General Liability
Expected as part of operating an LHCSA, with proof of insurance required at licensure and renewal. Contracts commonly add $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
New York Home Care Insurance
For agencies already operating in New York. If a health system or managed care plan 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 New York 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 New York, and we do it mid-term when the contract will not wait.
New York raises the stakes on getting it right. Your LHCSA licence took a Certificate of Need and a character and competence review to obtain, it sits under a per-county cap, and it is not transferable. That makes it one of the most valuable things your agency owns, and it is what an uninsured claim actually puts at risk.
An agency running seventy-five to a hundred caregivers across New York City and its surrounding counties, or across Buffalo, Rochester, Syracuse and Albany, has a different problem from a startup, and this page is written for the former.
What New York contracts require, and what happens when yours falls short
New York is the rare state where the core coverages are not a matter of what your contracts ask for. Workers compensation and disability benefits are legal requirements tied to operating an LHCSA. Your contracts then build from there.
What the contracts typically ask for
General liability is expected for an LHCSA, and beyond that hospitals, facilities and payers commonly ask for $1 million per occurrence and $2 million aggregate. Professional liability is expected of skilled agencies for their clinical exposure. Evidence of workers compensation and of disability benefits, both mandatory here. Auto liability covering agency vehicles and caregivers driving their own. Abuse and molestation coverage, increasingly named rather than assumed. And an umbrella where hospital partnerships demand higher totals.
Wording matters as much as the number. Contracts routinely ask to be named as an additional insured, for a waiver of subrogation, for cover to respond on a primary and non-contributory basis, and for advance notice of cancellation. Each is an endorsement on a policy rather than a sentence on a certificate.
The mandated coverages are the floor, not the answer. An agency can be fully compliant with New York law and still fall short of what a Managed Long Term Care plan or a hospital system writes into its vendor packet, which is where most of our New York work sits.
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, and that is 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 usually get there quicker and for less than rebuilding the primary underneath.
The third is re-marketing, where a carrier will not extend or the required 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. Both are where a placement quietly fails.
Certificates
A certificate is evidence, not coverage. It states only what a policy already does. If a New York City 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 plan sends paperwork, send us the insurance requirements immediately. Certificates already on file should carry over rather than be rebuilt each year. Your licensure and renewal filings need proof of insurance too, so those dates are worth keeping alongside your policy dates.
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.
- A new service line, particularly a move into skilled care, which weights professional liability more heavily.
- A new office or county, in a market where the per-county cap makes any expansion a considered move.
- Agency-owned vehicles, which need commercial auto rather than a caregiver reimbursement arrangement.
- A change in office headcount, because both mandated coverages reach administrative staff as well as aides.
- An acquisition, a new entity, or a change of ownership, remembering the licence itself is not transferable.
- 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 an audit from producing an unwelcome additional premium.
Coverages New York 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 New York skilled agencies, weighted for the exposure that skilled care under a plan of care carries.
Professional liability coverageWorkers Compensation
Mandatory from the first employee under the New York State Workers' Compensation Board, covering full-time and part-time staff. Priced on payroll and your experience modifier.
Workers compensation coverageDisability Benefits
A second mandatory New York coverage, separate from workers compensation, that pays for an employee's off-the-job injury or illness. Required for caregivers and office staff alike.
How the required coverages fitCommercial Auto
Coverage for agency-owned vehicles carrying caregivers through New York City traffic and across upstate county 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 through city traffic or on longer upstate routes, an exposure most New York 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 and a single allegation can threaten a license.
Abuse and molestation coverageUmbrella Liability
Excess limits stacked on top of your liability and auto, the efficient way to reach the higher totals New York 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 New York
Home Care Agencies
New York Licensed Home Care Services Agencies delivering non-medical personal care and companion services under Article 36.
Home care agency insuranceHome Health Agencies
New York skilled agencies delivering care under a plan of care and able to pursue Medicare certification.
