Do I have to have it?
There are some exceptions, but in Ohio if you have employees it is your responsibility to have Workers’ Compensation coverage.
Is Workers’ Comp the same everywhere?
Ohio is one of four states in the country that has a state-run monopoly. Most other states require private insurance.
Will it cost a lot?
Workers’ Compensation Rates are based on several criteria. Among them are Payroll, Industry and Experience. Changes in any of these can cause a variance in a company’s Workers’ Comp Premium.
Payroll – Employers report their payroll twice a year to the Bureau of Workers’ Compensation. This information is used to calculate the premium owed.
Industry – The industry classification is used to determine your rates.
Experience – Claims from the previous five years (excluding the most recent year) are used in the calculation.
How am I billed?
In arrears. The bill you pay is for the previous six months.
What contributes to the cost of a Workers’ Comp Claim?
It is more than just medical claims - In fact, lost time claims are of much more concern. These claims involve time off from work. There are also varying degrees of disability and wage loss compensation claims.
What does it mean to be self-insured?
The Ohio Bureau of Workers’ Compensation (BWC) and the Industrial Commission of Ohio (IC) comprise the Ohio workers’ compensation system, which includes state-fund employers and self-insuring employers.
Under the state-fund program, BWC pays compensation directly to injured workers. Self-insuring employers pay their own workers’ compensation claims and are monitored by BWC.
Is my company eligible to be self-insured?
Self-insurance is a privilege granted to employers with proven financial strength and administrative ability to ensure prompt handling of all obligations. All employers granted the privilege to pay compensation directly shall demonstrate sufficient financial strength and administrative ability to assure that all obligations under section 4123.35 of the Revised Code will be met promptly. The administrator of workers’ compensation shall deny the privilege to pay compensation, etc., directly, where the employer is unable to demonstrate its ability to promptly meet all the obligations under the rules of the commission and bureau and section 4123.35 of the Revised Code.
What are the requirements for self-insurance?
- Have a minimum of 500 employees within Ohio
- Possess two-years’ experience with the state insurance fund
- Demonstrate strong financial stability
- Possess the ability to administer workers’ compensation insurance
- Maintain an account with a financial institution in Ohio, or draw compensation checks from the same account as the payroll checks
- Have a BWC-certified Qualified Health Plan (QHP)
How long does the application process take?
The entire qualification process takes approximately 90 days. After BWC processes all applications and documents, the bureau will render a written decision granting or denying self-insurance. Should the applicant disagree with the decision, the employer may submit an appeal to the Self-Insured Review Panel for a hearing. If approved, BWC assigns the employer a policy number and the SI process begins.
Do I have to attend any type of training?
BWC schedules each applicant for a self-insurance orientation session after the application is approved but before the SI status is effective. This session introduces the self-insurance process, procedures and administrative requirements.
Once self-insured, will I be responsible for any special assessments?
Once an employer becomes self-insured, the employer is responsible for paying assessments to the self-insured guaranty fund for the first three years of self-insurance. BWC bases the guaranty fund assessment on the total of an employer’s last two state-fund payroll premiums at base rate, multiplied by 6 percent. The minimum assessment is $5,000 for any 12-month period of coverage.
In addition, and if applicable, self-insuring employers must reimburse the disabled workers’ relief fund (DWRF) payments on a semiannual basis. This fund is for permanently and totally disabled employees whose workers’ compensation benefits have not kept up with inflation. BWC bills the employer dollar for dollar regardless of the date of injury.
For the first five years of self-insurance, BWC adds the indemnity (compensation) payments made on the state-fund claims to the amount of paid compensation reported by the self-insuring employer to establish the assessment base.
Once self-insured, will I have to renew my coverage?
Yes, active self-insuring employers must renew their self-insurance annually by filing the Application for Renewal of Authorization to Operate as a Self-Insured Risk with the BWC self-insured department. BWC mails the renewal application to the self-insuring employer 120 days prior to the renewal month. Return the completed application forms no later than 90 days prior to your renewal date.
Can my workers’ compensation files be housed at a location outside the State of Ohio?
Workers’ compensation claim files must be housed at an Ohio location of the self-insuring employer. Should the employer wish to maintain claim files out of the state, prior approval must be obtained through the BWC’s Self-Insured Department.
Is an incident/accident report to be completed for all work related injuries and occupational diseases?
Yes, an incident report is to be completed for all work related injuries and occupational diseases. Company policy may require that a separate incident report be completed by the injured worker and a company representative (e.g. supervisor, safety manager, etc.)
Does a self-insuring employer have to file a medical-only claim?
