OhioBWC - Basics: (Policy library) - File


Policy Name:

Grow Ohio Incentive Program

Policy #:

EP-07-03

Code/Rule Reference:

Ohio Revised Code (ORC) 4123.29,  4123.34; Ohio Administrative Code (OAC) 4123-17-14, 4123-17-61.1, 4123-17-69, and 4123-17-74, (including Appendices A, B, and C).

Effective Date:

July 1, 2016

Origin:

Employer Policy

Supersedes:

All policies and procedures regarding Grow Ohio that predate the effective date of this policy.

History:

September 12, 2018; July 1, 2015; May 2, 2014; January 1, 2013. New policy issued July 1, 2011.

Review Date:

July 1, 2020

 

 

I.          Policy Purpose

The Ohio Bureau of Workers’ Compensation (BWC) will permit new employers to participate in the Grow Ohio Incentive Program (Grow Ohio) in accordance with the applicable laws and rules.

II.          Applicability

This policy applies to employers, employer authorized representatives, BWC Employer Programs, Division of Safety and Hygiene (DSH), Claims Services and Policy Processing.

III.          Definitions

A.     Application for Ohio Workers' Compensation Coverage (U-3): Form used by an employer to apply for workers’ compensation coverage.

B.     Continuing eligibility evaluation date: The date an employer is reevaluated following the first or succeeding year of participation to determine continued eligibility in the program. The date for a private employer (PA) is April 1, and the date for a Public Employer Taxing District (PEC) is October 1.

C.      Group Experience Rating (Group Rating): Employers joined together under a Sponsoring Organization in order to be evaluated as one (1) employer for the purpose of workers' compensation premium calculation and for receiving up to the maximum discount for that program year on their payroll rate.

D.     Gross misrepresentation: When an employer fails to disclose:

1.      That it has merged with one or more entities; or,

2.      The true nature of its business practice in its application for Group Rating coverage; and this failure to disclose would cause financial harm to the other members of the Group.

E.      Initial rating year: The policy year including the date on which the new employer’s coverage becomes effective unless changed at BWC’s discretion in section IV.A.3. below.

F.      New employer: An employer creating one or more jobs in the state of Ohio on or after July 1, 2011, and for which any of the following is true:

1.      The employer is a new business entity in Ohio; or,

2.      The employer is an out-of-state employer with no prior operations in Ohio or prior workers’ compensation insurance coverage in Ohio.

G.     Predecessor: An employer that precedes another in whole or in part in the operation of a business.

H.     Program eligibility period: The new employer’s initial policy year and the two consecutive policy years thereafter.

I.       Safety Management Self-Assessment (SH-26): This form is intended to help employers evaluate their safety and claims management systems and identify opportunities for improvement. The form contains eleven (11) safety and health categories considered critical to an effective safety and health process. The person(s) in the organization most familiar with the current safety and claims management process should complete the form.

J.       Sponsoring Organization: An entity (usually a business entity) with governing members certified by BWC to sponsor and market Group Experience Rating and Group Retrospective Rating programs through BWC. Certification requirements for Sponsoring Organizations are outlined in OAC 4123-17-61.1.

K.      Successor: An employer that succeeds another in whole or in part in the operation of a business.

L.      Third Party Administrator (TPA): Any person or organization that works with certified Sponsoring Organizations to administer and facilitate an employer’s application to Group Rating programs.

M.    True-up: Annual reconciliation of estimated payroll and actual payroll. BWC will calculate any premium obligation or credit for the completed policy year.

IV.          Policy

A.     Eligibility Criteria. BWC evaluates program eligibility at the time an employer files an Application for Ohio Workers’ Compensation Coverage (U-3).

1.      The employer must be a new employer as defined in section III.F. above.

2.      BWC will permit a successor to participate in Grow Ohio only under the following circumstances:

a.      The predecessor was participating in Grow Ohio; and,

b.      The successor is a new employer as defined in section III.F. above. The successor’s program eligibility period will end on the same date as the predecessor’s eligibility period would have ended.

