General Liability
The centre of a Washington program. It carries the limits contracts name and the additional insured status a state fund account cannot provide.
General liability coverage
Coverage by State
Washington Home Care Insurance
For agencies already operating in Washington. If a health system contract just demanded limits or additional insured wording your policy cannot reach, that is a solvable problem, and it does not have to wait for your renewal date.
If you already run a Washington home care agency
Here is the short answer. When a contract demands limits your policy cannot reach, the fix is general liability written at the limit the contract names, professional liability sized to the care you actually deliver, an umbrella stacked behind both, and certificates issued with the additional insured and waiver wording the contract specifies. We place that through exclusive carrier programs that write home care in Washington, and we do it mid-term when the contract will not wait.
One thing about Washington shapes everything else. Workers compensation here comes from the state fund and cannot be bought from a private carrier, so we do not place that line in this state and we will not suggest otherwise. What follows from that is more important than it sounds: every contractual requirement a hospital or facility writes down has to be satisfied on the private side of your program, because there is no private workers compensation policy to carry any of it.
An agency running seventy-five to a hundred caregivers across the Puget Sound corridor, Spokane or the Vancouver area has a different problem from a startup, and this page is written for the former.
What Washington contracts require, and what happens when yours falls short
No Washington statute sets your liability limits. Your contracts do, and they ask for more than the law.
What the contracts typically ask for
Hospitals, health systems, skilled nursing facilities, managed care payers and government contracts converge on a familiar list. General liability at $1 million per occurrence and $2 million aggregate is the common floor. Professional liability is expected wherever care runs under a plan of care, often at matching limits. Auto liability covering agency vehicles and caregivers driving their own. Abuse and molestation coverage, increasingly named specifically rather than assumed. Evidence of industrial insurance, which here means your Labor and Industries account. And an umbrella to lift the total where the primary layers stop.
Wording usually 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 if a policy is cancelled. Each of those is an endorsement on a policy rather than a sentence on a certificate.
Why the private lines carry more weight here
In an ordinary state those requirements spread across the whole program. In Washington they cannot. Your industrial insurance is an account with a state agency rather than a policy a broker can endorse, so contractual requests for additional insured status, waivers and policy documentation land on general liability, professional liability, auto and umbrella or nowhere at all. That is a reason to build the private lines deliberately rather than treat them as the smaller half of the file.
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 and auto usually get there quicker and for less than rebuilding the primary program underneath.
The third is re-marketing. Where a carrier will not extend, or the required wording sits outside what the form allows, the program moves. 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 can only state what a policy already does. If a Seattle or Spokane health system requires additional insured status and your general liability carries no such endorsement, no certificate can create it. The delay agencies feel there is an underwriter deciding whether to add it, not paperwork.
So the habit that helps is simple: when a new client, facility or payer sends paperwork, send us the insurance requirements immediately. Certificates already on file should carry over rather than being rebuilt each year.
What to report during the year
Adding and removing caregivers does not require a change to your private lines each time, because they are rated on payroll and headcount and trued up at audit. What needs reporting is a change in the shape of the agency.
- A new service line, particularly a move from home care into home health or hospice.
- A new office, or a move into counties you did not previously serve.
- Agency-owned vehicles, which need commercial auto rather than a caregiver reimbursement arrangement.
- Caregivers regularly crossing into Oregon or Idaho.
- An acquisition, a new entity, or a change of ownership.
- 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 rather than reacting to. Payroll records split properly by class are what keep an audit from producing an unwelcome additional premium.
Coverages Washington home care agencies carry
The private program, sized to your payroll, territory and contracts. Workers compensation is not on this list because it comes from the state fund rather than from any carrier.
Professional Liability
Clinical claims coverage for care delivered under a plan of care, usually required at limits matching your general liability.
Professional liability coverageCommercial Auto
For agency-owned vehicles in Puget Sound traffic and on the long routes east of the Cascades.
Commercial auto coverageHired and Non-Owned Auto
The line most established agencies are short on, covering caregivers who drive their own cars between visits.
Hired and non-owned autoAbuse and Molestation
Coverage of up to $1 million for allegations standard liability excludes, and increasingly named in contracts rather than assumed.
Abuse and molestation coverageUmbrella Liability
Excess limits stacked over liability and auto, usually the fastest way to reach a total a contract has just raised.
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 Washington
Home Care Agencies
Licensed home care agencies delivering personal care and homemaking under RCW chapter 70.127.
Home care agency insuranceHome Health Agencies
Agencies licensed by the Department of Health delivering care under a plan of care.
