General Liability
The foundation Maine hospitals and health systems expect, commonly at $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
Maine Home Care Insurance
For agencies already operating in Maine. 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 Maine 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 that write home care in Maine, mid-term when the contract will not wait.
Two Maine details are worth a look on an established program. Personal care agency registration became a licence, with right of entry, penalties and enforcement behind it, so a file built in the registration era is describing a regime that no longer exists. And in Maine an exemption is not a default you fall into, it is a position you have to prove.
An agency running seventy-five to a hundred caregivers from greater Portland out into the north and east has a different problem from a startup, and this page is written for the former.
What Maine 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 larger Portland and Bangor 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.
Which licence you hold is the frame a carrier underwrites against. A personal care agency book and a skilled book are priced against different exposures, 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 Portland 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 skilled services, which moves you onto the medical facilities licensing side rather than broadening the personal care agency licence.
- A new office, or clients further north and east where a single visit consumes most of a shift.
- A material rise in caregiver mileage, which moves the auto exposure more here than in a dense state.
- Caregivers regularly working over the New Hampshire 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 Maine home care agencies carry
The full program, sized to your licence and your driving. Each coverage has a page of its own.
Professional Liability
Clinical claims coverage for agencies on the skilled side, weighted heavier than personal care agency work.
Professional liability coverageWorkers Compensation
Required with no headcount threshold, and the policy that keeps you from losing the section 103 defence.
Workers compensation coverageCommercial Auto
Coverage for agency-owned vehicles carrying caregivers across long rural routes in weather that makes them longer.
Commercial auto coverageHired and Non-Owned Auto
For caregivers driving their own cars for work, which in rural Maine is most of the working day.
Hired and non-owned autoAbuse and Molestation
Coverage of up to $1 million for allegations standard liability excludes, essential given caregivers work alone with the oldest client base we cover.
Abuse and molestation coverageUmbrella Liability
Excess limits stacked on your liability and auto, the efficient way to reach the totals Portland and Bangor 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 Maine
Home Care Agencies
Personal Care Agencies licensed under 10-144 CMR Chapter 129, delivering non-medical personal care and companion services.
Home care agency insuranceHome Health Agencies
Skilled providers on the medical facilities side of DHHS licensing, delivering care under a plan of care.
Home health agency insurancePersonal Care Services
Bathing, dressing, grooming, and daily living support, the core of a Maine personal care agency book.
Personal care services coverageSenior Care Providers
Agencies serving the oldest population of any state we cover, about 23 percent aged 65 or 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 coverageMaine workers compensation for home care agencies
Workers compensation runs under 39-A M.R.S. section 401, administered by the Maine Workers' Compensation Board. There is no headcount threshold. Private employers, persons harvesting forest products who are not exempt, and governmental bodies must secure payment of compensation, by purchasing a policy or self-insuring under section 403.
Domestic service is exempt outright, and the condition beside it is not
Section 401 lists employers of employees engaged in domestic service among the exemptions, and attaches nothing to that paragraph. No hours test. No earnings test. No headcount condition. Several states bound their household exemption with a quarterly earnings or weekly hours figure. Maine does not.
Here is the trap. The paragraph next to domestic service exempts employers of employees engaged in agriculture or aquaculture as seasonal or casual laborers, if the employer maintains coverage by an employer's liability insurance policy with total limits of not less than $25,000 and medical payment coverage of not less than $5,000. Those limits attach to the agriculture and aquaculture paragraph only. Summaries that run the two paragraphs together make it look as though domestic service carries a $25,000 employer's liability condition. Reading the subsection itself shows it does not.
The burden of proof sits on you
Section 401 also states that the burden of proof to establish an exempt status under this subsection is on the employer claiming the exemption.
That line changes how an agency should treat every exemption in this statute. An exemption in Maine is not a default you fall into, it is a position you have to establish, and you establish it after something has gone wrong rather than before. An agency that decided its caregivers were exempt has not made a finding. It has taken on a burden to discharge at the worst possible moment.
What section 401 does not settle
The domestic service exemption is written around employers of employees engaged in domestic service, language built for a household employer rather than for a licensed agency. It does not on its face address a caregiver employed by a Maine Personal Care Agency and assigned to a client.
Whether it could ever reach that arrangement is a legal question section 401 does not answer, and we are not going to tell you it exempts your caregivers or that it captures them. Put that alongside the burden of proof and the practical advice writes itself. If your agency employs caregivers, build on that footing and read how the coverage works on our workers compensation page.
What failing to secure payment costs
Maine's consequence is not primarily a fine, it is the loss of a defence. An employer that fails to secure payment is not entitled, in a civil action brought by an employee or the employee's representative for personal injuries or death arising out of and in the course of employment, to the defense set forth in section 103. The statute adds that the employee of any such employer may, instead of bringing a civil action, claim compensation from the employer under this Act.
So the injured caregiver picks the route. They can claim compensation from the employer directly, or sue, and if they sue the uninsured employer goes into that action stripped of a defence it would otherwise have had. Being uninsured in Maine does not remove the problem, it removes your protection and hands the choice to the person you injured.
Maine licensing and regulatory context
Short version, because you already hold your licence. It earns space for one reason: the regime changed, and a compliance file written before the change is describing something that no longer exists.
