NDDHS wants $1M / $3M on the certificate.
Where no state rule on this page sets a figure, your referral contracts set it, and the one asking the most decides what you carry. Ask each referral source for its insurance exhibit before you buy. We set the coverage up and produce the certificate — usually the same day.
Tell us the situation.
One licensed human replies the same business day — not five agents, not an auto-responder. If the policy you have is already the right one, we will tell you.
We use this to quote and service your insurance, and we do not sell it or pass it to lead networks. Privacy policy.
What North Dakota requires
Does North Dakota require workers compensation for home health agencies?
Yes. Workforce Safety and Insurance (WSI) is the sole provider of workers compensation in North Dakota, and every employer subject to the law pays its premium into the WSI fund. Agencies enrolling as Medicaid Qualified Service Providers must upload current verification of WSI coverage.
North Dakota WSI·checked 2026-10-04
What is WSI and how does a home health agency enroll?
WSI is the sole provider and administrator of North Dakota's workers compensation system. Every employer subject to the law pays premiums into the WSI fund at rates WSI sets by job classification.
N.D.C.C. 65-04-04·checked 2026-10-04
What insurance do ND Medicaid contractors need?
North Dakota's Qualified Service Provider Agency Handbook (January 2026) has agencies enrolling to serve public pay clients upload current verification of Workforce Safety and Insurance coverage and of unemployment insurance coverage. Liability insurance and bonding are required for environmental modification work.
ND HHS QSP Agency Handbook (Jan 2026)·checked 2026-10-04
North Dakota has 20 Medicare-certified home health agencies on CMS's Care Compare list (July 2026). (CMS Care Compare home health agency list (July 2026))
Send us what you have. We’ll tell you if it’s right.
Your current policy paperwork, a renewal notice, or nothing at all. A licensed agent reads it and replies the same business day.
Limits
What to carry, and why that number.
- General liability$1M / $3M
- Abuse & molestationMatch the contract
- Excluded from standard general liability almost everywhere, and the sublimit that does appear rarely reaches the figure a North Dakota contract names. Read that figure before you buy.
- Hired & non-owned autoMatch the contract
- Nobody insures the drive. Personal auto excludes business use, general liability carries no auto coverage at all, and this endorsement is what closes the gap for a North Dakota agency.
Coverage
Six lines. Each one closes a specific hole.
Professional liability
Covers claims that care delivered in the home fell below the standard a reasonable provider would meet.
Without it — A single allegation of negligent care is defended out of pocket, and most state and MCO contracts will not accept the agency without it.
General liability
Bodily injury and property damage arising from operations: a fall in a client home, damage to a client residence.
Without it — The most common home-visit claim there is has no defense behind it.
Abuse and molestation
Defense and indemnity for allegations against a caregiver, including claims that the agency hired or supervised negligently.
Without it — Nearly every general liability form excludes it by endorsement, so the exposure most likely to end an agency is the one most often uninsured.
Workers compensation
Statutory benefits for caregiver injury, the highest-frequency loss in the industry, driven by lifting and transfers.
Without it — Medical and indemnity costs land on the agency directly, and in most states operating without it is illegal.
Non-owned and hired auto
Liability when a caregiver drives their own car between clients or transports a client.
Without it — The caregiver’s personal auto policy defends the caregiver. The agency is named anyway, and has nothing responding.
Cyber and privacy
Breach response, notification and regulatory defense for PHI held in scheduling, EVV and billing systems.
Without it — HIPAA notification costs begin immediately and are not covered by any other line on the policy.
What home health and home care agencies we placed in 2025 and 2026 actually paid.
These are annual premiums from policies we bound, effective January 2025 to September 2026. We show the median and the middle half of what clients paid, never the cheapest or the most expensive, and only for lines where at least five agencies stand behind the figure.
- Professional liability (including combined general and professional packages)
- $800median a year
- Middle half: $510 to $1,580
- 33 policies from 24 agencies
- Workers compensation
- $2,060median a year
- Middle half: $1,610 to $3,150
- 21 policies from 17 agencies
- General liability, written on its own
- $350median a year
- Middle half: $350 to $510
- 7 policies from 7 agencies
Payroll moves workers compensation more than anything else, and the services you provide, your limits and your claims history move the rest, so treat these as a sense of scale rather than a quote. Source: Boring Insurance bound policies, cancelled policies and test records excluded, refreshed 2026-10-04.
In North Dakota
The organizations that will ask for your certificate.
- Lake Region AAA (Devils Lake) · Area Agencies on Aging
- Souris Basin Planning Council AAA (Minot) · Area Agencies on Aging
- Southeast ND AAA (Fargo) · Area Agencies on Aging
- West Central Human Service Center AAA (Bismarck) · Area Agencies on Aging
- ND Medicaid (largely fee-for-service) · North Dakota Medicaid
- Sanford Health Plan · North Dakota Medicaid
- ND Aging Services Division · Other
- ND Developmental Disabilities Division · Other
Questions
Does my North Dakota agency need hired and non-owned auto coverage?
If caregivers drive personal vehicles to client homes across North Dakota’s rural geography, your GL does not cover that exposure.
Our caregivers drive their own cars. What does the carrier require?
That they keep their own auto insurance, and that you check their driving records every year. Hired and non-owned auto is written excess of the driver’s personal policy rather than instead of it, so a caregiver whose own coverage lapsed is functionally uninsured on a client visit and the agency absorbs what follows. Annual motor vehicle record checks are the second condition, and annual means annual: a check at hire and nothing after is the version carriers find at claim time. Both are cheaper to build into hiring and review than to explain afterwards.
What limits do most contracts require?
$1,000,000 per occurrence and $3,000,000 aggregate is the common requirement across state Medicaid contracts and managed care organizations. Some MCOs require the agency be named on a certificate before the first authorization is issued.
Is abuse and molestation coverage really necessary?
For an agency sending caregivers into private homes, it is the coverage most likely to be needed and least likely to be present. Standard general liability forms exclude it, so it has to be added deliberately, and most contracts now require evidence of it.
Do caregivers driving their own cars need to be covered?
Yes. A caregiver’s personal auto policy responds for the caregiver, not the agency. Hired and non-owned auto liability is what responds when the agency is named in the suit, which it will be.
How fast can coverage be bound?
Same day is normal for a licensed agency with clean loss history. What slows it down is missing payroll detail or an incomplete list of services provided. Have both ready.
Read next
The coverage itself, explained.
North Dakota decides what you must carry. These explain what you are buying, what it excludes, and what moves the price.
Coverage
Nearby states
Tell us what you do. We’ll tell you what it costs.
Licensed in North Dakota. Have your payroll figures and a list of services on hand — those are the two things that slow a quote down.
Start a quoteLast reviewed 2026-08-16