Moon Insurance Managers, Inc. · TDI license #5595
Workers’ Compensation Insurance in Houston, TX
Texas is the one state where workers’ compensation is optional for most private employers. That fact is on every brochure. What the brochures skip is what “optional” costs the day an employee is hurt — and it is spelled out in the Labor Code, not in anybody’s sales copy.
What the statute does if you go without
- Coverage
- Elective, § 406.002
- Common-law defenses
- Barred, § 406.033
- Employee must prove
- Ordinary negligence
- A pre-injury waiver
- Void by statute
- Non-subscriber filing
- DWC-005, 1 Feb – 30 Apr
- 41years in Houston
- 20+markets compared
- Same dayDPS filing
- #5595TDI license
The employee’s side
What workers’ comp pays for
Three things, and they are the straightforward half of the product:
- Medical care Treatment
- Care for injuries and illnesses that come from the job, delivered under a system the Texas Division of Workers’ Compensation regulates rather than one the employer negotiates after the fact.
- Part of lost wages Income benefits
- Income benefits while an injured employee cannot work. Part of the wage, not all of it — the percentages and caps are DWC’s and they move, so ask rather than plan around a number you read somewhere.
- Death benefits The worst case
- Burial expenses and benefits to the employee’s family. It is the coverage nobody wants to price and the one that decides whether a bad day ends a business.
The employer’s side is a legal protection rather than a benefit, and it is the half Texas makes interesting.
What the Labor Code actually says
Optional in Texas — here is what that actually means
Labor Code § 406.002 says a private employer may elect to carry workers’ compensation. Electing out is lawful, and anyone who tells you otherwise has not read it. It is also a trade, and the code states both sides of that trade plainly.
| Criterion | If you carry it | If you elect out |
|---|---|---|
| If an employee is hurt and sues | Benefits under the policy are generally their exclusive remedy | They can sue you for damages |
| The three defenses employers reach for first | The exclusive-remedy bar applies instead | Unavailable — you cannot argue the employee’s own carelessness, that they accepted a known risk, or that a co-worker was at fault |
| What the employee has to prove | That the injury was work-related | Ordinary negligence, and nothing more |
| A waiver signed before the injury | Not something the policy needs | Void — the statute says so outright |
| A cap on what a court can award | The bar is the protection | None |
| The exception worth knowing exactly | A family can still seek exemplary damages where gross negligence or an intentional act caused a death | — |
| Annual paperwork with the state | Ordinary policy administration | DWC Form-005, filed between 1 February and 30 April every year |
That is the whole optional-in-Texas story, taken from the code itself: skip the premium, keep the courtroom. Worth stating the exception exactly rather than softening it, because it is the one competitors get wrong in both directions — carrying coverage does not make an employer untouchable, and the exception is narrow: the family of an employee who dies because of an employer’s gross negligence or intentional act can still seek exemplary damages.
Sources: Tex. Labor Code ch. 406 — §§ 406.002, 406.033; Tex. Labor Code § 408.001 — exclusive remedy. Verified .
Non-subscriber duties
Going without still comes with homework
Choosing not to carry workers’ comp does not take you off the state’s books. It puts you on them as a non-subscriber, with duties attached:
- File with DWC every year. Non-subscribers file DWC Form-005 between 1 February and 30 April, and again whenever they first drop or decline coverage. Missing the filing is an administrative violation under § 406.004.
- Post notices and tell new hires in writing. Notices go up in the workplace, and every new employee is told in writing that they are not covered by workers’ compensation.
- Report injuries to DWC. Work injuries involving more than a day of lost time, occupational illnesses, and deaths.
We say this whichever way you are leaning, because it is the part nobody mentions until it is late. Plenty of owners who came in certain they would stay non-subscribers changed their minds at the second bullet.
Source: TDI / DWC — employer resources and non-subscriber requirements. Verified .
