NEMT Insurance Cost: Ranges + Calculator
Non-emergency medical transportation (NEMT) moves a vulnerable population — wheelchair and mobility passengers, dialysis and appointment runs — which shapes the whole insurance program. Commercial (livery) auto at high limits is the core, and sexual abuse & molestation (SAM) coverage is increasingly mandatory because standard auto and general-liability policies do not carry it. Broker networks (the entities that assign the trips) add their own certificate-of-insurance requirements — additional-insured, primary & non-contributory wording, and a 30-day cancellation notice.
As an industry-typical estimate, NEMT programs commonly require $1,000,000 combined-single-limit commercial auto (state Medicaid and broker rules push the range $300,000–$1,500,000) plus $1M/$2M general liability and SAM. No insurance bureau publishes NEMT premiums, so every dollar here is an estimate; each fact is sourced to a named authority (III, IRMI). Use the calculator below, then get a real quote in 5 minutes.
| Business activity |
|---|
| Disabled or elderly passenger transportation services |
| Nonemergency medical transportation services (except ambulance services) |
| Paratransit transportation services |
| Pet transportation services |
| Senior citizens transportation services |
| Special needs passenger transportation services |
What businesses actually request
Across 41 recent commercial-insurance quote requests on Get Business Coverage, here is how often each coverage line is requested — our own first-party demand data, not a rate quote.
| Coverage | Share of requests |
|---|---|
| Commercial Auto | 82.9% |
| General Liability | 41.5% |
| Business Owner's Policy | 22% |
Estimate your commercial insurance cost
Plug in a few business details and we'll show an industry-typical annual range for General Liability + Workers Compensation + Commercial Auto, with the source for every number. Real quotes vary by carrier, claims history, and underwriting — get an actual quote here.
Industry-typical market ranges
Sourced from III, NCCI, ISO, NAIC, BLS, FMCSA, FDA, NRA — government and bureau publications, not from our quote form
Coverage lines a NEMT operation typically carries (industry-typical estimates):
- Commercial (livery) auto: transporting passengers for hire at high limits (commonly $1,000,000 CSL; Medicaid/broker rules vary). III commercial auto.
- Sexual abuse & molestation (SAM): allegations from transporting vulnerable passengers — not carried by standard auto or GL, and increasingly required. IRMI abuse or molestation.
- General liability: slips and injuries during loading, boarding and assistance. III commercial general liability.
- Workers' compensation: mandatory for drivers and attendants in nearly every state. III workers comp.
Broker network, Medicaid contract limits and fleet size are primary rating factors.
Recent rate-filing activity — 8 state filings across 1 commercial line
Commercial carriers can't charge whatever they want — each state's Department of Insurance must approve loss-cost filings before they take effect. These are primary-source, government-held records available on SERFF Filing Access. Cited below: the most-recent active filings affecting nemt operations, each cited to the regulator or bureau filing it came from.
| Line | State | Overall change | Effective | Filing |
|---|---|---|---|---|
| WC | NV | -32.8% voluntary loss cost decrease (legislatively-driven; SB 317) | Oct 1, 2026 | SERFF #NCCI-134895530 |
| WC | RI | Overall -2.5% voluntary (industrial); -12.9% federal classes | Aug 1, 2026 | SERFF #NCCI-134743616 |
| WC | AR | Overall -9.8% voluntary loss cost; -9.8% assigned risk market | Jul 1, 2026 | SERFF #NCCI-134876672 |
| WC | TX | Overall -3.8% adjustment to voluntary loss cost level | Jul 1, 2026 | SERFF #NCCI-134745334 |
| WC | OH | -1% private-employer rate cut (~$10M aggregate; -50% cumulative since 2019) | Jul 1, 2026 | — |
| WC | SC | -0.4% voluntary loss cost decrease | Apr 1, 2026 | SERFF #NCCI-134702984 |
| WC | NC | per $100 payroll (advisory loss cost) | Apr 1, 2026 | Filing #NCRI-134628278 |
| WC | NC | per $100 payroll (advisory loss cost) | Apr 1, 2026 | Filing #NCRI-134628278 |
Source: SERFF Filing Access (filingaccess.serff.com) — the official public-records interface for state Department of Insurance filings. Loss-cost changes shown are the overall bureau-wide change in each state; the actual impact on your quote depends on your class code, payroll, experience modifier, and carrier-specific loss-cost multiplier (LCM). Get a quote for your exact numbers.
Bureau-filed loss-cost activity by state — 45 states with filings
Each link below opens a nemt-specific page showing only that state's most-recent bureau-filed loss-cost filings (NCCI workers' comp and/or ISO commercial-lines), cited to the regulator or bureau filing each came from. Filed-rate data ≠ carrier final rates.
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Sources cited
- Commercial Auto Insurance — Insurance Information Institute (III), 2024
- Abuse or Molestation Coverage — International Risk Management Institute (IRMI), 2024
- Commercial General Liability Insurance — Insurance Information Institute (III), 2024
- Workers Compensation Insurance — Insurance Information Institute (III), 2024