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What Should be in a Nurse Practitioner Contract Termination Letter?

Blog, Nurse Practitioner Contract

What should go into a contract termination letter from a nurse practitioner?  First, when somebody wants to leave a job, for whatever reason, there’s going to be something in the contract that states how they can terminate the contract. Briefly, usually, it’s one of four ways. Either the initial term just ends, so if you have a two or three-year contract, it doesn’t automatically renew and it ends, you can move on. You don’t need a letter in that circumstance. You can do it by mutual agreement and in that circumstance, you wouldn’t need to provide a termination letter. If one of the parties terminates the contract for cause, let’s say one party is in breach of contract, the other states, you need to fix the breach or I’m going to terminate the contract immediately.

That would have to be a written letter. However, that’s more of just a notice they’re in breach. That’s not necessarily a termination letter. The most common scenario when a nurse practitioner would need a termination letter would be if they’re utilizing the without cause termination provision in their contract. Without cause termination simply means either party can terminate the agreement at any time with a certain amount of notice to the other. Normally in healthcare, it’s between 30 to 90 days. In a circumstance where an NP said, I don’t want to work with this employer anymore. Then you look in the without cause termination section in your contract and determine how much time is left. If it’s 90-day notice, then 90 days prior to your leaving, write them a letter.

And then in the letter, it just needs to simply say, per the agreement, I am terminating the contract with 90 days’ notice, my last day of work will be X date. Thank you for the opportunity. That’s it. I find many healthcare providers find that they want the termination letter to be airing of grievances. Just listing all the things that are wrong, here’s all the reasons why I’m leaving, here’s all the things that you screwed up on, all the things I’m unhappy with. There is no benefit if you are leaving an employer, to go into any of that, it doesn’t matter and it doesn’t help you. Maybe it can shed some light on some of the problems that the employer has, but that’s not a problem. That’s not your job. If you don’t want to work there anymore, just give notice and leave. And for a couple of reasons, one, even if you’re very unhappy, it still doesn’t make sense to burn bridges when you don’t have to. Other blogs of interest include:

And then what about a scenario where maybe at the time that you left the job was undesirable, but something happens, a manager quits and a new one is hired that has a better relationship with or the compensation changes or the venue changes. I mean, there are many things that can happen in a business where things can change quickly. And if you just send some flame thrower of a termination letter, and completely burn the bridge of the employer, even if some of the things that were wrong when you decide to leave have been changed, you may not have the opportunity to go back there simply because you burn the bridge on the way out. So, although I know it feels good emotionally to say, you stink, and therefore I’m leaving, there’s honestly no benefit to the nurse practitioner in doing that.

So, keep it short and sweet. Per the agreement, whatever without cause section termination that is, you give the exact number of days, this is the date that will be your last day. Appreciate the opportunity and that’s it. That’s all you must do. You don’t have to make some big justification, just without cause, that’s all you need legally. You don’t have to provide any reason why. It’s just, I’m terminating the contract, and that’s it. So, those are my thoughts on that. I kind of hear it time to time again about people wanting to put together a two-page letter of termination. And honestly, it just doesn’t make a lot of sense in my opinion.

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May 2, 2022/by admin
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Tail Insurance Cost for a Nurse Practitioner

Blog, Nurse Practitioner Contract

How much does tail insurance cost for a nurse practitioner? First, we need to talk about what types of malpractice insurance are available, and then when you have a certain type, do you need tail insurance? First, the setting is important. If an NP is employed by a hospital or hospital network, usually, at least nowadays, they’re self-insured, which means tail insurance generally is not necessary. If they do have a claims-made policy, then tail insurance is necessary. However, if you’re employed by a hospital or hospital network, it is very rare that a nurse practitioner would have to pay for their own tail. When they would have to pay for their own tail is in a kind of private practice setting.

