Employer questions and answers
(Q&A)
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Claims
Discount Programs
Financial information
Initial coverage
Micro Insurance Reserving Analysis (MIRA)
Personalized Policy Scenarios
Premiums/Payroll/Continuous Coverage
Professional employer organizations (PEOs)
Rating Programs
Self-Insured
Safety & Hygiene
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| Initial coverage |
top |
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| 1Q. Do I need to have a workers' compensation policy? |
1A. If you have any employees, you must have an
active workers compensation policy to insure coverage for those employees
against a workplace injury. ORC
4123.01 details the requirements for workers compensation coverage
for Ohio employers.
|
| 2Q. What if I own my own business, do I still need coverage? |
2A. Owners of sole proprietorships, partners in a partnership and
individuals incorporated as a corporation (with no employees) are not considered employees and have the option
whether or not to cover themselves.
|
| 3Q. What are the pros and cons of sole proprietors, partners,
individuals incorporated as a corporation (with no employees) or family farm corporate officers electing to
cover themselves?
|
3A. The benefit of elective supplemental coverage is that sole
proprietors, partners, individuals incorporated as a corporation (with no employees) or family farm corporate
officers can report a work injury against their policy and upon BWC approval of the claim,
medical bills and lost time wages can be paid. The liability of elective coverage is that
sole proprietors, partners, individuals incorporated as a corporation (with no employees)
or family farm corporate officers must report their wages to BWC and pay the appropriate
premiums on their net income.
Minimum/Maximum payroll
reporting requirements
|
| 4Q. If I incorporate my business will I have to get workers'
compensation coverage? |
4A. All employees including corporate officers, except for individuals
incorporated as a corporation with no employees or family farm corporate officers,
are considered employees and must have an active workers' compensation policy covering them.
|
| 5Q. How do I apply for workers' compensation coverage? |
5A. The Application for Ohio Workers Compensation
Coverage U-3 is available to complete and submit online or it can printed
and mailed in to BWC. A $10 deposit is required.
Click here to access the online
U-3 Ohio Workers
Compensation Coverage application
|
| 6Q. What benefits are provided by workers' compensation coverage? |
6A. After a claim for a work injury is allowed,
the policy will cover payment of medical bills, compensation for lost
wages, permanent disability and settlements. To learn more about additional
benefits that may be available to injured workers, click below.
Types of Compensation available to Injured
Workers
|
| 7Q. What can I do to have my coverage reinstated if it lapses? |
7A. The employer can either pay the estimated bill
with penalties or submit the payroll report and pay the actual premium
due. When payment is received, coverage will be reinstated. Reinstated
coverage is not retroactive but goes into effective the date payment
is received.
|
| 8Q. If I pay premium for the period of time I first had employees
up to the date I took out coverage, will that make my coverage retroactive
back to that date? |
8A. No. But if an injury occurred prior to an employer
taking out coverage, the employer can request that the premium due for
the prior to coverage period be applied to the costs of the claim.
|
| 9Q. Why do I have to pay premiums for this period if coverage
is not retroactive for this period? |
9A. ORC 4123-01
states that an employer must have workers compensation coverage when
there are employees working for the business. ORC
4123.37 and OAC 4123-14-02
outline the procedures for collecting premiums for coverage when an
employer is non-compliant.
|
| 10Q. Do I have to cover an employee if he only works a short
time? |
10A. Yes. All employees must be covered.
|
| 11Q. Can volunteers be covered? |
11A. Coverage is not available for individuals who
volunteer for private employers including non-profit organizations.
However, public employers such as villages, townships etc., are required
to obtain coverage for volunteers who provide emergency services. Click
below for more information on coverage for volunteers.
Volunteers Performing Emergency
Service Duties
Volunteers Performing Non-Emergency
Duties
|
| 12Q. Why do I keep receiving paperwork when I'm no longer
in business? |
12A. When an employer stops doing business in Ohio,
they must notify BWC in writing to cancel their workers compensation
coverage. If this is not done BWC will continue to estimate premiums,
assess penalties and send invoices.
Click here for additional information on Canceling
Coverage
|
| 13Q. Can I establish coverage online and obtain a certificate
of coverage? |
13A. Yes, you can establish coverage by completing
your application online. You can obtain a certificate of premium payment
and it can be downloaded and printed if the entire premium payment is
made online using Quick Pay.
Click here to access the online U-3
Ohio Workers Compensation Coverage Application
Or you can fax your application if you are paying by credit card and
BWC can establish your coverage the same day your application is received.
Certificates can be faxed upon request. Same day coverage can also be
obtained by personally applying at one of BWC's 21 Customer Service
Offices.
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| 14Q. How can I get the address for my business/company changed?
|
14A. Employers can now update their name and address
online.
Click here to
Update Employer Demographics.
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| 15Q. Can employers cancel coverage online? |
15A. Yes. If an employer wishes to cancel their
entire policy they can do so by accessing their Coverage History through
the Employer Policy menu. Once viewing the coverage history the employer
is given the option to request cancellation of the policy. Elective coverage
can be added or canceled through Elective coverage.
|
| 16Q. I cant find a word for my industry in the keyword
search field; what am I doing wrong? |
16A. The keyword must be in the selected category
(e.g., manufacturing, service, agriculture) Try another category.
|
| 17Q. Why cant I change my manual classification after
I click on submit? |
17A. Once you select a classification and the rates
are displayed, you cannot change or select another classification.
|
| 18Q. What happens when I acquire
or purchase an existing business? |
18A. First, you are responsible for notifying BWC of the
succession by completing and submitting Notification of Acquisition/Merger or
Purchase/Sale (U-118). For successions taking place on or after Sept. 1, 2006,
BWC transfers any and all existing and future liabilities or credits of the former
(predecessor) employer as well as the experience rating when a new employer
(successor) wholly succeeds another employer in the operation of a business.
