How should a multi-state senior living operator structure its program?

A shared annual aggregate across every location means one bad building can consume the limit protecting all the others. For a single-site operator that is not a distinction. For a portfolio it is the most consequential structural term in the program.

Per-location aggregates cost more and are worth it above a small number of buildings. The intermediate structure is a shared aggregate with a per-location reinstatement, which is cheaper than full per-location and removes the worst outcome. Ask for all three priced so the choice is a number.

Rating in this class is heavily venue-driven. A portfolio with buildings in a handful of the most severe jurisdictions will be priced as though the entire portfolio sits there, because the underwriter is pricing the tail and the tail lives in those buildings.

Two responses exist. Accept the blended rate and treat the severe-state buildings as subsidized by the rest, which is simple and often correct. Or ring-fence them into a separate entity with a separate program, which prices honestly but loses the credit for the good buildings and doubles the administrative load.

The ring-fence only pays when the severe-state exposure is a meaningful share of beds and the rest of the portfolio is genuinely low severity. Below that it costs more in program efficiency than it saves in rate.

Most senior care liability is written on surplus lines paper. A handful of states impose licensure or lender-driven requirements that are easier to satisfy on admitted paper, and where that is true the usual answer is a small admitted policy satisfying the requirement sitting beneath the real program rather than moving the whole program.

Confirm surplus lines tax and stamping obligations state by state, and confirm which entity is the named insured for each filing, because a multi-state filing error surfaces at audit rather than at binding.

Fund the retention centrally rather than at the building. A per-location retention funded locally means every claim becomes a negotiation with a building operator whose budget it hits, which delays reporting, and delayed reporting is expensive on a claims-made program.

Then draw the entity map: property owner, operator, manager, and any joint venture partner for each building, and confirm each one that a plaintiff would name is a named insured. On a portfolio this is the single most common finding, because entities get added at acquisition and never get added to the policy.