If they’re employed by a smaller physician-owned group, or in some states if they have their own practice. In that case, two types of insurance are the most common. One is called an occurrence-based and one is claims made. Now, with an occurrence-based policy, the malpractice incident only must occur while a policy is in effect and meaning tail insurance is unnecessary. As far as claims made insurance goes, a policy must be in effect when the claim is made. And so, tail insurance is necessary for a claims-made policy. Just to kind of break down claims made, let’s say, a nurse practitioner is employed with a private physician-owned practice. If they terminate their employment, there still is a gap from when a patient knows the last day that the nurse practitioner provided care for the practice.

Usually, there’s a two-year statute of limitations in most states. And in that case, the patient can sue after the nurse practitioner no longer works for that practice. Therefore, a policy must be in effect that kind of covers that gap in between when they leave and then the last day, they can be sued by somebody. As I said before, in most states, it’s two years from when the patient either knew or should have known of the malpractice incident. There are also some minor exceptions for minors when they become adults, that type of thing. But for the most part, two years is kind of a good rule of thumb. In the employment contract, if the nurse practitioner has a claims-made policy, it’s going to state who pays for tail insurance. If it’s a private practice, I’d say it’s often, the NP would be responsible for it. Other blogs of interest include:

  • Tail Insurance Cost for a Nurse Practitioner
  • What Should be in a Nurse Practitioner Contract Termination Letter?

As I said before, if they’re in a hospital or hospital network, more times than not, the hospital is going to cover it. If the nurse practitioner is responsible to pay for tail, it must be purchased generally prior or right around the date of termination with the employer. And a good rule of thumb is it’s about twice what your annual premium is. Your annual premium is simply how much the employer must pay to insure you each year. If you had to pay for tail insurance, it normally is around twice what your annual premium is, and it’s a one-time payment. You don’t have to pay it every year. It’s all paid upfront and your tail is covered for as long as whatever the length of the tail policy you bought was. Tail insurance can have longer tails than others.

I mean, you could get theoretically one year tail, two-year tail, or an infinite tail. For most people, five years is kind of a good safe amount. If you had a two-year tail, but then something happened in year four or five, you are no longer insured, and it would be an issue. Now, how much does malpractice insurance cost for most NPs? Usually, it’s somewhere between 1500 to 2,500. So, let’s just say it’s $2,000. Then your tail cost would be around 4,000. Not like an enormous amount of money, but certainly something you may want to negotiate prior to signing the employment agreement. A couple of things to think about: one, if an, if it states that you must pay for tail, you can always ask the employer to pay for it. That’s one way of doing it.

If they’re unwilling to pay the entire amount, sometimes we’re successful in kind of tiering it. Let’s say, you have a three-year term for your contract. You could say one-third of the tail costs will be taken over by the employer for each year they’re there. So, by the time the three years is over, the employer pays the entire cost of tail insurance. Another way of getting out of having to pay for it would be if your new employer pays for your old tail. That’s called nose insurance. Or, if you stay with the same insurance company, normally, they will just roll over your policy wherever your new employer is, and you wouldn’t have to pay for tail insurance. This is something you can negotiate in the contract. Now, some employers are just simply unwilling to change any terms in the agreement, or maybe unwilling to change this term. And then, if that’s the scenario, you must make the decision of whether it’s a deal-breaker for you or not. So, that’s how much tail insurance costs, usually around twice what your annual premium is. You certainly want to find out what your annual premium is prior to signing the agreement. And that way you can forecast what your tail insurance cost will be.

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April 29, 2022/by admin
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What is Tail Insurance for a Nurse Practitioner?

Blog, Nurse Practitioner Contract

What is tail insurance for a nurse practitioner? Anytime a nurse practitioner is employed, they need to have professional liability insurance, also known as malpractice insurance, and depending upon what type of policy it is, they may need a tail insurance. Let’s first break down the different types of policies for a nurse practitioner. Normally, there are two types of main policies. One is called occurrence-based then the other is called claims-made. In an occurrence-based policy, a policy must be in effect when the malpractice occurs. This means tail insurance is unnecessary for occurrence-based insurance. Now, why would someone go with occurrence over claims made? Well, it’s kind of a math equation, but occurrence coverage generally costs about a third more than claims-made coverage.

