General Liability
The foundation Nebraska hospitals and health systems expect, commonly at $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
Nebraska Home Care Insurance
For agencies already operating in Nebraska. 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 Nebraska 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 Nebraska, mid-term when the contract will not wait.
Two Nebraska details are worth a look on an established program. Two of the state's markets cross a border, so multi-state exposure is routine rather than something only large operators deal with, and the statute reaches nonresident employers working in Nebraska. And where your services sit against the skilled boundary is something to settle with the state rather than assume.
An agency running seventy-five to a hundred caregivers across Omaha, Lincoln, Grand Island or the western counties has a different problem from a startup, and this page is written for the former.
What Nebraska 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 Omaha and Lincoln 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.
The description on your certificate should match what a payer or hospital thinks it is buying. If your services sit near the skilled boundary and you have not settled where Nebraska draws it, confirm that with the Licensure Unit before the exhibit goes out.
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 Omaha 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 change in your licence position, particularly if your service mix has moved toward skilled work.
- A new office, or a move into central or western counties where a single visit can take most of a shift.
- Regular work in the Omaha or Sioux City corners, since both cross a state line as a matter of routine.
- Caregivers regularly working over the Iowa, South Dakota, Missouri, Kansas, Colorado or Wyoming 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 Nebraska home care agencies carry
The full program, sized to your payroll, territory and footprint. Each coverage has a page of its own.
Professional Liability
Clinical claims coverage weighted for licensed Nebraska home health agencies delivering care under a plan of care.
Professional liability coverageWorkers Compensation
Required at one or more employees in your regular business, and reaching nonresident employers performing work in Nebraska.
Workers compensation coverageCommercial Auto
Coverage for agency-owned vehicles carrying caregivers through Omaha and Lincoln traffic and across long western routes.
Commercial auto coverageHired and Non-Owned Auto
For caregivers driving their own cars for work, a short metro 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 Omaha and Lincoln 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 Nebraska
Home Care Agencies
Non-medical agencies delivering personal care and companion work across the eastern metros and the rural balance.
Home care agency insuranceHome Health Agencies
Agencies licensed through the DHHS Division of Public Health Licensure Unit, delivering care under a plan of care.
Home health agency insurancePersonal Care Services
Bathing, dressing, grooming, and daily living support, the core of a Nebraska non-medical book.
Personal care services coverageSenior Care Providers
Agencies serving the roughly 340,000 Nebraska 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 coverageNebraska workers compensation for home care agencies
A note on sourcing first. The facts below come from the statute itself, Neb. Rev. Stat. section 48-106, published by the Nebraska Legislature, because the Nebraska Workers' Compensation Court website did not respond during our research, on repeated attempts. The statute is the stronger source, but it means we have not reproduced what the Court publishes about penalties, injury reporting deadlines or owner and officer treatment. Where this page is silent, that is why.
No threshold, and a qualifier that matters
Section 48-106 applies the Nebraska Workers' Compensation Act to the State of Nebraska, to every governmental agency created by the state, and, except as provided in the section, to every resident employer in this state and nonresident employer performing work in this state who employs one or more employees in the regular trade, business, profession, or vocation of such employer.
Two things to take from that. There is no headcount, no payroll floor and no hours test. And coverage attaches to employment in the regular trade, business, profession, or vocation of the employer, which in some states is where an argument starts. Not here: caregiving delivered by an agency is exactly the employer's regular business. The section also reaches a nonresident employer performing work in this state, which matters in both directions in the Omaha and Sioux City corners. Read how the coverage works on our workers compensation page.
The household domestic servant exception
Section 48-106(2)(b) excepts service performed by a worker who is a household domestic servant in a private residence. That is the whole of it. No hours test, no earnings test, no headcount condition, no duration requirement.
Here is where we stop. The wording describes a household domestic servant in a private residence, language built around a worker in a home rather than an agency assigning staff to clients. Whether it could reach a caregiver employed by a licensed Nebraska agency is a legal question section 48-106 does not settle, so we will not tell you it excepts your caregivers or that it captures them.
The comparison that tells you how to read it
This is the most useful thing on the page, and it comes from setting two parts of the same section beside each other. For agriculture, Nebraska writes with real precision. Service is excepted where performed for an employer engaged in an agricultural operation who employs only related employees. Where such an employer employs unrelated employees, the exception falls away where during any calendar year the employer employs ten or more unrelated, full-time employees, whether in one or more locations, on each working day for thirteen calendar weeks, whether or not such weeks are consecutive, and the Act applies to that employer thirty days after the thirteenth such week.
Count what is specified there. A number of employees. Whether they are related. Whether they are full-time. Locations. Each working day. Thirteen calendar weeks. Whether those weeks run consecutively. And the precise day the Act attaches afterwards. Now read the household exception again: a household domestic servant in a private residence. Nothing measured at all.
The lesson is not that one exception is broader than the other. It is that Nebraska plainly knows how to write conditions into an exception when it wants them, and chose not to here. Alongside those, section 48-106 excepts a railroad company engaged in interstate or foreign commerce.
Nebraska licensing and regulatory context
Short version, and here it includes an honest gap. Home health agencies are licensed through the Department of Health and Human Services, Division of Public Health, Licensure Unit, and the licence appears in the state's One Stop business licensing listing alongside the DHHS licensure pages.
