Call / Text : 480-771-3009

Growing Your NEMT Company From Ten Vans to Twenty

Share on Pinterest Share on LinkedIn

TL;DR

  • Doubling a fleet usually means adding drivers, and a larger team can cross federal employee-count thresholds.
  • At 15 employees, federal laws on discrimination and disability apply, and at 20 employees, age discrimination law and COBRA health coverage rules apply.
  • Ground passenger transportation companies with more than 10 employees generally must keep OSHA injury and illness records.
  • Every new driver paid by Medicaid must meet the federal minimum driver requirements, and every new van needs its own inspection and maintenance records.
  • A larger fleet also needs enough phone agents and dispatchers to book trips and keep vehicles moving.

Adding ten vans is a major step for an NEMT company. It can bring more trips, along with more drivers, more records, and more calls to answer. This post covers what changes under US law and in daily operations when an NEMT fleet grows from 10 vans to 20.

How Fleet Growth Changes Your Headcount

Each van needs at least one driver, and many companies also add office staff as they grow. Here is a simple example. A company with 10 vans, one driver per van, and five office staff has 15 employees. If it doubles its fleet on the same model, it has 25 employees. If it runs two driver shifts per van, the number is higher.

Many federal employment laws apply based on how many employees a company has. Some of these thresholds fall right in the range an NEMT company reaches when it goes from 10 vans to 20. Independent contractors generally do not count toward these numbers, but whether a driver is an employee or a contractor depends on the actual working relationship.

Federal Employment Laws That Start at 15 and 20 Employees

The US Equal Employment Opportunity Commission (EEOC) enforces federal laws against job discrimination. According to the EEOC, a private business is covered if it has 15 or more employees for at least 20 calendar weeks in the current or previous year. This includes Title VII of the Civil Rights Act and the employment section of the Americans with Disabilities Act (ADA). For age discrimination complaints, the threshold is 20 employees for at least 20 calendar weeks.

COBRA is a federal law that lets workers and their families keep their job-based health coverage for a time after certain events, such as leaving a job. According to the US Department of Labor, COBRA generally applies to private-sector group health plans of employers that had at least 20 employees on more than half of their typical business days in the previous calendar year. Part-time employees count as a fraction based on their hours. These laws look back over weeks or a full year, so coverage does not start the day a company hires its 15th or 20th employee. Tracking headcount each month makes it easier to see when a threshold is coming.

OSHA Injury Records After 10 Employees

The Occupational Safety and Health Administration (OSHA) requires many employers to keep records of work-related injuries and illnesses. Under OSHA’s recordkeeping rules, companies that had 10 or fewer employees at all times during the previous calendar year do not need to keep these records unless the government asks them to.

OSHA also lists certain industries that are partially exempt. OSHA’s list includes scenic and sightseeing transportation, and it does not include taxi, transit, or other ground passenger transportation. An NEMT company that grows past 10 employees should plan to keep OSHA injury and illness records. Every employer, of any size, must report to OSHA any work-related fatality, in-patient hospitalization, amputation, or loss of an eye.

Thresholds to Watch at 50 Employees

A 20-van fleet with two driver shifts, plus office staff, can approach 50 employees. Two federal requirements start at that number.

The Family and Medical Leave Act (FMLA) covers private employers with 50 or more employees in 20 or more workweeks in the current or previous calendar year. Eligible employees can take up to 12 workweeks of unpaid, job-protected leave in a year for certain family and medical reasons.

Under the Affordable Care Act, a company that averaged at least 50 full-time employees, including full-time equivalents, during the prior year is an applicable large employer. These employers are subject to the employer shared responsibility provisions and must file information returns about the health coverage they offer. The IRS counts an employee as full-time if they average at least 30 hours of service per week.