Two doors close
When it stops being optional
Government work. A governmental entity’s building or construction contract must require the contractor to certify workers’ compensation for its employees on the project, and the requirement flows down to every subcontractor (§ 406.096). DWC’s rule reads it wider: everyone providing services on the project, haulers and owner-operators included, whether or not they have employees of their own (28 TAC § 110.110). Bidding city, county, school-district or state building work means carrying it, full stop. The duties that come with it are set out under contractors and subcontractors, below.
Private contracts. General contractors, clients and staffing agreements demand coverage every day for reasons of their own. In practice your contract usually settles the question before the law gets to it.
If you are a trade weighing this against a bid, the liability half of your paperwork lives on our contractors general liability page.
Sources: Tex. Labor Code § 406.096 — public building and construction contracts; 28 TAC § 110.110 — DWC compiled rules, pp. 24–30. Verified .
Who covers whom on a job
Contractors and subcontractors
Construction is where the election stops being one employer’s decision. The general contractor’s policy, the sub’s policy and the Labor Code’s own default all meet on the same job, and the default is not the one most subs expect.
The default: a covered general contractor’s people include the sub’s. Under § 406.122, a person working for a general contractor that carries workers’ comp is that contractor’s employee for comp purposes, unless they are operating as an independent contractor or were hired by one. For a subcontractor and its crew to stay off the general contractor’s side, the sub has to do both: operate as an independent contractor, and sign a written agreement with the general contractor taking on the responsibilities of an employer for the work. Either one alone is not what the statute says.
Section 406.121 lists what an independent contractor ordinarily does:
- Employs their own people. Pays their wages and directs their work.
- Decides how the work gets done. Including the hours worked and the method of payment.
- Brings the tools. Furnishes, or has their employees furnish, the tools, supplies and materials the job uses.
- Has the skills the work needs.
The statute’s word is ordinarily. Meeting the list does not make someone an independent contractor, and whether a particular sub is one is a legal question about the facts of the job — not one this page can answer for you. The same subchapter says a general contractor may direct a sub or its employees to stop or change an unsafe work practice (§ 406.125), and it carries parallel rules for motor carriers and owner-operators.
When the general contractor provides the coverage. Section 406.123 lets a general contractor and a sub sign a written agreement under which the general contractor provides workers’ comp to the sub and the sub’s employees. The mechanics are specific:
- With a sub who has no employees, it is automatic. A general contractor that carries comp and contracts with a subcontractor who has no employees is treated as that sub’s employer for comp purposes. That is the statute’s doing, not a choice. Work for an oil or gas well operator is the stated exception: there, an independent contractor with no employees is covered only under an agreement.
- The premium can come off the contract price. Where the general contractor provides the coverage, the actual premium for it, based on payroll, may be deducted from the contract price or other amount owed to the sub. The agreement says whether it will be.
- It is for comp purposes only. The agreement makes the general contractor the sub’s employer under the workers’ compensation laws and for nothing else.
- A copy goes to the carrier within 10 days. The general contractor files it with its own workers’ comp carrier no later than the 10th day after the contract is executed — or with DWC, if the general contractor is a certified self-insurer. Missing the filing is an administrative violation, and DWC’s rule says an illegible or incomplete copy is not considered filed.
- Coverage starts no earlier than the signatures. Under 28 TAC § 112.101 the agreement is in writing, signed and dated by both, and states its term and the estimated number of workers. Coverage begins no sooner than the date it is signed, and no premium may be deducted for any time before that.
Subcontracting to avoid comp does not work. If an employer that has workers’ comp subcontracts work with the intent to avoid liability as an employer, an injured employee of that sub is treated as the employer’s employee for comp purposes, and keeps a separate right of action against the sub (§ 406.124). That section turns on the intent. The § 406.122 default above is the broader rule.
