Workplace Wellness Grant Program

Employers wanting to improve the health and wellness of their workers can benefit from our newest program, the Workplace Wellness Grant Program (WWGP). It provides funding to assist employers in establishing training and programs to reduce health risk factors specific to their employees.

BWC established WWGP to study the effect of a wellness program in the workplace on bringing down incidence and cost of accidents and illnesses. The goal is to control the escalating cost of workers' compensation claims through addressing health risk factors. The WWGP's collateral goals are also to reduce health-care costs for employers, as well as improve the health of the workforce.

For additional information about a specific component of the program, click on the appropriate link below. Purpose
Who's eligible
Fund details
Participation requirements
How to apply
Application checklist
Next steps after approval
Next steps after first year
Required program data
Required annual case study

Purpose
We've established this program to meet the challenges of obesity, rising incidence of chronic diseases and the aging workforce. This program will assist employers with the creation and implementation of a workplace wellness program. The goal is to limit and control the escalating cost of workers' compensation claims by helping employers develop health promotion programs for their employees. The secondary goals are to reduce health-care costs for employers, and improve the health and well-being of the workforce.

Who's eligible
Below is a list of eligibility requirements to receive a workplace wellness grant.

• Be a state-fund employer
• Be current on monies owed to BWC – not more than 45 days past due
• Maintain active coverage – not more than 40 days lapsed in the prior 12 months
• Do not have a wellness program

A workplace wellness program consists of the following tools:

• A health-risk appraisal (HRA) and a biometric assessment – both of which measure health-risk factors;
• Programs designed to address those health-risk factors.

Participation requirements
Once approved for a grant, you must contract with a third-party wellness program vendor. You also must share aggregated data related to your employees' health-risk factors and costs with us, and demonstrate proper use of grant awards and effective implementation of your wellness program. We will subsequently use the data to determine the effectiveness of the wellness program on workers' compensation claims frequency, claims costs and the timeliness of post-injury return to work.

You also agree to allow us to inspect original program records of wellness program participants upon demand and on-site in the event that questions arise regarding participation. You agree to provide us access to information to help us measure the effectiveness of the wellness program. You will allow us to use grant program results in the following ways, but not limited to, literature, data, videos, specifications and/or photos for the purposes of illustrating, educating, and training employers and employees.

Fund details
Participating employers may receive $300 per participating employee over a four-year period, up to a maximum amount of $15,000 per policy. We define participating employee as someone who completes an HRA and biometric screening in the first three months of the first year and each of the subsequent years of the grant program. In addition, employees must participate in at least one activity to improve or maintain their health in each program year. We divide the $300 over the four years per employee as follows.

Grant-fund use
Employers must use wellness grant funds to compensate the external wellness program vendor for providing HRA biometric screenings and subsequent activities designed to address the results of the screening and assessment. These activities include, but are not limited to, weight-loss management programs, educational seminars on improving health, physical fitness activities and nutritional counseling to benefit the participating employees. Employers must provide us with documentation showing the use of the awarded funds. The documentation is due to us within three months reporting the aggregate HRA/biometric data elements and the employee data. It may include, but is not limited to, original invoices and canceled checks.

Employers must provide us with receipt documentation showing the use of the awarded funds. The HRA and biometric screening receipt documentation is due to us within three months after reporting the aggregate HRA/biometric data elements and the employee data. The receipt documentation for the health promotion programs/activities is due with OR prior to submission of the annual case study report. Both may include, but are not limited to, original invoices and canceled checks.

Below are examples of health promotion programs/activities developed and implemented by your external wellness vendor which are covered by the grant funds.

• Health risk appraisals
• Biometric screenings
• Smoking cessation classes which may include smoking patches
• Weight management classes
• Weight loss challenges
• Exercise classes
• Nutrition classes
• Walking programs
• Educational materials for the classes (booklets, videos)
• Lunch and learns
• Disease prevention training

• Flu shots
• Medicine
• T-shirts
• Incentive items
• Pedometers
• Yoga mats
• Water bottles
• Baseball caps
• Food
• Exercise equipment

Employers may not use funds to cover salaries, wages, internal labor or any costs associated with preparing the application. We will hold a company responsible for using the grant in the intended manner. An employer may face civil and/or criminal sanctions if he or she misappropriates and/or misuses grant funds or misrepresents information when submitting a request for grant funds or any documents submitted for securing grant funds.

BWC and IRS requirements
We must issue an IRS 1099 form to you for all unused and/or unverified funds. Acceptable verification is your paid invoice and copies of canceled check(s) to verify payment. If you fail to submit all documentation in accordance with the terms of the program and/or do not verify that by Dec. 31 of a given year you spent the funds, the IRS could consider the award income, which may be taxable.
Note: The issuance of a 1099 form does not preclude BWC from seeking administrative, civil and/or criminal sanctions, if you do not reimburse BWC all unused grant money and/or funds deemed misappropriated.

