HomeMy WebLinkAboutItem T10 BOARD OF COUNTY COMMISSIONERS
COUNTY of MONROE Mayor Michelle Lincoln,District 2
The Florida. Keys Mayor Pro Tem David Rice,District 4
p Craig Cates,District I
James K. Scholl,District 3
Holly Merrill Raschein,District 5
Regular Meeting
April 15, 2026
Agenda Item Number: T10
26-0771
BULK ITEM: No DEPARTMENT: Risk Management
TIME APPROXIMATE: N/A. STAFF CONTACT: Gaelan Jones
AGENDA ITEM WORDING: Approval to purchase Professional liability coverage for Air Flight
Nurse and the Medical Examiner for a cost of$34,100.
ITEM BACKGROUND: The County's Professional liability policy for its Flight Nurses and Medical
Examiner expires May 1, 2026. The County is required to have this policy because its primary liability
specially excludes healthcare services rendered by nurses. The current policy is provided by Markle
Insurance Company and has a per incident limit of$1M, an annual aggregate and$3M, and no
deductible. Coverage is provided on a "Claims Made"basis with a retroactive date 4/26/2007. The
annual premium for the expiring policy is $31,000. Markle has agreed to renew the coverage with
terms and conditions with the expiring policy for an annual premium of$34,100. This represents an
increase of 10%. This is considered a reasonable increase under current market conditions. This
renewal would extend coverage by an additional one-year term,beginning May 1, 2026, and expiring
May 1, 2027.
PREVIOUS RELEVANT BOCC ACTION: April 16, 2025, BOCC approved to accept the proposal
for Professional liability for Flight Air Nurses and Medical Examiner from Markle insurance through
Marsh agent.
INSURANCE REQUIRED: No.
CONTRACT/AGREEMENT CHANGES: N/A.
STAFF RECOMMENDATION: Approval.
DOCUMENTATION:
Renewal Quote 2026-27
Renewal Application
FINANCIAL IMPACT:
Effective Date: 5/1/26
Expiration Date: 5/1/27
Total Dollar Value of Contract: $34,100
Total Cost to County: $34,100
Current Year Portion: $34,100
Budgeted: Yes.
Source of Funds: SC 00054 CC 08502
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: If yes, amount:
Grant:
County Match:
Insurance Required:
3/24/26
To:
Andrew Barakat
Marsh USA, LLC
For:
Monroe County Board of County Commissioners
Express Renewal quote
Evanston Insurance Company
Expiring policy: MKLVIPSM001696-0
Expiring policy period: 5/1/25 - 5/1/26
We are pleased to present this renewal quotation on the above referenced policy. This quote is based on expiring
information.A list of forms applicable to the renewal term is provided below.All mandatory state endorsements
that are applicable will be added to the policy.All other terms and conditions remain unchanged and are the same
as contained in the expiring policy.
Note: If the insured has had a material change in ownership, operations,professional services, financial position,
or changes in the underlying policy for excess coverage, please contact your Markel underwriter.
Express Renewal terms:
............................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................................
Premium: $34,100
Policy period: 5/1/26 - 5/1/27
Limits of insurance: All limits as expiring
Deductibles or SIR: Where applicable, as expiring
,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,
Retroactive date: Where applicable, as expiring
Forms/endorsements:
EIL520025%0704 Minimum Earned Premium Endorsement
MEIL52290910 Longer Duratn Extended Report Period Availability
MESM20041012 Claim Exp in Add to Each Claim Limit of Liab
MESM2074FL1112 Consent to Settlement-Florida
ZZ4400201 Mold Exclusion
MJIL10000810 Policy jacket
MPIL1006FL0I IO Florida Policyholder Notice
MPIL10070120 Privacy Notice
MPIL10830415 U.S. Treasury Department's Office Of Foreign Assets Control
(OFAC)Advisory Notice To Policyholders
MIL12140917 Trade Or Economic Sanctions
MESM50100220 Specified Medical Professions Professional Liability Insurance
Coverage Part
MESM51000220 Common Policy Conditions
MESM21620321 Amendment Of The Insured B.Addition Of Physician, Surgeon,
Dentist, Or Podiatrist
MESM30291019 Exclusion - Correctional Medicine
MESM30410223 Exclusion—Cyber Incident
MDSM50130220 Declarations- Specified Medical Professions Insurance Policy
MDIL 10010810 Forms Schedule
MESM21440220 Sexual Acts Liability Scheduled Deductible And Retroactive Date
MESM21470520 Changes—Multiple Insureds, Claims And Claimants
Evanston Insurance Company
III
MARKED
NE HEALTH CARE AND HEALTH CARE STAFFING ORGANIZATIONS
ZITY APPLICATION (CLAIMS MADE)
Alest�M�T completed in full.
