General Liability
The foundation Kentucky hospitals and health systems expect, commonly at $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
Kentucky Home Care Insurance
For agencies already operating in Kentucky. 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 Kentucky 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 Kentucky, mid-term when the contract will not wait.
Two Kentucky details are worth a look on an established program. Four of the five largest metros span a state line, so cross-border exposure is structural rather than occasional. And every executive officer of a corporation is an employee by default for workers compensation, reversing the assumption most owners bring with them.
An agency running seventy-five to a hundred caregivers across Louisville, Lexington, northern Kentucky or the eastern mountains has a different problem from a startup, and this page is for the former.
What Kentucky 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 Louisville, Lexington and Cincinnati 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 notice of cancellation. Each is an endorsement rather than a line on a certificate.
Get the word right on your paperwork. A Personal Services Agency is certified rather than licensed, and describing it the other way on a certificate or a contract schedule is the kind of inaccuracy that gets noticed at the wrong moment.
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 Louisville 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 move from certified non-medical work into licensed home health, which requires a Certificate of Need before the licence.
- A new office, or a move into the eastern mountains where a short distance is a long journey.
- Caregivers regularly crossing into Ohio, Indiana, West Virginia or Tennessee, which for most Kentucky agencies is routine.
- 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 Kentucky home care agencies carry
The full program, sized to your certificate or licence. Each coverage has a page of its own.
Professional Liability
Clinical claims coverage weighted for licensed Kentucky home health agencies, the side that sits behind a Certificate of Need.
Professional liability coverageWorkers Compensation
No headcount threshold, executive officers covered by default, and helpers and assistants of employees inside the definition.
Workers compensation coverageCommercial Auto
Coverage for agency-owned vehicles crossing state lines and climbing mountain roads.
Commercial auto coverageHired and Non-Owned Auto
For caregivers driving their own cars for work, a short metro run or a long mountain route alike.
Hired and non-owned autoAbuse and Molestation
Coverage of up to $1 million for allegations standard liability excludes, in a state requiring three separate screening checks.
Abuse and molestation coverageUmbrella Liability
Excess limits stacked on your liability and auto, the efficient way to reach the totals Louisville, Lexington and Cincinnati 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 Kentucky
Home Care Agencies
Personal Services Agencies certified by the OIG under 906 KAR 1:180, delivering non-medical personal care and companion work.
Home care agency insuranceHome Health Agencies
Licensed skilled agencies that have cleared a Certificate of Need, delivering care under a plan of care.
Home health agency insurancePersonal Care Services
Bathing, dressing, grooming, and daily living support, the core of a certified PSA book.
Personal care services coverageSenior Care Providers
Agencies serving the roughly 807,000 Kentucky 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 coverageKentucky workers compensation for home care agencies
Workers compensation runs under KRS Chapter 342, administered by the Kentucky Department of Workers' Claims within the Labor Cabinet, with no headcount threshold anywhere in it.
The definition, and the clause home care should read twice
KRS 342.640 defines an employee as every person, including a minor, whether lawfully or unlawfully employed, in the service of an employer under any contract of hire or apprenticeship, express or implied, and all helpers and assistants of employees, whether paid by the employer or employee, if employed with the knowledge, actual or constructive, of the employer. The exemptions sit in KRS 342.650, and an agency is inside the requirement from its first caregiver.
Tucked inside that definition is something most summaries skip. A person your caregiver brings to help can be your employee, it does not matter that you did not pay them, and constructive knowledge means the test is not only what you authorised but what you had reason to know about. Caregivers work unsupervised in private homes, and one who quietly brings a relative to help with a heavy transfer is not rare, so this is a supervision question before it is an insurance one. Read how the coverage works on our workers compensation page.
Officers are employees by default
KRS 342.640 also makes every executive officer of a corporation an employee. That is the default, where in a good many states officers have to opt in, so owners who have operated elsewhere assume the wrong starting point here more often than any other Kentucky fact we deal with. If a different position is wanted, KRS 342.650 provides for a person who would otherwise be covered electing not to be, in accordance with the regulations promulgated by the commissioner. That is a deliberate election, so confirm what is on file.
The domestic servant exemption counts the employer, not the worker
KRS 342.650(1) exempts any person employed as a domestic servant in a private home by an employer who has less than two employees each regularly employed forty or more hours a week in domestic servant employment.
Look at what is being measured. Not the worker's hours, but the employer's own count of domestic employees working forty or more hours a week, and both limbs must hold. Here is where we stop: the exemption is written around a private home and an employer of domestic servants, language built for a household rather than a certified agency. Whether it could reach a caregiver employed by a Kentucky Personal Services Agency is a legal question KRS 342.650 does not settle, and we will not tell you it exempts your caregivers or that it captures them.
The section also exempts, outright, any person employed in agriculture, and a person employed for not exceeding twenty consecutive work days to do maintenance, repair, remodeling, or similar work in or about the private home of the employer, alongside carve-outs for work done for aid or sustenance from a religious or charitable organisation, persons covered by federal liability rules, vanpool and carpool participants, and members of certain religious sects. None is a home care exemption.
Kentucky licensing and regulatory context
Short version, because you already hold what you hold. It earns space because Kentucky draws a line most states do not, and the words on your paperwork should match it.
Non-medical home care runs on certification. A Personal Services Agency is certified by the Cabinet for Health and Family Services, through the Office of Inspector General, Division of Health Care, which issues a certificate to operate a personal services agency. The governing regulation is 906 KAR 1:180, referencing KRS 216.712. A PSA is not licensed, and saying otherwise on a certificate or a contract schedule gets noticed at the wrong moment.
