OhioBWC - Employer: (One Claim Program)

OhioBWC - Employer: (One Claim Program)

One Claim Program

Introduction
BWC’s One Claim Program (OCP) is open to private, state-fund employers currently enrolled in a group-experience-rating program.

To participate in the OCP, you must have a single significant claim entering your experience for the first time from the green year. A significant claim is one whose total cost exceeds the expected losses for an employer based on size and industry — also known as total limited losses (TLL) — calculated for that policy year. You may only designate one significant, lost-time claim every four years.

In addition to the one significant claim, you may carry up to three medical-only claims in your experience. The sum total of these medical-only claims must not exceed your TLL. As the medical-only claims move out of your experience another may enter, so long as you never have more than four total claims in your experience.

Program benefits
If you qualify and participate in the program, you will receive a 40-percent discount off of your base rate. The program also provides an opportunity for you to work closer with your managed care organization, third-party administrator and BWC representatives to better manage claims and work to prevent future claims. A strong relationship with workers’ compensation partners and effective claims management can help you get back into a group-experience-rating program faster.

Participation requirements
Each year you are in the program, you must attend BWC-approved training sessions. Also, you may not have any outstanding balances, and you must be in compliance with BWC rules and law. Additional eligibility requirements may also apply.

If you continue to meet eligibility requirements, you can remain in the OCP up to four years. If you fail to continually meet the eligibility requirements, BWC will remove you from the program. Should this occur, then we will give you your individual experience modifier (EM).

You may choose to opt out at the beginning of each policy year. If you choose to opt out, you must notify BWC by the preceding March 31. Then, your EM will be based on your individual experience. If the one significant, lost-time claim remains in your experience and you continue to meet the OCP requirements, you may re-enter the program.

Enrolling in the program
If you meet the OCP’s eligibility criteria, complete the application form (see Related links). Applications are due to BWC’s employer programs unit by April 30. Fax applications to (614) 728-3205.

For more information
You may contact John Lykins, BWC underwriting consultant, for additional information regarding the OCP. Call him at (614) 466-6773, or send an e-mail.