If ace is insufficie o answer any question fully, attach a separate sheet.
Name of Applicant(including any DBAs): Monroe County Board of County Commissioners
Principal Business Address: 1111 121" Street, Suite 408 Monroe County
Street County
Key West FL 33040
City State Zip
Website Address:_MonroeCounty-FL.gov NAICS:
Contact Person or Risk Manager: Jaclyn Flatt Risk Manager
Name Title
Email:f att.:..�U_gg n g!2 p!2q -�tl„i .!E ov Phone Number: 305-292-3576
Date Established: 2001 Number of Years Under Current Management: 25
Applicant is a(n):
❑ Individual ❑ Partnership ❑ Joint Venture ❑ Professional Association ❑ Professional Corporation (For Profit)
❑ Professional Corporation (Not for Profit) ® Government Entity ❑ Other
EXPOSURE INFORMATION
1. Description of operations (check all that apply):
❑ Home Health Care Provider ❑ Visiting Nurse Agency ❑ Nurse Registry ❑ Medical Staffing Organization
❑ Infusion Therapy Provider ® Other Medical Examiner Office/ Emergency Medical Air Transport
2. List all states where the applicant provides services, and show the percentage of services by state (total must equal
100%): Florida 100%
3. Is the applicant owned or controlled by another entity? ❑Yes ® No
If yes, provide details:
4. List all subsidiaries and affiliates that coverage is requested for:
Name Relationship Description of Operations Date Ownership Retroactive Date
Acquired % On Current
Policy
5. Provide the applicant's annual gross revenues:
Second Year Prior First Year Prior Current Year Projected for the next 12 months
N/A
MASM 5038 01 19 Page 1 of 8
6. Provide the percentage of services provided at each location (must equal 100%):
Private Homes: Correctional Facilities: Other(specify): Medical Examiner Office (10%)
Hospitals: Outpatient Facilities: Other(specify): Trauma Star Helicopters (90%)
Skilled Nursing Facilities: Schools: Other(specify):
pAssisted Living Facilities:
e 40-4W provided to hospitals, specify the departments (must equal 100%):
Emergency Department: Neonatal: General Medical Services:
Surgery: Intensive Care: Other (specify):
Obstetrics: Psychiatric: Other (specify):
8. For In-Home Services, specify the services provided (must equal 100%):
In-Home Services: % of In-Home Services:
Speech and/or Occupational Therapy:
Personal and Companion Care: non-medical care, housekeeping, meal prep, general
companionship, assistance bathing, dressing, grooming, using the bathroom, taking
medications, etc.:
General Nursing Care: palliative care, dietary/nutrition support, hospice services,
physical therapy, medication management, etc.:
Advance Skilled Care: tracheotomy/ventilator care, radiation therapy, chemotherapy,
feeding tube, complex wound care, etc.:
Other(specify):
9. What percentage of Advanced Skilled Care services are provided to patients under 18 years of age?_10 %
10. Does the applicant:
a. Provide live-in home care services? ❑ Yes ® No
If yes, explain:
b. Prescribe medications? ❑Yes ® No
If yes, explain:
c. Administer anesthesia, other than topical anesthesia? ❑Yes ® No
If yes, explain:
11. Describe any changes in operations, including new services or discontinued services, anticipated for the next year:
N/A
EMPLOYEES AND STAFF
1. Provide the following information for all employed or contracted physicians including Medical Directors:
Name Specialty Employed or Hours Per Month
Contracted
Dr. Michael Steckbauer Medical Examiner Employed 173
Note: Coverage for physicians is not automatically included. If coverage is requested, a separate application must be
completed.
