General Liability
The foundation Indiana hospitals and health systems expect, commonly at $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
Indiana Home Care Insurance
For agencies already operating in Indiana. 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 Indiana 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 the contract specifies. We place that through exclusive carrier programs that write home care in Indiana, mid-term when the contract will not wait.
One Indiana detail changes how the auto side of a program should be built. Transportation and escort services sit inside the licensed Personal Services Agency category, so driving a client to an appointment is licensed work rather than a favour outside the scope.
An agency running seventy-five to a hundred caregivers across Indianapolis, Fort Wayne or the northwest corner has a different problem from a startup, and this page is written for the former.
What Indiana 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 for agencies delivering skilled services. 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 the large Indianapolis systems 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.
Indianapolis contracts come from large institutions with standard requirements, so the wording is rarely negotiable but predictable. The complication is at the corners: an agency in the northwest works inside the Chicago metropolitan area and one in the southeast inside Cincinnati's, and a counterparty over the line will want its own state evidenced.
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 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, and both are where a placement quietly fails.
Certificates
A certificate is evidence, not coverage; it states only what a policy does. If an Indianapolis 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 needs no 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 move onto the skilled side, which is a separate Home Health Agency licence rather than a bigger version of your PSA.
- Starting or expanding client transportation, which is licensed work and moves the auto exposure.
- A new office, or a move into counties you did not previously serve.
- Agency-owned vehicles, which need commercial auto rather than a caregiver reimbursement arrangement.
- Caregivers regularly working over the Illinois, Ohio, Michigan or Kentucky line.
- 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 Indiana home care agencies carry
The full program, sized to your licence and driving. Each coverage has a page of its own.
Professional Liability
Clinical claims coverage weighted for Indiana Home Health Agencies under 410 IAC Article 17, where nursing and therapy run in the patient\'s residence.
Professional liability coverageWorkers Compensation
A universal duty with exclusions by worker category, including a household employee exemption the state\'s rating organisation says to check with an expert.
Workers compensation coverageCommercial Auto
Coverage for agency-owned vehicles, and for transportation and escort services inside the licensed PSA category.
Commercial auto coverageHired and Non-Owned Auto
For caregivers driving their own cars for work, a short Indianapolis run or a long county route alike.
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 Indianapolis system 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.
Home care agency insuranceProvider types we insure in Indiana
Home Care Agencies
Personal Services Agencies licensed by IDOH, delivering attendant care, homemaker and companion services.
Home care agency insuranceHome Health Agencies
Skilled agencies licensed separately, delivering nursing, therapy and medical social work at home.
Home health agency insurancePersonal Care Services
Bathing, dressing, grooming, and daily living support, the attendant care side of a PSA licence.
Personal care services coverageSenior Care Providers
Agencies serving the roughly 1.18 million Indiana residents aged 65 and older.
Senior care coveragePrivate Duty Nursing
Skilled, high-acuity care that drives professional liability limits higher, often with an umbrella behind it.
Private duty nursing coverageGroup Home Care
Residential group homes combining a facility with hands-on care, carrying premises and property exposure.
Group home care coverageIndiana workers compensation for home care agencies
Workers compensation in Indiana is administered by the Worker's Compensation Board of Indiana under IC 22-3. Before the rules, a note about sourcing, because it changes how much weight to put on them.
Where this material comes from, and why we are telling you
The workers compensation statements here are sourced to the Indiana Compensation Rating Bureau, the state's designated rating organisation. It is authoritative and cites the code sections directly, but it is not the Worker's Compensation Board and not the Indiana Code read at source: the legislature's own site serves a JavaScript shell to automated requests and the usual mirrors are blocked or gone. So we say what the bureau says, attribute it plainly, and recommend confirming anything that turns on exact wording against IC 22-3-2-2 and IC 22-3-2-9, or with the Board. Most broker pages present this as settled statute. It is one step removed, so we say so.
