Healthcare is a diverse industry, ranging from individual practitioners and home health nurses, to ambulatory care centers and integrated systems with revenues in the billions of dollars. The risks along that spectrum also vary widely, but the insurance marketplace for healthcare organizations has been almost uniformly tight. Several insurance companies that underwrote healthcare business for decades have withdrawn from some classes, citing high loss ratios. In their place, new sources of capacity have emerged. Historically, the presence of new entrants has signaled competition and a loosening of terms, conditions and rates. Unfortunately for insureds, that is not happening in the current marketplace. It's a challenging environment that requires retailers to approach the renewal process differently.