Employer Coverage vs Personal Policy for Physician Assistants: 7 Hidden Gaps That Cost Real Money

Many PAs assume the employer policy is enough. It often is not. Employer coverage vs personal policy for physician assistants comes down to control: limits, defense, tail, and what is actually covered when you moonlight, switch jobs, or face a board complaint.

Quick links:

• Physician Assistant Cost by State (2025)

• Claims-Made vs Occurrence for Physician Assistants

• Definitions and coverage: Physician Assistant Insurance

• State Specific Guides:

  • Arizona Physician Assistant Insurance

  • Florida Physician Assistant Insurance

  • Pennsylvania Physician Assistant Insurance

  • New York Physician Assistant Insurance

  • California Physician Assistant Insurance

Why This Matters

An employer policy is built to protect the employer first. It can share limits across many clinicians, control settlement, exclude side work, and leave you without tail when you leave. A personal PA malpractice policy follows you, not the facility. It can make the difference between a fast defense with your consent to settle and a years-long headache that puts your license and savings at risk.

The Short Answer First

• If you only practice inside one employer facility and never change jobs, the employer policy might be enough.

• If you moonlight, do telemedicine, switch employers, or want control of defense and limits, a personal policy is smart protection.

• The cost of a personal PA policy is often modest compared to the financial and career risk a gap can create. See typical ranges on our Physician Assistant Cost by State (2025)

Employer Coverage vs Personal Policy for Physician Assistants: 7 Hidden Gaps

1) Shared Limits vs Your Own Limits

Many employer policies use shared aggregate limits across physicians, PAs, and other providers. A large claim early in the policy year can erode the aggregate before your claim is even reported. Personal policy advantage: Your limits are yours, not shared.

2) Moonlighting, Telemedicine, and Off-site Work

Employer coverage often excludes side gigs, telemedicine, urgent care shifts outside the facility, or coverage in other states. Personal policy advantage: You can schedule all practice sites and telehealth, and add multi-state endorsements where available.

3) Settlement Control and the Hammer Clause

Employers or carriers may retain settlement control, prioritizing speed or cost over your reputation. Some policies apply a hammer clause, effectively penalizing you if you refuse a recommended settlement. Personal policy advantage: Often includes stronger consent to settle terms and puts your interests first.

4) Tail Coverage When You Leave

If the employer policy is claims-made, you may not be granted tail when you resign, are terminated, or the group changes carriers. Personal policy advantage: You can maintain your retroactive date when switching carriers or purchase your own tail if needed. For structure basics, see Claims-Made vs Occurrence for Physician Assistants

5) Board and License Defense

Employer policies may not include robust administrative or board defense for complaints to your state PA or medical board. Personal policy advantage: Many personal policies include board defense and related expenses.

6) Discovery, Subpoena, and HIPAA Defense

Not all employer policies include deposition representation, subpoena assistance, or HIPAA/privacy defense. Personal policy advantage: These endorsements are commonly available on personal policies, helping control costs when incidents do not rise to malpractice but still require legal help.

7) Employment Changes, Mergers, and Lapses

During acquisitions or payer credentialing changes, coverage can be restructured or delayed. Even a short lapse can matter with claims-made policies. Personal policy advantage: You keep continuity on your own terms, ensuring no gap.

How a Personal Policy Works With Employer Coverage

Think of your employer policy as the facility layer and your personal policy as the clinician layer. Used together, they can:

• Provide your own limits that are not shared with colleagues.

• Ensure defense provisions (consent to settle, defense outside limits) that prioritize you.

• Maintain coverage continuity as your career evolves.

• Cover non-employer work that would otherwise be excluded.

Cost Reality Check

Every situation is underwritten, but a typical individual PA policy often falls within the ranges shown in the Physician Assistant Cost by State (2025). Price varies by state, specialty, procedures, prior claims, and whether you add endorsements like board defense or cyber/privacy defense.

Choosing With Confidence: A Simple Framework

1. Map your work for the next 12 to 24 months. Will you moonlight, add telemedicine, or change jobs or states

2. Compare structures side by side: claims-made (with retro date) and occurrence. See pros and tail implications in the blog Claims-Made vs Occurrence for Physician Assistants

3. Confirm in writing whether your new policy will carry your retroactive date.

4. Review defense provisions: consent to settle, defense inside vs outside limits, board defense, subpoena assistance, HIPAA defense.

5. Align endorsements with your real work: telemedicine, multi-state, cosmetic or procedural endorsements if applicable.

Examples That Clarify the Risk

Moonlighting Weekends You pick up urgent care shifts off-site. Employer policy excludes off-site or non-facility work. Your personal policy schedules the location and protects you.

Employer Switch With Lost Retro Date You leave Employer A, whose carrier will not extend tail. Employer B’s carrier refuses to carry your retro date. Without your own tail, a claim from prior years may be uncovered. A personal policy strategy can avoid the gap.

Board Complaint After a Discharge A patient files a board complaint after you change jobs. Employer A may decline administrative defense. A personal policy with board defense engages counsel quickly.

What Good Looks Like (Checklist)

• Limits align with hospital or payer requirements (for example, 1,000,000 per claim / 3,000,000 aggregate or 2,000,000 / 4,000,000).

• Defense outside the liability limits whenever possible.

• Consent to settle language that respects your professional judgment.

• Board defense and HIPAA defense endorsements included.

• Telemedicine and multi-state coverage listed if needed.

• Retro date preserved when changing carriers; tail arranged when not.

Frequently Asked Questions

Do I really need a personal policy if my employer covers me? If you never moonlight, never switch jobs, never do telemedicine, and are guaranteed tail at exit, you may be fine. Most PAs do not live in that world. A personal policy provides your own limits, defense, and continuity.

Will a personal policy duplicate my employer coverage? No. It is designed to follow you across roles and sites, fill exclusions, and protect you when you leave.

What about tail? If the new carrier will not carry your retro date, you likely need tail from the old carrier. Read more on our Claims-Made vs Occurrence for Physician Assistants blog

Compliance Note

Rates and examples are illustrative only. Each individual situation will be underwritten. Coverage availability and pricing vary by state, specialty, procedures, carrier, and loss history. Common limits include 1,000,000 per claim / 3,000,000 aggregate and 2,000,000 / 4,000,000 aggregate.