By Sur) - Shared Limits 2100 79108 72203 Nurse Surgical / Assistant 2201 80116 80116 Physician Assistant - Employed - Class 1 2202 80116 80116 Physician Assistant - Employed - Class 2 2203 80116 80116 Physician Assistant - Employed - Class 3 2204 72998 72298 Physician's Assistant (Prescribing) 2205 80129 80129 Physician's Assistant - Shared Limits 2210 79101 80116 Physician Surgical Assistant 2250 72205 80945 Perfusionist - Employed 2601 80410 80410 Chiropractor 2610 71801 79801 Optometrist - self-employed 2611 79801 79801 Optometrist - Employed 2612 71801 71801 Optometry - Shared Limits 2620 72001 59181 Pharmacist - self-employed 2621 72003 59181 Pharmacist - employed 2630 80993 72301 Podiatrist (No Surgery) 2631 80994 72303 Podiatrist (Maj or Min Surgery) 2632 80950 80950 Podiatric Corporations - no surgery 2634 80950 80950 Podiatric Corporations - surgery 2650 72401 72401 Psychologist - Employed Special instructions: 1) If your company has no rates for ALL MIA special Sort Codes from 2001 to 2250, leave everything blank for these classes. If your company has at least one rate for this sub-group, refer to reporting requirements in the update2010 tab. 2) If your company has no rates for all MIA Special Sort Codes from 2601 to 2650, leave everything blank for these classes. If your company has at least one rate for this sub-group, refer to reporting requirements in the update2010 tab. NAIC Grp NAIC Comp Effective Company MIA Special ISO Company Terr 1 Terr 2 Terr 3 leave Code Code Date Name Sort Code MIA Code Code Code Description/Name of Class Premium Premium Premium blank 3000 n/a Audiologists - Employed 3001 n/a Basic / Intermediate Emergency Medical Technician - Employed 3002 n/a Bio-medical Technician/Technologist - Employed 3003 n/a Blood Bank Technician/Technologist - Employed 3004 n/a Cardiology Technician/Technologist - Employed 3005 n/a Case Manager Individual - Employed 3006 n/a Case Manager Separate Limit - Employed 3007 n/a Chiropractic Assistant - Employed 3008 n/a Circulation Technician/Technologist - Employed 3009 n/a Clinical Lab Technician/Technologist - Employed 3010 n/a Clinical/Rehabilitation Counselor - Employed 3011 n/a Diagnostic Medical Sonographer - Employed 3012 n/a Dialysis Technician/Technologist - Employed 3013 n/a Dietitian - employed 3014 n/a EEG Technician/Technologist - Employed 3015 n/a EKG Technician/Technologist - Employed 3016 n/a Electrologist - Employed 3017 n/a Histologic Technician/Technologist - Employed 3018 n/a Home Health - Employed 3019 n/a Home Health Aide - Employed 3020 n/a Hospital Pharmacy Technician/Technologist - Employed 3021 n/a Medical Assistant - Employed 3022 n/a Medical Laboratory Technician/Technologist - Employed 3023 n/a Medical Records Administrator - Employed 3024 n/a Medical Records Technician/Technologist - Employed 3025 n/a Medical Technician/Technologist Assistant - Employed 3026 n/a Nuclear Medical Technician/Technologist - Employed 3027 n/a Nutritionist - employed 3028 n/a Occupational Therapists - Employed 3029 n/a Occupational Therapy Assistant - Employed 3030 n/a Ophthalmologic Technician - Employed 3031 n/a Optician - employed 3032 n/a Optometric Technician/Assistant - Employed 3033 n/a Orthopedic Technician/Assistant - Employed 3034 n/a Orthotist/Prosthetist - Employed 3035 n/a Orthotist/Prosthetist Technician - Employed 3036 n/a Paramedic/EMT (Certified) - Employed 3037 n/a