No headcount threshold
The Rating Bureau, quoting IC 22-3-2-2, states that every employer and every employee, except as stated in IC 22-3-2 through IC 22-3-6, shall comply with those provisions to pay and accept compensation for personal injury or death by accident arising out of and in the course of the employment. Read the structure rather than the length: the duty is universal, and the way out is by worker category rather than employer size. Read how the coverage works on our workers compensation page.
The household employee exemption, and the warning attached to it
The exclusions sit at IC 22-3-2-9, which is also where farm and agricultural employees are excluded. The Rating Bureau states that the employment of household employees is exempted from mandatory coverage under the Act. No hours test, no earnings test, open-ended on its face. Then it adds the most useful sentence on the page: individuals employing household help should check with an insurance expert or an attorney for advice on whether their employees meet the definition, and if not, they must be covered.
Sit with that. On almost every state page we write, we are the ones saying the domestic exemption is unsettled. In Indiana the body closest to the system says it first. So we will not tell you the exemption reaches a caregiver employed by a licensed Indiana Personal Services Agency, and we will not tell you it does not. Treating it as settled in your favour goes further than the source does.
On farm labour the Rating Bureau makes a related point about how these exclusions work: the burden is on the employer to prove the worker meets the definition and is therefore excluded. Exclusions here are things you establish, not things you assume.
Casual labour is not about how long the job lasts
Casual labour is excluded too, and the test is counter-intuitive. The Rating Bureau states that in defining casual employment, infrequency of employment or its duration is immaterial, and that the analysis is concerned with the service rendered or work done rather than the temporary nature of the employment contract. So a two-week engagement is not casual just for being two weeks, and a fill-in caregiver is doing your agency's core work.
Optional coverage runs through a form, and what a lapse costs
Household employees, casual labour, and farm and agricultural employees are all listed as relationships that may elect optional coverage, notified to the Board on an Election of Coverage Form, as can sole proprietors, partners, owner-operators, LLC members and managers, and executive officers of public or nonprofit corporations. Where a state builds a documented process, an informal understanding is the wrong answer. The Rating Bureau describes a penalty of not more than one thousand dollars for each violation, rising to not more than ten thousand dollars where the commissioner finds the violation willful. Note the per violation structure, and that these figures carry the same sourcing caveat as the rest of this section.
Indiana licensing and regulatory context
Short version, because you already hold your licence. It earns space because Indiana is unusually specific about what falls inside the non-medical category.
Non-medical home care is licensed as a Personal Services Agency by the Indiana Department of Health, through Consumer Services and Healthcare Regulation. Its Division of Home and Community-Based Care covers home health agencies, home health aides, personal services agencies, mobile out-of-state healthcare entities, hospice and end stage renal disease facilities.
A PSA licence covers attendant care services; homemaker services that assist with or perform household tasks including housekeeping, shopping, laundry, meal planning and preparation, and cleaning; and companion services providing fellowship, care and protection, including transportation, letter writing, mail reading and escort services. Note transportation and escort inside the licensed category. Skilled work sits under its own Home Health Agency licence, covering nursing, physical, occupational and speech therapy, medical social work, home health aide and other therapeutic services in the patient's residence, at 410 IAC Article 17.
Medicare, Medicaid and what actually sets your limits
Medicare covers short-term skilled home health under a plan of care, raising the stakes on documentation and on professional liability. It sits on a different footing from the attendant care, homemaker and companion services a PSA licence covers.
For most personal services agencies the limits on your certificates are not set by statute at all. They are set by the hospitals, health systems, facilities and payers you contract with, which is why we ask to see the contract language rather than guessing.
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 Indiana home care market
Indiana has about 6.92 million residents, roughly 1.18 million of them 65 or older, close to 17.2 percent of the civilian population.
Indianapolis and its surrounding area holds about 2.17 million and is the largest metropolitan area centred inside the state, with Fort Wayne, Evansville, South Bend and Mishawaka, and Lafayette behind it. Two of the largest metros touching Indiana are centred elsewhere: Chicago, about 9.41 million, reaches into the northwest corner, and Cincinnati, about 2.3 million, reaches in from Ohio. In those corners cross-border work is routine.