Obligation during change of ownership
If the employer sells, merges or combines its business after receiving a grant but before completing the annual case study, our Successorship Liability Policy will go into effect.

• The grant/predecessor employer is responsible for notifying the successor employer of the obligations under the WWGP.
• The successor employer may be liable to repay any and all previously paid grant monies if these obligations are not met.

Disqualification
If for any reason the employer participating in the program fails to satisfy one or more of the criteria established in the application and instructions, legal agreement and the Ohio Administrative Code (OAC) 4123-17-56.1, including but not limited to; the requirement of maintaining active coverage, timely payments therefore, and the obligations described in the employer responsibilities and requirements for each year of participation, we may disqualify the employer from the program. Disqualification means the termination of our obligations under this agreement, and we reserve the right to recover grant monies by one or more of the following methods: billing the employer for the grant money received; forwarding to the Office of the Attorney General of Ohio for collection; set-off; recoupment, or other civil and/or legal remedy.

How to apply
The employer must complete the online grant application, so we can understand your workplace wellness goals, the steps you've taken in the past, and the methods you'll use to measure program effectiveness. We'd like to learn of any wellness efforts undertaken at your workplace and any efforts you'd like to undertake. We also want to know about any challenges and pushback encountered by past wellness efforts. The more we learn, the better we can measure the outcome and successes of your program at the end of the four years.

Note: Each eligible applicant must complete the Safety Management Self-Assessment (SH-26) online when applying. We'll use the information to identify opportunities to improve your safety and claims-management processes. We require this assessment for many of our programs, so if you have filled this out in the last year for another program we won't require you to complete one for another year.

Program document requirements

• Agreement between BWC/employer
• Vendor information form, direct deposit form and a W-9 tax form to Ohio Shared Services

The agreement
Employers must sign a legal contract agreement with BWC to participate. The agreement is a four-year contract between BWC and the employer. It outlines the employer's obligations to receive grant funds. The agreement is located under Resources on this page. Employers applying for this grant program must download the agreement, sign and mail the agreement with original signatures to Workplace Wellness Grant Program, Division of Safety & Hygiene, 13430 Yarmouth Drive, Pickerington, OH 43147-8310. BWC must receive this contract agreement prior to processing your online grant application.

Signature on application and agreement
Private employers must sign the application and agreement, signifying they are either the owner, chief executive officer, chief financial officer, plant manager or other person having fiduciary responsibilities with the employer. In addition, the employer agrees the signer or his or her successor will have the authority to oversee the employer's responsibilities for the duration of the grant program. The signer's authority will continue until the employer notifies us of the name of the successor.
Public employers must sign the application and agreement, signifying they have primary fiduciary responsibilities under their BWC policy number. In addition, the employer agrees the signer or his or her successor will have the authority to oversee the carrying out of the employer's responsibilities for the duration of the grant program.

The online application requires an e-signature from the responsible party mentioned above.

State required vendor forms
As a grant recipient the state considers you a vendor of the state. This means you must complete the following three forms and send them to Ohio Shared Services. You'll find links to all three forms within the Application for Workplace Wellness Grant Program (SH-27) available under Resources.

• Vendor Information Form (OBM-5657-Rev.11/1/2011)
  Verify all fields are complete and the form is signed. We do not accept electronic signatures. Also, verify information contained on the W-9 matches that provided on the Vendor Information Form - specifically, legal business name, taxpayer ID # (TIN), and business type/business entity.
• IRS Form W-9 Request for Taxpayer Identification Number & Certification
  Complete all applicable sections of the document, including taxpayer type, a valid tax identification number and responsible party's signature. We do not accept electronic signatures. The information you provide must match how you're registered with the IRS. You can find instructions for completing the form on the IRS website. Should you require additional assistance, contact the IRS at 1-800-829-1040.
• Authorization Agreement for Direct Deposit of EFT Payments (OBM-4310-Rev.11/1/2011)
  The preferred method of payment for the State of Ohio is electronic funds transfer (EFT); complete this form and include a current voided check or bank letter. The agreement contains instructions.

If you have questions, contact Ohio Shared Services at 1-877-OHIOSS1 (1-877-644-6771) or 614-338-4781.

Once you submit your application, we'll review, and then approve or deny it based on its merit. If approved, you'll receive a letter explaining the next steps in the grant award process. If denied, we'll send you a letter explaining the reason for the denial.