MASM 5038 01 19 Page 2 of 8
2. Provide the total number of allied health care personnel and annual hours worked in each category:
Type Employees Independent Contractors Volunteers
FTEs Hours FTEs Hours FTEs Hours
(annual) (annual) (annual)
Physician Assistant
iftse Practitioner
Registered Nurse
Licensed Practical Nurse
Home Health Aide
Certified Nurse Assistant
Social Worker
Case Manager
Occupational/Speech
Therapist
Physical Therapist
Respiratory Therapist
Pharmacist
Nutritionist/Dietician
Other(specify) 7 2080
Flight Nurse
Other(specify) 4 Varies
Flight Nurse Part time
Other(specify)
Other(specify)
3. Are all above staff members licensed in accordance with applicable state and federal regulations? ®Yes ❑ No
If no, explain:
LICENSURE/ACCREDITATIONS
1. Is the applicant licensed in accordance with applicable state and federal regulations? ® Yes ❑ No
If no, explain:
2. Has the applicant's license ever been revoked, suspended, cancelled? ❑ Yes ® No
If yes, explain:
3. Is the applicant a member of any professional associations? ❑ Yes ® No
If yes, list the professional associations:
4. List all accreditations by any governmental entity or patient safety/quality organization:
Monroe County Board of County Commissioners
HIRING AND STAFF MANAGEMENT
1. Does the applicant use the following procedures in hiring and screening of staff members:
Criminal background checks: ® Yes ❑ No
If yes, at which level? ® Federal ® State
MASM 5038 01 19 Page 3 of 8
Drug/alcohol testing: ®Yes ❑ No
Verification of employment history: ® Yes ❑ No
Verification of education: ® Yes ❑ No
Verification of certifications/licensure: ® Yes ❑ No
Reference checks: ® Yes ❑ No
Mrification of driver's license: ® Yes ❑ No
Verification of denial or cancellation of prior insurance: ® Yes ❑ No For Medical Examiner
Verification of prior professional liability claims/litigation: ® Yes ❑ No
Screening for prior allegations involving sexual abuse: ® Yes ❑ No
2. Are job descriptions provided for all employees? ®Yes ❑ No
3. Do employees participate in training and/or continuing educational programs? ®Yes ❑ No
If yes, describe: The medical examiner and nurses all maintain their CPD for license maintain
4. Average staff turnover rate % In this section extremely low.
RISK MANAGEMENT
1. Is the applicant a "Covered Entity" under the Health Insurance Portability and Accountability Act of
1996 (HIPAA) Privacy Rule? ® Yes ❑ No
If yes,
a. Has the applicant implemented procedures to comply with the HIPAA Privacy Rule? ® Yes ❑ No
b. Provide the name and title of the applicant's Privacy Officer. Christine Hurley
Our Business Associate Agreement is available at..h..t..t.Ra-://www..irnairkelcorp..coim/US I nsurance/1 fli"AA. This is the only
Business Associate Agreement we will recognize.
2. Does the applicant have a dedicated Risk Manager and/or Patient Safety officer or similar position? ® Yes ❑ No
If yes, provide resume(s).
3. Does the applicant have written Risk Management, Quality Assurance, Patient Safety policies in place? ®Yes ❑ No
4. Does the applicant conduct patient satisfaction surveys? ❑Yes ® No
5. Does the applicant have written policies and protocols in place for the following (attach supporting documentation):
Treatment plans/orders prescribed by physicians? ❑Yes ® No
Medication management? ❑ Yes ® No
Assessment and acceptance of patients? ® Yes ❑ No
Informed consent? ® Yes ❑ No
Patient discharging? ® Yes ❑ No
Medical record documentation? ® Yes ❑ No
Incident reporting? ® Yes ❑ No
Emergency management? ®Yes ❑ No
Patient lifting/transferring? ®Yes ❑ No
Medical equipment usage and training? ®Yes ❑ No
First aid? ®Yes ❑ No
Complaint management? ®Yes ❑ No
6. Do third-party contracts contain the following provisions: No third-party contract
MASM 5038 01 19 Page 4 of 8
a. Hold harmless and indemnification clauses? ❑Yes ❑ No
b. Insurance requirements? ❑ Yes ❑ No
If yes,
(1) What professional liability limits are required: $ /$
(2) Do you require certificates of insurance? ❑ Yes ❑ No
c. Confidentiality clauses? ❑ Yes ❑ No
d. Additional insured requirements? ® Yes ❑ No
If yes, provide details of the third party and its relationship to the applicant: No third-party contracts are used for
provision of these healthcare services. Policy requires all contractors to list BOCC as additional insured.