3.      BWC may determine an alternate initial policy year based on several factors that include but are not limited to:

a.      An employer that established coverage during the last thirty (30) calendar days of a policy year.

b.      An employer granted an earlier or later effective date of coverage through the BWC General Employer Complaint policy or process as set forth in OAC 4123-14-06.

4.      The following types of employers are not eligible to participate in Grow Ohio:

a.      A Professional Employer Organization (PEO) as defined in OAC 4123-17-15.

b.      A self-insuring employer or a state fund employer that was previously self-insured.

c.      A PEC employer, if the employer is one of the following:

i.       A public nonprofit, nonsectarian, community school that operates independently of any school district under contract with an authorized sponsoring entity and was established under ORC Chapter 3314; or,

ii.      A public-private partnership securing workers’ compensation insurance under ORC 4123.03.

d.      An employer for which a combination or transfer of experience is indicated under OAC 4123-17-02 except as provided in section IV.A.2. above.

e.      An employer that BWC determines is essentially the same employer for which coverage has previously been provided including a debtor-in-possession employer.

f.       An employer that elects to participate in a program that is incompatible with Grow Ohio, as outlined in OAC 4123-17-74, Appendix C.

5.      An employer participating in Grow Ohio shall be eligible to continue its participation in the program only if, as of each continuing eligibility evaluation date, the employer holds active workers' compensation coverage according to all the following standards:

i.       The employer must be current with respect to all payments due BWC, as defined in paragraph (A)(1)(b) of OAC 4123-17-14;

ii.      The employer must be current on the payment schedule of any part-pay agreement entered into for payment of premiums or assessment obligations; and

iii.     The employer must not have cumulative lapses in workers’ compensation coverage in excess of forty (40) days within the prior twelve (12) months.

B.     Operation of program.

1.      BWC will automatically provide eligible employers with a twenty-five percent (25%) Grow Ohio discount on premium for the policy year their coverage becomes effective and up to the next two following policy years based on the employer continuing to meet eligibility requirements.

a.      BWC will apply the twenty-five percent (25%) Grow Ohio discount for the duration of the employer’s program eligibility period unless the employer elects to participate in Group Rating or other alternative rating program.

b.      The Grow Ohio discount will not apply to:

i.       No coverage penalties as referenced in OAC 4123-17-16.

ii.      Any findings of premium deficiencies resulting from a review of the employer in which BWC determines the employer misrepresented or failed to report payroll for any period.

iii.     Deductible claim cost billings.

iv.     The minimum administrative charge as outlined in OAC 4123-17-26.

2.      Application for Group Rating through Grow Ohio.

a.      Under Grow Ohio, BWC waives the Group Rating application deadline as set forth in OAC 4123-17-74, Appendix A and Appendix B.

i.       The employer must meet all other Group Rating requirements outlined in OAC 4123-17-61 through 4123-17-68.

ii.      The employer’s participation in Group Rating after the initial policy year is subject to all the requirements as outlined in OAC 4123-17-61 through 4123-17-68.

b.      New employers can access the Grow Ohio service offering on www.bwc.ohio.gov which provides a link to a list of Sponsoring Organizations and their available groups categorized by industry type. Each Group identifies the TPA that represents each Sponsoring Organization.

c.      TPAs may contact new employers using a list of employers recently assigned a policy number.

d.      The employer must file an Employer Statement for Group-Experience-Rating Program (AC-26) form with the Group’s Sponsoring Organization within thirty (30) days of the date BWC assigns a policy number to the new employer.

e.      A new PA employer receiving a finalized policy within thirty (30) days prior to the Group Rating deadline and the end of the current policy year may be eligible for both the current policy year and the next year’s Group by completion of the AC-26. (Example: A new PA employer receives a policy number November 1, of the current policy year. This employer can apply to Group Rating for the remainder of the current policy year as well as for all of next policy year.)

