General Liability
Required in practice from day one, since Arkansas asks for proof of liability insurance as part of Private Care Agency licensure. Contracts commonly add $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
Arkansas Home Care Insurance
For agencies already operating in Arkansas. If a hospital, health system or payer has handed you a contract demanding limits your current policy cannot reach, that is a solvable problem, and it does not have to wait for your renewal date.
If you already run an Arkansas home care agency
Here is the short answer. When a contract demands limits your policy cannot reach, the fix is general liability at the limit the contract names, professional liability sized to the care you deliver, an umbrella behind both, and certificates carrying the additional insured and waiver wording specified. We place that through exclusive carriers writing home care in Arkansas, mid-term when the contract will not wait.
Two Arkansas details are worth a look on an established program. Liability coverage is a licensure requirement here rather than only a contract one, so a lapse threatens the licence itself. And Act 853 of 2025 moved four things, which means older guidance still circulating is wrong in places your compliance file may still follow.
An agency running seventy-five to a hundred caregivers across Little Rock, Northwest Arkansas, Fort Smith, Jonesboro or the rural counties has a different problem from a startup, and this page is written for the former.
What Arkansas contracts require, and what happens when yours falls short
On liability the numbers come from your contracts rather than a statute, and they ask more than the law does.
What the contracts typically ask for
Hospitals, facilities and payers usually require general liability at $1 million per occurrence and $2 million aggregate. Professional liability is expected of agencies delivering skilled care. Workers compensation at statutory limits with employers liability behind it. Auto liability for agency vehicles and caregivers driving their own. Abuse and molestation coverage, increasingly named rather than assumed. And an umbrella, which agencies working pursuing hospital partnerships often need.
Wording matters as much as the number. Contracts routinely ask for additional insured status, a waiver of subrogation, primary and non-contributory response, and advance notice of cancellation. Each is an endorsement rather than a sentence on a certificate.
Arkansas is one of the states that names coverage in the licensing rules rather than leaving the whole question to your contracts. Proof of liability insurance is part of Private Care Agency licensure, so general liability has to stay in place as a condition of operating, not only as a condition of a contract.
When the contract asks for more than you carry
The first route is endorsement. The incumbent carrier will sometimes raise a limit or add required wording mid-term for additional premium, the fastest path where it is available.
The second is an umbrella. Where a contract wants a total your primary layers cannot reach, excess limits stacked over general liability, auto and employers liability get there quicker and for less than rebuilding the primary underneath.
The third is re-marketing, where a carrier will not extend or the wording sits outside what the form allows. That takes longer, which is the argument for sending contract language when it first appears rather than the week it has to be signed.
Certificates of insurance and the rest of the operating year
For a running agency the broker relationship is mostly certificates and mid-term changes. Both are where a placement quietly fails.
Certificates
A certificate is evidence, not coverage; it states only what a policy already does. If a Little Rock health system requires additional insured status and your policy carries no such endorsement, no certificate can create it. The delay agencies feel there is an underwriter deciding, not paperwork.
So the habit that helps: when a new client, facility or payer sends paperwork, send us the requirements immediately. Certificates already on file should carry over rather than be rebuilt each year.
What to report during the year
Adding and removing caregivers does not require a policy change each time, because the program is rated on payroll and headcount and trued up at audit. What needs reporting is a change in the agency's shape.
- A move between the Private Care Agency licence and a Class A or Class B Home Health Agency licence, which changes the professional liability picture.
- A new office, or clients further out, since running from a single primary office lengthens the routes rather than shortening them.
- Medicaid provider enrollment, which after Act 853 is a separate process from licensure.
- Caregivers regularly working over the Texas, Louisiana, Oklahoma, Missouri, Tennessee or Mississippi line.
- Agency-owned vehicles, which need commercial auto rather than a caregiver reimbursement arrangement.
- An acquisition, a new entity or a change of ownership, and any incident that could become a claim, reported when it happens rather than when it is served.
The payroll audit at the end of the term is worth preparing for. Records split properly by class keep it from producing an unwelcome additional premium.
Coverages Arkansas home care agencies carry
The full program, sized to your services, your contracts, and your driving. Each coverage below has a page of its own.
