HOME CARE HOME HEALTH INSURANCE SOLUTIONS

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Frequently Asked Questions

Home Care Organization

  • What are the insurance requirements for Home Care Organization (HCO) required by Licensing?

    According to the Health and Safety Code Sections 1796.42(b) – 1976.42(d), a Home Care Organizations (HCO), is required to the following insurance:

  • What happens if the Department of Social Services catches a Home Care Organization (HCO) operating without the required insurance?

    If a Home Care Organization (HCO) is caught without the proper insurance required by law, the department can assess penalties and fines. In addition, the HCO’s license can be suspended or revoked.

  • When does the Department of Social Services send an inspector to a Home Care Organization (HCO)?

    If a Home Care Organization (HCO) is caught without the proper insurance required by law, the department can assess penalties and fines. In addition, the HCO’s license can be suspended or revoked.

  • During an on-site inspection, what personnel records can be reviewed by CA Department of Social Services?

    1. Personnel Record (HCS 501)
    2. TB Clearance
    3. Fingerprinted documentation of employees that are required by the Department.
      1. A signed statement regarding their criminal record history (LIC 508)
      2. Documentation of a criminal record clearance, exemption, or transfer received from the Caregiver Background Check Bureau.
      3. All communication received from the Caregiver Background Check Bureau including denials, exemptions needed requests, renewal letters, closures, revocations, forfeitures, and renewal letters
    4. Verification of training hours
    5. A signed statement acknowledging requirement to report suspected abuse of dependent adults and elders (SOC 341A)
  • During an on-site inspection, what administrative records can be reviewed by CA Department of Social Services?

    1. Verification of a valid workers' compensation policy
    2. Verification of a valid employee dishonesty bond, including third-party coverage, with a minimum of ten thousand dollars ($10,000)
    3. Verification of a general and professional liability insurance policy in the amount of at least one million dollars ($1,000,000) per occurrence and three million dollars ($3,000,000) in the aggregate
    4. Program Description- a general overview of the program and services provided
    5. Documentation from the Department of any waivers and exceptions (if applicable)
    6. Proof of completion of the Department orientation
    7. Suspected abuse reports (SOC 341)
    8. Application documents submitted to the Department
    9. Board of Directors Statement (HCS 9165) for all members of the board of directors
  • Can a Home Care Organization (HCO) conduct business out of a residential home?

    A Home Care Organization (HCO) can conduct business from a residential home as a home based business. The licensee must be aware that the inspections and investigations will be conducted at the licensee’s home address.

  • Can a Home Care Organization (HCO) hire an independent Home Care Aide and be in compliance with the Department?

    According to the CA Dept. of Social Services, an independent Home Care Aide is defined as an individual, 18 years of age or older, who is not employed by a home care organization, but who is listed on the home care aide registry and is providing home care services through a direct agreement with a client.

    A Home Care Organization may hire independent Home Care Aides. However, once the independent Home Care Aide is part of Home Care Organization through a transfer of paperwork & fingerprints, the Home Care Aide has become an affiliated Home Care Aide. This voids the independent Home Care Aide status.

  • Can an Affiliated Home Care Aide be independent contracted (1099)?

    No, once a Home Care Organization (HCO) hires an affiliated Home Care Aide, then there is an employer/employee relationship pertaining to registration, training and background checks. Since there is an established employer/employee relationship, the aide must be classified as an employee not 1099 independent contractor.

  • Where should the business license and hours be posted?

    It should be at the business location in an area visible to both clients and your employees.

Home Health Agency

  • What is the difference between Home Care Organization (HCO) and Home Health Agency (HHA)?

    “Home Care” provides only non-medical services and assistance such as companionship, homemaker, bathing, dressing, feeding, or housekeeping and licensed through California Department of Social Services. A “Home Health Agency” provides both medical services and non-medical services to individuals at their home and licensed through California Department of Public health.e Care Organization (HCO) can conduct business from a residential home as a home based business. The licensee must be aware that the inspections and investigations will be conducted at the licensee’s home address.

  • What are the required insurance requirements of Home Health Agency (HHA) by CA Department of Public Health?

    As of 2016, CA Department of Public Health has not forced a statue requiring a Home Health Agency to have $ 1million per occurrence and $3 million aggregate for general and professional liability, workers compensation insurance, or $10,000 employee dishonesty bond like a Home Care Organization (HCO) with CA Department of Social Services. Although it is not enforced by CA Dept. of Public Health, most HHA businesses should consider at least having the proper general and professional liability. If a HHA has employees, then it is required by law to have workers’ compensation insurance. If you are operating a business, it is always a good idea to have the proper insurance even though license department may not require it yet.

  • What type of insurance should a Home Health Agency (HHA) consider when running a business?

    A home health agency should consider commercial liability insurance, commercial property insurance, workers’ compensation insurance, commercial auto, and EPLI. Liability insurance should include general liability, professional liability, abuse coverage and hired/non-owned auto with limits of $1 million per occurrence and $3 million aggregate. The liability insurance will protect both you and staff when services are conducted at resident’s homes. Workers’ compensation insurance is required by law when you have W-2 employees on the payroll. It protects both the employer and employee from suing each other and provides medical care when an employee is injured at work. Commercial auto provides coverage when you or your staff uses a vehicle for commercial use such as business errands and transporting clients. EPLI (Employee Practice Liability Insurance) provides coverage in case a dismissed employee accuses your HHA of discrimination, harassment or wrongful termination.

  • What are the differences between 1099 independent contractors and W-2 employees?

    According to the IRS, a 1099 independent contractor must meet the 1099 requirements set by the agency to qualify as a 1099 (usually called 20-Point check). If not, then an individual will be classified as an employee who is subjected to Social Security, Medicare Taxes and Unemployment Tax and any applicable state taxes. Here are some of the requirements to classify an individual as a 1099, and you can also visit www.irs.gov for further information.

    • 1099 independent contractor has his/her approach on completing the job
    • 1099 has the right to refuse the job
    • A written contract describing the relationship of the independent contractor
    • There is no employee benefits such as insurance, pension plan, vacation pay or sick pay given by the employer to the 1099
    • 1099 either own his/her own business or has a professional license
    • 1099 has his/her own business or liability insurance coverage

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  • 01 - Business Insurance Evaluation 

    • Understand your business operations
    • Understand your insurance needs
    • Set priorities on your business goals
    • Design an insurance plan to meet your goals
  • 02 - Quoting 

    • Represent top insurance carriers in your industry
    • Review & analyze coverage of each insurance quote
    • Compare & negotiate rates
    • Present a side by side comparison for your review
  • 03 - Binding Policy

    • Issue & send certificate to appropriate party
    • Contact mortgage, landlord, or 3rd party regarding insurance
    • Deliver insurance policy both electronic and hard copy
  • 04 - Servicing Your Policy   

    • Handle billing issues
    • Assist in claims
    • Perform premium audits
    • Complete policy changes
  • 05 - Annual Renewal Review

    • Review your business operations & goals
    • Review your insurance coverage
    • Complete renewal paperwork & shop with other insurance carriers
    • Design a new insurance plan for the year

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