Next steps after approval
Once we approve your application, you must complete the following steps within three months from the date on the approval letter to receive grant funds:

• Contract with a vendor;
• Submit a copy of the vendor contract to BWC;
• Complete health risk appraisals and biometric screenings;
• Submit aggregate health risk appraisal and biometric data to BWC using Progress look-up;
• Submit required employee data using Progress look-up;
• Notify the third-party vendor to provide a copy of the aggregate data report directly to BWC (same address as grant submission).

Select a third-party wellness program vendor
Employers approved to receive workplace wellness grant funds must select and contract with a third-party wellness program vendor. Employers may not self-administer any portions of the wellness program, including HRAs, biometric screenings and guidance on health promotion programs. Employers may contract with multiple vendors to establish their wellness programs, i.e. vendor to administer the HRAs and biometric screenings and a vendor to implement health promotion programs.

Vendor selection guidelines
We're providing the following wellness program vendor guidelines to assist you in the selection of a vendor. We do not endorse the use of any particular vendor.

1. Experience in developing wellness programs for companies in your industry
2. Secured data systems
3. Online portal and other means of collecting protected health data and providing guidance
4. HRA and biometric analysis software
5. Knowledge of legal and regulatory compliance
6. Access to licensed health professionals, health coaches and counselors
7. Personnel with strong business backgrounds and analytical skills
8. Wellness vendors could possess the following certifications:
• NCQA = National Committee Quality Assurance;
• URAQ = Utilization Review Accreditation Commission.
9. References

We require a vendor to provide services for all elements of the wellness program: the biometric screenings, health-risk appraisals and health promotion programs. You're allowed to use more than one vendor. We suggest you review the required data elements with potential vendors. This way, the vendor will know upfront whether it will be able to assist you in meeting the program requirements. Make sure the vendor knows we award the grant AFTER we receive the HRA and biometric data elements. This may assist you in setting up a payment system between yourself and the vendor.
NOTE: Change of vendor
If for any reason you need to change your wellness program vendor, notify us immediately. After securing a new vendor, provide us with a copy of the contract between you and the new vendor.

Data required from employer and wellness vendor
Participating employers must enter total health-care utilization costs, aggregated biometric data, aggregated HRA data and employee information, including participating employee names and claims for each year of program participation into Progress look-up. The data are due within three months of the grant application approval and, in subsequent years, within three months after the year-end case study. You'll receive instructions for what information is required for the employee participation data with the employer grant approval letter from us.

Employers also must have their third-party vendor provide a copy of the aggregate data report directly to us within three months from the date of approval. This report must include the aggregate data listed under biometric data and health risk appraisal data.
Mail the report to:
Ohio Bureau of Workers' Compensation
Workplace Wellness Grant Program
13430 Yarmouth Drive
Pickerington, OH 43147-8310.

Grant recipient names
Pursuant to Ohio Revised Code 125.112 (F), we must post the names of grant recipients and dollar amounts awarded on this website.

Limitations
We will remove an employer from the grant program, and he or she may face civil and criminal sanctions accordingly, if we find any of these to be true.

• Employers are strictly prohibited from improperly obtaining access to or disclosing personal health information.
• Employers are prohibited from coercing employees into participating in wellness programs.

Next steps after first year

1. Submit a year-end case study
   Employers who receive grant funds must submit a case study to us at the end of each year of participation. The purpose of the case study is to:
   • Assess the impact of wellness on workplace safety;
   • Assess the frequency and severity of workers' compensation claims;
   • Establish best practices for the implementation of workplace wellness programs.
   Additional information on the annual case study is found at the bottom of the web page.
2. Submit paid, itemized invoices and copies of all canceled checks to support all invoices associated with the workplace wellness grant program biometric screening and HRAs within three months of reporting this data each year. All invoices and copies of canceled checks for the health promotion programs and activities must be submitted by the case study date.
3. Employer requirements for years two through four
Employers must meet the following requirements to receive funding in years two through four.
• Complete the safety management self-assessment;
• Obtain approval for the grant funds;
• Complete and timely submit the case study to receive funding for the next year;
• Complete the following steps within three months of receiving application approval:
• Execute a contract with a wellness program vendor and submit a copy to BWC if the prior year contract changed or you chose a new vendor ;
• Complete HRAs and biometric screenings for all your employees through your wellness program vendor;
• Submit aggregate baseline data to BWC (HRAs, biometrics, employee data).
• Notify the third-party vendor to provide a copy of the aggregate data report directly to BWC (same address as grant submission). This report must include the aggregate data listed under biometric data and health risk appraisal data on this Web page. Employers are to include their policy number on all employer submitted documents, correspondence, and emails.