Professional Liability
Clinical claims coverage for Arkansas Class A and Class B home health agencies, weighted for the exposure that skilled care under a plan of care carries.
Professional liability coverageWorkers Compensation
Required at three or more employees, with part-time and seasonal staff counted, the domestic exemption not reaching agency caregivers, and classification handled correctly. Priced on payroll and your experience modifier.
Workers compensation coverageCommercial Auto
Coverage for agency-owned vehicles carrying caregivers across Arkansas's long rural distances, where a personal policy will not respond.
Commercial auto coverageHired and Non-Owned Auto
Central in Arkansas. The coverage for caregivers driving their own cars on long work trips between clients, an exposure most agencies here carry.
Hired and non-owned autoAbuse and Molestation
Coverage of up to $1 million for allegations that standard liability excludes, essential given caregivers work alone with vulnerable clients and the state requires background checks on owners and employees.
Abuse and molestation coverageUmbrella Liability
Excess limits stacked on top of your liability and auto, the efficient way to reach the higher totals Arkansas hospital contracts require.
Umbrella liability coverageCyber Liability
Breach response for the protected health information your agency holds, including notification, ransomware, and regulatory defense.
Cyber liability coverageProvider types we insure in Arkansas
Home Care Agencies
Arkansas Private Care Agencies licensed by the Department of Health, delivering non-medical personal care and companion services.
Home care agency insuranceHome Health Agencies
Class A and Class B Arkansas agencies delivering skilled care under a plan of care and able to pursue Medicare certification.
Home health agency insurancePersonal Care Services
Bathing, dressing, and daily living support, the work ARChoices funds through enrolled Arkansas providers.
Personal care services coverageSenior Care Providers
Agencies serving the roughly 555,000 Arkansans who are 65 or older, weighted for wandering, falls, and abuse exposure.
Senior care coveragePrivate Duty Nursing
Skilled, high-acuity care that drives professional liability limits higher, often backed by an umbrella.
Private duty nursing coverageArkansas workers compensation and the licensure liability requirement
Arkansas gives you two requirements from two different directions, and neither waits for your contracts to ask.
Liability is a condition of the licence
Proof of liability insurance is required as part of Private Care Agency licensure, and background checks are required for owners and employees. So general liability is a precondition rather than an afterthought, and it has to stay in place. For an established agency that changes what a lapse means: it is not only a contract problem, it reaches the licence you operate on.
Workers compensation at three employees
Coverage is administered by the Arkansas Workers' Compensation Commission and becomes required once a business has three or more employees, whether full-time, part-time or seasonal. Part-time caregivers count, which is how agencies cross the line sooner than they planned. At your size that threshold is long behind you, but it still matters for any separate entity you run.
Owners, partners and LLC members can exclude themselves by filing a Certificate of Non-Coverage with the Commission. That covers the owner and nothing else. Independent contractors are not counted toward the threshold, and that is where classification becomes a live question, because misclassifying a caregiver who functions as an employee is a real risk rather than a gray area. Read how the coverage works on our workers compensation page.
The domestic servant exemption does not cover your caregivers
This is the Arkansas point worth reading twice. Arkansas exempts domestic servants working in a private home from workers compensation. An owner hears that, looks at caregivers working in private homes, and draws the obvious conclusion. The conclusion is wrong, and it only surfaces when someone gets hurt.
The exemption turns on who employs the worker, not where the work happens. It covers a person the household hires directly. Your caregivers do not work for the client. You recruit them, schedule them, train them, pay them and can dismiss them, which makes them employees of your agency, whatever home they are standing in.
What going uninsured costs
Penalties can reach $1,000 per day, up to $10,000 for a complete failure to secure coverage, with a possible Class D felony on top. Arkansas also runs on a reporting clock: injuries are reported within 10 days. For an agency that has already met a licensure requirement to carry liability coverage, going uninsured on workers compensation is an odd place to economize, because the same licence that required one is at risk from neglecting the other.
Arkansas licensing and regulatory context
Short version, because you already hold your licence. It earns space because Act 853 of 2025 is recent enough that older guidance still circulating is now wrong in places, and a compliance file built before it may still be following the old regime.