Home building and small commercial jobs have their own rules. Subchapter G covers contractors and workers preparing to build, building, altering, repairing, extending or demolishing a residential structure, a commercial structure of not more than three stories or 20,000 square feet, or an appurtenance to either (§ 406.142). It has its own independent-contractor test: paid by the job rather than by the hour, free to hire as many helpers as they want and set their pay, and free to work for other contractors at the same time (§ 406.141). Within it:
- A sub with no employees is not covered by default. An independent contractor without employees is not entitled to coverage under the hiring contractor’s policy unless the two sign a § 406.144 agreement, under which the hiring contractor withholds the cost of coverage from the contract price and is the employer for comp purposes only, and sends a copy to its carrier (§§ 406.143, 406.144).
- A joint agreement settles status for a year. A joint agreement declaring the sub an independent contractor, signed by both and filed with DWC, makes the sub an independent contractor as a matter of law until the first anniversary of its filing. Once it is filed, an insurer may not require premium from the hiring contractor for that sub’s coverage, except under a § 406.144 agreement (§ 406.145).
That is a separate set of rules from the ones above, and a job can look as though it fits both. Which governs a particular job is a question for a phone call with the contract in hand, not for a web page.
What your own policy charges for. The Labor Code bars an insurer from demanding premium from an employer for coverage of an independent contractor, or an independent contractor’s employee, who is under a contract of hire with that employer (§ 406.127). Whether a given sub is one is the § 406.121 question again. Beyond the statute, the answer is in your policy: ask how its audit treats subcontractors who cannot show their own certificate. And remember what a certificate is — evidence that a policy exists, not the policy itself.
Sources: Tex. Labor Code ch. 406, subchapter F — §§ 406.121–406.127; subchapter G — §§ 406.141–406.145; 28 TAC § 112.101 — DWC compiled rules, pp. 30–31. Verified .
On public building work, the rule reaches everyone on the site. DWC’s rule for a governmental entity’s building and construction contracts, 28 TAC § 110.110, requires coverage for every person providing services on the project, whether or not they contracted directly with the contractor and whether or not they have employees. That includes independent contractors, subcontractors, leasing companies, motor carriers and owner-operators, and “services” includes hauling or delivering equipment or materials. The rule’s own examples of what falls outside are food and drink vendors, office-supply deliveries and portable-toilet delivery. The contractor’s duties:
- A certificate before work starts. The contractor gives the governmental entity a certificate of coverage before beginning work, covering the project until the entity has completed and accepted it, and a new one before the current coverage period ends if it expires mid-project.
- A certificate from everyone below it. It collects a certificate from each person providing services before that person starts work, passes it to the entity, and passes on renewed certificates within seven days of receiving them.
- Changes in writing within ten days. By certified mail or personal delivery, within ten days after the contractor knew or should have known of any change that materially affects anyone’s coverage.
- A notice posted on every site. DWC’s Notice 8, in English and Spanish and any other language common to the workforce, telling everyone on the project that they must be covered and how to verify coverage and report a failure to cover.
- The same duties in every subcontract. So they flow down each tier.
- Records kept. The contractor keeps every certificate for the project and one year after. The governmental entity keeps them for the project and three years after.
Handing over a certificate on a public job is itself a representation: that every employee on the project is covered, and that the coverage rests on properly reported class codes and payroll. A false or misleading certificate, or failing to provide or maintain one or to report a material change, can bring administrative, criminal or civil penalties. The rule is limited to building and construction contracts for a governmental entity. It does not reach private jobs.
Sources: 28 TAC § 110.110 — DWC compiled rules, pp. 24–30; DWC Notice 8 (Rev. 12/15). Verified .
Fixable
A lapsed policy is ordinary work
People type workers comp lapse into a search box at eleven at night, so here is the honest answer. From the day a policy lapses you are a non-subscriber — the exposure above applies and the DWC filing duty starts. Some carriers also read a lapse as a warning sign and price it that way.
Both problems are ordinary and both are fixable. Bring us the notice, tell us what happened, and we go to the markets that will look at the whole story rather than the one line. Nobody here treats a lapse as a character flaw.
The same goes for payrolls the standard market prices badly — a claim in the history, a tough class code, a new venture with no track record. Placing the account that got a hard no somewhere else is the work an independent desk exists for.