Non-medical home care is licensed as a Personal Care Agency by the Maine Department of Health and Human Services, through its Division of Licensing and Certification. The governing rule is 10-144 CMR Chapter 129, the Personal Care Agency Licensing Rule. DHHS describes it in its own rulemaking: it replaces the existing requirement for registration with a licensing process, incorporates a new statutory definition for Personal Care Agency, establishes standards and fees for the licensing of personal care agencies, establishes types and terms of licenses, creates quality assurance and technical assistance mechanisms, and establishes right of entry, penalties, and enforcement actions.
Read what is packed into that sentence. A registry became a licence. Standards, licence types and terms and quality assurance arrived, and so did a right of entry, penalties and enforcement actions, which is the part a registration never carried. If your operating file or an article you are working from describes registering a personal care agency in Maine, it describes the previous regime, and the difference between being on a list and holding a licence with enforcement behind it changes what a carrier is underwriting.
Two other offices are worth knowing. DHHS operates a Background Check Center linked from the Personal Care Agency licensing page, and the Office of Aging and Disability Services runs home and community support services licensing alongside personal care agency initiatives. On the skilled side, the Division of Licensing and Certification also handles medical facilities licensing.
Medicare, payers and what actually sets your limits
Medicare covers short-term skilled home health under a plan of care. That work raises the stakes on documentation and on professional liability, and it sits on a different footing from the personal care a PCA licence covers.
For most personal care agencies the limits on your certificates are set by the hospitals, health systems and payers you contract with rather than by any statute. In a state with one dominant metro, a small number of institutions set a lot of the terms, which is why we ask to see the contract language rather than guessing at a number.
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 Maine home care market
Maine has about 1.41 million residents, roughly 321,000 of them 65 or older. At about 23 percent of the civilian population that is the highest share of any state we cover, and it is the number the whole business case rests on here.
The population is concentrated in one place and then thins out fast. Portland and South Portland hold about 572,000, roughly 41 percent of the state. Bangor holds about 157,000 and Lewiston and Auburn about 115,000. Nothing else comes close.
The rest of Maine is rural in a way few states match. The north and east are very sparsely settled, the drives between clients are long, and for months of the year they are icy. A caregiver working greater Portland makes reasonably short trips; one covering the north or east drives long stretches on roads that ice, in the dark for much of the winter, often to a single client. The oldest population in the set combined with the thinnest road network is the defining fact for a Maine agency: high demand, spread thin, reached slowly.
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. In a state this rural that is the shape of the working day rather than an edge case. If your caregivers work beyond Maine, the program has to satisfy each state they enter. Operators working the western border can read our New Hampshire page, and the full list is on our coverage by state hub.
Maine resources for home care providers
The sources behind everything above.
- Maine DHHS Personal Care Agency licensing, which carries 10-144 CMR Chapter 129 and links the Background Check Center.
- Division of Licensing and Certification, and its medical facilities licensing for the skilled side.
- Office of Aging and Disability Services, which runs home and community support services licensing.
- Maine Workers' Compensation Board, which administers coverage under Title 39-A.
- 39-A M.R.S. section 401, the liability of employer section carrying the exemptions and the burden of proof.
- Maine Alliance for Care at Home, the state home care industry body.
- National Association for Home Care and Hospice, for national home care standards and guidance.
Why Maine 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 an iced route north 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 Maine specifically, we do not treat any section 401 exemption as settled, because the statute puts the burden of proof to establish exempt status on the employer claiming it, and that burden falls due after an injury rather than before. We also price the winter driving as it actually is rather than as a summer radius, which is the most commonly underrated line on an existing Maine placement.
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 winter 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 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.
Maine home care insurance FAQ
Answers for agencies operating under Maine 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 skilled services, a new office or territory, a material rise in caregiver mileage, agency-owned vehicles, or regular work over a state line.
There is no headcount threshold. Under 39-A M.R.S. section 401, administered by the Maine Workers' Compensation Board, private employers, persons harvesting forest products who are not exempt, and governmental bodies must secure payment of compensation, either by purchasing a policy or by self-insuring under section 403. The section does carry exemptions, but Maine puts the burden of establishing one on the employer claiming it.
No, and this is the most common Maine misreading. Section 401 lists employers of employees engaged in domestic service among the exemptions and attaches nothing to that paragraph: no hours test, no earnings test, no headcount condition. The paragraph beside it exempts agriculture and aquaculture seasonal or casual laborers if the employer maintains employer's liability coverage with total limits of not less than $25,000 and medical payment coverage of not less than $5,000. Those limits belong to the agriculture and aquaculture paragraph only. Summaries that run the two together get Maine wrong.
We would not build a program on it, for two reasons. The exemption is written around employers of employees engaged in domestic service, language built for a household employer, and it does not on its face address a caregiver employed by a licensed Personal Care Agency and assigned to a client. And section 401 states that the burden of proof to establish an exempt status under this subsection is on the employer claiming the exemption. An exemption in Maine is not a default you fall into, it is a position you have to establish, and you establish it after something has gone wrong rather than before.
You lose a defence rather than simply paying a fine. An employer that fails to secure payment is not entitled, in a civil action brought by an employee or the employee's representative for personal injuries or death arising out of and in the course of employment, to the defense set forth in section 103, and the employee may instead claim compensation from the employer under the Act. So the injured caregiver picks the route: claim against you directly, or sue you stripped of a defence you would otherwise have had.
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 licence you hold, and how far north and east your routes run, 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 Maine. There is no obligation.