Resources/Case Studies

Per-shift coverage in the provider's own name — and more facilities saying yes

How a healthcare shift marketplace gives per-diem clinicians per-shift workers' comp in their own name — a COI before every shift, audit protection for facilities, and a faster yes when insurance used to stall the deal.
Fitzgerald Ventura
Co-founder & CEO
3 min readJune 18, 2026

A healthcare shift marketplace requires per-diem clinicians to bind workers' comp in their own name before they can accept a shift — protecting facilities from audit exposure, and giving the marketplace's team a stronger answer when insurance is the thing standing between them and a new facility.

The company

A healthcare workforce marketplace connects facilities with per-diem clinicians — CNAs, nurses, and other healthcare professionals. Those professionals are independent contractors picking up shifts, including replacement and urgent shifts, across a large network of facilities.

The challenge

When a 1099 healthcare professional works a shift without workers' compensation, a facility's workers'-comp carrier can treat that labor as uninsured exposure attributable to the facility. In most NCCI states, the facility can be charged premium at audit for uninsured subcontractors — often on 100% of the subcontracted amount — and carriers frequently reserve a three-year look-back, which can turn a single gap into a large retroactive assessment plus penalties and interest.

That risk makes insurance a real objection in the sales conversation: a facility worried about audit exposure is a facility that hesitates to onboard. And the obvious workaround — a platform extending its own coverage to contractors — is dangerous, because workers' comp is a statutory employer–employee remedy, so doing so concedes employee status and invites reclassification.

The solution

The marketplace and 1099Policy make per-shift workers' comp a hard requirement, bound in the provider's own name, before a shift can be accepted:

  • When a professional picks up a shift (including replacement or urgent shifts), they must opt in and bind workers' comp before they can accept — typically in under a minute.

  • At opt-in, a certificate of insurance is automatically generated for the provider, the marketplace, and the facility — so there's confirmation of coverage before the professional ever steps foot in the facility — and each COI is held in a repository facilities can use at audit.

  • Because coverage sits in the provider's own name, it credibly excludes that labor from the facility's workers'-comp exposure: at audit, the first question — did workers' comp coverage exist? — is answered clearly in the professional's name, removing the basis for retroactive premium, penalties, and interest.

  • 1099Policy provides a waiver of subrogation on the professional's policy when required by contract, and the in-name structure means an injured provider's statutory remedy is their own policy — with no pathway to assert employee status against the facility.

The impact

The audit-avoidance mechanics are the foundation — but the downstream effect shows up in sales. With coverage confirmed before every shift and a COI on file for the facility, insurance stops being a reason to say no. The marketplace reports that the embedded coverage is helping its team close facilities that previously stalled on insurance questions — turning a compliance requirement into a reason facilities feel safe signing on.

Why it matters

Workers' comp audits are where uninsured 1099 labor quietly becomes the contracting entity's liability. By making per-shift, in-name coverage a hard gate — with a COI generated before the professional arrives — a marketplace protects its facilities' audit posture and its own classification model at once, and gives its go-to-market team a cleaner path to yes.

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