General Liability
The foundation Delaware hospitals and health systems expect, commonly at $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
Delaware Home Care Insurance
For agencies already operating in Delaware. 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 a Delaware 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 carrier programs writing home care in Delaware, mid-term when the contract will not wait.
Two Delaware details are worth a look on an established program. The state splits home care three ways rather than two, so a growing service mix can cross a licence boundary an operator never thinks about. And workers compensation here must be in place before an employee starts work.
An agency running seventy-five to a hundred caregivers from Wilmington through Kent and Sussex has a different problem from a startup, and this page is written for the former.
What Delaware contracts require, and what happens when yours falls short
On liability the numbers come from your contracts, and they ask more than the law does.
What the contracts typically ask for
Hospitals, health systems 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 with the large systems in the Wilmington and Philadelphia corridor 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 notice of cancellation. Each is an endorsement rather than a line on a certificate.
Which of the three licence categories you hold is the frame a carrier underwrites against. A book including aide-level care carries more clinical weight than companion and personal assistance work, so say which you hold when you send the exhibit.
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 extra premium, the fastest path where available.
The second is an umbrella. Where a contract wants a total your primary layers cannot reach, excess limits over general liability, auto and employers liability get there quicker and cheaper than rebuilding the primary.
The third is re-marketing, where a carrier will not extend or the wording sits outside the form. That takes longer, which is the argument for sending contract language when it appears rather than the week it must 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, and both are where a placement quietly fails.
Certificates
A certificate is evidence, not coverage; it states only what a policy does. If a Wilmington 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 on file should carry over rather than be rebuilt each year.
What to report during the year
Adding and removing caregivers does not need a policy change each time: 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 service mix drifting toward aide-level care, which may be a move toward a different DHCQ licence rather than growth within the one you hold.
- A new office, or clients further downstate where the driving profile changes entirely.
- Taking on self-directed cases, since those change who the employer is.
- Caregivers regularly working over the Pennsylvania, New Jersey or Maryland 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 a surprise premium.
Coverages Delaware home care agencies carry
The full program, sized to your license category, contracts, and driving. Each coverage has a page of its own.
Professional Liability
Clinical claims coverage weighted for Delaware agencies holding a skilled or aides-only license, where care carries more clinical weight than personal assistance.
Professional liability coverageWorkers Compensation
Required before an employee starts work, covering full-time, part-time, seasonal, and temporary caregivers alike. Priced on payroll and your experience modifier.
Workers compensation coverageCommercial Auto
Coverage for agency-owned vehicles carrying caregivers through the Wilmington corridor and across Kent and Sussex, where a personal policy will not respond.
Commercial auto coverageHired and Non-Owned Auto
For caregivers driving their own cars for work, a short corridor run or a long downstate route alike, an exposure most Delaware agencies carry.
Hired and non-owned autoAbuse and Molestation
Coverage of up to $1 million for allegations standard liability excludes, essential given caregivers work alone with vulnerable clients inside their homes.
Abuse and molestation coverageUmbrella Liability
Excess limits stacked on your liability and auto, the efficient way to reach the totals Wilmington and Philadelphia corridor contracts require.
Umbrella liability coverageCyber Liability
Breach response for the protected health information your agency holds: notification, ransomware, regulatory defense.
Cyber liability coverageProperty and Business Owners Policy
Cover for the office, its contents, and business interruption after a loss, sized to the footprint you actually run.
Home care agency insuranceProvider types we insure in Delaware
Home Care Agencies
Personal Assistance Services Agencies licensed by DHCQ, delivering non-medical personal care and companion services.
Home care agency insuranceHome Health Aides
Agencies holding the aides-only license, the middle tier between personal assistance and skilled home health.
Home health aide coverageHome Health Agencies
Skilled agencies licensed in their own DHCQ category, where care runs under a plan of care and documentation carries more weight.
Home health agency insurancePersonal Care Services
Bathing, dressing, grooming, and daily living support, the work Diamond State Health Plan Plus helps fund.
Personal care services coverageSenior Care Providers
Agencies serving a state where about 21.3 percent of residents are 65 or older, weighted for wandering, falls, and abuse.
Senior care coveragePrivate Duty Nursing
Skilled, high-acuity care that drives professional liability limits higher, often with an umbrella behind it.
Private duty nursing coverageDelaware workers compensation for home care agencies
The Delaware Department of Labor, through the Division of Industrial Affairs and its Office of Workers' Compensation, states that almost every employer with one or more employees is required to carry Workers' Compensation insurance. Take the qualifier seriously, because Title 19 carries specific exclusions, and the rest too, because an agency employing caregivers is squarely inside the requirement.