If the new employer acquires only a portion of the business, BWC only transfers
that portion of the former employer’s experience to the new employer. A BWC auditor
inspects the former employer’s payroll records to allocate payroll to be transferred.
In addition, the auditor verifies the payroll and claims to be transferred to the
successor for rate calculations.
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| Claims |
top |
| 1Q. What happens if one of my employees is injured when I
do not have active coverage? |
1A. BWC will give the same consideration to the
claim as is given to all claims. If the claim is allowed and benefits
are subsequently paid, the employer will be responsible to reimburse
BWC dollar for dollar for the costs of the claim.
|
| 2Q. What is a managed care organization (MCO)? |
2A. A managed care organization (MCO) is a private
company that an employer contracts to medically manage the workers compensation
claims for injured employees. MCOs are an integral part of the Health
Partnership Program.
Click here to learn more about Employers
and the Health Partnership Program (HPP)
|
| 3Q. Do I have to have an MCO? |
3A. Yes. Employers are required to select an MCO.
Employers who do not select may have an MCO randomly assigned to them.
|
| 4Q. What should I do if one of my employees is injured on the
job? |
4A. Advise the employee to seek medical attention.
Contact your MCO to report the injury. If you would like to file your
employee's claim with BWC directly, click File
a Claim online
|
| 5Q. What does benefit type mean? |
5A. Benefit type indicates the type of claim.
Benefit types can be one of the following:
- Medical-Only (MO) - a claim filed when seven or fewer calendar
days are lost from the job due to an industrial injury or occupational
disease;
-
Lost-Time (LT) - a claim filed when eight or more calendar days
are lost from the job due to an industrial injury or occupational
disease; the days need not be consecutive;
- Rehab medical-only (RM) - a claim filed because of an injury while
participating in a BWC approved rehabilitation program when seven
or fewer calendar days are lost from the job due to that rehabilitation
injury;
- Rehab lost-time (RL) - a claim filed because of an injury while
participating in a BWC approved rehabilitation program when eight
or more calendar days are lost from the job due to that rehabiliation
injury;
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| 6Q. Can employers look up claims using a social security
number? |
6A. Employers, their designees, and their representatives
will be able to enter a social security number and view the claims that
are associated with that number. However, they will be limited to viewing
only the claims that are associated with their policy number.
|
| 7Q. What information can be accessed using a social security
number? |
7A. The claim number, injured worker name, claim
status, benefit type, employer policy number, employer name, MCO, and
date of injury are all displayed. A user can link to additional information
specific to a particular claim from the window.
|
| 8Q. Can employers view a list of all their claims? |
8A. Yes, employers can access a list of all of
the claims associated with their policy number. They will be able to
sort the list according to date of injury, claim status, and benefit
type.
|
| 9Q. Can employers certify or reject claims online? |
9A. Yes, employers, their representatives and their
designees can certify or reject claims in a new, pending or allowed
appeal status online.
Click here to link to claim certification
|
| 10Q. What does it mean if an employer certifies a claim? |
10A. By certifying a claim the employer is stating
that they are in agreement that the facts reported are correct and valid
to the best of their knowledge.
|
| 11Q. If an employer certifies a claim, does that mean that
the claim will be allowed? |
11A. Certification does not mean that BWC will grant
the allowance of a claim, just as rejection does not mean that BWC will
deny a claim. BWC will conduct an investigation and determine whether
the claim should be allowed or denied, regardless of the employer certification
|
| 12Q. If BWC makes the claim determination, why do they need
employer certification? |
12A. Certification can expedite the payment of lost
wages for the injured worker off work due to a work related injury or
illness. If the employer certifies the claim, payment of lost wages
may be made immediately upon issuance of the BWC Claim Allowance Order.
Without the employer certification, payment will be held for an appeal
period.
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| 13Q. What if an employer does not want to certify a claim? |
13A. If an employer does not agree with the allowance
of a claim they should check off the box marked "rejection."
They should also include a short explanation as to why they are not
in agreement with the allowance of the claim.
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| 14Q. What does fund type mean? |
14A. The fund type displays where the payments
issued in a claim come from. Fund types are as follows:
- OSIF - State Fund;
- PE - Public Employer;
- SI - Self-Insured;
- BL - Black Lung;
- MF - Marine Fund;
- APP - Apprentice;
- CD - Civil Defense;
- CDF - Contract Coverage;
- ONG - Ohio National Guard;
- PWRE - Public Worker Relief Employee;
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| 15Q. What does coverage type mean? |
15A. Coverage type indicates the status of employer's
policy at the time that the claim was filed. Coverage types are as follows:
- Covered - policy that had coverage at the time of injury as a result
of timely payment of premiums.
- No coverage - Period of no coverage when an employer fails to pay
premiums timely;
- No record - BWC shows there was no record of coverage for this employer;
-
Bankrupt - An account status showing that the employer's business
is bankrupt;
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| 16Q. How do I view the notes, correspondence or exam information
for my claim? |
16A. From the BWC home page, click on Your claim,
View notes, Sign on, Enter claim number, View notes information. Injured
workers, Employers, authorized representatives, online designees and
managed care organizations (MCOs) have to be associated with the claim.
|
| 17Q. What can providers view? |
17A. Providers cannot view correspondence or notes
on any claim, but they can view exam information on any claim.
|
| 18Q. Why didnt I receive a particular piece of correspondence? |
18A. Check to make sure BWC has your correct mailing
address.
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| Financial Information |
top |
| 1Q. What is Quick Pay? |
1A. Quick Pay offers employers the option of paying
their initial security deposit and subsequent premiums online by using
a credit card. BWC accepts VISA, MasterCard, or American Express.
|
| 2Q. Is there a minimum or maximum payment required to use
Quick Pay? |
2A. When using Quick Pay to apply for coverage
online, the minimum payment amount is $50 for state-fund employers and
$100 for public employers. The maximum is $1,000.