Pedorthist - Employed 3038 n/a Pharmacist Technician/Technologist/Assistant - Employed 3039 n/a Phlebotomist - Employed 3040 n/a Physical Therapist - Employed 3041 n/a Physical Therapist Technician/Assistant - Employed 3042 n/a Podiatric Assistant - Employed 3043 n/a Radiation Therapist - Employed 3044 n/a Radiologic Technician/Technologist - Employed 3045 n/a Rehabilitation Assistant - Employed 3046 n/a Rehabilitation Therapist - Employed 3047 n/a Respiratory Care Provider - Employed 3048 n/a Respiratory Therapist - Employed 3049 n/a Respiratory Therapist Technician/Technologist - Employed 3050 n/a Speech Hearing Therapist - Employed 3051 n/a Speech Language Pathologist - Employed 3052 n/a Surgical Technician/Technologist - Employed 3053 n/a Volunteer Emergency Medical Technician - Employed 3054 n/a X-Ray Technician/Machine Operator - Employed DO NOT DELETE THIS ROW 3100 n/a Health Sc/Biologist (employed) 3101 n/a Health Services NOC - Medical Office Asst (employed) 3102 n/a Health Services NOC - Operating Room Tech (employed) 3103 n/a Health Services NOC - Paramedic/EMT (employed) 3104 n/a Lab Supervisor/Director (Employed) 3105 n/a Surgical/O.R. Technician (employed) 3106 n/a Anesthesia Assistant (employed) 3107 n/a Technician NOC - Level I (employed) 3108 n/a Technician NOC - Level II (employed) 3109 n/a Laboratory Aide - Employed DO NOT DELETE THIS ROW 3200 n/a Audiologists - Self-Employed 3201 n/a Basic / Intermediate Emergency Medical Technician - Self-Employed 3202 n/a Bio-medical Technician/Technologist - Self-Employed 3203 n/a Blood Bank Technician/Technologist - Self-Employed 3204 n/a Cardiology Technician/Technologist - Self-Employed 3205 n/a Case Manager Individual - Self-Employed 3206 n/a Case Manager Separate Limit - Self-Employed 3207 n/a Chiropractic Assistant - Self-Employed 3208 n/a Circulation Technician/Technologist - Self-Employed 3209 n/a Clinical Lab Technician/Technologist - Self-Employed 3210 n/a Clinical/Rehabilitation Counselor - Self-Employed 3211 n/a Diagnostic Medical Sonographer - Self-Employed 3212 n/a Dialysis Technician/Technologist - Self-Employed 3213 n/a Dietitian - self-employed 3214 n/a EEG Technician/Technologist - Self-Employed 3215 n/a EKG Technician/Technologist - Self-Employed 3216 n/a Electrologist - Self-Employed 3217 n/a Histologic Technician/Technologist - Self-Employed 3218 n/a Home Health - Self-Employed 3219 n/a Home Health Aide - Self-Employed 3220 n/a Hospital Pharmacy Technician/Technologist - Self-Employed 3221 n/a Medical Assistant - Self-Employed 3222 n/a Medical Laboratory Technician/Technologist - Self-Employed 3223 n/a Medical Records Administrator - Self-Employed 3224 n/a Medical Records Technician/Technologist - Self-Employed 3225 n/a Medical Technician/Technologist Assistant - Self-Employed 3226 n/a Nuclear Medical Technician/Technologist - Self-Employed 3227 n/a Nutritionist - self-employed 3228 n/a Occupational Therapist - Self-Employed 3229 n/a Occupational Therapy Assistant - Self-Employed 3230 n/a Ophthalmologic Technician - Self-Employed 3231 n/a Optician - self-employed 3232 n/a Optometric Technician/Assistant - Self-Employed 3233 n/a Orthopedic Technician/Assistant - Self-Employed 3234 n/a Orthotist/Prosthetist - Self-Employed 3235 n/a Orthotist/Prosthetist Technician - Self-Employed 3236 n/a Paramedic/EMT (Certified) - Self-Employed 3237 n/a Pedorthist - Self-Employed 3238 n/a