Everywhere between them is farmland. A caregiver in Marion County makes short trips through city traffic; one covering rural counties can spend more of a shift behind the wheel than in the home. Because transportation and escort services sit inside the PSA category, client driving is licensed work rather than an extra, which is a reason to get the auto side right rather than treat it as the small line.
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. Both ends of the state face outward, so the program has to satisfy each state your caregivers enter. Operators working the northwest can read our Illinois page, and the full list is on our coverage by state hub.
Indiana resources for home care providers
These are the sources behind everything above.
- IDOH Personal Services Agency licensing programme, which sets out what the non-medical licence covers.
- IDOH Home Health Agency licensing and certification programme, for the skilled side.
- IDOH Division of Home and Community-Based Care, the division responsible for both.
- Worker's Compensation Board of Indiana and its compliance page. Confirm anything turning on exact statutory wording with the Board.
- Indiana Compensation Rating Bureau, the state's designated workers compensation rating organisation and the source for the workers compensation material above.
- Indiana Association for Home & Hospice Care, the state home care and hospice industry body.
- National Association for Home Care and Hospice, for national home care standards and guidance.
Why Indiana 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 rural route, driving a client to an appointment, 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 Indiana we tell you where the facts came from. The workers compensation material here is the rating bureau's account rather than the Code read at source, and we say so in the section rather than a footnote. We take the same line on the household employee exemption that the bureau does: it publishes the exemption and then says the definition needs professional advice, so we will not resolve it either way.
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 city traffic and long rural routes 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.
Indiana home care insurance FAQ
Answers for agencies operating under Indiana 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 needs no policy change. What does need reporting is a change in what the agency does: a move onto the skilled side, starting or expanding client transportation, a new office or county, agency-owned vehicles, or regular work over a state line.
There is no headcount threshold. Quoting IC 22-3-2-2, the Indiana Compensation Rating Bureau states that every employer and every employee, except as stated in IC 22-3-2 through IC 22-3-6, shall comply with those provisions to pay and accept compensation for personal injury or death by accident arising out of and in the course of the employment. The duty is universal and the way out is by worker category rather than by employer size, so there is no small-agency window to sit inside.
The Indiana Compensation Rating Bureau, the state's designated workers compensation rating organisation, rather than the Worker's Compensation Board or the Indiana Code read at source. The legislature's own site serves a JavaScript shell to automated requests and the usual mirrors are blocked or gone. The bureau is authoritative and cites the code sections directly, but it is one step removed, so confirm anything turning on exact wording against IC 22-3-2-2 and IC 22-3-2-9 or with the Board.
We will not tell you either way, and the state's own rating organisation is the reason. It states that the employment of household employees is exempted from mandatory coverage under the Act, with no hours test and no earnings test. Then in the same breath it says individuals employing household help should check with an insurance expert or an attorney for advice on whether their employees meet the definition, and if not, they must be covered. Treating it as settled in your favour goes further than the source does.
Almost certainly not, and the test is counter-intuitive. The Rating Bureau states that in defining casual employment, infrequency of employment or its duration is immaterial, and that the analysis is concerned with the service rendered or work done rather than the temporary nature of the employment contract. So a two-week engagement is not casual just for being two weeks. What matters is what the person was doing, and a fill-in caregiver is doing your agency's core work.
More than most owners expect. The Indiana Department of Health licenses agencies providing attendant care services; homemaker services covering household tasks; and companion services providing fellowship, care and protection, including transportation, letter writing, mail reading and escort services. Transportation and escort sit inside the licensed category, so client driving is licensed work rather than a favour outside the scope. Skilled work sits under a separate Home Health Agency licence at 410 IAC Article 17.
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, whether your caregivers transport clients, the counties you serve, 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 Indiana. There is no obligation.