For Accounts Receivable Balance History, there is no minimum or maximum
payment amount.
When using Quick Pay for Payroll/Paid compensation, the minimum payment
is $50. There is no maximum.
For the Flexible payment plan, there is no minimum or maximum.
|
| 3Q. Can an employer use more than one credit card to pay
premiums online? |
3A. Multiple cards may be used if there is not
enough available credit to pay the entire premium using one card.
|
| 4Q. What information do I need to have to use Quick Pay? |
4A. Employers using Quick Pay are required to input
their credit card type, number and expiration date. They also must input
the amount to be paid, their name as it appears on the credit card and
the billing address.
|
| 5Q. Is credit card information secure using Quick Pay? |
5A. All of the credit card information that is
entered is encrypted to ensure that financial information remains secure.
|
| 6Q. How long does it take to process a payment using Quick
Pay? |
6A. Credit card payments made online before 11
a.m. will be posted to your account within one business day. Payments
made after 11 a.m. will be posted to your account within two business
days.
|
| 7Q. Does an employer have to pay the entire premium due when
using Quick Pay? |
7A. No, employers do not have to pay the entire
amount if they use Quick Pay. They can pay a portion of the amount due
and send in the remainder of the premium with a check and a copy of
the DP-21 to BWC. Employers must send the remaining balance to BWC by
the established deadlines, Feb. 28 and Aug. 31 to avoid a lapse in coverage
and penalties.
|
| 8Q. Can I report payroll and pay premiums online? |
8A. Private and public state fund employers can
report their payroll online. Once the payroll report is completed, employers
can pay their premium online using Quick Pay.
|
| 9Q. Can employers obtain a breakdown of the costs associated
with each claim? |
9A. Yes, employers can view the costs associated
with individual claims. They are broken down into medical, indemnity,
and reserve costs. Each of these is further broken down into risk and
surplus costs. The subrogation amount and handicapped percentage are
also listed. In addition, the claim present value and total unlimited
charges are also displayed.
|
| 10Q. What do I currently owe BWC? |
10A. Account balances and balance detail is available
through Accounts Receivable Balance Information.
|
| 11Q. What have I paid to BWC? |
11A. Payment transactions can be viewed through
Accounts Receivable Transaction History.
|
| 12Q. Why do I have a credit balance? |
12A. Account balances and balance detail is available
through Accounts Receivable Balance Detail.
|
| 13Q. How can I view past payroll reports? |
13A. Past payroll reports can be viewed in Accounts
Receivable Transaction History then select Payroll or you can view specific
payroll periods in Payroll Period Transaction History.
|
| 14Q. How much is the security deposit on my account? |
14A. View your security deposit paid and billed
through Accounts Receivable Balance Information. Detail of security
deposit can be viewed in Accounts Receivable Transaction History then
select Security Deposit.
|
| 15Q. What is a premium security deposit? |
15A. The initial deposit ranges from $10.00 to $1,000.00,
depending on the estimated payroll entered on the Application For Coverage.
An annual evaluation is conducted based on the prior year's actual payroll.
An adjustment is then completed to reduce or increase the required deposit
(not to exceed the minimum $10.00 or maximum $1,000.00).
|
| 15Q. What refunds have been issued? |
15A. Refund transactions can be viewed through Accounts
Receivable Transaction History
|
| 16Q. Why have I been billed for non-compliance claims? |
16A. An injury occurred during a period when you
did not have active coverage with BWC.
|
| 17Q. What is an Attorney General balance? |
17A. Any unpaid balance older than sixty days that
has been certified to the Ohio Attorney General's office for collection.
|
| 18Q. What have I been billed for VSSR awards? |
18A. Claims transactions can be viewed through Accounts
Receivable Transaction History by transaction type.
|
| 19Q. My credit card was declined. What should I do? |
19A. You should contact your credit card company
for information about why your card was declined. You can mail your
payment to BWC, make the payment at your local customer service office
or try again to pay online.
|
| 20Q. Today is the due date for reporting payroll. If I pay
online today, will it be considered timely? |
20A. Yes.
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| MIRA |
top |
|
| 1Q. What is MIRA? |
1A. MIRA is an individual case reserving system
used for workers' compensation claims. It is currently the primary workers'
compensation reserving system in over 70 companies. It is used by four
of the five largest workers' compensation insurer writers in the United
States.
|
| 2Q. What is a reserve? |
|
2A. A reserve is the estimated future cost of a
claim at a point in time.
|
|
| 3Q. Why is BWC changing its reserves system to MIRA? |
3A. Our current reserving system has been in place
for 20 years and needs to be improved. MIRA is recognized as the most
accurate, fully-developed reserving system available in the U.S. This
change is another step in providing you a better workers' compensation
system.
|
| 4Q. How is MIRA different from BWC's reserving system? |
|
4A. BWC's tabular reserving system uses only 15 claim characteristics
and calculates an average reserve for claims with the same indemnity
type. The MIRA system uses 160 data elements of which 20 are considered cost drivers, which
will provide a more precise estimate of future costs.
|
|
| 5Q. How will the change in reserving systems affect my rates? |
5A. On an aggregate basis, BWC will collect the same
amount of premium. The effects of MIRA on individual employers will
depend on their individual loss histories.
|
| 6Q. When will BWC implement MIRA? |
|
6A. BWC will implement MIRA on July 1, 2002, for
private employers and Jan. 1, 2003, for public employer taxing districts.
Private employers can get a preview of the new MIRA reserves for their
claims in the Claim
Costs service offering. For more information, call BWC's actuarial
department at (614) 752-8318.
