As more physicians are moving away from independent practice and under the umbrella of a hospital or health system, health system risk managers are (or should be) working closely with the physician recruiting staff to identify and address the expanding risks of the organization. In many cases, risk managers are retooling their insurance program structure to accommodate the expanding risks to the organization. Should the health system retain or transfer the physician exposure? Once employed, should the physicians share the limits of the health system or is it better to provide separate limits? If the employed physician was previously insured on a claims made basis, what is the best approach to manage the prior acts liability? Under what circumstances is it appropriate to assume the prior liability and what are the underwriting, claims, legal and tax consequences of those decisions?