Pharmacist Technician/Technologist/Assistant - Self-Employed 3239 n/a Phlebotomist - Self-Employed 3240 n/a Physical Therapist - Self-Employed(Owner) 3241 n/a Physical Therapist Technician/Assistant - Self-Employed 3242 n/a Podiatric Assistant - Self-Employed 3243 n/a Radiation Therapist - Self-Employed 3244 n/a Radiologic Technician/Technologist - Self-Employed 3245 n/a Rehabilitation Assistant - Self-Employed 3246 n/a Rehabilitation Therapist - Self-Employed 3247 n/a Respiratory Care Provider - Self-Employed 3248 n/a Respiratory Therapist - Self-Employed 3249 n/a Respiratory Therapist Technician/Technologist - Self-Employed 3250 n/a Speech Hearing Therapist - Self-Employed 3251 n/a Speech Language Pathologist - Self-Employed 3252 n/a Surgical Technician/Technologist - Self-Employed 3253 n/a Volunteer Emergency Medical Technician - Self-Employed 3254 n/a X-Ray Technician/Machine Operator - Self-Employed NAIC Grp NAIC Comp Effective Company MIA Special ISO Company Terr 1 Terr 2 Terr 3 leave Accepts Business Risk Purchasi Code Code Date Name Sort Code MIA Code Code Code Description/Name of Class Premium Premium Premium blank NEW RENEWAL Group 5001 89701 80211 Dentist - Not Otherwise Classified 5002 89702 80211 Orthodontics (Local Anesthetics Only) 5003 89703 80211 Pedodontist (Local Anesthetics Only) 5004 89704 80211 Periodontist (Local Anesthetics Only) 5005 89705 80211 Prosthodontist (Local Anesthetics) 5006 89706 80211 Endodontics (Local Anesthetics Only) 5007 89707 80210 Oral Pathologist 5008 89708 80211 Public Health Dentist 5009 89709 80211 Dentist - Not Oral Surgeon, Sedation 5010 89710 80210 Oral Or Maxillofacial Surgeon 5011 89711 80210 Dentist - Not Oral Surgeon, Anesthesia 5012 89712 89712 Oral/Maxillofacial Surgeon (Hosp. , Surgi-center) 5013 89713 89713 Specialists In Dental Anesthesia 5014 80208 80208 Host Dentist 5015 80209 80209 Implants (Incl. osseointegration) 5016 80211 80211 Dental Pathologist 5017 80211 80210 Temporomandibular Joint Specialist 5100 89740 80210 Dental Hygienist 5101 80964 80964 Nurse-Student Nurse 5102 80964 80964 Nurse-Dental Assistant NAIC GrpNAIC CompEffective Company MIA Special ISO Company Terr 1 Terr 2 Terr 3 leave Accepts Business Risk Purchasing Code Code Date Name Sort Code MIA Code Code Code Description/Name of Class Premium Premium Premium blank NEW RENEWAL Group 6001 80522 80522 Assisted Living Facility 6002 80522 80522 Extended Congregate Care 6003 80926 80926 Hospice For Profit - In-Patient Care (Beds) 6004 80926 80926 Hospice Not for Profit - In-Patient Care (Beds) 6005 80522 N/A Independent Care - For Profit 6006 80522 N/A Independent Care - Not for Profit 6007 80522 80522 Independent Living Facility 6008 80923 N/A Intermediate Care - For Profit 6009 80923 N/A Intermediate Care - Not for Profit 6010 80923 80923 Intermediate Care Facility 6011 80923 80923 Long Term Care (Beds) 6012 80954 80954 Palliative Care - Non-Hospice Patients - For Profit (Visits) 6013 80953 80953 Palliative Care - Non-Hospice Patients - Not for Profit (Visits) 6015 80522 N/A Resident Care - For Profit 6016 80522 N/A Resident Care - Not for Profit 6017 80923 N/A Skilled Care - For Profit 6018 80923 N/A Skilled Care - Not for Profit 6019 80923 80923 Skilled Nursing Facility 6020 80923 N/A Cognitive Impairment Care-For Profit 6021 80923 N/A Cognitive Impairment Care-Not For Profit DO NOT DELETE THIS ROW 6101 N/A N/A Births/Birthing