Staffing Models and Who Needs Coverage

Employees versus independent contractors

Most states apply a test that looks at control: who sets the schedule, who trains the worker, who supplies the work and whether the worker runs an independent business. Caregivers who follow the agency's care plans, schedules and policies are often treated as employees even if they signed a contractor agreement. If a state agency or court decides a worker was really an employee, the business can owe benefits and premium.

Registries and referral models

Some businesses act as registries that match families with independent caregivers, while the family is the employer. Whether that structure holds up depends on state law and on how much the registry controls the work. Families who directly employ a caregiver may themselves need comp under some states' rules for household employees.

PEOs and leased employees

A professional employer organization can cover caregivers under its master policy. If you leave a PEO, you need your own policy on the day the arrangement ends, and your claims history may be reported under the PEO rather than your agency. Ask the PEO for loss runs before you leave.

Subcontracted staff

• Collect a current certificate of comp insurance from each staffing firm
• Check that the certificate covers the right state and dates
• Keep certificates on file for the premium audit

Owners and officers

Corporate officers and LLC members may be included in or excluded from coverage depending on state rules and the elections filed with the insurer or state. Owners who also provide care should ask whether excluding themselves leaves them without benefits after an injury.

Frequently asked questions