Before the first shift, and no category to schedule around
Two details do more work than the threshold itself. Coverage is required for full-time, part-time, seasonal, or temporary employees, so there is no category of caregiver to schedule around. And it must be in place before the first shift, not by the end of the first pay period. The governing sections cited are 19 Del. C. Section 2306 and Section 2372. Read how the coverage works on our workers compensation page.
The household worker exclusion is earnings tested, per household
Delaware writes no open-ended domestic servant exemption. Section 2307 provides that the chapter shall not apply to any person employed as a household worker in a private home or household who earns less than $750 in cash in any 3-month period from a single private home or household.
Read each part. It is measured in cash, over three months, and tested against a single private home or household rather than against a worker or a business, which is materially narrower than the open household carve-outs some states write.
Here is where we stop. The exclusion is written around a household worker in a private home or household, and it does not on its face address a caregiver employed by a licensed Delaware agency and assigned to a client. Whether it could ever reach that arrangement is a legal question Section 2307 does not settle, so we will not tell you it excludes your caregivers or that it captures them. A statute that does not answer a question is not one that answers it in your favor.
Casual employment is narrower than the word suggests
Section 2308 defines casual employment as employment for not over 2 weeks or a total salary during the employment not to exceed $100. Agencies use the word loosely, usually meaning a fill-in or a per diem shift, but the statutory definition is far tighter, and a fill-in working a fortnight of shifts is unlikely to fit inside it on the salary limb.
The same section addresses family members only in the farm context: the spouse and minor children of a farm employer are excluded unless named as bona fide employees in an insurance endorsement. There is no general family carve-out, so do not assume one for a relative on payroll.
Delaware licensing and regulatory context
Short version, because you already hold your licence. It earns space because the middle tier of Delaware's three-way split is a boundary an established agency can drift across without noticing.
Home care is licensed by Delaware Health and Social Services through its Division of Health Care Quality, specifically the Office of Health Facilities Licensing and Certification. Most states split home care two ways. Delaware splits it three: Home Health Agency Skilled, Home Health Agency Aides Only, and Personal Assistance Services Agency, the non-medical category, with rules at 16 DE Admin. Code 3345. Each has its own DHCQ application and licence page, hospice is separate again, and most non-medical operators hold the PASA licence.
An aides-only category between skilled home health and personal assistance is unusual, and it creates a boundary most operators never think about until they are near it. A PASA book that grows into aide-level work may be moving toward a different licence category rather than broadening within the one you hold. We are not going to tell you where that line falls, because the service definitions are for DHCQ to confirm rather than a broker page to infer. It is worth settling deliberately, before a service mix drifts, because a book including aide-level care carries more clinical weight and professional liability is weighted accordingly.
Medicaid, Medicare and what actually sets your limits
Delaware Medicaid is administered by the Division of Medicaid and Medical Assistance. Long term care runs through Diamond State Health Plan Plus, a mandatory managed care program covering long term care for residents who are elderly or physically disabled, alongside the Division of Services for Aging and Adults with Physical Disabilities. Its home and community-based services can include adult day care, home meal delivery, personal care assistance, personal emergency response and respite, and a Personal Attendant Services program runs through it with self-direction options extending to a client hiring family and friends.
That last point deserves care on an established book. Self-directed arrangements change who the employer is, and an agency supporting a self-directed client is in a different position from one employing the caregiver. Tell us which you are doing on which cases, because the answer moves both the workers compensation and the liability picture.
Medicare comes in separately, covering short-term skilled home health under a plan of care, the heaviest documentation and professional liability work an agency can take on. What sets your limits is neither programme: it is the hospitals, health systems and payers you contract with. If your agency runs skilled care, our home health agency insurance page covers how that program is built. For the non-medical side, see personal care services.
The Delaware home care market
Delaware has about 1.05 million residents, roughly 219,000 of them 65 or older. At about 21.3 percent of the civilian population that is one of the higher shares among the states we cover, and a small state with an old population is a deep home care market rather than a thin one.
Where those clients sit is unusual, because Delaware has no large metropolitan area of its own. Northern New Castle County sits inside the Philadelphia, Camden and Wilmington metropolitan area, which spans Delaware, Pennsylvania, New Jersey and Maryland and holds about 6.33 million people. Dover, at about 193,000, is the only metro wholly inside the state, and the Salisbury area crosses the Maryland line too.
