Hospital Corporation of America and Subsidiaries - Page 9

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          $350,000.  For captive insurance companies, the Tennessee                   
          Department of Commerce and Insurance, Division of Insurance                 
          (Department of Insurance), requires the ratio of net written                
          premiums to policyholders' surplus (i.e., the net worth of an               
          insurance company) to be no greater than 3 to 1.  Captive                   
          insurance company rates may not be excessive, inadequate, or                
          unfairly discriminatory.  The Tennessee captive insurance statute           
          does not require pure captive companies to use the NAIC format.             
               Tennessee insurance company regulatory provisions require              
          less startup capital for "pure captive" insurers than for                   
          companies licensed to sell insurance to the general public,                 
          impose lower premium taxes in comparison to commercial companies,           
          and provide an exemption from participation in State involuntary            
          risk plans, such as assigned risk pools and guaranty funds.  The            
          business functions and operations of captive insurance companies            
          in Tennessee are subject to examination by the Department of                
          Insurance at least once in a 5-year period, or when the                     
          Commissioner deems it prudent to conduct an examination.                    
          Business functions include underwriting, marketing, investing,              
          claims adjusting, loss reserving, and financial reporting.                  
               Prior to the mid-1970's, the availability and price of                 
          coverage for medical malpractice risks were not significant                 
          concerns for an organization the size of HCA.  During the mid-              
          1970's, however, increases in the size and frequency of medical             





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Last modified: May 25, 2011