f.       When the original Sponsoring Organization did not have a compatible industry group to place an employer, BWC may accept an AC-26 more than thirty (30) days after the assignment of a policy number if all the following conditions are met:

i.       The employer‘s AC-26 is filed with a different Sponsoring Organization, and

ii.      The new Sponsoring Organization must electronically submit the fully executed AC-26, and an addendum to the Employer Roster for Group Rating (AC-25) to BWC within thirty (30) days of the date the employer was notified by the original Sponsoring Organization there was no compatible industry group.

C.      Program Safety Requirements.

1.      A new employer participating in Grow Ohio electing the twenty-five percent (25%) discount must complete one of the four safety requirements listed below in order to remain eligible for the program:

a.      An online Grow Ohio safety survey;

b.      At least two hours of safety training offered by DSH at any BWC training location, the annual Ohio Safety Congress, or online through the BWC Learning Center;

c.      The Safety Management Self-Assessment (SH-26); or,

d.      A training class or seminar developed by BWC and approved by DSH for satisfying Grow Ohio safety requirements.

2.      Completion of one of the four safety requirements listed in section IV.C.1. must be finalized by the following applicable date:

a.      The last business day of December for an employer policy with an initial effective date of January 1 through and including June 30.

b.      The last business day of June for an employer policy with an initial effective date of July 1 through and including December 31.

3.      An employer withdrawing from a Group Rating program with remaining Grow Ohio eligibility that has not completed the required program safety requirements will have until the end of its current policy year to complete the safety requirements to receive the discount.

 

D.     Removal/Exit from Program.

1.      BWC will remove an employer from participation in the Grow Ohio at the beginning of the next policy year if either of the following apply:

a.      The employer fails to complete the required safety training for its year of participation; or

b.      The employer elects to participate in a program that is incompatible with the program as outlined in OAC 4123-17-74, Appendix C.

2.      BWC will immediately disqualify an employer from the Grow Ohio program if the employer is removed from a Group for a gross misrepresentation on its application for Group Rating as outlined in OAC 4123-17-62(F).

3.      The employers must timely report actual payroll and pay any premium due upon reconciliation of estimated premium and actual premium. An employer will be deemed to have met this requirement if BWC receives the payroll report and the employer pays premium associated with such report before the expiration of any grace period. See the Payroll True-Up Policy for additional information.

4.      An employer may voluntarily withdraw from Grow Ohio by notifying BWC in writing.

a.      The request must be signed by the chief executive officer (CEO) or designated management representative of the employer.

b.      The effective date of withdrawal will be the beginning date of the policy year in which BWC receives the employer’s withdrawal request.

c.      The withdrawal will be permanent regardless of the employer’s program eligibility period and completion of the required training.

E.      Resolution of complaints.

1.      An employer may appeal BWC’s decision that it is ineligible to participate in, or has been removed from, Grow Ohio.

2.      Employer complaints should be processed under the General Employer Complaint Policy. BWC has not identified any specific extenuating circumstances that apply to Grow Ohio.

F.      Scenario.

An employer was disqualified from enrolling in Group Rating through Grow Ohio for not being included on a Group roster within thirty (30) days of policy finalization due to additional application review by BWC. Will BWC extend the time an employer has to apply for Group Rating?

 

Answer: BWC will grant the employer additional time but all of the following must be satisfied:

1.      The employer must have been on the Group Rating roster;

2.      The employer must be rejected for not being timely submitted as outlined in section IV.B.2.;

3.      BWC’s Policy Processing department determines a combination is not warranted and informs BWC Employer Programs to reconsider the employer for eligibility;

4.      The employer was included on a Group Rating roster within thirty (30) days of notification of Grow Ohio eligibility; and

5.      The employer has met all other eligibility requirements for Group Rating.