Kent and Sussex counties are a different business from New Castle: far more rural, with longer drives between clients and fewer agencies covering them. A caregiver working the Wilmington corridor makes short trips through heavy traffic, where the exposure is accident frequency; a caregiver covering Sussex drives long stretches between visits. An operator running both out of one office is running two different auto exposures in a state you can drive end to end in a couple of hours.
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. Crossing a state line is ordinary here, so the program has to satisfy each state your caregivers enter. Read our Pennsylvania, New Jersey and Maryland pages, and the full list is on our coverage by state hub.
Delaware resources for home care providers
These are the bodies that shape how home care operates in Delaware, so you know where each requirement comes from.
- Delaware Health and Social Services, Division of Health Care Quality, Office of Health Facilities Licensing and Certification, which licenses Personal Assistance Services Agencies under 16 DE Admin. Code 3345 alongside skilled and aides-only home health agencies.
- Delaware Department of Labor, Division of Industrial Affairs, Office of Workers' Compensation, which administers coverage under Title 19.
- Division of Medicaid and Medical Assistance, which runs Diamond State Health Plan Plus.
- Division of Services for Aging and Adults with Physical Disabilities, the partner division on long term care.
- Home Care Association of America, Delaware chapter, the state chapter of the national private duty home care association.
- National Association for Home Care and Hospice, for national home care standards and guidance.
Why Delaware agencies choose HCBI
We work with agencies already running, and their problems are contract problems.
A health system raises its 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 downstate 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 Delaware specifically, we ask two things first. Which of the three DHCQ licence categories you hold, and whether your service mix is drifting toward the aides-only tier, because that boundary changes the professional liability weighting. And whether any cases are self-directed, since that changes who the employer is and moves both the workers compensation and the liability picture.
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 corridor traffic and downstate distance alike, umbrella limits to reach what your contracts demand, cyber, and abuse and molestation coverage of up to $1 million. That reach is backed by relationships across the home care and healthcare industry, including CareerStaff Unlimited and Genesis Healthcare in staffing, HOMELINK in medical equipment and home care networks, and Bright Horizons Family Solutions on the family care side.
Delaware home care insurance FAQ
Answers for agencies operating under Delaware 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; the wording matters as much as the number.
The certificate is quick. What takes time is anything it must evidence that your policy does not yet do: additional insured status, 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 needs no policy change. What does need reporting is a change in what the agency does: a service mix drifting toward aide-level care, a new office or territory, taking on self-directed cases, agency-owned vehicles, or regular work over a state line.
Before an employee starts work. Not by the end of the first pay period, not once the hire settles in, before the first shift. The Delaware Department of Labor, through the Division of Industrial Affairs and its Office of Workers' Compensation, states that almost every employer with one or more employees is required to carry the coverage, and that it is required for full-time, part-time, seasonal or temporary employees, so there is no category of caregiver to schedule around. The governing sections cited are 19 Del. C. Section 2306 and Section 2372.
It is much narrower than an open domestic carve-out, and it does not clearly reach an agency at all. Section 2307 provides that the chapter shall not apply to any person employed as a household worker in a private home or household who earns less than $750 in cash in any 3-month period from a single private home or household. It is measured in cash, over three months, and tested against a single household rather than against a worker or a business. It is also written around a household employer and does not on its face address a caregiver employed by a licensed Delaware agency and assigned to a client.
Almost certainly not. Section 2308 defines casual employment as employment for not over 2 weeks or a total salary during the employment not to exceed $100. Agencies use the word loosely, usually meaning a fill-in or a per diem shift, but the statutory definition is far tighter and a fill-in working a fortnight of shifts is unlikely to fit inside it on the salary limb. The same section addresses family members only in the farm context, so do not assume a general carve-out for a relative on your payroll.
Because the middle tier is a boundary an established agency can cross without noticing. Delaware Health and Social Services, through its Division of Health Care Quality, licenses Home Health Agency Skilled, Home Health Agency Aides Only, and Personal Assistance Services Agency, the non-medical category with rules at 16 DE Admin. Code 3345. That middle category is genuinely unusual, and a PASA book growing into aide-level work may be moving toward a different licence rather than broadening within the one you hold. Confirm where the line falls with DHCQ: aide-level care carries more clinical weight and professional liability follows.
Loss runs for the last five years, declarations pages for every line, payroll by class, caregiver headcount, the counties you serve, and the exhibits from your largest contracts. Start sixty to ninety days out. A non-renewal shortens the carrier list, 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 of the three licence categories you hold, and how much of your book sits downstate, 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 Delaware. There is no obligation.