Washington Home Care Agency Insurance Requirements: $1M DOH Minimum & L&I Comp (2026)

Washington's in-home services agency license

The Department of Health licenses In-Home Services Agencies under WAC Chapter 246-335, with three service categories: home care for non-medical personal care, home health for skilled services, and hospice. A single agency can hold more than one category. This is a cleaner structure than most states — but it also means the DOH insurance condition applies to non-medical home care agencies exactly as it applies to skilled ones.

The insurance requirement is written into the rule

WAC 246-335-320(2)(b) requires an applicant to submit evidence of current commercial general liability insurance covering bodily injury, property damage and contractual liability at $1,000,000 per occurrence, or a $2,000,000 combined single limit. It applies to home care, home health and hospice license categories alike. In practice, agencies buy $1M per occurrence with a $2M aggregate, which satisfies the rule and matches what payers ask for.

L&I is your only workers' comp option

Washington does not allow private workers' compensation policies. Coverage comes from Labor & Industries industrial insurance, or through certification as a self-insured employer. Two practical points for home care agencies: workers based in Washington who travel out of state must still be reported and covered through L&I, subject to limited reciprocal agreements with neighboring states; and because a private comp policy does not exist here, your package policy should include stop-gap employer's liability to fill the gap an L&I account leaves.

Background checks and Home Care Aide certification

WAC 246-335-320(2)(d) requires Washington State Patrol criminal history background checks and disclosure statements, dated within three months of application, for the on-site administrator and the supervisor of direct care services (or director of clinical services for home health and hospice). Separately, long-term care workers must obtain DOH Home Care Aide certification: 75 hours of DSHS-approved training plus a certification exam, completed within 120 days of hire with certification within 365 days. Document both — underwriters reward a verifiable training and screening file with better abuse and molestation pricing.

Apple Health and COPES contracts

Washington Apple Health is the state Medicaid program, and COPES — the Community Options Program Entry System — is the 1915(c) waiver funding in-home personal care as an alternative to nursing home placement. Contracting agencies typically face professional liability, additional insured and waiver of subrogation requirements beyond the DOH general liability minimum. The DOH number is a floor for licensure, not a ceiling for contracts.

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What a complete Washington program looks like

Start with $1M/$2M general liability to satisfy DOH, add professional liability on the same tower, a dedicated abuse and molestation limit, an employee dishonesty bond with third-party coverage, hired and non-owned auto for caregivers driving between clients, stop-gap employer's liability alongside your L&I account, and cyber liability once you hold electronic client records. Hospice and home health categories usually add an umbrella for hospital discharge partners.