General Liability
The foundation Michigan hospitals, health systems and payers expect, commonly at $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
Michigan Home Care Insurance
For agencies already operating in Michigan. 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 Michigan 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 actually 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 Michigan, and we do it mid-term when the contract will not wait.
Michigan makes your insurance do work it does not have to do elsewhere. There is no state licence for the agency, so a licence number cannot vouch for you to a family, a discharge planner or a payer. What you can evidence on a certificate is the credential, which makes the program a positioning decision rather than only a compliance cost.
An agency running seventy-five to a hundred caregivers across metro Detroit, Grand Rapids, Lansing or the north has a different problem from a startup, and this page is written for the former.
What Michigan contracts require, and what happens when yours falls short
On liability the numbers come from your contracts rather than a statute, and in an unlicensed market that is doubly true.
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 the large Detroit and Grand Rapids 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.
Because no state licence exists on the agency side, those documents carry more weight in Michigan than they do in a licensed state. A counterparty checking you out has your certificates, your Medicare certification if you hold it, and any voluntary accreditation. That is the whole file, which is a reason to build it deliberately.
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 additional premium, the fastest path where it is 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 already does. If a Detroit or Grand Rapids 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 already on file should carry over rather than be rebuilt each year.
What to report during the year
Adding and removing caregivers does not require a policy change each time, because the program is rated on payroll and headcount and trued up at audit. What needs reporting is a change in the agency's shape.
- Crossing either limb of the workers compensation test, which can happen on hours rather than headcount.
- A move into skilled nursing, or pursuing Medicare and Medicaid certification.
- A new office, or a move north where the driving profile changes entirely.
- Agency-owned vehicles, which need commercial auto rather than a caregiver reimbursement arrangement.
- Caregivers regularly working over the Indiana, Ohio or Wisconsin 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 an unwelcome additional premium.
Coverages Michigan home care agencies carry
The full program, sized to your staffing pattern and your driving. Each coverage has a page of its own.
Professional Liability
Clinical claims coverage for Michigan agencies delivering skilled nursing, where Medicare certification is the main external check.
Professional liability coverageWorkers Compensation
Triggered by three employees at one time, or by one employee at 35 or more hours a week for 13 weeks, whichever you reach first.
Workers compensation coverageCommercial Auto
Coverage for agency-owned vehicles carrying caregivers through metro traffic and across long northern winter roads.
Commercial auto coverageHired and Non-Owned Auto
For caregivers driving their own cars for work, a short Detroit run or a long January route north.
Hired and non-owned autoAbuse and Molestation
Coverage of up to $1 million for allegations standard liability excludes, and in an unlicensed market one of the clearest signals you can give a client.
Abuse and molestation coverageUmbrella Liability
Excess limits stacked on your liability and auto, the efficient way to reach the totals Detroit and Grand Rapids 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 Michigan
Home Care Agencies
Non-medical agencies operating without state licensure, delivering personal care and companion work.
Home care agency insuranceHome Health Agencies
Skilled agencies whose main external credential is Medicare and Medicaid certification, surveyed by LARA under contract to CMS.
Home health agency insurancePersonal Care Services
Bathing, dressing, grooming, and daily living support, the core of a Michigan non-medical book.
Personal care services coverageSenior Care Providers
Agencies serving the roughly 1.93 million Michigan 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 coverageMichigan workers compensation for home care agencies
Where Michigan is loose on licensing it is precise on workers compensation, and the precision matters because the rule is not a single number.
Two limbs, and either one brings you inside
MCL 418.115, part of the Worker's Disability Compensation Act of 1969, applies the act to two categories of private employer. All private employers, other than agricultural employers, who regularly employ 3 or more employees at 1 time. And all private employers, other than agricultural employers, who regularly employ less than 3 employees if at least 1 of them has been regularly employed by that same employer for 35 or more hours per week for 13 weeks or longer during the preceding 52 weeks. Either limb on its own brings you inside the act. The system is administered by the Department of Labor and Economic Opportunity through the Workers' Disability Compensation Agency. Read how the coverage works on our workers compensation page.
