Insurance Department > Mcare

2013 Assessment

Relocation Notice: Mcare has announced the relocation of its office effective Monday, May 20, 2013. All visitors, inquiries, e-216s, correspondence and claim reports should be directed to the new address listed below. Telephone and facsimile numbers, as well as the PO Box mailing address, will not change.

While relocating, the office will have limited access to view email or to receive phone calls or faxes beginning Wednesday, May 15. There will be no phone or fax service on Friday, May 17. Email accounts will continue to be in operation; however, expect response delays. All services are expected to resume on Monday, May 20. Please plan accordingly for these interruptions. Thank you in advance for your patience during our transition period.

New Street Address: 1010 North 7th Street, Suite 201, Harrisburg, PA 17102-1410

2013 Assessment Rate of 25% as published in the Pennsylvania Bulletin.

The annual assessment to be levied for calendar year 2013 will be 25% applied to the prevailing primary premium for each participating health care provider. The Mcare Act defines “prevailing primary premium” as the schedule of occurrence rates approved by the Insurance Commissioner for the Joint Underwriting Association (JUA).

For purposes of the 2013 annual assessment, the rates shall be those currently approved for use by the JUA. Participating health care providers having approved self-insurance plans shall be assessed an amount equal to the assessment imposed on a participating health care provider of like class, size, risk and kind as determined by the Department.

Rating:

2013 Assessment Manual v.2 Published 3.18.2013 | Cover Letter

- Updated Section: Extended Reporting Period ("Tail") Coverage, page 33

The 2013 Mcare Assessment Manual ("Manual") is intended to assist in calculating Mcare assessments pursuant to Act 13 of 2002. Please be certain to read it in its entirety to determine how changes may alter your processes.

Exhibit 1 Rates for 2013 Individual Health Care Providers

Exhibit 2 Rates for 2013 Hospitals, Nursing Homes and Primary Health Care Centers

Exhibit 3 JUA's Specialty Classification Codes for Physicians, Surgeons and Other Health Care Providers

Reporting:

e-216 Remittance Advice Form v.6 Published 5.2.2013

IMPORTANT PROCESSING UPDATE - ELECTRONIC SUBMISSIONS: Effective January 1, 2013, electronic submission of Excel type e-216 is the preferred method of reporting basic professional liability insurance coverage to Mcare. No longer is a hardcopy 216 required when submitting your e-216 with or without payment. This change applies to all submissions, regardless of the assessment year, with a run date on or after January 1, 2013. The e-216 must be sent to the following e-mail address ra-in-remittance@pa.gov If payment is due, the check must be mailed to Mcare at the same time the e-216 is emailed. For complete details, please refer to page 8 of the 2013 Assessment Manual.

The standard for submitting new and renewal business to Mcare is to do so electronically via Form e-216, or one of the other two approved formats listed in the manual. Submitting electronically increases Mcare's ability to process coverage information and payment in a more efficient and expeditious manner.

This form is to be used by basic professional liability insurance carriers and approved self-insurers for summarizing surcharges/assessments collected, payable and refundable. Except for an approved self-insured health care provider, a health care provider may not complete this form.

All surcharges and assessments due, should be received in Mcare’s Office within 60 days from the effective date of coverage, cancellation or endorsement.

Tail:

PMSLIC Tail Rates - Tail rates for primary insurance companies who did not have approved rates in PA prior to 1997. These rates are to be used for physicians, podiatrists, certified nurse midwives, professional corporations and birth centers.

PHICO Tail Rates - - These rates are to be used for hospitals, nursing homes, and primary health centers.

Laws, Regulations, Statements of Policy and Notices:

Click here to access Laws, Regulations, Statements of Policy and Notices that may assist your understanding and reporting of Mcare coverage and/or claims.

The Pennsylvania Code is the official repository for all Commonwealth regulations. The Insurance Department's regulations are available at http://www.pacode.com/secure/data/031/031toc.html

Click here for Mcare regulations published in the Pennsylvania Code.