If you pass our examination and we determine that you meet the eligibility requirements for direct pay, we will issue you a Notice of Eligibility. You must submit proof of your professional or business liability insurance to us before you can be eligible for direct payment.
In addition to providing proof of your professional or business liability insurance to establish eligibility for direct pay, you must provide proof of professional or business liability insurance indicating coverage for the minimum amounts per incident and annual aggregate amounts listed below whenever:
- You change insurance providers;
- After any period of ineligibility;
- Your insurance policy is renewed;
- You change employment status; and
- We request proof of professional or business liability insurance during an audit.
All insurance documents must be submitted to us through StratComm, Inc.
You must carry professional liability insurance coverage of at least $100,000 per incident and a minimum annual aggregate coverage of $500,000 (see 2005 FR Vol 70 No.136). For a business liability malpractice insurance policy, the minimal annual aggregate amount is determined in accordance with the following schedule:
Number of Covered Employees |
Minimum Aggregate Amount |
1 to 10 |
$500,000 |
11 to 25 |
$1 million |
26 to 50 |
$2 million |
51 to 100 |
$3 million |
101 to 200 |
$4 million |
201 or more |
$5 million |
We consider business liability insurance to constitute insurance equivalent to professional liability insurance provided the business liability insurance provides coverage that satisfies the required minimum per-incident and aggregate amounts. You must submit your certificate of insurance, binder of insurance, or other actual policy containing the following information:
- Effective dates of the insurance policy;
- Policy number; and
- Limits of professional liability insurance for malpractice.
Proposals, quotes for professional or business liability insurance, or any other documents that do not clearly establish that a policy meeting our requirements has been purchased, are not acceptable. Your professional or business liability insurance must be in effect at the time you submit proof to us. If you fail to submit proof of sufficient professional or business liability insurance, you will not be eligible for direct payment.
You will not be eligible for direct payment until your evidence of professional or business liability insurance is both submitted and approved by us. If we do not receive and approve your documents on or before the final day of the month by the 3:00 p.m. EST deadline, you will not be eligible for direct fee payment until the month after the month we receive and approve your documents.
If you are establishing eligibility for direct pay for the first time, you must submit a completed Form SSA-1699 on or after your assigned date of eligibility.