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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) 4123-17-69, 4123-17-74, 4123-17-74 Appendix A, B, and C.

Effective Date:

July 1, 2015

Origin:

Employer Policy

Supersedes:

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

History:

New July 1, 2011; Revised January 1, 2013; May 2, 2014; July 1, 2015.

Review Date:

July 1, 2017

 

 

I.       Policy Purpose

 

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

 

II.     Applicability

 

This policy applies to employers, authorized representatives, BWC Employer Programs, and Policy Processing.

 

III.    Definitions

A.     Continuing eligibility evaluation date: Each April 1 of the program eligibility period for a private employer (PA) and each October 1 of the program eligibility period for a public employer taxing district (PEC).

B.     Initial application for coverage: The employer’s initial application for coverage as provided for in OAC 4123-17-13(A).

C.    Initial policy year: The policy year including the date on which the new employer’s coverage becomes effective.

D.    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 made amenable to Ohio workers’ compensation laws by such job creation; or,

2.     The employer is an out of state employer that has not had prior operations in Ohio and has not had prior workers’ compensation insurance coverage in Ohio.

E.     Program eligibility period:

1.     The new employer’s initial policy year and the two consecutive policy years thereafter.

2.     For a PA employer that started in Grow Ohio prior to July 1, 2015, BWC may extend the program eligibility period to end on the last day of the policy year (June 30).

IV.   Policy

A.     Eligibility Criteria.

1.     The employer must be a new employer (as defined above).

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

a.     Predecessor employer is participating in Grow Ohio, and;

b.     Successor is a new employer as defined above, and;

c.      Successor’s program eligibility period will end on the same date as the predecessor’s.

3.     The following 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 public employer, if the employer is not:

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 Ohio Revised Code (ORC) 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.

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 set forth in OAC 4123-17-74, Appendix C.

4.     BWC will review the employer on the continuing eligibility evaluation date to determine if it continues to be eligible for Grow Ohio.

a.     To continue participation, as of each continuing eligibility evaluation date, the employer must have active workers’ compensation coverage according to the following standards:

i.       The employer must be current with respect to all payments due BWC as defined in OAC 4123-17-14.

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

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.     BWC will immediately remove an employer from Grow Ohio if the employer fails to report actual payroll for a policy year, and fails to pay any premium owed upon reconciliation of estimated premium and actual premium, no later than the expiration of any applicable grace period.

B.     Application Requirements / BWC evaluation of eligibility.

1.     There is no specific application form for Grow Ohio. BWC automatically evaluates an employer’s eligibility for the program at the time the employer files an application for coverage.

2.     BWC may determine an alternate initial policy year for the employer for Grow Ohio. Factors that may cause BWC to determine an alternate initial policy year include, but are not limited to:

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

b.     The employer was granted an earlier or later effective date of coverage through the BWC Complaint or Adjudication process.

C.    Operation of program.

1.     Twenty-five percent (25%) discount.

a.     BWC will automatically provide eligible employers with a twenty-five percent (25%) discount on blended premium.

b.     BWC will apply the discount  for the duration of the employer’s program eligibility period unless:

i.       The employer elects the Group Experience Rating Program (Group Rating). An employer that later exits Group Rating may receive the twenty-five percent (25%) discount for any remaining policy years in the program eligibility period.

ii.      The employer fails to meet continuing eligibility requirements set forth in OAC 4123-17-69.

iii.     The employer fails to report actual payroll for the initial policy year, and fails to pay any premium owed upon reconciliation of estimated premium and actual premium, no later than any applicable grace period.

c.      The discount will NOT:

i.       Apply to any prior-to-coverage penalties.

ii.      Apply to any findings of premium deficiencies resulting from an audit of the employer in which BWC determines the employer misrepresented or failed to report payroll for any period.

iii.     Apply to deductible claim cost billings.

iv.    Apply to the minimum administrative charge outlined in OAC 4123-17-26.

