General Liability
The foundation Wisconsin hospitals and health systems expect, commonly at $1 million per occurrence and $2 million aggregate.
General liability coverage
Coverage by State
Wisconsin Home Care Insurance
For agencies already operating in Wisconsin. 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 Wisconsin 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 carrier programs that write home care in Wisconsin, mid-term when the contract will not wait.
Two Wisconsin details are worth a look on an existing program. Your policy has to name Wisconsin as a covered state, a one-line check on the declarations page and a serious gap if it is wrong. And if you run personal care you are certified rather than licensed, so calling the agency licensed on a certificate is an inaccuracy that gets noticed at an awkward moment.
An agency running seventy-five to a hundred caregivers across Milwaukee, Madison or the northern counties has a different problem from a startup, and this page is written for the former.
What Wisconsin 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 licensed home health agencies. 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 Milwaukee and Madison 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.
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. Both are where a placement quietly fails.
Certificates
A certificate is evidence, not coverage; it states only what a policy already does. If a Milwaukee or Madison 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.
- Moving from certification under DHS 105.17 toward licensure under DHS 133, which changes the instrument and the exposure together.
- A new office, or a move into the northern counties where the driving profile changes entirely.
- Agency-owned vehicles, which need commercial auto rather than a caregiver reimbursement arrangement.
- Caregivers regularly working over the Minnesota, Illinois, Iowa or Michigan 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.
Check once a year that the declarations page still names Wisconsin as a covered state, particularly if the program was written around a different home state.
Coverages Wisconsin home care agencies carry
The full program, sized to your instrument. Each coverage has a page of its own.
Professional Liability
Clinical claims coverage weighted for licensed home health agencies under DHS 133, heavier than certified personal care work.
Professional liability coverageWorkers Compensation
Triggered by three employees or $500 of gross wages in any quarter, whichever comes first, on a policy naming Wisconsin as a covered state.
Workers compensation coverageCommercial Auto
Coverage for agency-owned vehicles crossing metro traffic and long northern winter roads.
Commercial auto coverageHired and Non-Owned Auto
For caregivers driving their own cars, a short Milwaukee 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, 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 Milwaukee and Madison 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 Wisconsin
Home Care Agencies
Personal care agencies certified under DHS 105.17, delivering non-medical personal care and companion work.
Home care agency insuranceHome Health Agencies
Agencies licensed under Wis. Stat. section 50.49 and DHS 133, delivering care under a plan of care.
Home health agency insurancePersonal Care Services
Bathing, dressing, grooming, and daily living support, the core of a certified PCA book.
Personal care services coverageSenior Care Providers
Agencies serving the 1.13 million Wisconsin 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 coverageWisconsin workers compensation for home care agencies
Wisconsin sets a compound test, and the word that carries it is any.
Two triggers, either one sufficient
The Department of Workforce Development states that you must carry worker's compensation insurance if you meet any of these conditions. Employ 3 or more full-time or part-time employees, with coverage required the day you employ the third person. Or pay gross wages of $500 or more in any quarter for 1 or more employees for work done in Wisconsin, with coverage required the 10th day of the 1st month of the next quarter. Two triggers, each with its own deadline, under Wis. Stat. chapter 102 and the DWD Worker's Compensation Division.
For home care, the wages limb is the one that decides it
This is the Wisconsin point worth reading twice, and where operators reasoning by headcount go wrong. Five hundred dollars of gross wages across a whole quarter is a very low bar in home care, and a single part-time caregiver working occasional shifts will pass it comfortably. So almost every Wisconsin agency is inside the requirement from its first caregiver, and the three-employee limb never becomes operative. The danger is an owner who read about the three-employee rule, counted two caregivers and concluded there is time yet. That agency has very likely been inside the requirement since its first full quarter, and the wages deadline has long since passed. Read how the coverage works on our workers compensation page.
