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Who Needs Coverage?
I hear there is a New to Practice Discount. Does it apply to
- You are eligible for a 25% New to
Practice Discount if you apply for JUA coverage within 1 year of
your first license date. This discount applies to the base rate,
ie. the premium you pay for the first 12 births. Your premium
for births above 12 is calculated at the full rate.
policies renew on my birthday? Or on Jan 1st?
- Unlike your midwifery license, your
JUA malpractice policy renews on Jan 1st every year. Each policy
term is for a full calendar year, except your very first year if
you start your policy after Jan 1st.
How do I estimate births? What if my estimate is too high or too
- In January each year, you will be asked how
many births you actually did the previous year, and your
premiums will be recalculated. If you overpaid, a credit will be
applied to the new policy term. If you underpaid, an invoice
will be sent for the extra owed. Some midwives prefer to
overestimate so there are no big bills in January, others prefer
to underestimate to help with cash flow. It's entirely your
my first policy starts mid-year, is it pro-rated?
- Yes, if you are planning to attend less than 12
The pro-ration is calculated as the greater of
number of births or number of days your policy is in effect. So, for example, if your policy will start Oct 1st and
you are planning to attend 6 births, you will pay approximately
1/2 of the base rate (based on births.) If you policy will start
Oct 1st and you will attend 1 birth, you will pay approximately
1/4 of the base rate (based on time.) If your policy will start Oct 1st but you
are planning to attend 20 births, you will pay the full premium.
email@example.com with your estimated start date and number of births and
I'll happily provide an estimated cost.
I graduated in the fall, so my first policy is only for a
couple of months. Will the New to Practice Discount also apply next
- If your first year policy is for less
than 6 months, then the New to Practice Discount is also applied
to your second full year policy.
How much will my policy
- The Rates page
gives the full details on how your premium is calculated.
My policy is described as "Claims-Made". What does that mean?
- A "Claims-Made" policy provides
coverage for incidents that happen after the policy retroactive
date and which are reported during the term of the policy. When
you terminate coverage, you are not covered for any lawsuit
filed against anything that occurred during your policy term
unless you either purchase a tail or reported the incidents to
the JUA during your policy term.
What is a Tail? How much is it?
- A Tail is optional coverage you can
purchase when you terminate coverage. It provides future
coverage for any lawsuits filed relating to incidents that
occurred during your policy term, even if you did not report
those incidents at that time. Tail coverage is calculated as
150% of the premiums you paid during the final 12 months of your
Is Washington Casualty or Midwifery Support Services my
- Neither. Your policy is written by the
JUA itself and always has been. Midwifery Support Services is
the administrator of the program, a role previously performed by
Washington Casualty and Physicians Insurance.
Which organizations are approved for peer review?
- The JUA requires proof of completion of peer review every two years. Peer Review must be through a WA State CQIP approved organization. The up to date list of approved organizations can be found here.
thinking of retiring so I'm
dramatically reducing my practice size. What options does the JUA
- For midwives who have been licensed
for 10 years or more and have had JUA coverage for 5 years or
more, you may qualify for the a Practice Reduction
for full details.
taking some time off to have a baby/travel overseas/etc. Is
there a sabbatical program?
- Yes, if you meet the following criteria:
- You have a minimum full-price policy
(i.e. you catch between 0 and 12 babies during the year that
youíre taking a leave)
- Youíve been a policyholder for at least
- Your leave will be between 3 months and
12 months long
- You will do absolutely no midwifery care
in Washington State during your leave
- The exact savings depend on how many babies
you catch and how much of the year you work. The period that you
are working is pro-rated based on the greater of the number of
births and number of days, and the period of your leave is then
calculated as a pro-rated 33% of the full policy cost. Email me
with your leave length and best estimate of number of births,
and Iíll crunch the numbers.
You may be curious why this
only applies to minimum policyholders. The reason is that
midwives who usually catch 50 babies already get a break if they
take half the year off because theyíll end up catching less
You may also wonder why sabbatical isnít totally
free. Itís all about tail coverageÖthe way liability insurance
works, you are only covered for incidents that happen while your
policy is active. If you cancel your policy, youíre no longer
covered unless you pay for tail, which costs 150% of your final
year coverage. So when youíre on sabbatical, itís like a
pseudo-cancellation, and the realities of insurance math mean
there is a cost in the form of liability exposure for the JUA
if you expect to be covered for incidents occurring prior to
I am hiring a birth assistant. Does the birth assistant need
We are bringing in a newly licensed midwife who will mostly be
supervised initially. Does she need malpractice coverage?
- Anyone providing any
unsupervised clinical care should have malpractice coverage.
- Birth assistants who are only employed
to assist at births with the midwife present, and who do not do
any unsupervised prenatal or postpartum visits may not need
- New midwives being brought into the
practice may well need malpractice coverage, since they are very
likely to do some amount of clinical care unsupervised.
Why should I bother reporting an incident?
- Reporting an incident serves two
purposes. By talking with us about the incident, we can advise
you on what to do and not do. Your actions following an incident
can influence the likelihood of an incident escalating to a
successful lawsuit. It also provides protection for you: by
reporting an incident, you ensure that you are covered for
future claims on that incident even if you do not purchase a
I should probably have reported an incident that happened last
year. Is it too late now?
- No. While your policy is active or a
tail in place, it is never too late to report an
Where should I send
- Please send payments to: JUA, PO Box
1206, Spokane WA 99210-1206
Insurance reimbursements are coming in really slowly right now, so
I'm struggling to come up with the premium that's due. Will my
coverage end if I don't pay in time?
- Coverage can be cancelled for
non-payment of premiums. However, I understand the realities of
midwifery finances. Please call or email me if you aren't going
to be able to pay your premium in time and we can discuss a plan
for catching up.