Home health agency insurancePersonal Care Services
Bathing, dressing, and daily living support, much of it authorized through Managed Long Term Care and consumer-directed care.
Personal care services coverageSenior Care Providers
Agencies serving New York's large and growing senior population, 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 coverageNew York workers compensation for home care agencies
New York mandates two employee coverages rather than one, and an agency that carries only the familiar one is not compliant.
Workers compensation from the first employee
Workers compensation in New York is administered by the New York State Workers' Compensation Board and is required for essentially all employers with employees, from the first one, covering full-time and part-time workers alike. There is no threshold to grow into. Labeling caregivers as independent contractors does not work, because a worker who functions as an employee is treated as one. Read how the coverage works on our workers compensation page.
Disability benefits: the second required policy
This is the New York requirement that catches out-of-state owners. Separately from workers compensation, New York requires disability benefits insurance for employees, a distinct mandatory coverage that pays for an off-the-job injury or illness.
Workers compensation responds when a caregiver is hurt on the job. Disability benefits responds when an employee is sidelined by something away from work. Very few states mandate this second policy. New York does, so an LHCSA needs both in place for its caregivers and its office staff, not one standing in for the other. If you inherited a program built out of state, this is the first thing to check.
How it is priced
Workers compensation is priced per $100 of payroll rather than as a flat premium, and your experience modifier adjusts it up or down based on your claims history. A clean claims record is the single best lever you control, and it improves how carriers underwrite the rest of your program.
New York licensing and regulatory context
Short version, because you already hold your licence. It earns space because in New York the licence is an asset with real value, and because it carries insurance conditions of its own.
Home care agencies are licensed as a Licensed Home Care Services Agency, an LHCSA, by the New York State Department of Health under Article 36 of the Public Health Law, with minimum standards at 10 NYCRR Part 766. LHCSAs are also subject to a separate registration requirement under Public Health Law section 3605-b.
What makes it valuable is what it takes to hold. New York requires a Certificate of Need, reviewed by the Public Health and Health Planning Council against public need, financial feasibility, and the character and competence of the owners. The state also caps the number of LHCSAs per county, and a licence is not transferable, so it cannot be bought and moved. That is what makes New York an established-operator market, and it rewards agencies already inside it.
Medicare, Medicaid and what actually sets your limits
New York delivers Medicaid long-term home care largely through Managed Long Term Care plans, so a large share of publicly funded care in the home is authorized and paid through those plans rather than directly by the state, which shapes both referral flow and the documentation you keep. The state also runs the Consumer Directed Personal Assistance Program, which lets eligible residents direct their own care rather than receive it through a traditional agency-managed model.
Medicare comes in separately, covering short-term skilled home health under a plan of care. That work raises the stakes on documentation and on professional liability.
What sets your limits above the mandated floor is the plans, hospitals and facilities 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, and for the non-medical side our personal care services page covers that exposure.
The New York home care market
New York has about 19.6 million residents and one of the largest home care markets in the country. Demand is concentrated heavily in New York City and its surrounding counties, with additional strength in Buffalo, Rochester, Syracuse and Albany. The senior population is large and growing.
What sets New York apart is the combination. It pairs that heavy demand with nation-leading home care wages and the tightest regulation of any state, so it is high-cost, high-value and heavily regulated at once. An agency here has thinner room for error, and the operators who do well treat compliance and coverage as core to the business rather than overhead.
The geography runs to both extremes. A New York City agency works dense, slow traffic and short distances between clients stacked close together. An upstate agency covers longer drives across counties where clients are further apart. Plenty of agencies serve more than one of those worlds, and the coverage that fits a Manhattan book does not automatically fit a rural upstate one.
Agency-owned vehicles need commercial auto, and caregivers using their own cars create a hired and non-owned auto exposure a personal policy usually will not cover on a work trip. If your caregivers work beyond New York, the program has to satisfy each state they enter. We also cover neighboring New Jersey, Connecticut and Vermont, and the full list is on our coverage by state hub.