The exception list, and the one door a home care agency cannot use
DWD publishes the exceptions in closed terms. The only employee exceptions are domestic servants; any person whose employment is not in the trade, business, profession or occupation of the employer; some farm employees; volunteers, including volunteers of non-profit organizations that receive money or other things of value totaling not more than $10.00 per week; religious sect members that qualify and are certified for an exemption; employees of Native American tribal enterprises unless the tribe elects to waive its sovereign immunity; and real estate brokers, agents and salespersons. Each applies unless the employer elects to cover them.
Note the second, because it is the exception a home care agency might reach for and cannot use. Employment not in the trade, business, profession or occupation of the employer does not describe caregiving delivered by a caregiving business. DWD cites Cornelius v. Industrial Commission, and the logic is unavoidable: the thing your business exists to do cannot be outside what your business does.
The domestic servant exception, and how unusually open it is
That leaves the first exception, and Wisconsin is candid about how it is built. DWD states that although neither the statutes nor the case law provide a definition of domestic servant as used in section 102.07(4) of the Act, the department has consistently ruled that persons hired in a private home to perform general household services, such as nanny services, baby-sitting, cooking, cleaning, laundering, gardening, yard and maintenance work and other duties commonly associated with the term, meet the definition intended by the Act.
Read the first clause again. Neither the statutes nor the case law provide a definition. What exists is a departmental interpretation, consistently applied, and the department says so in the same sentence in which it gives it. Two features are worth noticing and neither settles the question: the services enumerated are household services and caregiving is not among them, and persons hired in a private home reads as direct household hiring rather than assignment by an agency.
Both point the same way, but pointing is not deciding. An administrative interpretation with no statute or case law behind it makes Wisconsin open ground rather than clear ground. We will not tell you the exception reaches the caregivers your agency employs, and we will not tell you it does not. With the trade-or-business door closed by Cornelius, it is the only one a home care agency could try, and the department itself calls it undefined by statute.
Wisconsin licensing and regulatory context
Short version, because you already hold your credential. It earns space because the vocabulary matters when a schedule asks what you hold.
Wisconsin splits the two sides of home care into two different regulatory instruments. Personal care agencies are certified: the Department of Health Services, Division of Quality Assurance, administers Wis. Admin. Code section DHS 105.17, which guides the certification of personal care agencies. Home health agencies are licensed, under Wis. Stat. section 50.49 and Wis. Admin. Code chapter DHS 133.
It matters beyond the paperwork: the instrument you hold is the frame a carrier underwrites against, and a certified personal care agency delivering non-medical support sits in a different place on professional liability than a licensed home health agency delivering clinical care under DHS 133. If you hold both, or are working toward the second, tell us.
Medicare, Medicaid and what actually sets your limits
Medicare covers short-term skilled home health under a plan of care, and the Division of Quality Assurance handles state regulation and federal certification together. That work raises the stakes on documentation and on professional liability.
For most agencies the limits on your certificates are set by the hospitals, health systems, facilities and payers you contract with rather than by statute, which is why we ask to see the contract language rather than guessing. It is worth being precise with a carrier about which side of the certification and licensure line your revenue comes from.
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 Wisconsin home care market
Wisconsin has about 5.96 million residents, roughly 1.13 million of them 65 or older, close to 19.1 percent of the civilian population, older than most of the country.
Milwaukee and Waukesha hold about 1.57 million and Madison about 708,000, with Green Bay and Appleton behind. The largest metro touching the state is not Wisconsin's own: Minneapolis and St. Paul, about 3.76 million, is centred in Minnesota and reaches into the western counties.
Northern Wisconsin is the other half: rural, long drives between clients, and winters severe enough to change what a working day looks like for months. An agency running Milwaukee and northern clients from one office is running two auto exposures, and from November it is running three. A caregiver in the Milwaukee area makes short trips through steady traffic; one covering the north drives long stretches on roads that ice, in the dark for much of the winter.
