Compliance and safety
What Does Additional Insured Mean for NEMT Contracts?
An additional insured is a person or organization your insurer adds to your liability policy by endorsement, so the policy also covers it for claims that come from your work. NEMT brokers, health plans, states, cities, and hospitals ask for it because a rider hurt on your trip can sue them too. It shares your limits, and only the endorsement creates it.
- An additional insured is covered by your policy for claims tied to your work, and it shares your limits instead of adding to them.
- Only an endorsement to the policy creates the status. A certificate that says additional insured without one gives the broker nothing.
- MTM Health, SafeRide Health, WellTrans, and Verida ask to be added, and Louisiana, Arizona, and Portland require the state or city on your policies.
- Contracts usually pair it with primary and non-contributory wording, a waiver of subrogation, and notice before cancellation.
- A missing endorsement can cost money: WellTrans charges $100 per vehicle for each day a van runs without it.
What additional insured means on a NEMT policy
Your company is the named insured: the business shown on the policy’s declarations page. An additional insured is someone else your insurer agrees to cover under the same policy. The contract insurance guide of Sonoma County, California, explains that an additional insured does not qualify as an insured under a standard general liability policy, so it must be added by an endorsement that changes the policy’s “who is an insured” section.
The coverage is narrow. It reaches only claims that come from your work for that party. Arizona’s health plan subcontract rules, for example, cover the State of Arizona “with respect to liability arising out of the activities performed by the Subcontractor” or on its behalf. Mass General Brigham’s 2026 supplier terms cover its “vicarious liabilities” caused by the supplier.
Here is how that plays out. A rider is hurt during a trip a broker assigned you, and the lawsuit names your company and the broker. If the broker is an additional insured, your insurer handles the broker’s part of the claim too, within your policy limits.
| Role | Who it is | What it gets |
|---|---|---|
| Named insured | Your company, on the declarations page | The coverage the policy describes |
| Additional insured | A broker, health plan, state, city, or facility added by endorsement | Coverage for claims that come from your work for it, out of your limits |
| Certificate holder | Whoever a certificate of insurance is addressed to | A copy of the certificate. The ACORD 25 form says it confers no rights. |
The last row matters most. A certificate of insurance only reports coverage. The ACORD 25 form, in the edition the Texas Department of Insurance approved on May 14, 2015, warns that if the holder is an additional insured, the policy must have additional insured provisions or be endorsed.
Why brokers, plans, and facilities ask to be added
The organizations that book, pay for, or license your rides can be pulled into a lawsuit over them. Naming themselves on your policy puts your insurer between them and that claim. These are the written requirements as of September 2026:
| Who asks | Who must be named | On which policies |
|---|---|---|
| MTM Health, standard agreement (January 1, 2023 version Pennsylvania posts) | “Medical Transportation Management, Inc. and all Affiliates” | General and auto liability, up to your full policy and umbrella limits |
| MTM Health, state provider pages such as Missouri | MTM, as certificate holder and additional insured | General and auto liability |
| SafeRide Health, provider page | SafeRide, on your certificate of insurance | Not named. The same list sets general liability and auto minimums. |
| WellTrans, Indiana (agreement revised October 16, 2025) | WellTrans, Professional Management Enterprises Inc, and the officers, agents, and employees of the State of Indiana and its Family and Social Services Administration | Every policy except workers’ compensation |
| Verida, Washington, DC | Verida and Health Services for Children with Special Needs | Auto and general liability |
| Paratransit Services, Washington (requirements file updated April 2024) | Paratransit Services and the Health Care Authority as primary additional insureds, plus the State of Washington | General and auto liability |
| Louisiana Medicaid health plans (MCO manual updated May 28, 2026) | The Louisiana Department of Health | Auto and general liability |
| Arizona health plan subcontractors (AHCCCS rules effective October 1, 2024, revised January 9, 2025) | The State of Arizona and its departments, agencies, officers, and employees | General liability and business auto |
| Portland, Oregon NEMT company permit (City Code 16.40.730) | The City and its officers, agents, and employees | The certificates you file for the permit |
| Nashville for-hire company application (revised August 23, 2022) | The Metropolitan Government | Company liability and vehicle insurance |
Hospitals and other facilities set their own terms. Mass General Brigham’s 2026 supplier insurance obligations, which expire December 31, 2026, ask a business that transports people for at least $20 million per accident in auto liability. Umbrella or excess policies can count toward that limit. The system and its related entities must be additional insureds on the liability, umbrella, and excess policies. See NEMT facility contracts before you quote a facility.
How an additional insured endorsement is added
Your insurance agent requests the endorsement from your insurer. You cannot add a name yourself, and a certificate cannot do it for you.
- Get the exact name in writing. Copy it from the contract, with the address the contract gives. MTM Health’s agreement asks for “Medical Transportation Management, Inc. and all Affiliates” at its Lake St. Louis, Missouri address. Arizona’s list runs to the state’s departments, agencies, boards, commissions, universities, officers, officials, agents, and employees.
- Tell your agent which policies it goes on. Most contracts in the table above name both general liability and commercial auto. Some add umbrella or excess policies.
