Who we serve

Three businesses that look alike and rate very differently.

California puts nearly all in-residence care into one classification. What separates these operations for rating purposes is not what the sign says — it is who is on the payroll, what they do, and where they do it.

Which classification applies to whom A decision tree from what an employee actually does, to four classifications: 8827(1) for non-medical personal care, 8827(2) for skilled clinical care, 8810 for office staff, and 8871 for office staff working mostly from home. What does this employee do? Non-medicalpersonal care8827(1)Skilled clinical carein the residence8827(2)Office duties,no shift coverage8810Same, but mostlyworking from home8871 Housekeeping-dominant work drifts to 9096One covered shift moves a whole year to 8827
The classification follows the duties, not the job title and not the licence your agency holds. The two notes beneath are where most agencies lose money — and the second one can undo a whole year of correct reporting.
A house above an arcade wall of seven openings, one marked A house joined by a dotted path to a continuous arcade wall pierced by seven arched openings, three of them shuttered and one marked.
8827(1)

Home care agencies

Non-medical personal care, companionship, homemaking and respite. Typically the highest headcount of the three and the highest turnover, which matters more than most operators realise: a disproportionate share of comp claims land in a caregiver's first ninety days.

This is also where clerical splits are most often missed. A home care agency of any size runs schedulers, billers, intake coordinators and recruiters. If they are all being reported under 8827, that payroll is being rated at more than thirteen times the clerical rate.

What we look at first

  • Whether office staff qualify for 8810 or 8871, and whether the recordkeeping supports it
  • Schedulers and coordinators who occasionally cover a shift — a genuine trap
  • Housekeeping-heavy engagements drifting toward 9096
  • Caregivers driving their own vehicles between clients
Typical exposure profile
Dominant injury cause
Patient handling
Second
Slips in residences
Claim pattern
High frequency, low severity
Mod sensitivity
Very high

High frequency and low severity is the worst possible shape for a California mod, because the formula counts every claim up to the primary threshold and ignores everything above it.

A clinical bag beside an arcade wall of four openings, a dotted route threading through them A clinical bag marked with a cross stands beside a continuous arcade wall of four arched openings, with a dotted route threading through each opening in turn.
8827(2)

Home health & skilled nursing

Licensed clinical care delivered in the residence — RNs, LVNs, therapists and home health aides working under a plan of care. Payroll per employee runs higher, headcount runs lower, and the claim mix changes: patient handling still dominates, but needlestick and exposure claims add a long tail that can sit open for years, quietly holding your mod up.

Open claims are the issue here. A reserve that never gets revisited keeps contributing to your modification at full primary value for three rating years. Under Section VI Rule 8, if closed claim values come in below sixty percent of the highest figure previously used, the WCIRB must revise the rating — and that revision can never increase your mod. Aggressive, accurate claim closure is a one-way bet, and very few agencies work it.

What we look at first

  • Open reserves sitting near the primary threshold, where reduction actually moves the number
  • Whether clinical and clerical payroll are genuinely separated
  • Cumulative trauma claims and how they are being dated
  • Subrogation recoveries that were never credited back to the rating
A clock above an arcade wall whose openings continue past both edges of the frame A clock at an off-hours time above a continuous arcade wall of arched openings that run past both edges of the frame without interruption.
8827

Hospice

Clinical staff, chaplains, social workers, bereavement counsellors and a volunteer corps — a payroll structure that does not fit neatly into any single classification, and one where the non-comp exposures are frequently the bigger problem.

Mileage is the exposure most often left unsurfaced. Hospice staff drive constantly, usually in their own vehicles, and non-owned auto liability is regularly either missing or badly limited. Volunteers raise their own questions about coverage status and about abuse and molestation exposure in a setting involving vulnerable adults.

What we look at first

  • Non-owned and hired auto limits against actual driving patterns
  • Volunteer status and whether they are covered anywhere
  • Abuse and molestation coverage terms, not just its presence
  • Mileage reimbursement treatment in the payroll audit

Not sure which one you are?

Plenty of agencies run two of these under one FEIN, which is its own rating question — and one worth settling before your next renewal rather than after it.

Schedule a callOr start with the Mod Analysis