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Premiums/Payroll/Continuous Coverage
|
top |
| 1Q. How much does workers' compensation coverage cost? |
1A. Workers' compensation rates are based on the
industrial pursuit of the employer. The gross wages of the employees
being insured are multiplied by the rate to calculate the premium to
be paid.
|
| 2Q. How often are premiums due? |
2A. Premiums are due every six months. The payroll
report for the first 6 months of the year is sent to the employer in
July. The payroll report and premium payment are due August 31.
The payroll report for the second 6 months of the year is sent to the
employer in January of the following year. This payroll report and premium
payment are due February 28 (or 29).
|
| 3Q. What's the difference between the money I sent as a deposit
and the money I send in with my payroll report? |
3A. BWC holds the deposit on account for as long
as the employer has coverage. When the employer notifies BWC to cancel
the policy, the deposit is returned to the employer less any monies
due BWC at the time of cancellation.
The premium payment sent in with the payroll report provides coverage
for the time period specified on the certificate of premium payment
and is used by BWC to pay benefits.
|
| 4Q. Can I apply my deposit to premiums due? |
4A. No. BWC will not apply the employers
deposit to premiums due to keep the employers account active. If an
employer notifies BWC of their desire to cancel coverage, premiums due
at that time will be deducted from the deposit prior to any refund being
made.
|
| 5Q. Is the initial $10.00 all I have to pay for my deposit? |
5A. No. BWC will calculate the balance of the premium
security deposit based on information supplied on the coverage application.
This balance will then be billed.
|
| 6Q. How long after I send in my 6-month payroll report with
premium payment should I receive my certificate? |
6A. The certificate is mailed to the employer approximately
10 days after the premium payment is received. Employers can also access the
Certificate of coverage reprint to see if the most current Certificate of Premium Payment
is available to print online.
|
| 7Q. What period of time does the certificate of premium payment
cover? |
7A. The certificate covers 8 months. This includes
the next 6-month reporting period and a 2-month grace period for filing.
|
| 8Q. What if my premium is late? |
8A. If the premium is not received by the due date,
the policy will automatically lapse. A lapse notice will be sent out.
If the employer does not respond, BWC will estimate the balance due,
assess penalties and bill the employer.
|
| 9Q. Why did I receive a payroll report for a period of time
before I took out coverage? |
9A. If an indication is made on the coverage application
that the employer has hired employees prior to applying for coverage,
a payroll report will be generated. The employer is required to pay
premiums on this period.
|
| 10Q. How do I know what wages to report on my payroll report? |
10A. The payroll report sent to the employer identifies
the to and from dates of the 6 month period to be reported. The payroll
report also advises the employer what is considered reportable payroll.
Click here to view a list of reportable
payroll
|
| 11Q. What if I don't have my new certificate of coverage and
my old one is about to expire? |
11A. Contact BWC. We will verify your premium payment
dates and either mail or fax your certificate to you.
|
| 12Q. Are there payroll limitations for corporate officers? |
12A. Yes. Payroll for corporate officers, except for individuals
incorporated as a corporation or family farm corporate officers, who do not elect
coverage, is to be reported up to the maximum required payroll.
Minimum/Maximum payroll
reporting requirements
|
| 13Q. Can I pay my premiums in installments? |
13A. An employer can apply for a premium payment
plan by submitting the completed payroll report, a money order or cashiers
check for at least 25 percent of the amount due, a recent financial statement
or income tax return, and a letter explaining the need for the plan. Also include
the name and daytime phone number of a contact person.
If BWC approves a premium payment plan, the payment schedule will include
interest. The premium payment plan option requires that a lien be set against
your property to secure an interest in the debt on behalf of BWC. Participation
in a premium payment plan may adversely affect future acceptance into any of BWC's
alternative rating plans. Group rating plans require that all outstanding
balances be paid in full by the group application deadline date.
Mail your request to apply for a premium payment plan to:
Payment Plan Request
P.O. Box 15875
Columbus, Ohio 43215-0875
|
| 14Q. If I have a credit on my account can I get a refund?
|
14A. Yes. If your account is active you may contact
BWC to request a refund of your credit amount.
|
| 15Q. Can I deduct my account credit from the premiums I owe?
|
15A. It is not advisable for an employer to deduct
a credit from the payroll premiums that are due. The employer should
pay the actual premium due and request BWC to refund any credit
|
| 16Q. How can I find out the manual classifications and rates
for my company? |
16A. This information is available through BWC's
automated voice response line. Call 1-800-OHIOBWC, and follow the options. Or, you may contact BWC and speak with an employer services
customer representative.
|
| 17Q. I don't understand the invoice I received. |
17A. Contact BWC for policy/account specific inquiries.
|
| 18Q. Can an employer change or add manual classifications
online when reporting payroll? |
18A. Employers should contact BWC if they need to
add or change a manual number when reporting payroll.
|
| 19Q. Are employers now required to report payroll online? |
19A. No. Employers will still have the ability to
complete the payroll report (DP-21) manually and mail it to BWC along
with a check for the amount that is due.
|
| 20Q. Can I apply a credit balance to my FlexPay plan, and
will I get a discount? |
20A.Yes.
|
| 21Q. Will I still receive a hard-copy payroll report? |
21A. Yes, if you have not finalized/submitted your
FlexPay plan before the end of the first week of June or December. This
is when we gather data for payroll reports. Your hard-copy payroll report
will note that you are in FlexPay.
|
| 22Q. Why did my rates change from the last time I enrolled
in FlexPay? |
22A. This could be due to various reasons. Please
contact BWC to learn more.
|
| 23Q. I just realized I reported the wrong payroll last month.
Can I correct it? |
23A. Yes. If you havent finalized your FlexPay
plan, re-access the service offering, select the month in which you
made the error and enter the correct payroll. If you finalized your
FlexPay plan, you will have to submit the correction manually via mail
or fax
|
| 24Q. Can any employer obtain a certificate of coverage online? |
24A. No, only four types of employers will be able
to obtain a certificate of coverage online. Those employers are those
with active, reinstated, debtor in possession (DIP) or those that are
newly lapsed (less than one payroll period). A certificate can only
be obtained if the entire premium is paid via Quick Pay.
