General Liability
The foundation Oregon hospitals and health systems expect, commonly at $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
Oregon Home Care Insurance
For agencies already operating in Oregon. 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 an Oregon 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 Oregon, mid-term when the contract will not wait.
Two Oregon details are worth a look on an established program. ORS 656.027 names home health workers inside its domestic servant category, then attaches a condition it does not define, so the exemption looks settled and is not. And the Portland metro spans the Columbia, where workers compensation is not a line we can place.
An agency running seventy-five to a hundred caregivers across Portland, Salem, Eugene, Bend or the eastern counties has a different problem from a startup, and this page is written for the former.
What Oregon 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 Portland 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.
Your licence category is the frame a carrier underwrites against. An in-home care agency and a home health agency delivering clinical care under a plan of care are two different propositions, 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.
- A move between the in-home care agency and home health agency categories, which changes the professional liability picture.
- A new office, or clients east of the Cascades where a visit can be an hour each way.
- Caregivers crossing the Columbia into Washington, since workers compensation works differently there.
- Caregivers regularly working over the California, Nevada or Idaho 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 Oregon home care agencies carry
The full program, sized to your category, contracts, and driving. Each coverage has a page of its own.
Professional Liability
Clinical claims coverage weighted for Oregon home health agencies delivering care under a plan of care, heavier than in-home care agency work.
Professional liability coverageWorkers Compensation
Required where you have subject workers, with a domestic servant exemption that names home health workers and then conditions it. Priced on payroll and your experience modifier.
Workers compensation coverageCommercial Auto
Coverage for agency-owned vehicles carrying caregivers through valley traffic and across eastern Oregon distance.
Commercial auto coverageHired and Non-Owned Auto
For caregivers driving their own cars for work, a short Portland run or a long eastern 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 Portland 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 Oregon
Home Care Agencies
In-home care agencies licensed by OHA under ORS 443, delivering non-medical personal care and companion services.
Home care agency insuranceHome Health Agencies
Skilled agencies in their own ORS 443 category, delivering care under a plan of care.
Home health agency insurancePersonal Care Services
Bathing, dressing, grooming, and daily living support, the core of most Oregon in-home care books.
Personal care services coverageSenior Care Providers
Agencies serving the roughly 829,000 Oregon residents aged 65 and older, weighted for wandering, falls, and abuse.
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 coverageOregon workers compensation for home care agencies
Oregon builds its rule from the opposite end to most states. Rather than listing who is covered, it covers everyone and then lists the exceptions. The Workers' Compensation Division, part of the Department of Consumer and Business Services, states it plainly: every worker in Oregon is a subject worker unless the worker falls under an exemption. So there is no headcount to reach, and an employer with one or more subject workers must purchase a policy. The duty to insure sits at ORS 656.017, the definition of a subject worker at ORS 656.027, and further exemptions at ORS 656.126.
The exemption that names home health workers
This is the Oregon clause worth reading twice. ORS 656.027 provides that all workers are subject to this chapter except those nonsubject workers described in the following subsections, and subsection (1) covers a worker employed as a domestic servant in or about a private home. It then adds: for the purposes of this subsection domestic servant means any worker engaged in household domestic service by private employment contract, including, but not limited to, home health workers.
Read that last phrase. Oregon put home health workers inside the domestic servant category by name. In almost every other state the question of whether home care work is domestic work is argued from silence; here the legislature spoke to it directly, and what it said points toward inclusion.
The four words that decide it
Here is where we stop, and where you should be wary of anyone who does not. The definition is qualified: a domestic servant means a worker engaged in household domestic service by private employment contract. Whether a caregiver employed by a licensed Oregon in-home care agency is engaged that way, or whether the phrase means contracted directly by the household, is the entire question. ORS 656.027 does not answer it.
So Oregon is not the clean answer it looks like. The text speaks to home care and then attaches a condition it does not define. We will not tell you your caregivers are exempt, or that they are not. The phrase is doing all the work, and building a program on the assumption of exemption is a decision rather than a finding. Read how the coverage works on our workers compensation page.
The neighbouring exemptions, and what they suggest
Subsection (2) covers a worker employed to do gardening, maintenance, repair, remodeling or similar work in or about the private home of the person employing the worker. Set that beside subsection (1) and a pattern shows: Oregon writes its home-based exemptions around work done for the person employing the worker, the same framing question the home health worker clause raises but does not settle.
The casual exemption is compound and worth knowing precisely. ORS 656.027(3)(a) covers a worker whose employment is casual and either the employment is not in the course of the trade, business or profession of the employer, or it is in the course of the trade, business or profession of a nonsubject employer. Casual alone is never enough, and for a home care agency a fill-in caregiver shift is squarely in the course of your trade, so the first branch fails on its face.
Across the river, workers compensation is not ours to place
The Portland metropolitan area spans the Columbia into Washington, so cross-river work is routine for agencies in the north of the state, and it is worth being blunt about what changes. Washington workers compensation comes from the state fund or from qualifying as a self-insurer rather than from a private carrier. It is not a line we can place there, and we would rather say so than let an Oregon operator assume their program travels intact across the bridge. Everything else does travel: general liability, professional liability, abuse and molestation, commercial and hired and non-owned auto, umbrella, cyber and property are unaffected.
