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OhioBWC - Employer - Form: (U-20; U-21) - Introduction
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Application for Individual-Retrospective Rating Plan
Private Employers (U-20); Public Employers (U-21)
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Introduction to individual-retrospective rating |
Individual-retrospective rating is an alternative rating plan that allows the employer
to initially pay BWC less premium than it would without the plan.
An employer participating in the individual-retrospective rating plan may earn a possible premium
reduction by assuming a portion of the risk. The greater the portion of the risk
assumed, the greater potential reduction in premiums.
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| Additional information |
Program info
Eligibility requirements
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| Required information |
- Policy number
- Tier type consideration
- Claim limit
- Maximum premium
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- Owner/Party/Officer name
- Owner/Party/Officer title
- Owner/Party/Officer signature
- Payroll amount
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| Complete the forms |
The free Adobe Reader
software is required to display and print the application.
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Do you have all the required information at hand? If so, you are ready to begin
completing the form.
Begin online form now.
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Are you missing some of the required information? If so, you may return here at a later time when you have all the information you need, and complete this online form.
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If you need additional assistance, please contact BWC's retrospective rating unit at 614-466-6773.
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