Non-medical home care agencies are licensed as Private Care Agencies by the Arkansas Department of Health, through its Division of Health Facility Services. That sits apart from the Class A and Class B Home Health Agency licence, which covers skilled and medical care.
Act 853 moved four things. Private care agencies are now licensed directly by the Department of Health. The former Department of Human Services certification requirement was eliminated. The requirement to maintain multiple regional offices was removed, so an agency needs only one primary office in Arkansas. And Medicaid participation became a separate provider enrollment rather than something bundled into licensure.
The regional office change is the one with the clearest operating consequence, and it cuts against the grain. An agency that once had to stand up offices around the state can now run from a single primary location, which lowers the cost of covering rural territory. What it does not lower is the driving. Serving those same counties from one office means more road time per caregiver, not less, so the auto exposure moves in the opposite direction from the overhead.
Medicaid, Medicare and what actually sets your limits
Arkansas Medicaid funds home and community-based care mainly through the ARChoices in Homecare waiver, a 1915(c) waiver serving adults aged 21 through 64 with a physical disability, along with residents 65 and older who need a nursing-facility level of care, administered by the Department of Human Services, Division of Aging, Adult, and Behavioral Health Services. Arkansas also offers a self-directed option, which lets eligible residents direct their own care at home rather than receive it through a traditional agency-managed model.
Act 853 matters here as well. Medicaid participation is now a separate provider enrollment rather than part of licensure, so holding a Private Care Agency licence does not by itself make you a Medicaid provider. Those are two processes to track rather than one.
Medicare comes in separately, covering short-term skilled home health under a plan of care, which raises the stakes on documentation and on professional liability. What sets your limits is none of these: it is the hospitals, facilities and payers you contract with. If your agency runs skilled care, our home health agency insurance page covers how that program is built, and for the non-medical side see personal care services.
The Arkansas home care market
Arkansas has about 3.07 million residents, roughly 555,000 of them, about 18 percent, 65 or older. Close to one in five people in the state sits in the population home care serves, and that share is growing.
Arkansas is heavily rural, and that single fact shapes almost everything about running an agency here. The largest markets are Little Rock, the Northwest Arkansas corridor around Fayetteville, Springdale and Rogers, Fort Smith, and Jonesboro. Those areas hold the density that makes scheduling and recruiting workable. Outside them, demand runs across a lot of open country, where seniors age in place with fewer agencies nearby.
The practical consequence is mileage. Caregivers here often travel long stretches between visits, and those are work miles whether the vehicle belongs to the agency or the caregiver. An agency covering rural counties is running vehicles hard, and now that Act 853 lets an agency run from a single primary office, those routes can get longer rather than shorter.
Agency-owned vehicles need commercial auto, and caregivers using their own cars create a hired and non-owned auto exposure a personal policy will not cover on a work trip, which is the gap most agencies find only after an accident on the way to a client. If your caregivers work beyond Arkansas, the program has to satisfy each state they enter. We also cover Texas, Louisiana and Oklahoma, and the full list is on our coverage by state hub.
Arkansas resources for home care providers
These are the Arkansas bodies that shape how home care operates, for licensing, workers compensation, Medicaid, and industry advocacy. We name them so you know where each requirement comes from.
- Arkansas Department of Health, Division of Health Facility Services, which licenses Private Care Agencies and, on the skilled side, Class A and Class B Home Health Agencies.
- Arkansas Workers' Compensation Commission, which administers the workers compensation requirement and receives Certificates of Non-Coverage.
- Arkansas Department of Human Services, Division of Aging, Adult, and Behavioral Health Services, which administers the ARChoices in Homecare waiver and the self-directed option.
- HomeCare Association of Arkansas, the state home care industry body representing agencies through advocacy.
- National Association for Home Care and Hospice, for national home care standards and guidance.
Why Arkansas agencies choose HCBI
We work with agencies already running, and their problems are contract problems.
A health system raises its required limits at renewal. A payer adds abuse and molestation as a named requirement. A facility wants additional insured status and primary and non-contributory wording your form does not carry. A caregiver crash on a long rural run exposes how little a personal auto policy does on a work trip. That is why we ask for the insurance exhibit rather than a summary.