Summary of Employee-Count Thresholds

Employees Law Rule
More than 10 OSHA recordkeeping Injury and illness records for ground passenger transportation companies.
15 Title VII and ADA (employment) Federal job discrimination and disability protections.
20 Age Discrimination in Employment Act Protection for workers age 40 and older.
20 COBRA Continuation of group health coverage.
50 FMLA Up to 12 workweeks of unpaid, job-protected leave for eligible employees.
50 full-time or equivalent Affordable Care Act Employer shared responsibility and health coverage reporting.

Sources: US Equal Employment Opportunity Commission; US Department of Labor (COBRA and FMLA); 29 CFR Part 1904 and OSHA Appendix A to Subpart B; IRS guidance on applicable large employers.

Medicaid Driver Rules Apply to Every New Driver

Federal Medicaid law sets minimum requirements for NEMT providers and drivers paid by Medicaid. According to a CMS bulletin to states, each state must have a way to confirm that:

  • The provider and every driver are not excluded from federal health care programs or listed on the HHS Office of Inspector General exclusion list.
  • Every driver has a valid driver’s license.
  • The provider has a process to address any violation of a state drug law.
  • The provider has a process to share each driver’s driving history, including traffic violations, with the state Medicaid program.

These requirements apply to each driver, so a company that doubles its drivers doubles the screening and record-keeping it must keep up with. Federal audits show why these records matter. In a 2021 audit of Massachusetts, the HHS Office of Inspector General found that driver qualifications and vehicle inspection, registration, and maintenance records were not adequately documented for all 100 sampled NEMT services.

Records for Every New Van

Each van added to the fleet needs its own records. The national accreditation standard from the Non-Emergency Medical Transportation Accreditation Commission (NEMTAC) gives a useful picture of what reviewers look for. It asks providers to keep:

  • A fleet list with each vehicle’s year, make, model, VIN, and level of service.
  • Daily vehicle checks for damage and equipment problems.
  • Fluid and tire pressure checks at least twice a week.
  • Inspection logs for wheelchair securement equipment, lifts, ramps, and stretchers where they apply.

Accreditation is voluntary, and state and broker requirements vary. The standard shows the kind of documentation an outside reviewer may expect for each vehicle.

Phone and Dispatch Coverage for a Larger Fleet

More vans means more trips to book, confirm, and assign. The NEMTAC standard asks providers to set minimum staffing levels for their call center and dispatch operations. These levels should account for peak demand and holidays, and providers should have backup plans for staffing shortages. The standard also asks for clear roles for answering calls, dispatching vehicles, and planning routes.

Phone agents and dispatchers do different jobs. Agents answer calls, book trips, and collect the details used for billing, such as the level of service and pickup and drop-off addresses. Dispatchers work with drivers throughout the day. When a rider cancels or reschedules, the dispatcher assigns the driver a new ride so the van does not travel empty. An empty van costs fuel and driver time without bringing in revenue, and a larger fleet has more vans to keep assigned.

Trained NEMT Agents and Dispatchers for Your Operation

Pac Biz answers your phones with trained NEMT agents, so no call goes unanswered and no trip gets lost. We also provide dispatchers who coordinate with your drivers throughout the day.

Talk to Pac Biz About NEMT Dispatch Support

Planning the Move to Twenty Vans

Going from 10 vans to 20 changes more than the size of the fleet. A larger team can bring a company under federal employment laws that start at 15 and 20 employees, and OSHA injury records once it passes 10. Every new driver must meet Medicaid’s minimum requirements, and every new van needs its own inspection and maintenance records. Planning for headcount, records, and phone and dispatch coverage before the new vans arrive helps the company meet these requirements from the first day the vans are in service.

Sources

Share on Pinterest Share on LinkedIn
Privacy Overview
Pac Biz Outsourcing

This website uses cookies so that we can provide you with the best user experience possible. Cookie information is stored in your browser and performs functions such as recognising you when you return to our website and helping our team to understand which sections of the website you find most interesting and useful.

Strictly Necessary Cookies

Strictly Necessary Cookie should be enabled at all times so that we can save your preferences for cookie settings.

Powered by  GDPR Cookie Compliance