Once a Certificate of Premium Payment has been issued, private employers
can reprint the most current one as long as the policy coverage status is active,
reinstated or DIP.
Certificate of coverage reprint
|
| 25Q. Do employers have to use Quick Pay to pay premiums if
payroll is reported online? |
25A. Employers can report payroll online without
using Quick Pay. However, the employer should make sure to attach a
copy of the payroll report (DP-21 form) with the check when they submit
it to BWC. If an employer mails in a check for payment without the payroll
report attached, the money may be applied toward any outstanding balances
that the employer has with BWC.
|
| 26Q. Can an employer make changes to a payroll report once
it has been submitted to BWC online? |
26A. No, once a payroll report has been submitted
to BWC online, the employer will not be able to make any changes. If
an employer wants to make changes they should contact BWC.
|
| 27Q. When reporting payroll, should the employer use BWC or
NCCI rates? |
27A. When completing the payroll report online the
amount of payroll for each manual classification should be entered.
BWC will automatically calculate the premiums due using both BWC and
NCCI rates (where applicable), select the lower amount as the amount
due, and display the amount that is due to BWC.
|
| 28Q. Why did BWC change from its manual classification system
to the National Council of Compensation Insurance (NCCI) manual classification
system? |
28A. NCCI classifications represent a more equitable
premium rate structure than the BWC system. Also, the NCCI system is
a more accurate and understandable classification system, which will
allow employers to better classify the functions of their businesses.
|
|
Professional employer organizations (PEOs)
|
top |
| 1Q. What is a PEO?
|
1A. Professional employer organization means a sole
proprietor, partnership, association, limited liability company or corporation
that enters into an agreement with one or more client employers for the purpose
of co-employing all or part of the client employer's work force at the client
employer's work site. A PEO usually provides an integrated and cost-effective
approach to the management and administration of the human resources and employer
risk of its clients.
Note:A temporary employment agency is not a PEO.
|
| 2Q. What rule and statute govern the PEO
industry and their obligations to BWC?
|
2A.
Ohio Administrative Code 4123-17-15 is the rule, and Ohio Revised Code 4125 is the statute that governs the PEO industry
in the state of Ohio.
|
| 3Q. Are PEOs required to register with BWC?
|
3A. Yes. A PEO is required to register with us
no later than 30 days after the effective date of the formation of the PEO.
PEOs should use the Professional Employer Organization Registration Application (UA-1)
PEOs also must submit the UA-1 by Dec. 31 annually to renew their PEO certification
status. To request a registration application, UA-1, contact BWC's PEO unit
at (614) 466-6773.
|
| 4Q. Are PEOs required to submit a form of securitization
to cover the workers’ compensation liabilities of the client employer?
|
4A. Yes. PEOs are required to submit securitization and must
identify the type of securitization provided to BWC on their registration form. PEOs
have several forms of securitization to chose from including: a bond or Letter of Credit;
Certification from a BWC-approved institution; or the BWC online monthly payment method.
BWC will calculate the amount of securitization required for each PEO policy per calendar
year based on the most recent two periods of premium paid by the PEO policy.
|
| 5Q. Do self-insuring PEOs provide securitization for PEO clients?
|
5A. PEOs, currently granted the privilege of self-insurance by the BWC
administrator, are not required to provide a form of securitization for the PEO registration
and certification process. The securitization provided to BWC when granted the privilege of
self-insurance will be used to meet the PEO securitization requirement. If the self-insuring
PEO loses that privilege and/or decides to return to the state fund, the PEO must provide
the appropriate form of securitization based on the state-fund policy.
|
| 6Q. Does BWC have the authority to revoke or deny a PEO’s registration?
|
6A. Yes. BWC has the right to deny or revoke the registration of any
PEO who fails to comply with requirements pursuant to Ohio Administrative Code 4125-17-15
and/or Ohio Revised Code 4125. If the BWC administrator revokes PEO status, the PEO is not
permitted to enter into any contracts to co-employ a work force in Ohio.
|
| 7Q. What forms should the PEO use to notify BWC of new and terminated PEO agreements?
|
7A. The PEO uses
Professional Employer Organization Client Relationship Notification (UA-3) to provide BWC
with the PEO and the client, the type of client contract and the effective date of the contract.
BWC sends all PEOs an initial copy of the UA-3 and allows them to make as many copies as they
need. PEOs use the Labor Lease Transaction - Payroll
(AC-18) and Labor Lease Transaction
- Claims (AC-19) to submit documentation to terminate a PEO agreement. These forms reflect the
payroll and claims reported under the PEO policy on behalf of the client employer that will
be transferred back to the client policy.
|
| 8Q. Why does a PEO have to fill out both a Payroll Report (DP-21)
and provide a breakdown of their clients' manual classifications, payrolls and claims on the
electronic payroll report to BWC?
|
8A. The electronic payroll and claim data assist BWC
in processing transfers of experience from PEO accounts to client accounts
and should over time eliminate the need for the PEO AC-18. The electronic payroll
and claim reports also assist BWC in reviewing and verifying the accuracy of the
payroll reported under the PEO on behalf of the client employer.
|
| 9Q. Can a PEO split an NCCI manual with their client?
|
9A. In a part-lease situation, splitting of manual classifications,
departments, divisions or operations between the PEO and the client may not be done in situations,
such as, but not limited to: union vs. non-union employees; hourly vs. salaried employees; or
part-time vs. full-time employees. PEOs should forward such requests to BWC's PEO unit
for approval.
|
| 10Q. Are PEOs obligated to maintain separate records for payrolls
and claims of their clients, and do they have to report them to BWC?
|
10A. Yes. PEOs are required to maintain complete records, separately
listing the payrolls and claims of its client employers for each payroll reporting period.