On Arkansas specifically, we treat the liability requirement as what it is, a condition of your licence rather than only of a contract, so a lapse reaches further here than in most states. We also check that your compliance file has caught up with Act 853, because the single-office change, the end of the DHS certification requirement and the separation of Medicaid enrollment from licensure all postdate a lot of the guidance still circulating.
We place coverage through exclusive carrier programs that write home care risks, and we coordinate the whole program: general liability, professional liability, workers compensation, commercial and hired and non-owned auto for long rural routes, umbrella limits to reach what your contracts demand, cyber, and abuse and molestation coverage of up to $1 million. That reach is backed by working relationships across the home care and healthcare industry, including CareerStaff Unlimited and Genesis Healthcare in staffing, HOMELINK in the medical equipment and home care network space, and Bright Horizons Family Solutions on the family care side.
Arkansas home care insurance FAQ
Specific answers for agencies operating under Arkansas rules.
Usually, and usually before renewal. The underlying general liability limit can sometimes be raised by endorsement. More often an umbrella stacked over general liability, auto and employers liability reaches the required total faster and for less than rebuilding the primary program. Where the carrier will not extend, the program is re-marketed. Send us the insurance exhibit rather than a summary, because the required wording matters as much as the number.
The certificate is quick. What takes time is anything it has to evidence that your policy does not yet do: additional insured status for a named health system, a waiver of subrogation, primary and non-contributory wording, or a notice of cancellation. Those are endorsements, not lines typed onto a form. Send us contract wording when it first arrives, not on the day the certificate is due.
Not person by person. The program is rated on payroll and headcount estimates and trued up at audit, so ordinary turnover does not require a policy change. What does need reporting is a change in what the agency does: a move between the Private Care Agency and Home Health Agency licences, a new office or territory, Medicaid provider enrollment, agency-owned vehicles, or regular work over a state line.
Yes. Proof of liability insurance is required as part of Private Care Agency licensure, and background checks are required for owners and employees, so Arkansas is one of the states that names coverage in the licensing rules rather than leaving the whole question to your contracts. That changes what a lapse means for an established agency: it is not only a contract problem, it reaches the licence you operate on.
Once a business has three or more employees, whether full-time, part-time or seasonal, administered by the Arkansas Workers' Compensation Commission. Part-time caregivers count, which is how agencies cross the line sooner than they planned. Owners, partners and LLC members can exclude themselves by filing a Certificate of Non-Coverage with the Commission, but that covers the owner and nothing else. Independent contractors are not counted toward the threshold, which is exactly why classification is a live question.
No. The exemption turns on who employs the worker, not where the work happens: it covers a person the household hires directly. Your caregivers do not work for the client. You recruit them, schedule them, train them, pay them and can dismiss them, which makes them employees of your agency whatever home they are standing in. Going uninsured is costly here too, with penalties reaching $1,000 per day and up to $10,000 for a complete failure to secure coverage, plus a possible Class D felony, and injuries are reported within 10 days.
Four things, and older guidance still circulating is now wrong in places. Private care agencies are now licensed directly by the Department of Health. The former Department of Human Services certification requirement was eliminated. The requirement to maintain multiple regional offices was removed, so an agency needs only one primary office in Arkansas. And Medicaid participation became a separate provider enrollment rather than something bundled into licensure, so holding a Private Care Agency licence does not by itself make you a Medicaid provider. The office change cuts against the grain on insurance: covering the same counties from one office means more road time per caregiver, not less.
Loss runs for the last five years, current declarations pages for every line, payroll by class, caregiver headcount, the counties you serve, and the insurance exhibits from your largest contracts. Start sixty to ninety days out. A non-renewal shortens the list of carriers, and lead time buys the options back.
Send us the contract and we will build to it
Tell us your payroll and caregiver count, which licence you hold, and how far your routes run from your primary office, and what your largest contract requires. If a limit needs raising before your renewal date, say so and we will start there. A specialist will build the program through exclusive carriers that write home care in Arkansas. There is no obligation.