General Liability
The contract-driven foundation Louisiana hospitals and facilities expect to see, commonly at $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
Louisiana Home Care Insurance
For agencies already operating in Louisiana, from a broker based here. 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.
Louisiana is our home state
Most brokers writing Louisiana home care are writing it from somewhere else. We are not. Wagley Agency Insurance Group, the agency behind HCBI, is based in Louisiana. Call about a contract requirement or a workers compensation question and you are not explaining the state to someone who has to look it up. Name a parish and we know the place.
It matters commercially, not sentimentally. Louisiana gates entry through Facility Need Review, requires workers compensation from the first caregiver, and carries a domestic employee exemption owners wrongly assume covers their staff.
If you already run a Louisiana 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 Louisiana, mid-term when the contract will not wait.
An agency running seventy-five to a hundred caregivers across New Orleans, Baton Rouge, Lafayette, Lake Charles or Shreveport has a different problem from a startup, and this page is written for the former. One detail is worth stating up front: your licence came through Facility Need Review, so a stop-work order does not just cost a fine, it interrupts an operation you had to get permission to build.
What Louisiana 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, 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 notice of cancellation. Each is an endorsement rather than a line on a certificate.
Your HCBS module is the frame a carrier underwrites against, because a Personal Care Attendant book and a skilled home health book are priced against different exposures. 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 New Orleans 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.
- Adding an HCBS module or moving into skilled home health, which is licensed separately.
- A new office, or a move into rural parishes where the driving profile changes entirely.
- A shift between LT-PCS and waiver work, since those pipelines behave differently.
- Caregivers regularly working over the Texas, Arkansas 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 a surprise premium.
Coverages Louisiana 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 Louisiana skilled agencies, weighted for the exposure that Medicare-certified home health carries under a plan of care.
Professional liability coverageWorkers Compensation
Required from your first employee under Title 23, with the domestic employee exemption not reaching agency caregivers and part-time and temporary staff counted. Priced on payroll and your experience modifier.
Workers compensation coverageCommercial Auto
Coverage for agency-owned vehicles carrying caregivers through New Orleans traffic and across rural parish routes, where a personal policy will not respond.
Commercial auto coverageHired and Non-Owned Auto
The coverage for caregivers driving their own cars for work, whether that is a short metro run or a long parish route, an exposure most Louisiana agencies 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 in their homes.
Abuse and molestation coverageUmbrella Liability
Excess limits stacked on top of your liability and auto, the efficient way to reach the higher totals Louisiana 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 Louisiana
Home Health Agencies
Louisiana skilled agencies licensed on the separate home health track, delivering care under a plan of care and able to pursue Medicare certification.
Home health agency insuranceHome Care Agencies
Non-medical Louisiana agencies licensed under the HCBS Personal Care Attendant module, subject to Facility Need Review before applying.
Home care agency insurancePersonal Care Services
Bathing, dressing, and daily living support, the work that LT-PCS and the Community Choices Waiver fund through licensed Louisiana providers.
Personal care services coverageSenior Care Providers
Agencies serving the roughly 816,000 Louisianans 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 coverageGroup Home Care
Residential group homes combining a facility with hands-on care, with premises and property exposure.
Group home care coverageLouisiana workers compensation for home care agencies
Louisiana's hardest insurance rule has no number attached to it, which is what makes it easy to miss. Coverage is required from your first employee, with no threshold to cross.
From the first employee, and subcontractors can count too
Coverage is governed by the Louisiana Workers' Compensation Act in Revised Statutes Title 23 and administered by the Louisiana Workforce Commission, Office of Workers' Compensation. Full-time, part-time, seasonal and temporary workers all count. Uninsured subcontractors can be counted as your employees under the statute, so routing work through uninsured contractors can leave those people treated as your own when a claim lands. It is one of the lowest thresholds in the country. Read how the coverage works on our workers compensation page.
The domestic employee exemption does not cover your caregivers
This is the point worth reading twice, because it costs agencies more than any other misunderstanding in this state. Louisiana exempts domestic employees working in a private residence from workers compensation coverage. An owner hears that and draws what feels like an obvious conclusion: my caregivers work in private residences, so they are domestic employees, so I am exempt. That reasoning is wrong in a way that only surfaces when someone gets hurt.
The exemption is about who employs the worker, not where the work happens. It covers a person the homeowner hires directly, the household's own employee. Your caregivers work for your agency, not the client: you recruit, schedule, train, pay and can dismiss them. That makes them your employees whichever living room they stand in.
Classification is the other half of this. Louisiana applies a strict test to whether a worker is genuinely an independent contractor, so labeling caregivers as 1099 contractors to stay outside the requirement is a real risk rather than a gray area. A caregiver you schedule and supervise is an employee, whatever the paperwork says.
What going uninsured actually costs
Penalties can reach $250 per employee for a first violation and $500 per employee for repeats, capped at $10,000, with criminal exposure on top, and the state can issue a stop-work order that closes an agency while its clients still need care.
The civil side is worse than the fines. An uninsured employer can be held personally liable for the injured worker's full costs and loses exclusive-remedy protection, the bargain at the centre of workers compensation: the employee gets benefits without proving fault, and the employer cannot be sued directly. Lose it and an injured caregiver can take you to court for the full measure of damages, with your personal assets in reach.
Louisiana licensing and regulatory context
Short version, because you already hold your licence. It earns space because of what the gate in front of it says about the value of what you hold.
Non-medical home care agencies are licensed by the Louisiana Department of Health, through its Health Standards Section, under the Home and Community-Based Services provider licence. HCBS is an umbrella licence with modules under it, and the one covering non-medical personal care is Personal Care Attendant, with rules in LAC 48:I, Chapters 50 and 51. Skilled home health is licensed separately.