The payroll should be kept in a manner that clearly identifies the appropriate manual
classifications assigned to each client employer to which the payroll should be reported
and the amount of premiums paid. Claims should be separately identified according to the
client employers. PEOs are obligated to maintain these records and must report them to BWC
on a biannual basis.
|
| 11Q. Can a PEO obtain the claims history of a prospective client?
|
11A. Yes. PEOs may obtain payroll and claims data on a potential client
employer not in a PEO arrangement by submitting a Temporary Authorization to Review Information
(AC-3) for the potential client employer. PEOs may obtain payroll and claims data on a
potential client employer in a PEO arrangement, when the potential client employer’s payroll
and claims are reported to the client policy number, by submitting an AC-3 signed by the
client employer. BWC will not release any claims or payroll information on a client employer
that is in a partial or full PEO arrangement when any payroll and claims are reported to the
PEO’s policy number.
|
| 12Q. Does an out-of-state PEO have to establish coverage in Ohio,
and if so why?
|
12A. Per the Ohio Revised Code workers’ compensation coverage
is required once an employer has an employee within the state of Ohio. When a PEO enters
into an agreement with a client, in which the PEO will report the payroll and claims under
its policy, coverage is required. The contractual liability essentially makes those
individuals the PEO’s employees. This active coverage also allows BWC to move the
client’s payroll/claims history to the PEO’s policy to calculate an accurate rate
for the employees’ exposures. PEOs are required to follow the same guidelines as any employer in the state of Ohio
when they have contracted to take over the employees of their clients.
|
| 13Q. If I want to find out if an employer is a client of PEO, whom do I contact?
|
13A. You should contact BWC's PEO unit at (614) 466-6773.
|
| 14Q. Is there a way I can tell if an employer is a PEO?
If so, where can I find this information?
|
14A. This Web site will provide a list of the PEOs and their
registration and certification status.
|
| 15Q. Are PEOs allowed to participate in alternative rating
programs such as group rating, Premium Discount Program +, Drug-Free Workplace and
retrospective rating?
|
15A. Yes. A PEO can participate in alternative rating programs
however, they are subject to meeting the applicable underwriting criteria for those
particular programs.
|
| 16Q. Once an employer/client contracts with a PEO, does the company
still have to maintain active workers’ compensation coverage?
|
16A. Yes. An employer must maintain an active workers' compensation
policy with BWC to enable BWC to establish a relationship between the PEO and the client
employer. It also is necessary in order for BWC to migrate the appropriate payroll and
claims experience back to the client employer upon termination of the PEO/client
relationship.
|
| 17Q. Can a PEO with Ohio coverage provide coverage for clients
out of state that do not have employees in Ohio?
|
17A. No. BWC will not recognize a PEO agreement between a PEO
and an out-of-state client employer where the employees of the out-of-state client
employer do not meet the jurisdictional requirements to receive Ohio workers’
compensation benefits as provided in Ohio Revised Code section 4123.54.
|
| 18Q. When an employer becomes a client of a PEO
and the employer has a different managed care organization (MCO) than the PEO,
which MCO will medically manage the claims?
|
18A. An employer who becomes a client of a PEO with all
payroll and claims for that client reported under the PEO's policy, the MCO of the
client will be changed to the MCO of the PEO. An employer who becomes a client of a
PEO but continues to report payroll and claims under its own policy will continue to
use the MCO assigned to its policy. In a partial relationship where the PEO only
takes on a portion of the client's employees, the client will continue to use the
MCO assigned to its policy for the employees it retains, and the PEO’s MCO will
manage the claims for the employees reported to the PEO’s policy.
|
| 19Q. How long do PEOs have to notify BWC when they enter
into a PEO agreement with an Ohio employer?
|
19A. PEOs are required to notify BWC in writing within 30 days
of all new PEO agreements or changes in payroll reporting.
|
| 20Q. How long do PEOs have to notify BWC when they terminate
a PEO agreement with an Ohio employer?
|
20A. PEOs are required to notify BWC in writing within 14 days
of all terminated PEO agreements or changes in payroll reporting.
|
| 21Q. If a client employer enters into a PEO agreement
with a PEO in the middle of a payroll period where the PEO will report all payroll
and claims, is the client/employer responsible for any payment of premiums for that
payroll period?
|
21A. The client is responsible for reporting any payroll or claims
under its own policy number up until the effective date of the PEO agreement. If an agreement
is terminated in the middle of a payroll reporting period, the client is responsible for
reporting payroll and claims under its own policy number from the effective date of the
agreement termination forward.
|
| 22Q. Can a PEO provide coverage to Ohio employees using a private
carrier outside of Ohio?
|
22A. No. Ohio is a monopolistic state concerning workers’ compensation
coverage. PEOs are required to follow the same guidelines as any employer in the state of Ohio
when they have contracted to take over the employees of their clients. Per the Ohio Revised Code
any employer that has one or more employees in the state of Ohio must cover them with the
BWC.
|
| 23Q. Does the PEO have the right to approve (sign off) on the settlement
of a claim that is associated with a client employer?
|
23A. The employer (PEO or client) listed as the employer of record for the
claim will have authorization to approve the claim settlement.
|
| 24Q. If an employer assumes the responsibility of managing the human resource
functions, including workers’ compensation, for client employers' work force and/or the client employers'
work force is hired by another employer, will BWC consider this a PEO agreement?
|
24A. Yes. BWC will treat the employer assuming the human resource functions
and/or work force (operations) from another entity as a PEO and will follow the successorship
rules pursuant to Ohio Revised Code section 4123-17-02 to transfer the appropriate experience
to the PEO policy.
|
| 25Q. How does the PEO process impact workers’ compensation?
|
25A. Depending on the type of PEO agreement, the client employer
is transferring (or outsourcing) all or part of its workers’ compensation liability and
experience, not to mention the function of managing the workers’ compensation
responsibilities, to the PEO. The PEO ensures that all aspects of the client employer's
workers’ compensation policy is maintained. The PEO assumes the responsibility of
reporting payroll and premium for the shared employees in addition to handling claim
management responsibilities.
|
| 26Q. How does BWC calculate the premium rate for the PEO?
|
26A. BWC follows Ohio Administrative Code 4123-17-02 when calculating
the premium rate for the PEO. The process involves transferring the experience of each
client employer of the PEO to the PEO policy to create a combined experience modifier.