7. Does the applicant require certificates of insurance from all independent contractors? ® Yes ❑ No
GENERAL LIABILITY(complete only if this insurance is requested)
1. Complete the following for any owned, occupied or leased location:
Location description and address Sq. Yr Type of No. of Type of fire protection
footage Built Construction stories
2. Does the applicant own, operate or control a day care facility? ❑ Yes ❑ No
If yes,
a. Number of: Children Adults (18-65) Seniors
b. Describe the medical needs of day care patients:
3. Does the applicant manufacture any products? ❑ Yes ❑ No
If yes, describe:
4. Does the applicant sell, rent or lease medical supplies or equipment? ❑Yes ❑ No
If yes, describe:
5. Does the applicant repair or perform maintenance on any medical supplies or equipment? ❑Yes ❑ No
If yes, describe:
6. Does the applicant modify products in any way from its original form or intended use? ❑ Yes ❑ No
If yes, describe:
7. Complete the following for all products sold/leased:
Category I EXPENDABLE ITEMS: Intended for one-time usage and disposed (i.e. adhesive tape, bandages,
hypodermic needles, etc.).
Sales Receipts $ Lease Receipts $
Category II NON-EXPENDABLE ITEMS: Equipment excluding diagnostic or treatment equipment or devices. This
category includes, but is not limited to, hospital beds, bathroom safety bars, portable toilets, patient lifts or hoists,
traction apparatus, ambulatory aids, walkers, strollers, canes, crutches, wheelchairs, and prosthetic devices and IV
stands.
Sales Receipts $ Lease Receipts $
Category III DIAGNOSTIC OR TREATMENT DEVICES: Treatment devices or equipment not used to sustain life or
perform critical life monitoring functions, including items such as blood pressure gauges, IV pumps, portable EKG
machines or sensing devices.
Sales Receipts $ Lease Receipts $
MASM 5038 01 19 Page 5 of 8
Category IV LIFE SUSTAINING OR CRITICAL LIFE MONITORING EQUIPMENT OR DEVICES: Includes oxygen
and other medical gases used in conjunction with respiratory therapy, dialysis or heart/lung machines, apnea
monitors or any other life dependent monitors or any other equipment or devices that malfunction or failure could
result in the death or serious deterioration of the patients' health condition.
Sales Receipts $ Lease Receipts $
8. Has any claim for General Liability ever been made against any person(s)or entity(ies) proposed
for this insurance? ❑ Yes ❑ No
If yes, provide currently values loss history for claims for a minimum of the last 5 years.
9. Is (are) any person(s) or organization(s) proposed for this insurance aware of any fact, circumstance,
situation or incident which may result in a General Liability claim, such as would fall under the
proposed insurance? ❑ Yes ❑ No
If yes, provide details for each.
COVERAGE REQUESTED
Effective Date:
® Professional Liability (claims made only) ❑ General Liability ❑ Claims Made ❑ Occurrence
Retroactive Date: Retroactive Date (if claims made):
Limits of Liability(each claim/aggregate):
® $1,000,000/$3,000,000 ❑ other(specify) $ /$
Deductible (each claim):
® No deductible ❑ $2,500 ❑ $5,000 ❑ $10,000 ❑ $25,000 ❑ $50,000 ❑ Other(specify)
❑ Employee Benefits Liability ❑ Hired and Non Owned Automobile Liability
Retroactive Date: No. of Employees: (Supplemental Application must be completed)
THE COMPANY DOES NOT GUARANTEE TO OFFER ANY OF THE ABOVE COVERAGES LIMITS AND/OR
DEDUCTIBLES.
OTHER INSURANCE AND CLAIM HISTORY
Attach a detailed explanation for any YES answers.