Why both limbs bite in home care
This is the Michigan point worth reading twice, because the shorthand version loses it. People say Michigan is a three-employee state. That is limb (a) only, and it is half the test.
Limb (a) counts heads at one time and names no hours condition at all, so three part-time caregivers on the schedule together reaches it regardless of how few hours each works. Limb (b) does the opposite: it reaches employers with fewer than three employees and asks instead whether any single one of them has been regularly employed at 35 or more hours a week for 13 weeks or longer in the preceding 52.
Set those against how a home care agency staffs. Either you run several part-timers to cover a schedule, landing on limb (a) at three, or you build around one or two near-full-time caregivers, landing on limb (b) after a quarter. Most agencies are inside one limb or the other faster than they expect, and an owner watching only headcount can sit inside limb (b) for months without knowing there was a second test.
The other categories in the section
MCL 418.115 also covers all public employers, irrespective of the number of persons employed. Agricultural employers are handled separately, with a limb covering agricultural employers of 3 or more regular employees paid hourly wages or salaries and not on a piecework basis, employed 35 or more hours per week for 13 or more consecutive weeks during the preceding 52, and a further limb covering agricultural employers of 1 or more employees for medical and hospital coverage. Neither describes home care, but they show how the section is built: Michigan writes thresholds as combinations of headcount, hours and duration rather than single numbers.
Michigan licensing and regulatory context
Short version, and unusual, because Michigan states its position rather than leaving you to infer it.
The Department of Licensing and Regulatory Affairs writes that state licensing is not required for home health agencies. We did not identify a separate state licence for non-medical home care either, and we would point you to LARA to confirm your own position rather than assert a clean negative we could not verify. The direction is not ambiguous, but the confirmation should come from the department.
What exists instead is federal, run by the state. Home health agencies providing skilled nursing may apply for Medicare and Medicaid certification, and CMS contracts with LARA to evaluate compliance with the federal regulations, so there is a survey and Michigan staff carry it out, but the standard applied is federal. Individual health professionals are licensed separately by the Bureau of Professional Licensing. That is the cleanest summary of the Michigan position and it is worth saying to anyone who asks: your nurses and therapists hold licences, the business does not, because the state does not issue one.
Medicare, Medicaid and what actually sets your limits
Medicare covers short-term skilled home health under a plan of care, and in Michigan it carries more weight than elsewhere. With no state licence in the picture, Medicare certification is the main external credential a home health agency holds, and LARA conducts those surveys under contract to CMS.
That has a practical consequence. In a licensed state an agency can point to a licence and a certification. In Michigan one document does the work, so a certified agency should treat its survey performance as a commercial asset rather than only a compliance obligation.
For agencies without certification, the limits on your certificates are set entirely by the hospitals, health systems and payers you contract with, 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 Michigan home care market
Michigan has about 10.14 million residents, and roughly 1.93 million of them are 65 or older, close to 19.2 percent of the civilian population. That is an older profile than most of the country and it makes Michigan one of the largest home care markets we write.
Detroit, Warren and Dearborn hold about 4.4 million people. Grand Rapids, Wyoming and Kentwood hold about 1.18 million, Lansing and East Lansing about 480,000, with Ann Arbor and Kalamazoo and Portage behind them.
Then the state changes character more sharply than almost any other. The Upper Peninsula and the northern Lower Peninsula are sparsely settled, the drives are long, and the winters reshape a working day for months. That range is what makes auto the hardest line to price here. A caregiver in Wayne or Oakland County makes short trips through heavy traffic, where the exposure is accident frequency. A caregiver covering the north drives long stretches on roads that ice, in the dark for much of the winter, sometimes to a single client.