The PEO will use this rate to pay premiums for shared employees, in addition to the PEOs
administrative staff. Any PEO agreement where the PEO elects to report premium under the
client policy will not have any experience transferred to the PEO policy. The PEO will
report this premium using the individual client employer's calculated experience modifier.
Note: The PEO must report shared employees payroll and pay premiums using the manual
classifications assigned by BWC to the client employer's policy.
|
| Rating programs |
top |
| 1Q. How can I tell if the Retrospective Rating plan would
benefit my company? |
1A. To see if Retrospective Rating could lower
your rates, you can use
Personalized Policy Scenarios to view possible savings.
|
| 2Q. What is Retrospecive Rating? |
2A. Retrospective Rating is a plan that allows
you to pay down premiums in return for assuming more risk. Click here
to learn about
Retrospective Rates.
|
| 3Q. What is group rating? |
3A. Group rating is a discount rating program that
allows industry similar employers to group together and pay their workers
compensation premiums as though they were one big company. For more
information on group rating, click below.
Group
Rating Program Description
|
| 4Q. Why did my rates go up if I'm in a group rating? |
4A. Group rates may go up or down based upon the
combined total experience of the employers in your particular group.
|
| 5Q. Which group will save me the most money? |
5A. BWC employees cannot recommend one group over
another to employers. Please contact the third-party administrator (TPA)
associated with the group.
|
| 6Q. What does GCCC SERVICE GR 3 mean? How can I tell who
this is? |
6A. The TPAs determine the group descriptions,
and BWC displays them exactly as they are entered into our computer
systems. If you need more explanation of a particular group description,
call 1-800-OHIOBWC.
|
| 7Q. How does BWC determine what groups are compatible with
my industry that I may want to consider joining? |
7A. We make our decision based on the highest premium
assessed per manual classification. You'll see all groups in that industry.
|
| Self-Insured |
top |
| 1Q. Can self-insuring employers report paid compensation
online? |
1A. Self-insured employers can report their paid
compensation online. The SI-40 form is now available for online completion.
|
| 2Q. Are self-insuring employers now required to report paid
compensation online? |
2A. Self-insured employers can still complete the
SI-40 form manually and mail it to BWC if they choose not to report
paid compensation online.
|
| 3Q. Can I view Paid Compensation reports? |
3A. Paid compensation can be viewed in Paid Compensation
History.
|
| 4Q. How can I view my financial transactions? |
4A. Financial transactions with BWC can be viewed
through Accounts Receivable Transaction History.
|
| 5Q. Is my company eligible to become self-insured? |
5A. To qualify for self-insured status, an employer
must meet several requirements. These include:
- A minimum of 500 employees with the state of Ohio
- Two years experience with the state insurance fund
- The ability to demonstrate strong financial stability
- An account with a financial institution in Ohio
- OR draw compensation checks from the same account as the payroll
checks
- A BWC certified Qualified Health Plan (QHP)
For more information regarding self-insurance, click
here.
|
| Personalized Policy Scenarios
(PPS) - Premium Discount Program Plus |
top |
| Q. Why are the scenario calculations based on the most currently
completed policy year instead of current rates? |
A. BWC uses past information since it is exact.
Estimated information may change and not give accurate results.
|
| Personalized Policy Scenarios
(PPS) - Drug-Free Workplace Program (DFWP) |
top |
| 1Q. Why dont I see a difference in my premium when
I run this scenario? |
1A. The discount may exceed the maximum allowed. If you
are in a group, you can earn premium discounts for participating in group rating
and the Drug-Free Workplace Program. However, the combined discount amount
cannot exceed the maximum allowed under the group rating plan.
|
| 2Q. How can I get more information on the DFWP program and
how do I enroll? |
2A. You can learn more about the DFWP and enroll
in the program online. You can link to DFWP information directly from
this PPS scenario.
|
| Personalized Policy Scenarios
(PPS) - Retrospective Rating |
top |
| 1Q. Can a representative for BWC come to my place of business
to explain the Retrospective Rating Program in more detail? |
1A. Yes. Please call 1-800-OHIOBWC, and follow the options for
the business consultant in your area.
|
| 2Q. How can I determine if I am a good candidate for retrospective
rating? |
2A. If you have had high claims costs for a few
years but have implemented changes that will result in fewer claims
and lower claims costs in future years, you may be a good candidate.
Also, larger companies that have few claims and high individual credibility
but are unable to participate in group rating may participate to realize
lower rates. Although the requirement for retrospective rating is $25,000
in experience premium, you can realize even greater benefits if your
premium is more than that.
|
| 3Q. Do I have to participate in retrospective rating for
10 years? |
3A. No. You must re-enroll each year, and BWC will
base your participation on an annual evaluation of your account. However,
you are responsible for the claims costs for the year of participation
for a 10-year period.
|
| Personalized Policy Scenarios
(PPS) - Elective coverage |
top |
| 1Q. What is the difference between cancellation of elective
coverage versus cancellation of the entire policy? |
1A. Elective coverage is for the owner,
partner, etc. of a company. This type of coverage is a voluntary additional
coverage, but your policy is required to cover your employees.
|
| 2Q. What are my payroll limitations, and what does BWC consider
reportable for elective coverage? |
2A.