And I find most employers, maybe some smaller owned physician practices, depending upon what state you are, maybe a smaller nurse practitioner owned practice, if it’s an employer, normally they’ll have a claims-made policy and then they’ll pay for the underlying premium, so how much they pay to insure the nurse practitioner per year, but they may put the cost of the tail insurance upon the nurse practitioner when the contract terminates. Going back to occurrence-based insurance. You do not need tail insurance for that. So, when you do need tail insurance is if there’s a claims-made policy, and that means a policy must be in effect when the claim is actually made. Think of the scenario where an NP leaves an employer. Well, there’s going to be a window from the last patient they see for that employer until the last day that patient can sue the nurse practitioner.

Normally, the statute limitation, so how long a person must sue someone for malpractice, in most states is two years from when you either knew or should have known that the malpractice occurred. There are some exceptions for minors when they become adults and that type of thing, but a general rule of thumb is two years is a standard amount. In that scenario, the NP would need a policy that covers that gap between when they leave and then the last day they can be sued and that’s called tail insurance also known as extended reporting coverage. I find it’s probably more likely than not that if the NP is with a smaller group, they’ll have to pay for the tail. Whereas if they’re with the hospital, hospital network, maybe a large corporate-owned practice, usually the tail costs will go to either hospital or corporation. Other blogs of interest include:

  • Tail Insurance Cost for a Nurse Practitioner
  • What Should be in a Nurse Practitioner Contract Termination Letter?

So, how much does it cost? Well, tail insurance is around twice what your annual premium is. For most nurse practitioners, their annual premium falls somewhere between 1500 to 2250 per year. Let’s just say, it’s 1500 a year annual premium. You multiply it by two, and tail cost will be around $3,000. Now, this is a one-time payment. You do not need to pay every year that you have tail coverage. And then, there are also different lengths for tail insurance. It could just be a short two-year window, you could have it indefinitely, it could be for five years, eight years, it just depends. And then the longer the tail, the more expensive it is. But as I said before, usually it’s going to be on average twice, but anywhere from 150%, all the way up to 300%. Now, if you’re a nurse practitioner and you’re negotiating an employment contract, this certainly could be something you could look at as far as who pays for the tail costs.

I mean, it’s not prohibitively expensive for a nurse practitioner. However, it still is going to be thousands of dollars that you’ll have to pay. And for NPs that jump around, you don’t want to have to pay two or $3,000 every time you leave a job. This certainly is something you can negotiate with the employer. If they’re unwilling to pay for the entire cost, one thing that we’ve found success in is asking the employer if they would then forgive a portion of it on an annual basis. For instance, let’s just say, we would say to the employer, okay, for every year that the nurse practitioner is employed, you’ll forgive 25% of the tail cost or cover 25% of the tail cost is, I guess, probably a better way of saying it. Let’s say, the nurse practitioner has been there for two years, they leave, then basically, they would split 50, 50 the cost of tail with the employer. And then, if they were to stay there for four years and then leave, then they wouldn’t have to pay for any tail insurance. Another way of having tail paid for is having your new employer pay for your old tail, that’s called nose coverage. Some employers will do that. It’s almost like a signing bonus in some way that they’ll pay for your old tail.

That’s another way of getting out of it. And then lastly, another way of getting out of it is, many times if you stay with the same insurance company, let’s just say you stay in the same state. Maybe there’s one big insurance company that does a lot of the nurse practitioner coverage. If you’re to move from one private physician-owned practice to another, and they use the same insurance company, then that new company would just roll over your old policy into a new one. And then you wouldn’t have to pay for tail. Obviously, in that scenario, it’s impossible to know, however, you’re going to go next if they use the same insurance company, but one you think about. So, that’s tail insurance for a nurse practitioner. I’d say high up on the list of things that people care about when I’m reviewing a contract with them, but it certainly is important to know the basics.

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April 25, 2022/by admin
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