New York resources for home care providers
These are the New York bodies that shape how home care operates, for licensing, workers compensation, and industry advocacy. We name them so you know where each requirement comes from.
- New York State Department of Health, which licenses Home Care Services Agencies under Article 36 of the Public Health Law, with standards at 10 NYCRR Part 766.
- Public Health and Health Planning Council, which reviews the Certificate of Need, including public need, financial feasibility, and the character and competence of the owners.
- New York State Workers' Compensation Board, which administers the mandatory workers compensation and disability benefits requirements for employees.
- Home Care Association of New York State, or HCA-NYS, 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 New York agencies choose HCBI
We work with agencies that are already running, and their problems are contract problems.
A health system raises its required limits at renewal. A Managed Long Term Care plan 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 in city traffic or on a long upstate route exposes how little a personal auto policy does on a work trip. Those are the calls, and they are why we ask for the insurance exhibit rather than a summary of it.
On New York specifically, we know the two mandated employee coverages and why carrying only workers compensation leaves a gap, we know that general liability is expected of an LHCSA and has to be evidenced at licensure and renewal, and we understand what the Certificate of Need, the character and competence review and the per-county cap make your licence worth. A broker who does not know that framework will treat a coverage gap as a premium question rather than as a threat to the asset it actually is.
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 city and upstate driving alike, umbrella limits to reach what your contracts demand, cyber, and abuse and molestation coverage of up to $1 million. In a state where a single allegation can threaten both the business and the licence, we treat that limit as essential rather than an afterthought. 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.
New York home care insurance FAQ
Specific answers for agencies operating under New York 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 to a policy, 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 hiring and turnover does not require a policy change. What does need reporting is a change in what the agency does: a new service line, a new office, agency-owned vehicles, an acquisition, or regular work over a state line. Remember that both mandated coverages reach office staff as well as aides, so a change in the office is a change in the exposure too.
Yes, from the first employee. Workers compensation is administered by the New York State Workers' Compensation Board and required for essentially all employers with employees, covering full-time and part-time workers alike. There is no threshold to grow into. Labeling caregivers as independent contractors does not work either, because a worker who functions as an employee is treated as one.
Yes, and this is the New York requirement that catches out-of-state owners most often. Separately from workers compensation, New York requires disability benefits insurance for employees, a distinct mandatory coverage paying for an off-the-job injury or illness. Workers compensation responds when a caregiver is hurt on the job; disability benefits responds when an employee is sidelined by something away from work. Very few states mandate this second policy. Having one does not satisfy the requirement for the other, and both reach office staff as well as aides.
More than the claim. A New York licence takes a Certificate of Need, a character and competence review by the Public Health and Health Planning Council, and it sits under a per-county cap that limits how many agencies can exist. It is not transferable, so it cannot be bought and moved. That makes the licence one of the most valuable things your agency owns, and an uninsured claim, a workers compensation gap or an abuse allegation with no coverage behind it threatens an asset that took years to build.
A Licensed Home Care Services Agency licence, or LHCSA, issued by the New York State Department of Health under Article 36 of the Public Health Law, with minimum standards at 10 NYCRR Part 766. On the insurance side the licence is not neutral: workers compensation and disability benefits are mandatory for all employees, general liability is expected as part of operating and maintaining an LHCSA, and agencies must show proof of insurance at licensure and renewal. LHCSAs are also subject to a separate registration requirement under Public Health Law section 3605-b.
Mostly on auto, and it is worth telling us rather than leaving it to be found at audit. A caregiver working New York City contends with dense, slow traffic and the accident frequency that comes with it. A caregiver covering upstate counties puts longer miles on the vehicle between visits. 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.
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 rather than in the last fortnight. A non-renewal shortens the list of carriers, and lead time is what buys the options back.
Send us the contract and we will build to it
Tell us your payroll and caregiver count, the counties you serve, whether you carry both mandated employee coverages, 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 New York. There is no obligation.