Home health agency insurancePersonal Care Services
Bathing, dressing, grooming, and daily living support, the core of a Washington home care book.
Personal care services coverageSenior Care Providers
Agencies serving the roughly 1.34 million Washington residents aged 65 and older.
Senior care coveragePrivate Duty Nursing
Skilled, high-acuity care that drives professional liability limits higher, usually 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 coverageWashington workers compensation and what the state fund means for you
Washington runs an exclusive state fund, and it is worth being exact about what that means for an operating agency.
Two routes, and only two
RCW 51.14.010 is short and leaves no room. Every employer under this title shall secure the payment of compensation under this title by insuring and keeping insured the payment of such benefits with the state fund, or by qualifying as a self-insurer under this title. A private carrier is not among the options. The coverage is administered by the Department of Labor and Industries, and Washington calls it industrial insurance rather than workers compensation.
We would rather be plain than vague. We do not place your Washington workers compensation. It comes from Labor and Industries, and any page suggesting a broker can write it here is wrong.
Self-insurance exists, but not for an agency your size
The second route is real, which is what separates Washington from North Dakota. An employer may qualify by establishing sufficient financial ability to make certain the prompt payment of all compensation under this title and all assessments which may become due from such employer, and self-insurers must also maintain certified claims administrators. Read that as written for very large employers. For a home care agency it is worth knowing the route exists rather than worth pursuing.
Working across a state line
Labor and Industries maintains reciprocal agreements with other states governing when it will accept another state's coverage. The mechanism is an Extraterritorial Coverage Certificate sent by the employer's home-state administrator, with the confirmation letter from Labor and Industries serving as the evidence of acceptance, and work of thirty or fewer days in a calendar year treated as temporary or incidental. This matters here because the Portland metro crosses the Columbia into Washington and a Vancouver-area agency often works an Oregon-centred market.
We have not set out which states those agreements cover or what carve-outs apply, because we could not verify that list at source. Confirm it with Labor and Industries rather than relying on a summary, including ours.
What this page does not say, and why
Title 51 places its exclusions in sections we did not examine, so this page describes no headcount threshold and no domestic or household carve-out for Washington. We are not going to guess at exceptions we have not seen written down, and we have not reproduced penalty figures or reporting deadlines for the same reason.
Washington licensing and regulatory context
Short version, because you already hold your licence. It earns space only because the category you hold is what a carrier underwrites against, and because Washington's regime has two features worth checking against your own structure.
Licensing runs through the Washington State Department of Health under RCW chapter 70.127, In-Home Services Agencies, with rules at WAC chapter 246-335. One statute covers home care, home health and hospice as sibling categories, and Washington does license non-medical work as a Home Care Agency.
The licensure trigger is set unusually low and reaches contractors as well as staff. The definition of person that drives it covers any entity that employs or contracts with two or more individuals, and any such person providing in-home services under the chapter is subject to licensure. Separately, an applicant for initial licensure must complete a department sponsored in-home services orientation class prior to submitting a state licensing application, which is worth knowing before you plan to add a category.
Washington also credentials Home Care Aides as an individual profession through the Department of Health, so the workers are credentialed as well as the agency. We have not set out the requirements here because we could not verify them to our own standard. Confirm your position with the Department, tell us what applies, and we will build the program to the licence you actually hold.
Medicare, Medicaid 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 homemaking.
We are not going to describe Washington's Medicaid in-home programmes, because we could not confirm how they are structured or funded. Those details should come from the state.
What matters commercially is the point this page opened with: your limits are set by the hospitals, health systems and payers you contract with, not by any Washington statute. That 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 Washington home care market
Washington has about 7.96 million residents, and roughly 1.34 million of them are 65 or older, close to 17.2 percent of the civilian population.
The state splits sharply. Seattle, Tacoma and Bellevue hold about 4.15 million between them, more than half the state. The Portland area holds about 2.54 million and crosses the Columbia into Washington. Spokane holds about 605,000, with Kennewick and Richland and the Olympia area behind it. East of the Cascades the country is agricultural and sparsely settled, with long drives between visits.
For an operating agency that split is the whole risk conversation. A Puget Sound book carries traffic density and accident frequency across short trips. An eastern Washington book carries distance and hours behind the wheel. And a Vancouver-area agency usually works an Oregon-centred market, which touches every line of the program.
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. Read our Oregon, Idaho, Montana and Alaska pages, and the full list is on our coverage by state hub.
Washington resources for home care providers
The sources behind everything above.
- RCW chapter 51.14, where the state fund and self-insurance routes are set out.
