We’re Moving!





The new THIE Headquarters is currently under
construction in Georgetown, TX.
THIE HQ is a custom-designed facility with space
for continued staff growth and will be available
for use by our Subscribers, for Board meetings,
in-service education sessions, or workspace when
visiting the Austin area.

Staff was joined at the groundbreaking celebration
by former THIE Board Chairman Ken Poteete.
Anticipated completion date: April 2022.

AM Best Upgrades Credit Ratings of Texas Hospital Insurance Exchange

AM Best Upgrades Credit Ratings of Texas Hospital Insurance Exchange


OLDWICK, N.J., January 18, 2022—AM Best has upgraded the Financial Strength Rating to A- (Excellent) from B++ (Good) and the Long-Term Issuer Credit Rating to “a-” (Excellent) from “bbb+” (Good) of Texas Hospital Insurance Exchange (THIE) (Austin, TX). The outlook of these Credit Ratings (ratings) is stable.

The ratings reflect THIE’s balance sheet strength, which AM Best assesses as strong, as well as its strong operating performance, limited business profile and appropriate enterprise risk management (ERM).

The upgrades reflect an improvement in the balance sheet strength assessment to the higher end of the strong category. THIE maintains the strongest level of risk-adjusted capitalization, as measured by Best’s Capital Adequacy Ratio (BCAR). The company has reported solid surplus growth over the most recent five-year period, despite ongoing cash distributions to policyholders. Through nine months of 2021, these trends persisted. Underwriting leverage metrics are very low and compare favorably with the commercial casualty composite average. Loss reserve development continues to be redundant, albeit with less magnitude in more recent years. Offsetting factors include limited scale and financial flexibility as a standalone reciprocal. In addition, the majority of surplus consists of subscribers’ savings account balances, which are subject to be returned to withdrawn members beginning five years after departing from the reciprocal exchange.

THIE’s operating performance has been strong and is the primary driver of surplus growth. The limited business profile assessment primarily reflects product and geographic concentration risks due to THIE’s niche focus on writing workers’ compensation, professional liability and related coverages for small rural hospitals in Texas. An appropriate ERM program is in place, with well-identified key risks and corresponding mitigation strategies.

Negative rating action could result from an unfavorable trend in operating performance due to an increase in claim frequency, severity or adverse loss development.


This press release relates to Credit Ratings that have been published on AM Best’s website. For all rating information relating to the release and pertinent disclosures, including details of the office responsible for issuing each of the individual ratings referenced in this release, please see AM Best’s Recent Rating Activity web page. For additional information regarding the use and limitations of Credit Rating opinions, please view Guide to Best’s Credit Ratings. For information on the proper use of Best’s Credit Ratings, Best’s Preliminary Credit Assessments and AM Best press releases, please view Guide to Proper Use of Best’s Ratings & Assessments.

AM Best is a global credit rating agency, news publisher and data analytics provider specializing in the insurance industry. Headquartered in the United States, the company does business in over 100 countries with regional offices in London, Amsterdam, Dubai, Hong Kong, Singapore and Mexico City. For more information, visit www.ambest.com.

Copyright © 2022 by A.M. Best Rating Services, Inc. and/or its affiliates. ALL RIGHTS RESERVED.




THIE From the Field: Health Care Worker Burnout and Moral Injury Amidst the Pandemic

THIE From the Field: Health Care Worker Burnout and Moral Injury Amidst the Pandemic

Written By: Angie Merrell, RN Vice President, Risk Management, Texas Hospital Insurance Exchange &
Cecil Conner, Risk Management Advisor, Texas Hospital Insurance Exchange


Since day one of the COVID-19 pandemic, there have been constant challenges that have exceeded and overwhelmed the capacity of our hospitals. Our health care workers have also faced countless additional stressors and anxiety. The long shifts combined with unprecedented regulatory restrictions, including personal isolation and other factors have affected their ability to cope with the job and, in many instances, life. But what impact has this had on our workers and what can health care leaders do to help?

We know that health care workers can be at heightened risk for anxiety, depression, burnout, insomnia, moral distress, and post-traumatic stress disorder. Under the usual working conditions, severe burnout syndrome affects as many as 33% of critical care nurses and up to 45% of critical care physicians. The pandemic has heightened risk factors, which include increased workloads, demands and little control over the work environment, as well as the trauma of caring for patients who are critically ill. These risk factors also represent important exacerbating factors for poor mental health among health care workers.

There is a distinction between burnout and moral injury. Burnout suggests the problem resides within the individual, who is in some way deficient and unable to cope. Moral injury describes the challenge of simultaneously knowing what patients need but are unable to provide it due to constraints that are beyond control. Moral injury is the consequence of the ever-present double binds in health care: do we take care of our patient, the hospital, the insurer, the EMR, the health care system, or our productivity metrics first?  Moral injury locates the source of distress in a troubled system, not within a troubled individual, and allows us to direct solutions at the causes of distress. In the end, addressing the drivers of moral injury on a large scale may be the most effective preventive treatment for its cumulative effects among health care providers.

To adequately support health care workers, we must understand their challenges and needs. Burnout and other forms of work-related psychological stress are unavoidable occupational health issues. By acknowledging the stress related to the effects on hospital staff during this difficult time, we can appropriately attend to the mental health needs of all health care workers affected by the pandemic.

As leaders in the health care industry, we must recognize and understand why so many caregivers feel frustrated and unfulfilled in their work as they face barriers to providing the highest quality care to their patients. Leadership and all levels of management have a vital role in leading and guiding their teams to address all aspects of the problem within their span of control and create the conditions for individuals to find fulfillment in their professions to care for patients.



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THIE Welcomes Dan Andersen, VP Underwriting and Business Development

THIE Welcomes Dan Andersen, VP Underwriting and Business Development

Following in the footsteps of tenured THIE staffer Liz Jennings, it is our pleasure to welcome Dan Andersen
to the THIE team. Dan joined the Texas Hospital Insurance Exchange in September of 2021 and has worked
closely with Liz to transition the VP of Underwriting role while meeting and working with many of our
subscribers and agents.

Dan Andersen is Vice President of Underwriting and Business Development for the Texas Hospital Insurance
Exchange (THIE) in Austin, Texas.  He has over 20 years’ experience underwriting all types of medical professional
liability coverage including large physician groups, hospitals, and other medical facilities.

In his new position, Dan is responsible for new business production and retention of subscribers through the
promotion and marketing of the products and services of THIE.  He oversees the operation of the underwriting
department including compliance with state agencies and regulatory authorities.

Dan’s prior insurance experience comes from his many years of service at COPIC Insurance Company and NORCAL.

Insurance coverage you deserve, from the insurance company you own.
Contact us, today, to learn more about our line of insurance products and how THIE can be the perfect
fit for your health care facility. 800/792-0060.




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