Read the fine print
Real workers’ comp vs. “alternatives”
Some sellers pitch non-subscriber “injury benefit plans”, or coverage from companies not licensed in Texas. The Texas Department of Insurance is blunt about these: an alternative policy bought from an unlicensed company does not count as workers’ compensation under state law. You keep the lawsuit exposure, benefits are limited to whatever the contract says, and there is no state guaranty backing behind it.
And if you have been declined everywhere, Texas keeps a door open: Texas Mutual was created by the legislature as the insurer of last resort, and an employer who cannot find coverage elsewhere can buy from it. We will tell you honestly which path fits before you spend another afternoon on hold.
Source: TDI — workers’ compensation insurance (cb030). Verified .
No obligation
Cover the people, keep the protection
Headcount, payroll, and what the business actually does — that is what a quote needs. Bring those and we will bring the markets.
Once the policy is placed, your certificates come from the same desk: certificate of insurance requests.
Monday to Thursday, 9:00 to 5:00; Friday, 9:00 to 4:00. 360 FM 1959, Houston, TX 77034. Policies written statewide — you do not have to be local.
Workers’ comp questions we get every week
Is workers’ compensation required in Texas?
For most private employers, no — coverage is elective under Labor Code § 406.002. But a governmental entity’s building or construction contract has to require it (§ 406.096), and DWC’s rule extends that to everyone providing services on the project (28 TAC § 110.110). Many private contracts demand it too, and electing out means losing key legal defenses if an employee is hurt and sues.
Do subcontractors need workers’ comp in Texas?
Not as a general rule — comp is elective for most private employers, and a sub is no different from the general contractor there (§ 406.002). What usually decides it is the job. Many general contractors ask for a certificate in the subcontract. On public building work, DWC’s rule requires coverage for everyone providing services on the project. And if the general contractor carries comp, the Labor Code treats the sub’s workers as the general contractor’s employees for comp purposes unless the sub operates as an independent contractor and has signed a written agreement taking on the employer’s responsibilities (§ 406.122). Home building and small commercial jobs run under a separate set of rules. The detail is in the contractors section above.
What happens if an employee is hurt and I don’t have workers’ comp?
The employee can sue you for damages. Under § 406.033 you cannot argue their own carelessness, their acceptance of the risk, or a co-worker’s fault — the employee needs to prove only ordinary negligence, and a waiver signed before the injury does not hold. With coverage in place, benefits are generally the exclusive remedy instead.
Do owners and officers have to be covered?
Texas lets certain executives and business owners make their own election about being included in coverage. The mechanics depend on how the business is set up, which makes it a two-minute question on the phone and a bad one to guess at from a web page.
Does my staffing agency, trucking company, or restaurant need workers’ comp?
Usually your contracts answer before the law does — clients, shippers, staffing agreements and franchise agreements require it routinely. What the industry changes is the class codes and the pricing, not the legal framework. Tell us what the business does and we quote it accordingly.
How fast can I get proof of coverage for a contract?
Tell us the deadline the contract set and we work to it. Quoting needs your headcount, your payroll and what the business does; certificates come from the same desk once the policy is placed.
From the library
Further reading
- Commercial insurance13 min readWhat Business Insurance Costs in Texas, Line by Line"Business insurance" is not one price, it is six or seven separate decisions that arrive on one invoice. Which is why the averages are useless and why two quotes for the same business can differ by half without either one being wrong.
- Commercial insurance13 min readWhat Changes Commercial Truck Insurance Cost in Texas — and What the Rules RequireEvery published figure for what commercial truck insurance costs describes a population you are not in. What is worth knowing instead: which parts of the number somebody else has already decided, which parts your operation decides, and how to tell whether two proposals are even quoting the same risk.
- Commercial insurance11 min readWhat Errors and Omissions Insurance Costs — and What the Price Is Actually BuyingTwo E&O quotes can differ by half and describe the same business, because most of what you are paying for is the shape of the policy rather than the size of the firm. The retroactive date is the part that decides it, and it is the part nobody reads.