Centers (Beds) 6102 89648 N/A Dialysis Center 6103 89640 N/A Inpatient Surgeries (per 100 procedures) 6104 89641 80453 Outpatient Surgeries (per 100 procedures 6105 N/A N/A Surgicenter - Minor Procedures (per 100 procedures) 6106 N/A N/A Surgicenter - Major Procedures (per 100 procedures) 6107 N/A N/A Surgicenter - Multi - Specialty (per 100 procedures) 6108 N/A N/A Surgicenter - Single Specialty (per 100 procedures) 6120 N/A N/A Medical Laboratory 6121 N/A N/A Dental Laboratory 6122 N/A N/A X-Ray/Imaging Center 6123 N/A N/A Optical Establishment DO NOT DELETE THIS ROW 6200 N/A N/A Cardiac Rehabilitation (Visit) 6201 80601 80601 Chemical Dependency & Rehabilitation (Beds) 6202 N/A N/A Physical/Occupational Rehabilitiation (Vistis) 6203 80923 80923 Rehabilitation - General (Beds) 6204 N/A N/A Substance Abuse - Counseling (Visits) 6205 N/A N/A Substance Abuse - Skilled Medical (Visits) 6206 N/A N/A Trauma Rehabilitiation - Skilled Medical (Beds) 6207 N/A N/A Trauma Rehabilitiation - Therapy (Beds) 6208 N/A N/A Trauma Rehabilitiation - Transitional Living (Beds) DO NOT DELETE THIS ROW 6400 80611 80611 Acute Care (Beds) 6401 80610 80610 All Other Outpatient (Visits) 6402 80611 80611 Bassinets - staff enhanced EFM training (Beds) 6403 80611 80611 Bassinets - no staff enhanced EFM training (Beds) 6404 80613 80613 Clinic (Visits) 6405 80610 80610 ER - Contracted Physicians (Visits) 6406 80610 80610 ER - Employed Physicians (Visits) 6407 80611 80611 Maternity (Beds) 6408 80611 80611 Neo Natal (Beds) 6409 80997 80997 Psychiatric (Beds) 6410 80990 80990 Psychiatric (Visits) DO NOT DELETE THIS ROW Special Instructions: 1) If your company has no rates for ALL MIA special Sort Codes from 6001 to 6021, leave everything blank for these classes. If your company has at least one rate for this sub-group, refer to reporting requirements in the update2010 tab. 2) If your company has no rates for all MIA Special Sort Codes from 6101 to 6123, leave everything blank for these classes. If your company has at least one rate for this sub-group, refer to reporting requirements in the update2010 tab. 3) If your company has no rates for ALL MIA special Sort Codes from 6200 to 6208, leave everything blank for these classes. If your company has at least one rate for this sub-group, refer to reporting requirements in the update2010 tab. 4) If your company has no rates for all MIA Special Sort Codes from 6400 to 6410, leave everything blank for these classes. If your company has at least one rate for this sub-group, refer to reporting requirements in the update2010 tab. Section A This section deals with the person completing(or submitting) the information. This is for MIA internal purposes only, and will not be part of the rate guide. contact name contact name Contact Name Company Name Address 1 City, State Zip phone number email Format Rules for above items First Last As it appears on the Premium pages city, state zip xxx-xxx-xxxx remove hyperlink Section B This section deals with information that will be on the rate guide. It is for contact information for potential insureds. Company Name as you would like to be 800 number for insureds to call website name for insureds and others shown on the rate guide for assistance/questions to visit to obtain info Format Rules for above items As it appears on the Premium pages xxx-xxx-xxxx www.compname .com (no http://) & remove hyperlink