Oregon licensing and regulatory context
Short version, because you already hold your licence. It earns space because the category is what a carrier underwrites against.
Non-medical home care is licensed by the Oregon Health Authority, through Health Care Regulation and Quality Improvement, as an In-Home Care Agency. The governing chapter is ORS Chapter 443, and its title tells you how Oregon organises this: Home Health Agencies, Residential Facilities, and In-Home Care Agencies sit together in one chapter. Non-medical home care is neither an afterthought bolted onto a facilities statute nor a separate regime. It is one of three named categories under a single chapter covering care delivered outside a hospital.
What matters for insurance is the category itself. An in-home care agency delivering personal care and companion services and a home health agency delivering clinical care under a plan of care are two different underwriting propositions, and professional liability is weighted accordingly. Tell us which you hold and whether you are working toward the other, and confirm the operational detail with OHA directly, because the authoritative text belongs to the Authority.
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 sits on a different footing from the personal care and companion work an in-home care agency licence is built around.
For most in-home care agencies the limits on your certificates are not set by a statute at all. They are set by the hospitals, health systems, facilities and payers you contract with, and in the Portland market those contracts tend to come from large institutions with standard requirements attached, which is why we ask to see the contract language rather than guessing.
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 Oregon home care market
Oregon has about 4.27 million residents, roughly 829,000 of them 65 or older, close to 19.6 percent of the civilian population. That is an older profile than most of the country, and it makes Oregon a deeper market than its size alone suggests.
The population sits along the Willamette Valley. Portland and its surrounding area holds about 2.54 million and spans the Columbia into Washington. Salem holds about 443,000, Eugene and Springfield about 382,000, with Medford and Bend behind them.
East of the Cascades the state changes entirely: high desert, thinly settled, with drives measured in hours rather than minutes. A caregiver working the valley makes short trips through steady traffic, where the exposure is accident frequency; one covering the east drives long high desert stretches where a visit can be an hour each way. An agency running both from one office is running two different auto exposures, and pricing either as the other gets both wrong.
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 Columbia matters most: an agency in Portland can send a caregiver into Washington in twenty minutes, and workers compensation works differently there. Operators working the southern and southeastern borders can read our California and Nevada pages, and the full list is on our coverage by state hub.
Oregon resources for home care providers
These are the sources that shape how home care operates in Oregon.
- Oregon Health Authority, Health Care Regulation and Quality Improvement, which licenses in-home care agencies under ORS Chapter 443.
- Oregon Workers' Compensation Division, Department of Consumer and Business Services, and its insurance overview for employers.
- ORS Chapter 656, carrying the duty to insure at 656.017 and the subject worker definitions and exemptions at 656.027.
- Oregon Association for Home Care, the state industry body for home care, home health and hospice.
- National Association for Home Care and Hospice, for national home care standards and guidance.
Why Oregon 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 eastern route 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 Oregon specifically, we will not tell you the ORS 656.027 exemption settles anything. It names home health workers inside the domestic servant category and then qualifies it with by private employment contract, a phrase the statute does not define, so assuming exemption is a decision rather than a finding. We are also blunt about the Columbia: Washington workers compensation comes from the state fund or self-insurance rather than a private carrier, so that one line does not travel across the bridge.
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 valley traffic and long eastern 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.
Oregon home care insurance FAQ
Answers for agencies operating under Oregon 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 move between licence categories, a new office or territory, caregivers crossing the Columbia into Washington, agency-owned vehicles, or regular work over a state line.
There is no headcount to reach. Oregon builds the rule from the opposite end to most states: rather than listing who is covered, it covers everyone and lists exceptions. The Workers' Compensation Division, part of the Department of Consumer and Business Services, states that every worker in Oregon is a subject worker unless the worker falls under an exemption, and an employer with one or more subject workers must purchase a policy. The duty to insure sits at ORS 656.017, the definition of a subject worker at ORS 656.027, and further exemptions at ORS 656.126.
It looks settled and it is not. ORS 656.027(1) covers a worker employed as a domestic servant in or about a private home, and defines domestic servant as any worker engaged in household domestic service by private employment contract, including, but not limited to, home health workers. Elsewhere that question is argued from silence; here the legislature spoke to it directly. But the definition is qualified by the words by private employment contract, and whether a caregiver employed by a licensed Oregon in-home care agency is engaged that way, or whether the phrase means contracted directly by the household, is the entire question. The section does not answer it, so this is one for counsel, and assuming exemption is a decision rather than a finding.
Everything except workers compensation. Washington workers compensation comes from the state fund or from qualifying as a self-insurer rather than from a private carrier, so it is not a line we can place there, and we would rather say so than let an Oregon operator assume the program travels intact across the bridge. General liability, professional liability, abuse and molestation, commercial and hired and non-owned auto, umbrella, cyber and property are unaffected. Tell us where your caregivers work and we build the footprint in.
No, because it is compound and the first branch fails on its face. ORS 656.027(3)(a) covers a worker whose employment is casual and either not in the course of the trade, business or profession of the employer, or in the course of that of a nonsubject employer. Casual alone is never enough, and for a home care agency a fill-in shift is squarely in the course of your trade, because delivering care is the business.
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 category you hold, whether your caregivers cross the Columbia, 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 Oregon. There is no obligation.