2.     Application for Group Rating.

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

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

ii.      The employer’s participation in Group Rating in policy years subsequent to the policy year it received a waiver under Grow Ohio for the Group Rating deadline, is subject to all the requirements set forth in OAC 4123-17-61 through 4123-17-68.

b.     BWC will provide new employers with a link to Third Party Administrator (TPA) information on the Grow Ohio service offering on www.bwc.ohio.gov. This link will provide a list of TPAs that offer Group Rating services and the industry groups that are available with each TPA. BWC provides TPAs with a service offering that lists employers that have applied for coverage or have been assigned a risk (policy) number.

c.      The employer must file an Employer Statement for Group-Experience-Rating Program (AC-26) form with the Group sponsoring organization. The sponsoring organization must electronically submit the fully executed AC-26 and an addendum to the Employer Roster for Group-Experience-Rating Program (AC-25) for the employer’s initial policy year, to BWC. The electronic submission must be made within thirty (30) days of the date BWC assigns a risk (policy) number to the new employer.

d.     For an employer electing the Group Rating option between twenty-nine (29) days prior to the Group Rating application deadline and the last date of the initial rating year, the sponsoring organization must electronically submit the fully executed AC-26 and an addendum to the AC-25, for the initial policy year and the policy year immediately following the employer’s initial policy year. The AC-26s and AC-25 addendums must be submitted to BWC within thirty (30) days of the date BWC assigns a risk (policy) number to the new employer.

e.     BWC may accept an AC-26 more than thirty (30) days after the assignment of a risk (policy) number when the original sponsoring organization did not have a compatible industry Group to place the employer, if the following conditions are met:

i.       The employer must file an AC-26 with a different sponsoring organization.

ii.      The new sponsoring organization must electronically submit the fully executed AC-26, and an addendum to the AC-25, to BWC.

iii.     BWC must receive the AC-26 and addendum to the AC-25 within thirty (30) days of the date the employer was notified by the original sponsoring organization that it did not have a compatible Group.

f.       If the sponsoring organization or its TPA identifies that an employer involved in a combination applied for Group Rating through a waiver under Grow Ohio, BWC will remove that employer from the Group for that policy year.

D.    Program Safety Requirements.

1.     A new employer participating in Grow Ohio (receiving the twenty-five percent (25%) discount) must complete one of the four components listed below by the last day of the policy year subsequent to the employer’s initial policy year in order to remain eligible for the program:

a.     An online Grow Ohio safety survey, including providing any follow-up information that may be requested by the Division of Safety & Hygiene (DSH), and acknowledge that the introduction to DSH offerings for the employer has been read; or,

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

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.     An employer returning to Grow Ohio from Group Rating who has not completed the program safety requirements will have until the end of the policy year subsequent to the employer’s initial policy year to complete the requirements. The employer must complete the safety requirements to receive the Grow Ohio discount.

E.     Removal / disqualification or withdrawal from program.

1.     BWC will immediately disqualify an employer from the Grow Ohio program, if the employer knowingly misrepresented information on the initial application for coverage.

a.     BWC will not consider an employer to have knowingly misrepresented information on the initial application for coverage if the employer’s determination on how to report was based on:

i.       The employer’s reasonable interpretation of law, rule, or manual classification.

ii.      Written advice received from BWC.

b.     BWC shall require the disqualified employer to make restitution for all discounts received from participation in the program.

2.     BWC will immediately disqualify an employer that knowingly misrepresents payroll to BWC. BWC shall require the disqualified employer to pay back all discounts received from participation in the program.

3.     For purposes of this policy, “Knowingly” means the employer had actual knowledge of the misrepresentation and was aware that it would cause a certain result.

4.     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).

5.     An employer may voluntarily withdraw from the Grow Ohio program by notifying BWC in writing.

a.     The request must be signed by the chief executive officer 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.

d.     BWC will recover any discount received prior to the withdrawal date.

F.     Resolution of complaints.

1.     An employer may file an appeal to the BWC Adjudicating Committee if BWC determines that the employer is ineligible for Grow Ohio because it is:

a.     A public employer, or,

b.     An employer for which a combination or transfer of experience was indicated, or,

c.      Essentially the same employer for which risk coverage was previously provided.

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.

G.    Scenarios.

1.     A PA employer’s coverage became effective on September 15, 2015. The employer wishes to enroll in Group Rating. Can the employer apply for Group Rating for the period September 15, 2015, to June 30, 2016? Or, is the employer only eligible to apply for the next full policy year beginning July 1, 2016?

Answer: The employer is eligible to apply for Group Rating for both the policy year that began on July 1, 2015, and for the policy year that will begin on July 1, 2016.

2.     A PA employer applied for coverage on November 30, 2015. The employer did not apply for Group Rating. Assuming all eligibility requirements are met, what is the last policy year that the twenty-five percent (25%) discount will apply?

Answer: The policy year beginning July 1, 2017, is the last policy year of Grow Ohio eligibility.

 


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