We could not identify a separate DHHS licence category for purely non-medical in-home personal care, and more importantly we could not establish exactly where Nebraska draws the boundary between skilled and non-medical work. That second point is why we are not going to give you a confident answer. Some states draw a clean line, with skilled services on one side and personal care on the other. We could not verify that Nebraska's sits in the same place, and assuming it does because a neighbour works that way is a poor basis for describing your operation on a contract schedule. Confirm your position with the Licensure Unit directly.
That gap matters because the licence category you hold, or do not hold, is what a carrier underwrites against. If your services sit near a boundary you have not settled, the description on your certificate may not match what a payer or hospital thinks it is buying. Get the answer from the state, tell us, and we will build to that rather than to a label.
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 personal care and companion work.
We are not going to describe Nebraska's Medicaid in-home programmes, because we could not confirm how they are structured or funded and those details should come from DHHS rather than from a broker page.
For most agencies the limits on your certificates are set by the hospitals, health systems and payers you contract with rather than by statute, 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 Nebraska home care market
Nebraska has about 2 million residents, roughly 340,000 of them 65 or older, close to 17.2 percent of the civilian population. The population sits in two places and then thins out sharply.
The Omaha and Council Bluffs area holds about 1 million and spans the Iowa line. Lincoln holds about 351,000. Grand Island follows, and the Sioux City area at about 146,000 spans Iowa and South Dakota, a tri-state corner. Everything west of Lincoln is sparsely settled.
So a Nebraska agency is usually anchored in the east with a long rural reach behind it, and two of its markets cross a border. A caregiver working Douglas or Lancaster County makes short trips through steady traffic, where the exposure is accident frequency. One covering the western counties drives long, open stretches where a single visit can take most of a shift and winter weather arrives with little shelter in between.
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. The eastern edge faces outward twice over, and section 48-106 also reaches a nonresident employer performing work in this state, which cuts the other way for agencies based over a line. Read our Iowa, Missouri, Kansas and Colorado pages, and the full list is on our coverage by state hub.
Nebraska resources for home care providers
The sources behind everything above.
- Nebraska DHHS home health agencies, through the Division of Public Health Licensure Unit.
- Home health agency licence on the state's One Stop listing.
- Statutes relating to health care facilities, the DHHS compilation.
- Neb. Rev. Stat. section 48-106, the coverage and exceptions section this page works from.
- Nebraska Workers' Compensation Court, which administers the Act. Its website did not respond during our research, so we have not linked it unchecked. Contact the Court directly for penalties and reporting requirements.
- Home Care Association of America, Nebraska chapter. We checked for a Nebraska-specific home care association and could not find one that resolves.
- National Association for Home Care and Hospice, for national home care standards and guidance.
Why Nebraska 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 Iowa on an ordinary Omaha shift exposes a program built to a state line. That is why we ask for the insurance exhibit rather than a summary.
On Nebraska specifically, we build for the border rather than the state, because the Omaha metro spans the Iowa line, the Sioux City corner spans Iowa and South Dakota, and section 48-106 reaches a nonresident employer performing work in this state. We also say plainly what we could not verify: where Nebraska draws the skilled boundary, and how its Medicaid in-home programmes are structured. Both belong to DHHS rather than a broker page.
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 western 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.
Nebraska home care insurance FAQ
Answers for agencies operating under Nebraska 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 change in your licence position, a new office or territory, regular work in the Omaha or Sioux City corners, agency-owned vehicles, or work over a state line.
Yes, with no threshold of any kind. Neb. Rev. Stat. section 48-106 applies the Act to every resident employer in this state and nonresident employer performing work in this state who employs one or more employees in the regular trade, business, profession, or vocation of such employer. There is no headcount, no payroll floor and no hours test. The regular trade qualifier is where an argument starts in some states, but not here: caregiving delivered by a home care agency is exactly the employer's regular business.
Section 48-106 reaches a nonresident employer performing work in this state, so yes on its face, and it cuts both ways. The Omaha metro spans the Iowa line and the Sioux City area spans Iowa and South Dakota, which makes multi-state work routine in those corners rather than something only large operators deal with. A program built to one state line will be wrong about a good share of the book.
The section does not settle it, and the comparison inside the statute is the useful part. Section 48-106(2)(b) excepts service performed by a worker who is a household domestic servant in a private residence, and that is the whole of it: no hours test, no earnings test, no headcount condition, no duration requirement. Set that beside the agriculture exception, which specifies a number of employees, whether they are related, whether they are full-time, locations, each working day, thirteen calendar weeks, whether those weeks run consecutively, and the precise day the Act attaches. Nebraska plainly knows how to write conditions into an exception and chose not to here. The wording is built around a worker in a home rather than an agency assigning staff to clients, so whether it reaches an agency-employed caregiver is a question the section does not answer.
Home health agencies are licensed through the Department of Health and Human Services, Division of Public Health, Licensure Unit. We could not identify a separate DHHS category for purely non-medical in-home personal care, and more importantly we could not establish where Nebraska draws the boundary between skilled and non-medical work, so we will not give you a confident answer. Confirm it with the Licensure Unit directly, because the category you hold, or do not hold, is what a carrier underwrites against, and a certificate that does not match what a payer thinks it is buying is a problem you find 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, where your licence position sits, and which state 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 Nebraska. There is no obligation.