California market
Four carrier systems group Orange County with Los Angeles County.
The territory can stay the same across the county line. The application facts and issued terms still decide how the location, clinicians, entities, and services are treated.
Compare four carrier territory systems
Each carrier assigns Orange County inside its own filed territory system.
| Carrier | Orange County treatment | Counties in the same filed group | Filing record |
|---|---|---|---|
| TDC | Territory B | Kern; Los Angeles; Orange; Ventura | The Doctors Company, California Rate Pages, Edition 10/14, p. CA-R-1; CDI filing DCTR-129531290, approved 2014-08-07 |
| MedPro | Area 1 | Los Angeles; Orange; Riverside; San Bernardino | MedPro SR-CA-III-4 / RT-CA, Edition 07/01/13; CDI filing 13-3635 / SERFF MDPC-129010877, approved 2013-08-07 |
| NORCAL | Territory 4 | Los Angeles; Orange; Ventura; Kern | NORCAL Mutual Insurance Company, California Medical Professional Liability Insurance Underwriting Manual, 08/01/2015 (corrected copy), pp. 7-11; CDI filing 14-7766;14-7767 / SERFF NCMC-129678275, approved 2015-09-28 |
| MIEC | 1.900 relativity | Los Angeles; Kern; Orange; Riverside; San Bernardino | Medical Insurance Exchange of California, Countrywide Underwriting Manual - HPL (Rev 2-1-2023) with California State Exception Pages; CDI filing 20-4143 / SERFF PERR-132594120, approved 2023-02-07, effective 2023-02-01 |
Filed base rates for ten specialties
The values use mature claims-made rates at $1 million per claim and $3 million annual aggregate. MIEC values are calculated from its filed formula. The other values come from the mapped manual rows.
| Specialty | TDC | MedPro | NORCAL | MIEC |
|---|---|---|---|---|
| Internal Medicine | $8,274 | $15,498 | $11,059 | $13,693.30 |
| Family Practice (No Surgery) | $9,158 | $12,960 | $11,765 | $13,693.30 |
| Psychiatry | $6,741 | $9,015 | $7,647 | $5,477.32 |
| Anesthesiology | $12,128 | $16,343 | $12,942 | $19,170.62 |
| Emergency Medicine | $23,742 | $33,810 | $22,354 | $30,809.92 |
| General Surgery | $41,775 | $47,335 | $39,178 | $49,295.88 |
| Obstetrics & Gynecology | $49,804 | $56,350 | $51,179 | $65,043.17 |
| Orthopedic Surgery | $34,021 | $33,810 | $37,061 | $41,079.90 |
| Plastic Surgery | $29,738 | $33,810 | $31,178 | $49,295.88 |
| Neurosurgery | $68,380 | $78,890 | $72,945 | $130,086.35 |
The full comparison also lists the class mapping, manual date, and filing reference.
California Department of Insurance filings 14-4043, 13-3635, 14-7766/14-7767, and 20-4143 place Orange and Los Angeles counties in the same geographic rate group. A comparable quote still requires consistent practice facts for each Orange County practice.
Irvine and Newport Beach have the same territory in these four manuals. The policy can still change if the practice uses different clinicians, procedures, facilities, or entities at the two addresses.
These Orange County cities share one carrier territory
Irvine, Newport Beach, Costa Mesa, Huntington Beach, Santa Ana, Anaheim, Fullerton, Orange, Tustin, Laguna Beach, Laguna Hills, Mission Viejo, and San Clemente are in Orange County. The four manuals do not use separate physician territories for these cities.
A move from Irvine to Newport Beach can add a surgery room, medical spa room, device, laboratory service, or new professional entity. Disclose the address and related operating changes when the application or policy requires them.
Record the first patient date for every satellite office. A location that operates one day each week still needs review.
Compare Orange County with nearby counties
The Doctors Company uses Territory B for Orange and Los Angeles. MedPro uses Area 1. NORCAL uses Territory 4. MIEC applies its 1.900 geographic rate multiplier.
Riverside County remains with Orange under MedPro and MIEC. The Doctors Company and NORCAL place Riverside in other groups. San Diego County changes the geographic input in all four systems.
A new county can change all, some, or none of the carrier territory assignments. Check each policy's location restrictions and notice terms before work begins.
Describe the outpatient practice
Many Orange County practices provide both office visits and procedures. A comparable submission identifies the people, procedures, facilities, entities, and requested policy terms separately.
People
The clinician roster should connect every physician, nurse practitioner, physician assistant, registered nurse, technician, surgical assistant, contractor, and temporary clinician with an employer and defined duties.
Procedures
Procedure classifications depend on both clinician and location. Office visits, injections, endoscopy, surgery, anesthesia, imaging, pathology, infusion, cosmetic treatments, device procedures, and telehealth should appear as distinct work when they differ.
Facilities
Each hospital, ambulatory surgery center, accredited office surgery setting, clinic, infusion site, imaging center, and laboratory needs the legal name shown in its facility records and contracts.
Entities
Name the professional entity that provides care. Also name each employer, lessee, facility entity, and management company. A trade name does not replace the legal entity name.
Policies
The issued terms should identify each insured physician, clinician, professional entity, and facility as defined by the policy and show whether applicable limits are shared or separate.
Separate the services sold under one brand
One practice can offer surgery, injections, skin care, weight-loss treatment, hormone treatment, infusion, and concierge care. These services can require different carrier classes and policy terms.
Separate medical work from nonmedical work. For each medical service, identify who selects the patient, orders treatment, performs the procedure, manages complications, and provides follow-up.
For a physician-led medical spa, list each drug, device, treatment, injector, supervising physician, and location. State which entity controls clinical care and keeps the medical record. Include the emergency and transfer procedures.
For office surgery, state the anesthesia level, recovery process, facility status, staff, and emergency procedures. Confirm the professional policy and facility policy separately.
Use the actual work to select the class
The rate table shows classes for ten specialties. The quote should classify the physician's disclosed work.
Dermatology without surgery can differ from invasive cosmetic work. Plastic surgery can change when elective cosmetic procedures are added. Orthopedics can change when the surgeon performs spine procedures.
A valid quote pairs the specialty name and procedure list with the carrier's written class description. Exclusions and restrictions belong beside the premium because they can explain a price difference.
Check the annual aggregate limit
The annual aggregate is the most the policy will pay for all covered claims during the policy period. A group can share this limit across physicians, advanced practice clinicians, and entities.
Adding clinicians, locations, or procedures can place more claims against the same aggregate. The resulting limit must still meet any facility contract that requires a specific amount for each physician.
Keep each clinician's retroactive date and first work date on the clinician list. One group policy can contain different coverage dates for different clinicians.
Review a new county location
Collect this information before the new location opens:
- Legal address and first patient date.
- Clinicians and employing entities.
- Services and procedures at the location.
- Facility contracts and required licenses, certifications, or accreditation.
- Equipment, drugs, imaging, laboratory, and recovery functions.
- Required policy limits and additional-insured terms.
- The policy-required notice response, written confirmation, or issued endorsement.
The county determines the geographic rate input. The application facts and issued policy determine the insured services, people, entities, locations, and restrictions.
A shared territory still requires an Orange County policy schedule
Los Angeles and Orange counties share a territory in all four manuals reviewed here. Each quote must use the correct Orange County address and the same disclosed clinicians, entities, services, facilities, limits, policy form, and restrictions before comparing filed base rates.