1. Has the applicant or any principal, partner, owner, officer, director, employee, manager or managing member of the
applicant or any person(s) or organization(s) proposed for this insurance or any predecessor, subsidiary or affiliated
organization ever:
a. Been the subject of disciplinary or investigative proceedings or reprimand by a
governmental or administrative agency, hospital or professional association? ® Yes ❑ No
b. Been convicted for an act committed in violation of any law or ordinance other than
traffic offenses? ® Yes ❑ No
c. Been treated for alcoholism or drug addiction? ® Yes ❑ No
d. Had any state professional license or license to prescribe or dispense narcotics been refused,
suspended, revoked, renewal refused or accepted only on special terms or ever voluntarily
surrendered same? ® Yes ❑ No
e. Had any insurance company or Lloyd's cancelled, declined, refused to renew or accept only
on special terms their malpractice insurance? ❑ Yes ® No
2. Does the applicant currently participate in or plan to participate in a state patient compensation
fund, health care stabilization fund or other governmentally established malpractice liability
funding mechanism? ❑Yes ® No
MASM 5038 01 19 Page 6 of 8
3. List current and prior Professional Liability Insurance for each of the last 4 years:
Is this a
Policy Policy Limits of Deductible Inception Expiration Claims Made Retro
Insurance Carrier Number Liability if an Premium MM/DD/YYYY. MM/DD/YYYY Policy Form? Date
Evanston Insurance Company- MKLV1 PSM001 240; $1M/$3M; $0; $31,000 5/1/25- 5/1/26 Yes No
® ❑ 4.26.2007
❑ ❑
❑ ❑
❑ ❑
4. Has any claim or suit for malpractice ever been made against the applicant, or any
principal, partner, owner, officer, director, employee, volunteer worker, manager or managing member of
the applicant or any or any person(s) or organization(s) proposed for this insurance or any predecessor,
subsidiary or affiliated organization? ❑Yes ❑ No
If yes, a Supplemental Claim Information Form must be completed for each claim or suit.
5. Is the applicant and/or any principal, partner, owner, officer, director, employee, manager or managing
member thereof or any person(s) or organization(s) proposed for this insurance aware of any act, error,
omission, fact, circumstance, situation, incident or allegation of negligence or wrongdoing, or records
request from any attorney which may result in a malpractice claim or suit? ❑Yes ® No
If yes, provide details on a separate sheet.
Fraud Warning: Any person who knowingly and with intent to defraud any insurance company or other person files an
application for insurance or statement of claim containing any materially false information or conceals for the purpose of
misleading, information concerning any fact material thereto, commits a fraudulent insurance act, which is a crime and
subjects the person to criminal and civil penalties.
NOTICE TO THE APPLICANT - PLEASE READ CAREFULLY
No fact, circumstance, situation or incident indicating the probability of a claim or action for which coverage may be
afforded by the proposed insurance is now known by any person(s) or organization(s) proposed for this insurance other
than that which is disclosed in this application. It is agreed by all concerned that if there is knowledge of any such fact,
circumstance, situation or incident, any claim subsequently emanating therefrom shall be excluded from coverage under
the proposed insurance.
This application, information submitted with this application and all previous applications related hereto and material
changes thereto of which the Company receives notice is on file with the Company and is considered physically attached
to and part of the of the policy if issued. The Company will have relied upon this application and all such attachments in
issuing the policy.
For the purpose of this application, the undersigned authorized agent of the person(s) and organization(s) proposed for
this insurance declares that to the best of his/her knowledge and belief, after reasonable inquiry, the statements in this
application and in any attachments, are true and complete. The Company is authorized to make any inquiry in connection
with this application. Signing this application does not bind the Company to provide or the applicant to purchase the
insurance.
If the information in this application or any attachment materially changes between the date this application is signed and
the effective date of the policy, the applicant will promptly notify the Company, who may modify or withdraw any
outstanding quotation or agreement to bind coverage.
The undersigned declares that the person(s) and organization(s) proposed for this insurance understand that the liability
coverage(s)for which this application is made apply(ies):
(i) Only to claims first made during the Policy Period;
(ii) Unless amended by endorsement, the limits of liability contained in the policy shall be reduced, and may be
completely exhausted by claim expenses and, in such event, the Company will not be liable for claim expenses or the
amount of any judgment or settlement to the extent that such costs exceed the limits of liability in the policy; and
(iii) Unless amended by endorsement, claim expenses shall be applied against the deductible.
MASM 5038 01 19 Page 7 of 8
WARRANTY
The undersigned warrant to the Company, that they understand and accept the notice stated above and that the
information contained herein is true and that it shall be the basis of the policy and deemed incorporated therein, should
the Company evidence its acceptance of this application by issuance of a policy. The undersigned authorize the release
of claim information from any prior insurer to the Company.
Must be signed within 60 days of the proposed effective date.
Gaelan Jones Assistant County Attorney- Risk Management
Name of applica/n Title
�t
aw rp 3/23/26
Si4nature of appliceo Date
MASM 5038 01 19 Page 8 of 8