A.M. Best has affirmed the Financial Strength Rating of B++(Good) and the Long-Term Issuer Credit Rating of "bbb" of . The outlook of these Credit Ratings (ratings)remains negative. Concurrently, A.M. Best has withdrawn the ratings as thecompany has requested to no longer participate in A.M. Best's interactiverating process.

The rating affirmations reflect MSH's balance sheet strengthand market position as a leading provider of medical professional liability(MPL) insurance in Montana and Wyoming. Negative rating factors includedeterioration in the company's risk-adjusted capitalization and operatingperformance in 2016, following significant adverse loss reserve development onprior accident years, and the challenges faced by MSH to return underwritingresults back to historical profitable levels, despite management's correctiveactions. The ratings also reflect the inherent challenges associated withhaving a concentration of underwriting risk in hospital and MPL insurance, andMSH's above-average risk profile with regard to high policy limits relative tosurplus and elevated common stock leverage, which remained in excess of 100% ofsurplus at March 31, 2017.