- Out-of-state employers and out-of-state workers, Labor and Industries.
- RCW chapter 70.127, In-Home Services Agencies.
- WAC chapter 246-335, the in-home services rules.
- Home care agencies, Department of Health.
- Home health agencies, Department of Health.
- Home Care Association of America, Washington chapter. A Washington-specific association domain is live but refused our automated checks, so we have not linked it unverified.
- National Association for Home Care and Hospice, for national home care standards and guidance.
Why Washington agencies choose HCBI
We are straightforward about the one thing we do not do here. Your workers compensation comes from the state fund, we do not place it, and we will not pretend otherwise to win a conversation.
What we do is everything Labor and Industries leaves on your side of the line, and in Washington that is more than it is elsewhere. A health system requires additional insured status a state fund account cannot carry. A payer wants a waiver of subrogation. A facility asks for policy documentation. A caregiver crash on a Puget Sound commute or a pass east of the Cascades exposes how little a personal auto policy does on a work trip. Each of those lands on the private program, which is ours to build and endorse.
On the Washington facts we work from the statute, the rules and the agencies' own pages, and where something was not written down we leave it out. That is why this page describes no headcount threshold, no domestic carve-out and no reciprocal-state list: Title 51's exclusions sit in sections we did not read, and the reciprocity list could not be verified at source.
We place coverage through exclusive carrier programs that write home care risks, and we coordinate the private side of the program end to end: general liability with the additional insured wording your contracts demand, professional liability, commercial and hired and non-owned auto for city traffic and mountain routes alike, umbrella limits to reach what your contracts require, cyber, and abuse and molestation coverage of up to $1 million. That reach is backed by working relationships across the wider 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.
Washington home care insurance FAQ
Answers for agencies already operating under Washington 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 and auto 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 wording matters as much as the number.
On your general liability, and it has to, because your industrial insurance account is not a private policy that endorsements can be added to. That is the practical shape of operating in an exclusive state fund state: the requirements a hospital or facility writes into a contract land on the private lines of your program. Send us the wording as soon as it arrives, because additional insured status, a waiver of subrogation and primary and non-contributory language are endorsements rather than certificate text.
No. Washington is an exclusive state fund state and we do not place the line here. RCW 51.14.010 gives every employer exactly two routes: insuring and keeping insured the payment of such benefits with the state fund, or qualifying as a self-insurer under this title. A private carrier is not one of them. Your coverage comes from the Department of Labor and Industries, which Washington calls industrial insurance. Everything else in your program is ordinary private-market business and is ours to build.
Almost certainly not. The statute allows an employer to qualify by establishing sufficient financial ability to make certain the prompt payment of all compensation under this title and all assessments which may become due from such employer, and self-insurers must also maintain certified claims administrators. In practice that route is built for very large employers. It is worth knowing it exists, but for a home care agency the state fund is the answer.
Not person by person. Your private lines are 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 move from home care into home health or hospice, a new office, agency-owned vehicles, an acquisition, or regular work across the Oregon or Idaho line. Your industrial insurance account is administered separately with Labor and Industries.
It affects every line, so tell us about it rather than leaving it to be discovered at audit. Labor and Industries maintains reciprocal agreements with other states governing when it will accept another state's coverage, worked through an Extraterritorial Coverage Certificate sent by the home-state administrator, with the confirmation letter serving as evidence of acceptance. Work of thirty or fewer days in a calendar year is treated as temporary or incidental. We have not reproduced which states those agreements cover, because we could not verify the list at source. Confirm it with Labor and Industries.
Yes, as a Home Care Agency, alongside home health and hospice under one statute, RCW chapter 70.127, In-Home Services Agencies, with rules at WAC chapter 246-335. The trigger is unusual and worth checking against your own structure: the definition of person that drives licensure reaches any entity that employs or contracts with two or more individuals, and any such person providing in-home services under the chapter is subject to licensure. Contractors count, not just employees.
Loss runs for the last five years, current declarations pages for every private 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.
Keep payroll records split properly by class through the year rather than reconstructing them at the end of it. Separate office staff from caregivers, keep hours and wages clean for anyone who moved between roles, and tell us mid-term when a new service line or a new county changes the picture. Most unwelcome audit results are not pricing decisions, they are records that did not match what the policy was rated on.
Send us the contract and we will build to it
Tell us your payroll and caregiver count, the states your caregivers actually work in, and what your largest contract requires. If a health system wants wording your current policy does not carry, start there. A specialist will place the private side of your program through exclusive carriers that write home care in Washington. There is no obligation.