Click here to view the minimum and maximum payroll reporting requirements.
|
| Personalized Policy Scenarios
(PPS) - Experience modifier calculations |
top |
| 1Q. How do claims settlements, handicap reimbursements or claims
management affect my rates? Can I get assistance in running the experience modifier
scenarios? |
1A. You can call 1-800-OHIOBWC, and follow the options or your local BWC customer
service office and ask to speak to your employer services specialist. He or she can
assist you in running the scenarios, understanding how your rates are derived and
the basics of claims costs management.
|
| 2Q. Which claims should I settle, and what is the effect
on my upcoming rates? |
2A. Call 1-800-OHIOBWC, and follow the options to speak with your employer
services specialist.
|
| 3Q. I am trying to apply a settlement to a specific claim
on my experience, but after applying the settlement, I am not seeing a
change to the experience modifier. Why? |
3A. This could be due to many reasons. For example,
there may still be a maximum value for the claim, and a settlement above
that amount will not have an effect.
|
| 4Q. How much of a handicap reimbursement should I apply to
a claim? |
4A. The handicap reimbursements vary by the claim.
BWC determines the actual amount of the reimbursement after we receive
your request and review the claim.
|
| Safety & Hygiene |
top |
| 1Q. Why doesn't the policy number I am using allow me access
to this service offering? |
1A. Double check your policy number. You must be
in an active, reinstated, or debtor in possession (DIP) status to view
this screen.
|
| 2Q. I submitted my request online and havent gotten
a response in two business days. What do I do now? |
2A. Call 1-800-OHIOBWC and follow the options to speak with
someone from the Division of Safety & Hygiene.
|
| 3Q. Where do I find the section of the Web site to request
safety consulting services? |
3A. Please call 1-800-OHIOBWC, and follow the options and someone will
walk you through it.
|
| Discount Programs |
top |
| 1Q. What is the Premium Discount Program Plus (PDP Plus)? |
1A. This is a program that was developed to assist
experience-rated employers establish a safer, more cost-effective workplace.
By implementing a workplace safety program and meeting certain performance
criteria, experience-rated employers can receive a discount on the premiums
paid for their workers compensation coverage.
Click here to learn more about the Premium
Discount Program Plus
|
| 2Q. How much is the Premium Discount? |
2A. Participants can receive up to 10% off their
premium during their first two years in PDP Plus and up to 5% off their third.
|
| 3Q. What do I have to do to earn the premium discount? |
3A. PDP Plus participants must implement BWC's 10-step
Business Plan and have reductions in claims frequency (lost time or medical
Only), claims severity or claims cost.
|
| 4Q. What is the 10-Step Business Plan? |
4A. The 10 steps are 10 management areas identified
to control costs of existing claims or prevent claims from occurring.
|
| 5Q. What BWC resources are available to assist me with 10-Step
implementation? |
5A. BWC Employer Services Specialists provide
guidance on the specifics of 10-step implementation. Safety consultants
are available from BWC's Division of Safety & Hygiene for technical
questions.
|
| 6Q. What must I/we do to demonstrate 10-Step Implementation? |
6A. BWC provides an introductory seminar, Controlling
Workers' Compensation costs, to help you get started. Employers must
complete a Plan of Action detailing how the 10-Steps will be implemented
and provide supporting documentation no later than nine months after
starting the program.
|
| 7Q. When do I receive the discount? |
7A. Since premium is paid in arrears in Ohio, employers
starting effective January 1 receive their first discount on their summer
premium payment. Employers beginning effective July 1 receive their
first discount on their winter premium payment.
|
| 8Q. What employee resources must I commit? |
8A. Senior Management must communicate and demonstrate
a commitment to safety by providing employee support for safety training,
safety committees, safety audits, etc.
|
| 9Q. How long can I participate? |
9A. Participation is limited to three years from
inception date into the program.
|
| 10Q. When can I start? |
10A. Employers may apply anytime. Official starting
dates are based on when the application is received by BWC, where participation
begins on the first day of the next six month bi-annual period, i.e.
January 1 or
July 1.
|
| 11Q. How can I apply? |
11A. Click here to go to the
PDP Plus application.
|
| 12Q. What is the Drug-Free Workplace Program (DFWP)? |
12A. The Drug-Free Workplace Program (DFWP) is an
incentive program designed to help employers establish a safer and more
cost-effective workplace. The program allows for discounts in the premium
for implementation of the plan. Click here to learn more about the Drug-Free
Workplace Program.
|
| 13Q. How much is the Drug-Free Workplace Discount? |
13A. Participants can receive up to 10% of their
premium at Level 1, 15% at Level 2, or 20% at Level 3 participation.
|
| 14Q. May I participate in more than one discount program
and earn the benefits for both programs?
|
14A. Yes and no. This depends on the programs.
Eligible employers may participate in group rating and the
Drug-Free Workplace Program (DFWP),
and receive both benefits UNLESS their group is already receiving a 93-percent
credit (through June 30, 2007) or a 90-percent credit for the July 1, 2007, rating year.
In this case, the employer will not receive an additional DFWP discount but may be eligible
for DFWP-related safety grant funds.
Employers who are eligible for Premium Discount Program
(PDP Plus) may also participate in DFWP and receive both benefits. Participating employers
who meet specified claims frequency and/or claims severity improvement objectives may receive a bonus
of up to 20 percent.
Employers may NOT participate in both group rating
and PDP Plus, or in retrospective rating
and PDP Plus.
Employers may participate in both DFWP and retrospective rating but may receive only the greater
of the two benefits. This would typically be the retrospective rating benefit. However,
employers who also implement a DFWP may apply for safety grant funds.
|
 
|