Maryland Workers' Comp Insurance for Home Health Care Agencies

Almost all Maryland employers with one or more employees must carry workers' compensation insurance, purchased either from any insurer licensed to write it in Maryland or from Chesapeake Employers' Insurance Company, or by qualifying as an approved self-insurer. There is no broad small-business exemption based on headcount alone; coverage is generally required from the first employee. See the Maryland Workers' Compensation Commission's employer guidance.

Common codes for this work include 8835 Home Health Care Services; 8810 Clerical Office Employees; 8842 Group Homes. Maryland uses NCCI class codes, so the codes below are the ones carriers typically assign to this work in Maryland.

Sole proprietors, partners, LLC members, and corporate officers are presumed to need coverage unless they take affirmative action to exclude themselves; simply not buying a policy isn't enough to be considered exempt. An owner who wants to opt out must own at least 20% of the business, actively work in it, and file Maryland's exclusion form (IC-16) online with the Workers' Compensation Commission. Until that exclusion is on file, these owners are treated as covered employees for compliance purposes.

Employers who fail to secure required coverage face a fine of not more than $10,000, and the officers responsible for a corporation's general management in Maryland can be held personally liable for that fine. Maryland's Workers' Compensation Commission has also stepped up enforcement around owner exclusion filings specifically, with initial fines in the $250-$2,500 range and hearing-stage fines that can run $10,000-$25,000 for businesses without either an active policy or a properly filed exclusion. An injured worker at an uninsured employer can pursue benefits through Maryland's Uninsured Employers' Fund, which then seeks reimbursement from the employer.

Price is driven by payroll in each class code, the Maryland rates filed for those codes, your claims history (experience modification), and underwriting factors such as split between field caregiving staff and office-based scheduling and administrative staff; level of care provided, from companionship to hands-on nursing care; whether the agency also operates a group home or residential setting. We compare carriers so you can see what you qualify for.

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No — home, public, and traveling healthcare has its own classification built around care delivered outside a fixed facility, which reflects the different exposure of working alone in a client's home versus a controlled clinical setting.

It can — group-home operations are typically rated under a related residential-care classification separate from staff who make one-on-one home visits, since supervising a residential setting carries different exposure.

Most home health aides performing regular, supervised caregiving work are properly classified as employees; misclassifying them as independent contractors to avoid workers' comp is a common audit finding that can result in back premium and penalties.

Yes, in almost all cases. Maryland requires coverage for essentially all employers with one or more employees, with no broad exemption for small headcount.

Yes, but only by actively filing exclusion form IC-16 with the Workers' Compensation Commission after meeting ownership and active-work requirements; simply declining to buy a policy isn't enough to be considered exempt.