No. The BWC does not require the self-insuring employer to file medical-only claims. However, the injured worker and/or the employer have the option of filing a claim with the BWC.
Why are Self-Insured Retention ( SIR) requirements so high?
Inflation is the culprit here; cost of care including medications. Major breakthroughs in medical science and new treatments that can give an employee a better quality of life and in many cases, extend life. All of which can increase the size of the claim.
Is there is difference in excess insurance coverage from carrier to carrier?
You bet! Some contracts exclude Intentional Torts, Intentional Acts and Substantial Certainty or may restrict coverages and/or require separate SIR's. My advice; get quotes from more than one broker and limit the number of carriers that each broker can submit your account to.
How can I find out how my Self-Insured Workers' Compensation program is performing? Are fees charged in line with industry standards ? Are we deploying fees in the right areas?
CRM Insurance Solutions, LLC can help you in all of these areas. One of our insurance carriers has a "Benchmarking" program. In this program, we can compare your claims experience to peer groups in order to match-up your frequency and severity to a model to determine your performance. From this analysis, we can audit your experience to determine the efficiency of your program in all areas.
What is Group Rating?
Group Rating is a program allowed by the State of Ohio by which substantially similar companies may pool their experience and achieve a discount off their Workers’ Comp premium.
What if my company can’t get into a group?
It is NOT hopeless. If a company is not eligible for a traditional group rating program, it can still achieve discounts through various other programs offered by the Bureau of Workers Compensation, subject to eligibility.
How do I apply for a group?
It’s simple and free. You can complete the AC3 on our website or you contact our office to request an AC-3 form. Once you complete the form and fax or scan it back to our office, our office will be able to obtain the necessary risk data from the BWC to determine your company’s group eligibility.
Are there any requirements to be in a group?
To be eligible for a group rating program (and most other discount programs) employers must:
• Be current on all undisputed premiums, administrative costs, assessments, fines or monies otherwise due to BWC;
• More specifically, you must be current (not more than 45 days past the due date) on any balance greater than $200 due to BWC, by the group-rating application deadline. The only exceptions are when a policy is placed into an appealed status or a BWC-approved payment plan is in place.
• Be current on the payment schedule for any scheduled part-pay agreement you've entered into to pay premiums or assessments otherwise due BWC as of the application deadline;
• Not have cumulative lapses in workers' compensation coverage in excess of 40 days in the past twelve months preceding the application deadline.
• Not be a member of more than one group. If you apply for more than one group on a valid group-experience-rating application, BWC may reject you from all groups.
• Be substantially similar (in the same industry group) to all other employers in the group.
Are there fees involved?
Yes. All groups in Ohio charge a claims administrative fee and a membership fee to the sponsoring association (if the Company is not already a member). CRM’s groups are no different. However, one important factor with our groups is that the claims administrative fee covers all claims representation before the Bureau of Workers’ Compensation and Industrial Commission of Ohio for one year. The services are detailed in the Participation Agreement that is sent to all enrolled Companies.
When will my discount start?
Groups are formed on an annual basis. All groups need to be filed with the BWC on the Monday before Thanksgiving for the rating year that will begin on July 1 of the following year.
How will I know if my Company qualifies for a group?
Once CRM receives your AC-3, we will process it with the BWC to obtain risk information relative to your Company. Our group rating department will review that information and determine whether your Company qualifies for a group. If eligible, your company will then receive an invitation to join the group, which will include the proposed savings, an invoice for the claims administration fees and the necessary enrollment documents.
Once in a group, do I still pay my premiums to the Bureau of Workers’ Compensation?
Yes, your premiums will still be paid directly to the BWC. The premiums due to the BWC will include the reduced group rates. Premiums are calculated as they were in the past, except at a lower rate.
What is the best program for my Company?
You can contact our office and we will be able to direct you to the best program based on the Company’s claim history and size. The BWC offers many programs besides group rating. A few discount programs outside of group rating are Group Retrospective Rating, EM Cap, and the One-Claim Program. There also exist the Destination: Excellence Programs, which can be “stacked” with the programs mentioned above (subject to BWC program compatibility rules).
How do I sign up for the Programs?
You can contact our office to obtain an application or you can file online at the Bureau’s website (www.ohiobwc.com).
What are the filing deadlines for the Programs?
• The Group Retrospective Rating deadline is the last business day in January.
• The One-Claim Program deadline is the last business day in January.
• The Destination: Excellence Program deadlines are the last business day in May.
As a reminder, the standard group rating deadline is the Monday before Thanksgiving.
Where can I find more information on these and other discount programs?
Information on BWC discount programs can be found at https://www.bwc.ohio.gov/employer/programs/