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What is Lone Star Alliance, RRG?

Lone Star Alliance is a risk retention group and an affiliated company of TMLT. It was established to provide medical liability and similar types of insurance to physicians, groups, health care facilities, and health care professionals in multiple states. Lone Star can meet the needs of TMLT's new and existing policyholders by writing insurance for those who have operations in states other than Texas.

Lone Star is domiciled in Washington DC and began writing business in December 2013.

What is a risk retention group (RRG)?

An RRG is an alternative insurance entity created by the federal Liability Risk Retention Act (LRRA). RRGs must form as liability insurance companies under the laws of at least one state — its charter state or domicile. The policyholders of the RRG are also its owners. Membership must be limited to organizations or persons engaged in similar businesses or activities, thus being exposed to the same types of liability.


Does TMLT own Lone Star Alliance?

No. While LSA is affiliated with TMLT, as an RRG it is owned by its policyholders. TMLT — directly and through its subsidiaries — provides LSA with all essential operational support. Such support includes financial and accounting services, information technology, underwriting, sales, marketing, claims handling, and risk management functions. These services are provided according to a management services agreement.

Where is Lone Star Alliance located?

Lone Star is domiciled in Washington DC, but our office is located in Austin, Texas.

What kind of policies does Lone Star offer?

Lone Star offers a full range of medical liability coverage options for individual and physician groups, and allied health care professionals. We offer claims-made (including prior acts or “nose coverage”) and occurrence policies at a variety of limits. Per-patient rated policies and shared-limit policies are also available. Policies include cyber liability protection, regulatory actions protection, medical director coverage, and employment practices liability insurance. View policy options.

Who can apply for coverage?

Any physician, group practice, allied health care professional, or health care entity located outside of Texas can apply for coverage with Lone Star.

If a practice located in multiple states applies for coverage, the Texas-based physicians may be insured through TMLT and the physicians based outside of Texas will be insured through Lone Star.


How do I obtain a quote or apply for coverage?

Please contact your agent or a Lone Star representative at or call 512-425-5890.


Do I have to be a member of the Texas Medical Association to purchase coverage with Lone Star?

No. TMA membership does not apply to Lone Star Alliance. TMA membership remains a requirement for coverage with TMLT.


How do I continue coverage if I leave Texas? Do I have to re-apply for coverage in Lone Star?

Because we will need information about your new practice, we will ask you to complete a short application. Please contact your underwriter at 800-580-8658.

What is the difference between Lone Star coverage and TMLT coverage?

The Lone Star policy mirrors the TMLT policy with the exception of state-specific requirements. Lone Star policies are flexible and specific policy needs can be modified or endorsed.


Do I qualify for Trust Rewards in Lone Star?

TMLT Trust Rewards cannot be extended to Lone Star Alliance policyholders.


What happens to my Trust Rewards balance if I move to Lone Star?

Because Lone Star policyholders are not eligible for the TMLT Trust Rewards program, you will not receive additional Trust Rewards allocations while you are insured with Lone Star. However, your existing Trust Rewards balance will remain intact while you are with Lone Star and you will be eligible for payout distributions pursuant to qualifying events.


Will I receive a dividend through Lone Star?

Lone Star does not have a dividend program at this time.


What discounts are available through Lone Star?

Lone Star rewards physicians for their patient safety efforts. The following premium discount opportunities are available in most states.

  • discounts for favorable claim experience
  • group purchasing credits
  • discounts for risk management participation
  • discounts for new-to-practice physicians
  • part-time discounts
  • discounts for completing a Lone Star CME course (up to 5 percent for two courses)


Does Lone Star offer CME?

Through our Risk Management Department, Lone Star offers home-study programs and online courses to help reduce liability risk. Courses are available at the Lone Star CME site.


Can I take a TMLT CME course and receive a discount for Lone Star?

No. You must take a Lone Star CME course to earn the discount. Courses are available at the Lone Star CME site.


Can I apply my TMLT practice review discount to my Lone Star policy?

No. Your TMLT practice review discount will not apply to your Lone Star policy.