- Ask which endorsement form your insurer uses. Sonoma County’s guide calls CG 20 26, Additional Insured, Designated Person or Organization, a catch-all for general liability. A blanket endorsement covers anyone your contract requires, without listing names. On a business auto policy, anyone legally liable for your conduct is already an insured, so many insurers issue a designated insured endorsement, CA 20 48, instead.
- Add the endorsements that usually travel with it. Contracts often ask for primary and non-contributory coverage, a waiver of subrogation, and notice before cancellation. MTM Health, WellTrans, and Arizona health plans ask for all three.
- Get proof and keep it. Ask for a certificate with the additional insured box marked and a copy of each endorsement. MTM’s agreement says endorsements go to MTM on request, and Paratransit Services wants a certified copy of the insurance with every endorsement.
- Check it at every renewal. A renewal is a new policy, so confirm it still carries each endorsement. MTM wants certificates at signing and at each renewal.
Texas adds a wrinkle. If your policy has only a blanket endorsement, the Texas Department of Insurance says the certificate may not name the holder as an additional insured, though it may say the policy has a blanket additional insured endorsement (FAQ last updated October 31, 2022). Your agent may still send the broker a copy of the endorsement itself, which the same FAQ allows.
What additional insured status costs you
Your limits are shared. Sonoma County’s guide says additional insured endorsements do not increase policy limits: the named insured and every additional insured share them. With a $1 million combined single limit, one crash that brings claims against you and a broker is paid from one $1 million. MTM Health’s status runs up to your full liability and umbrella limits, so a larger umbrella policy protects MTM too.
Your policy pays first. Primary means your policy pays before the other party’s insurance. Non-contributory means their insurance does not share the loss with yours. MTM’s agreement and Arizona’s rules require both.
Your insurer gives up its right to recover. A waiver of subrogation stops your insurer from suing the broker to get back what it paid. WellTrans’s agreement describes it as a waiver of any right your insurer gains against WellTrans by paying a loss.
Your premium may change. Your insurer decides whether each endorsement adds a charge. Get the answer from your agent before you sign a contract, and ask whether a blanket endorsement is available.
Your promise can be bigger than your policy. MTM’s agreement says its insurance terms do not limit your duty to defend and indemnify MTM and its client. If a claim goes past your limits, the contract can still make you pay the rest.
A missing endorsement costs money. WellTrans charges $100 per vehicle per calendar day for running vehicles when WellTrans and its client are not named as additional insureds. See NEMT liability for how these contract terms fit together.
Mistakes that stall credentialing
- The box is checked, but no endorsement exists. Sonoma County’s guide says that without an endorsement, the holder is not an additional insured, whatever the certificate says.
- The name is incomplete. MTM asks for “and all Affiliates,” and WellTrans’s list runs to the State of Indiana and its Medicaid agency. A shortened name can fail the check.
- The endorsement covers the wrong work. An endorsement limited to other operations may not reach your rides. Sonoma County’s guide describes one that covered only food donations and client referrals, so it did not protect the county.
- Only one policy carries it. MTM, Verida in DC, and Louisiana want it on both general liability and auto.
- The renewal dropped it. Check each renewed policy before you send the new certificate.
For the full list of coverage each program requires, see NEMT insurance requirements. For where the endorsement fits in the paperwork, see NEMT broker credentialing.
Frequently asked questions
What is the difference between an additional insured and a certificate holder?
An additional insured is covered by your policy for claims tied to your work, through an endorsement your insurer adds. A certificate holder is only the party a certificate of insurance is addressed to, and the standard ACORD 25 form says the certificate confers no rights on it. Many brokers ask to be both: MTM Health's Missouri provider page lists MTM as certificate holder and additional insured.
Does adding a broker as additional insured cost more?
The larger cost is shared limits. The named insured and every additional insured draw on the same policy limits, so one crash that brings claims against you and a broker is paid from one limit. Your insurer decides whether an endorsement changes your premium. Ask your agent before you sign, and ask whether your policy has a blanket endorsement that covers anyone your contract requires.
Is checking the additional insured box on my certificate enough?
No. The ACORD 25 certificate says that if the holder is an additional insured, the policy must have additional insured provisions or be endorsed. The Texas Department of Insurance tells agents to check the box only when the policy has an endorsement naming the holder. MTM Health's standard agreement lets MTM ask for the endorsement itself, so keep a copy on file.
Which of my policies need the additional insured endorsement?
Usually general liability and commercial auto. MTM Health, Verida in DC, and Louisiana health plans name both. WellTrans wants every policy except workers' compensation, and Mass General Brigham's 2026 supplier terms include umbrella and excess policies. Arizona's health plan subcontract rules ask for a waiver of subrogation on workers' compensation instead.
Can a broker be an additional insured on my auto policy?
Yes, though the form can differ. A business auto policy already counts anyone legally liable for your conduct as an insured, so many insurers issue a designated insured endorsement (CA 20 48) instead of an additional insured endorsement, according to Sonoma County's contract insurance guide. Ask each broker in writing whether it accepts that form before your policy renews.
What happens if the endorsement is missing?
Credentialing stalls, and some contracts charge for it. WellTrans's Indiana agreement, revised October 16, 2025, sets liquidated damages of $100 per vehicle per calendar day for running vehicles when WellTrans and its client are not named as additional insureds. It also voids the agreement if the certificate naming them is not in by the effective date.