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 western edge changes most: Minneapolis and St. Paul reaches into western Wisconsin and Duluth spans the line, and crossing it changes more than the workers compensation rules because Minnesota licenses home care at two levels. Read our Minnesota, Illinois and Iowa pages, and the full list is on our coverage by state hub.
Wisconsin resources for home care providers
The sources behind everything above.
- DWD worker's compensation insurance requirements, which sets out both triggers and both deadlines.
- DWD employee coverage exceptions, including the domestic servant interpretation.
- DHS personal care agencies and the PCA certification process.
- Home health agency licensure application and the home health rules under DHS 133.
- Home Care Association of America, Wisconsin chapter, the state chapter of the national private duty home care association. We have not been able to confirm a separate Wisconsin-specific home care association.
- National Association for Home Care and Hospice, for national home care standards and guidance.
Why Wisconsin 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 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.
On Wisconsin specifically, we read the compound test as written. The wages limb usually arrives first and on its own is enough, so an owner counting to three is watching the wrong trigger. We check the declarations page names Wisconsin as a covered state, and we are careful with the certified and licensed vocabulary because a carrier and a counterparty both notice it. On the domestic servant exception we say what the department says: neither the statutes nor the case law define the term, so we will not resolve it in either direction.
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 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, HOMELINK in the medical equipment and home care network space, and Bright Horizons Family Solutions on the family care side.
Wisconsin home care insurance FAQ
Answers for agencies operating under Wisconsin 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: moving from certification toward licensure, a new office or northern territory, agency-owned vehicles, or regular work over a state line.
Only half of it, and for home care the other half usually decides. The Department of Workforce Development says you must carry coverage if you meet any of these conditions: employ 3 or more full-time or part-time employees, coverage required the day you employ the third person; or pay gross wages of $500 or more in any quarter for 1 or more employees for work done in Wisconsin, coverage required the 10th day of the 1st month of the next quarter. Either trigger on its own is enough.
Almost certainly not. Five hundred dollars of gross wages across a whole quarter is a very low bar in home care, and a single part-time caregiver working occasional shifts will pass it comfortably. Almost every Wisconsin agency is inside the requirement from its first caregiver, and the three-employee limb never becomes operative. An owner who counted two caregivers and concluded there is time yet has very likely been inside since the first full quarter.
Yes, and it is easy to overlook. DWD requires that the policy name Wisconsin as a covered state. For an agency headquartered here that is usually automatic, less so for one based over a border that takes work here or whose policy was written around a different home state. It is a one-line check on the declarations page and a serious gap if wrong, so confirm it once a year.
No, and it is the exception agencies most often reach for. DWD lists as an exception any person whose employment is not in the trade, business, profession or occupation of the employer, and cites Cornelius v. Industrial Commission. Caregiving delivered by a caregiving business is squarely inside the employer's trade, so the logic is unavoidable: the thing your business exists to do cannot be outside the thing your business does.
We will not tell you either way, and Wisconsin is candid about why. DWD states that although neither the statutes nor the case law provide a definition of domestic servant as used in section 102.07(4), the department has consistently ruled that persons hired in a private home to perform general household services, such as nanny services, baby-sitting, cooking, cleaning, laundering, gardening and yard work, meet the definition. Caregiving is not among the services listed, and persons hired in a private home reads as direct household hiring rather than agency assignment. Both point one way, but an administrative interpretation with no statute behind it is open ground rather than an answer.
It depends which side you run, and the vocabulary matters on a certificate. Personal care agencies are certified: the Department of Health Services, Division of Quality Assurance, administers Wis. Admin. Code section DHS 105.17. Home health agencies are licensed, under Wis. Stat. section 50.49 and Wis. Admin. Code chapter DHS 133. Calling a certified agency licensed is an inaccuracy that gets noticed at an awkward moment, and the two are different propositions to a carrier.
Send us the contract and we will build to it
Tell us your payroll and caregiver count, whether you are certified, licensed or both, 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 Wisconsin. There is no obligation.