Now the part that makes Louisiana different from an open-entry state. Several HCBS modules, Personal Care Attendant among them, require approval from the Facility Need Review committee before an agency can apply for the licence at all. That is a gate in front of the gate: you are not simply meeting requirements and receiving a licence, you are asking the state to agree that another provider is needed first. That is why a Louisiana licence is worth more once you hold it than one in an open state.
Medicaid, Medicare and what actually sets your limits
Louisiana funds in-home personal care through two separate paths, and the difference is operational rather than academic. Long Term-Personal Care Services, usually called LT-PCS, is a Medicaid state plan entitlement. Entitlement is the word that matters: eligible residents are entitled to the service, and there is no waitlist. Care is delivered through licensed providers, which is where a Personal Care Attendant agency fits. The Community Choices Waiver is a separate waiver programme carrying a significant waitlist, because waivers run on limited slots rather than an entitlement. Both are administered by the Louisiana Department of Health, Office of Aging and Adult Services, and delivered through Healthy Louisiana managed care.
Knowing which programme a referral comes through tells you how steady that pipeline is. Plan capacity around the wrong assumption and you end up short-staffed or carrying payroll you cannot fill, and since workers compensation is priced on payroll, staffing and insurance costs move together.
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: 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. For the non-medical side, see personal care services.
The Louisiana home care market
Louisiana has about 4.6 million residents, roughly 816,000 of them, close to 18 percent, 65 or older. That is the population home care serves, nearly one in five people in the state.
The demand is growing, and it is spread out in a way that shapes how an agency operates. Louisiana is not a single-metro state, and it is not uniformly rural either. It is both at once. The largest markets are New Orleans and Metairie, Baton Rouge, Lafayette, Lake Charles, and Shreveport and Bossier City. Outside those, demand runs across rural Louisiana, where seniors age in place with fewer agencies nearby.
That split is the practical fact here. A caregiver working New Orleans makes frequent short trips through dense traffic, where the exposure is accident frequency. One covering rural parishes drives long stretches, where the exposure is miles and time on the road. Plenty of agencies run both books at once, and pricing either as the other gets the auto exposure wrong in both directions.
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. This is our home state, so the areas we serve are not a list assembled from a map. If your caregivers work beyond Louisiana, the program has to satisfy each state they enter. Operators working toward the western border can read our Texas home care insurance page, and the full list is on our coverage by state hub.
Louisiana resources for home care providers
These are the Louisiana 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.
- Louisiana Department of Health, Health Standards Section, which licenses Home and Community-Based Services providers including the Personal Care Attendant module under LAC 48:I, Chapters 50 and 51.
- Facility Need Review committee, whose approval is required for several HCBS modules, including Personal Care Attendant, before an agency can apply for its license.
- Louisiana Workforce Commission, Office of Workers' Compensation, which administers the workers compensation requirement under the Louisiana Workers' Compensation Act in Revised Statutes Title 23.
- Louisiana Department of Health, Office of Aging and Adult Services, which administers Long Term-Personal Care Services and the Community Choices Waiver, delivered through Healthy Louisiana managed care.
- HomeCare Association of Louisiana, 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 Louisiana 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 long parish 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 Louisiana specifically, we are working from here rather than reading about it. We treat the domestic employee exemption as what it is, a rule about who employs the worker rather than where the work happens, so it does not reach caregivers on your payroll. And we take the Facility Need Review gate seriously when pricing a lapse, because a stop-work order in a gated state threatens something that took approval to build.
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 metro traffic and rural parish mileage 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.
Louisiana home care insurance FAQ
Specific answers for agencies operating under Louisiana 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: adding an HCBS module or moving into skilled home health, a new office or territory, a shift between LT-PCS and waiver work, or agency-owned vehicles.
From the first employee, with no threshold and no grace period while you are small. Coverage is governed by the Louisiana Workers' Compensation Act in Revised Statutes Title 23 and administered by the Louisiana Workforce Commission, Office of Workers' Compensation. Full-time, part-time, seasonal and temporary workers all count, and uninsured subcontractors can be counted as your employees under the statute, so routing work through uninsured contractors does not move the exposure off your books.
No, and this misunderstanding costs Louisiana agencies more than any other. The exemption is about who employs the worker, not where the work happens: it covers a person the homeowner hires directly, the household's own employee. Your caregivers do not work for the client, they work for your agency. You recruit them, schedule them, train them, pay them and can dismiss them, which makes them your employees no matter whose living room they are standing in.
Penalties can reach $250 per employee for a first violation and $500 per employee for repeats, capped at $10,000, with criminal exposure on top, and the state can issue a stop-work order that closes an agency while its clients still need care. The civil side is worse: an uninsured employer can be held personally liable for the injured worker's full costs and loses exclusive-remedy protection, so an injured caregiver can sue for the full measure of damages with your personal assets in reach.
How steady the pipeline is. Long Term-Personal Care Services is a Medicaid state plan entitlement, so eligible residents are entitled to the service and there is no waitlist, and care runs through licensed providers, which is where a Personal Care Attendant agency fits. The Community Choices Waiver is a separate programme carrying a significant waitlist, because waivers run on limited slots rather than an entitlement. Both are administered by the Louisiana Department of Health, Office of Aging and Adult Services, through Healthy Louisiana managed care. Plan capacity around the wrong assumption and you end up short-staffed or carrying payroll you cannot fill.
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 HCBS module you hold, how much of your book sits outside the metros, 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 Louisiana. There is no obligation.