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. Michigan borders Indiana, Ohio and Wisconsin, and agencies in the south and the western Upper Peninsula often recruit or serve across a line, where the rules differ sharply on licensing since Michigan sits at one end of that range. Read our Indiana and Wisconsin pages, and the full list is on our coverage by state hub.
Michigan resources for home care providers
The sources behind everything above.
- LARA home health agencies, which states that state licensing is not required and explains the federal certification route.
- MCL 418.115, the section carrying both workers compensation limbs.
- Workers' Disability Compensation Agency and its insurance requirements page.
- Michigan HomeCare & Hospice Association, the home health and hospice side of the industry.
- Michigan In-Home Care Association, the in-home and non-medical side.
- National Association for Home Care and Hospice, for national home care standards and guidance.
Michigan is the only state we cover with two distinct verified state associations. That is not an accident of history. With no state licence defining the category, the industry drew the line itself, and the two bodies sit on either side of it.
Why Michigan 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 current form does not carry. A caregiver crash on an iced northern road 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 of it.
On Michigan specifically, we read MCL 418.115 as two limbs rather than one number, because an owner watching only headcount can be inside limb (b) for months without knowing a second test existed. And we take the unlicensed market seriously rather than treating it as a gap. Where no state licence vouches for the agency, your general liability limits, your workers compensation, your abuse cover and your auto program are the credential a referral source can actually check.
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 long northern winter 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 working relationships across the home care and healthcare industry, including CareerStaff Unlimited and Genesis Healthcare in staffing and healthcare services, HOMELINK in the medical equipment and home care network space, and Bright Horizons Family Solutions on the family care side.
Michigan home care insurance FAQ
Answers for agencies operating under Michigan 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 does not require a policy change. What does need reporting is a change in what the agency does: a move into skilled nursing or Medicare certification, a new office, a move north, agency-owned vehicles, or regular work over a state line. Watch the hours your longest-serving caregivers work too, because that is a workers compensation trigger here.
Only half of it is, and the shorthand loses the other half. MCL 418.115 applies the act to all private employers, other than agricultural employers, who regularly employ 3 or more employees at 1 time. That is limb (a). There is a second limb covering private employers who regularly employ less than 3 employees if at least 1 of them has been regularly employed by that same employer for 35 or more hours per week for 13 weeks or longer during the preceding 52 weeks. Either limb on its own brings you inside the act.
Not necessarily, and this is where owners get caught. Limb (b) reaches employers with fewer than three employees and asks whether any single one has been regularly employed at 35 or more hours a week for 13 weeks or longer in the preceding 52. An agency built around one or two near-full-time caregivers lands on that limb after a quarter. An owner watching only the headcount can be inside limb (b) for months without knowing there was a second test.
Yes. Limb (a) counts employees at one time and names no hours condition at all, so three part-time caregivers on the schedule together reaches it regardless of how few hours each of them works. Between the two limbs, most home care agencies are inside one or the other faster than they expect: several part-timers lands on limb (a), and one or two near-full-timers lands on limb (b).
On the agency side, no, and it is worth saying accurately to anyone who asks. The Department of Licensing and Regulatory Affairs writes that state licensing is not required for home health agencies, and we did not identify a separate state licence for non-medical home care either. We would point you to LARA to confirm your own position rather than assert a clean negative we could not verify. Your individual health professionals are licensed separately by the Bureau of Professional Licensing, so the people hold licences and the business does not.
What you can show, which is why the program matters more here. In a licensed state a licence number does quiet work for you: it tells a family, a discharge planner and a payer that somebody has inspected the operation. Michigan does not give you that shortcut on the agency side. What fills the gap is general liability at the limits your contracts ask for, workers compensation covering every caregiver, abuse and molestation cover that standard liability excludes, auto coverage matching how far your people really drive, Medicare certification if you hold it, and voluntary accreditation if you pursue it.
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, the hours your longest-serving caregivers work, how far north 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 Michigan. There is no obligation.