Health system has interest in Caymans [Cumberland Times-News, Md.]

Oct. 22--CUMBERLAND -- The Western Maryland Health System recently sent representatives to the mandatory annual meeting of a "captive" insurance company in the Cayman Islands. Expenses of the representatives were paid by the Maryland Insurance Company, Ltd., not the health system, said WMHS spokeswoman Kathy Rogers.

<p>The Maryland Insurance Company is domiciled in the Cayman Islands.

"The captive pays the travel expenses for the WMHS attendees since it requires personal attendance by hospital executives once a year to perform routine corporate maintenance required by any entity. If an individual chooses to take his/her spouse, the individual is responsible for all of the spouse's expenses," Rogers said in an email in response to a Times-News inquiry.

Questions about the trip from members of the public came in the wake of recent layoffs and financial troubles at the health system.

The hospital, though, says the captive company saves money. "WMHS has saved more than $9 million in insurance premiums since establishing the captive. It has eliminated our dependence on commercial insurance and has resulted in lower, more predictable costs since funding is based on our own claims history and not on a larger of pool over which we have no control," Rogers said.

The health system takes travel expenses seriously, Rogers said.

"We realize that the timing of this year's meeting is unfortunate, but the meeting was scheduled a year in advance since it requires the attendance of many actuaries, auditors, attorneys and others in addition to WMHS," Rogers said.

"We always take a judicious approach on travel to educational conferences and other events. ... We are continuing to approve travel requests when they are deemed appropriate," Rogers said.

Online meetings and education programs have decreased the requests for travel, Rogers said.

The health system created the captive company in 2004 in response to rapidly rising insurance premiums in the insurance market, Rogers said. The insurance company provides professional liability insurance and general liability insurance for all health system entities, employees and more than 50 physicians.

The captive insurance company has other benefits, Rogers said. Investment income from the insurance company stays with WMHS instead of going to the stockholders of an insurance company. The captive also funds a risk management grant program used to promote patient safety initiatives at the health system.

The health system announced last month that in order to help save $5.9 million annually in salaries and benefits, 44 employees were being displaced from their current positions. About half of those were to be offered other opportunities within the system. Two executive positions have also been eliminated through attrition.

Dwindling health care spending by the federal government as well as Maryland's payment reforms are blamed by the health system for the need for belt-tightening.

Captive companies are being used increasingly by hospitals.

Fortune 500 companies and large nonprofit organizations, like hospitals and medical schools, have used captives for many years, Rogers said. "The majority of hospitals in Maryland have off-shore captives, all of which are domiciled in the Cayman Islands, except for one that is in Bermuda. A Baltimore-based firm (Riggs, Counselman, Michaels, and Downes) manages the insurance program and claims administration for our captive," Rogers said.

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