Home health is a different proposition. It needs both a Certificate of Need and a licence from the OIG, and the CON comes first. Kentucky runs a strong CON programme whose stated purpose is to prevent proliferation of health care facilities, services and major medical equipment that increase the cost of care, and long term care facilities must hold a Certificate of Need prior to licensure, with family care homes excepted. So for an operator growing from one into the other, the point at which you need heavier professional liability sits behind a gate outside your control.
One more thing worth checking on an established book. 906 KAR 1:180 requires a PSA to obtain criminal record information maintained by the Justice and Public Safety Cabinet or Administrative Office of the Courts, a check of the nurse aide and home health aide abuse registry established by 906 KAR 1:100, and a check of the caregiver misconduct registry. An agency running one criminal check has done a third of what the regulation asks.
Medicaid, Medicare and what actually sets your limits
Kentucky Medicaid is administered by the Cabinet for Health and Family Services through its Department for Medicaid Services. The useful point is how tightly the state ties participation to the front-end gate: DMS publishes home health provider requirements, and providers must obtain a Certificate of Need and a licence from the Office of Inspector General. So on the skilled side the CON is not only an entry barrier, it stands between you and the payer relationship as well.
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 neither programme: it is the hospitals, health systems and payers you contract with, which is why we ask to see the contract language. 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 Kentucky home care market
Kentucky has about 4.59 million residents, roughly 807,000 of them 65 or older, close to 17.9 percent of the civilian population. What makes the market unusual is where its edges are.
Four of Kentucky's five largest metropolitan areas span a state line. Cincinnati, at about 2.3 million, reaches in from Ohio and Indiana. Louisville and Jefferson County, at about 1.39 million, spans into Indiana. Huntington and Ashland, at about 367,000, spans West Virginia and Ohio. Clarksville, at about 346,000, spans Tennessee. Only Lexington and Fayette County, at about 533,000, sits wholly inside the state.
That is the shape of the business rather than a detail. Multi-state exposure is structural for a large share of Kentucky agencies, and a program built as though the state line were the edge of the book will be wrong about most of the metro population. Eastern Kentucky is the other half: mountainous, rural and slow to drive. A caregiver in Jefferson or Fayette County makes short trips through steady traffic; one covering the east drives mountain roads where a short distance is a long journey.
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. With four of the five largest metros spanning a state line, a caregiver crossing into Ohio, Indiana, West Virginia or Tennessee on a normal working day is ordinary, and those rules differ sharply on exactly the questions this page has covered. Operators working those borders can read our Indiana, Illinois and Virginia pages, and the full list is on our coverage by state hub.
Kentucky resources for home care providers
The sources behind everything above.
- CHFS OIG licensure and certification applications, the front door for both routes.
- 906 KAR 1:180, the personal services agency regulation, including the background check requirements.
- Kentucky Certificate of Need programme, which sits in front of a home health licence.
- CHFS licensing and certification.
- KRS 342.650, the workers compensation exemptions section.
- Kentucky Department of Workers' Claims, Labor Cabinet, which administers KRS Chapter 342.
- Kentucky Home Care Association, the state home care industry body.
- National Association for Home Care and Hospice, for national home care standards and guidance.
Why Kentucky 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 crossing into Ohio or Indiana on an ordinary shift exposes a program built to a state line. That is why we ask for the insurance exhibit rather than a summary.
On Kentucky specifically, we build around the border rather than the state, because four of the five largest metros span one and a caregiver crossing it on a normal working day is routine. We also check two defaults owners bring from elsewhere: every executive officer of a corporation is an employee here unless an election is on file, and KRS 342.640 can make a helper your caregiver brought along your employee too, paid by you or not.
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 cross-border metro work and eastern mountain 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.
Kentucky home care insurance FAQ
Answers for agencies operating under Kentucky 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 move into licensed home health, a new office or territory, a change in which state lines your caregivers cross, or agency-owned vehicles.
Inside by default, which reverses the assumption most owners bring with them. KRS 342.640 makes every executive officer of a corporation an employee, where in a good many states officers have to opt in. If a different position is wanted, KRS 342.650 provides for a person who would otherwise be covered electing not to be, in accordance with the regulations promulgated by the commissioner. That is a deliberate election rather than a status you fall into, so confirm what is actually on file.
It can be, and this is the Kentucky clause most summaries skip. KRS 342.640 defines an employee to include all helpers and assistants of employees, whether paid by the employer or employee, if employed with the knowledge, actual or constructive, of the employer. So a person your caregiver brings to help can be your employee, it does not matter that you did not pay them, and constructive knowledge means the test is not only what you authorised but what you had reason to know about. That is a supervision question before it is an insurance one.
It is not written for an agency and does not settle the question. KRS 342.650(1) exempts any person employed as a domestic servant in a private home by an employer who has less than two employees each regularly employed forty or more hours a week in domestic servant employment. What is measured is the employer's own count of domestic employees at forty or more hours, not the worker's hours, and both limbs must hold. The language is built for a household rather than a certified agency, so whether it reaches a caregiver employed by a Kentucky Personal Services Agency is a question the section does not answer.
Non-medical home care is certified, not licensed, and your paperwork should say so. A Personal Services Agency is certified by the Cabinet for Health and Family Services through the Office of Inspector General, Division of Health Care, under 906 KAR 1:180, referencing KRS 216.712. Home health is different: it needs both a Certificate of Need and an OIG licence, with the CON first. Describing a PSA as licensed on a certificate of insurance or a contract schedule is the kind of inaccuracy that gets noticed at the wrong moment.
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, whether you hold a PSA certificate or a home health licence, which lines your caregivers cross, 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 Kentucky. There is no obligation.