Application checklist

1. Review program requirements.
2. Have the following information available prior to applying:
   • Policy number, federal tax ID or Social Security number;
   • Whether you currently have a wellness program with a health-risk appraisal and biometric assessment;
   • Whether you have a wellness program with healthy promotion and activities designed to address health risk factors;
   • Wellness program contact name, phone number, email address, and title;
   • Potential budget items including type of service(s) and estimated cost(s);
   • Whether your current business culture supports workplace wellness;
   • Number of employees interested in participating and timeline for implementation.
3. Complete and submit online application.
4. Complete the online Safety Management Self-Assessment (SH-26).
5. Download, sign, and mail the BWC/employer contract agreement.
6. Submit the three State of Ohio required forms below to receive grant funds from the state. All signatures must be original. (As a grant recipient the state considers you a vendor.)
   
   Vendor information form
   Direct deposit form
   W-9 tax form
   
   Mail all three completed forms to:
   Ohio Shared Services
   Attn: Vendor Maintenance
   P.O. Box 182880
   Columbus, OH 43218-2880
   Phone: 1-877-644-6771
   Fax: 614-485-1039
   Email: vendor@ohio.gov
7. BWC will evaluate the application and notify you via email, whether we approved or denied your participation in the grant program.

Required program data
You and your vendor must report this information to BWC within three months of receiving approval to participate in the program. We intend to use this data to determine the effectiveness of participation in a wellness program.

Employee data

• Total number of employees in the company
• Participating employee names
  We're collecting names for research purposes and tracking workers' compensation claims. The list of names will also assist us in knowing how many participating employees there are.
• Total health care utilization costs (non-workers' comp) if available for each of the past two years.
  Health-care utilization costs are the total monies paid by the health-insurance company for the employees' health-related products and services. We understand that employers may not have this data readily available at the time of applying for the grant. However, BWC expects the employer to start keeping track of this data as participation continues.
• Total number of hours worked by each participating employee in each of the previous two years prior to participation. This is required for Year 1 participation. In each of years two through four the employer will only report the prior one year.
• Total number of sick days for each participating employee in each of the previous two years prior to participation. This is required for Year 1 participation. In each of years two through four the employer will only report the prior one year.

Biometric data
As an employer you're required to have your third-party vendor provide a copy of the aggregate data report directly to us within three months from the date of approval. Mail the report to:
Ohio Bureau of Workers' Compensation
Workplace Wellness Grant Program
13430 Yarmouth Drive
Pickerington, OH 43147-8310

Below is the specific aggregate data we require from the biometric screenings, which are services provided by a wellness program vendor. You must submit this data each year of participation.

• Body mass index (BMI) - Percentage of participating employees who are underweight, normal, overweight or obese
• Blood pressure - Percentage of participating employees with low, normal, elevated or high blood pressure
• Blood glucose - Percentage of participating employees with normal, elevated or high blood glucose levels (fasting)
• Total cholesterol - Percentage of participating employees with desirable, elevated or high total cholesterol
• LDL cholesterol - Percentage of participating employees with optimal, good, elevated or high LDL cholesterol
• HDL cholesterol - Percentage of participating employees with optimal, good or low HDL cholesterol
• Triglycerides - Percentage of participating employees with normal, elevated and high triglycerides

Health risk appraisal data
Below is the specific aggregate data we require from the HRAs, which are services provided by a wellness program vendor. You must submit this data each year of participation.

• Percentage of participating employees that have a specific number of health risk factors
• Percentage of participating employees engaged in the following categories of physical activity. More information about physical activity can be found on the Centers for Disease Control's website.
• Percentage of smokers among participating employees
• Percentage of participating employees with the following nutritional habits. More information about nutrition is provided here.
• Percentage of participating employees who can be categorized into stress levels

Required annual case study
The case study is due one year from the date we warrant the grant check in each year of the grant program. The purpose of this case study is to assess the impact of wellness on workplace safety, the frequency and severity of workers' compensation claims, and to establish best practices for the implementation of workplace wellness programs.

The annual case study is available as a PDF under Resources on the right side of this page. Answer all questions and email or mail it to Workplace Wellness Grant Program, Division of Safety & Hygiene, 13430 Yarmouth Drive, Pickerington, OH, 43147-8310.

Resources

Application for Workplace Wellness Grant Program (SH-27)

Program contract (PDF)

Vendors list (Excel)

Glossary of terms (PDF)

Frequently asked questions

Safety Management Self-Assessment

• Safety resources guide - provides recommendations, links to safety management tools, lists of training classes and video resources. It's intended to assist you with making safety and claims management improvements identified in the SH-26. So, it's organized using the same 10 categories.

Annual case study

Progress look-up

Grant recipients