OhioBWC - Basics: (Policy library) - File

 

Policy Name:

Transitional Work Performance Bonus

Policy #:

EP-20-02

Code/Rule Reference

ORC 4125.01. OAC 4123-17-55, 4123-6-01, 4123-6-02.2, 4123-17-15, 4123-17-75 and Appendix; 4123-17-74, and Appendices A, B, and C; 4123-17-14, 4123-17-16.

Effective Date:

November 5, 2018

Approved:

Ronald L. Suttles, Chief Employer Services

Origin:

Employer Policy

Supersedes:

Transitional Work Performance Bonus dated July 1, 2016.

History:

Revised August 22, 2019; December 29, 2016; May 12, 2015. New policy issued October 25, 2013.

Review Date:

November 5, 2023

 

 

I.      Policy Purpose

 

The Ohio Bureau of Workers’ Compensation (BWC) provides a Transitional Work Performance Bonus to eligible employers that meet program requirements in accordance with all applicable laws and rules.

 

II.    Applicability

 

This policy applies to employers, authorized representatives, BWC Employer Programs, BWC Transitional Work Unit, BWC Regional Employer Management Services, and transitional work developers.

 

III.   Definitions

A.    Client employer: A sole proprietor, partnership, association, limited liability company, or corporation that enters into a Professional Employer Organization (PEO) agreement and is assigned shared employees by the PEO. OAC 4123-17-15.

B.    Professional employer organization (PEO): A sole proprietor, partnership, association, limited liability company or corporation that enters into an agreement with one or more client employers for the purpose of co-employing all or part of the client employer’s workforce at the client employer’s work site. PEO does not include a temporary service agency. OAC 4123-17-15.

C.   Program period: The policy year an employer participates in the Transitional Work Performance Bonus program.

D.   Pure premium: The employer’s calculated premiums before any administrative costs or Disabled Workers’ Relief Fund (DWRF) assessments are added.

E.    Transitional work (TW): A work-site program that provides an individualized interim step in the recovery of an injured worker (IW) with job restrictions resulting from the allowed conditions in the claim. Developed in conjunction with the employer and the IW, or with others as needed, including, but not limited to the collective bargaining agent (where applicable), the physician of record, rehabilitation professionals, and the managed care organization (MCO), a transitional work program assists the IW in progressively performing the duties of a targeted job. OAC 4123-6-01(AA).

F.    Transitional work developer: The provider who develops the employer’s transitional work program.

IV.  Policy

A.    Eligibility criteria: To qualify for the Transitional Work Performance Bonus program the employer must be a state-fund private employer (PA employer) or a public employer taxing district employer (PEC employer). The employer must meet the following eligibility criteria.

1.    As of the application deadline, the employer must:

a.    Be current with respect to all payments due BWC, as defined in OAC 4123-17-14.

b.    Be in an active policy status. “Active policy status” does not include an employer with a coverage status of “no coverage” or “lapsed.”

c.     Not have cumulative lapses in workers’ compensation coverage in excess of forty (40) days within the preceding twelve (12) months.

d.    Timely report actual payroll for the preceding policy year 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.

2.    The employer must provide documentation proving that the employer has developed and implemented a transitional work program. BWC will accept the following documentation:

a.    A transitional work plan developed with a previous BWC grant;

b.    A company-created transitional work plan;

c.     A copy of the company’s transitional work policy from its human resource manual or employee handbook;

d.    A transitional work plan developed under the Transitional Work Grant Program that began on or after July 1, 2012; or

e.    A signed letter from a company officer stating the employer has a transitional work plan or is in the process of developing a BWC Transitional Work Grant plan.

3.    BWC must receive documentation of the employer’s transitional work program no later than thirty (30) days after the application deadline. An employer previously approved to participate in the Transitional Work Performance Bonus program is not required to submit transitional work plan documentation for subsequent program periods.

4.    The following employers are not eligible for the Transitional Work Performance Bonus program:

a.    State agencies;

b.    Self-insuring employers; and

c.     Employers paying only the minimum administrative charge for the applicable payroll period.

5.    An employer who is determined to be ineligible for the Transitional Work Performance Bonus program may apply for a subsequent program period, if the employer becomes eligible.

B.    PEO participation. A PEO may participate in the Transitional Work Performance Bonus program as follows.

1.    For Transitional Work Performance Bonus calculation purposes, BWC will assign eligible claims to the employer of record on the date of injury, regardless of a subsequent PEO contract termination or change.

2.    Transitional work may be provided under a transitional work program of either the PEO or the client employer.

C.   Application requirements / BWC evaluation of application.

1.    An employer must file an Application for Transitional Work Bonus Program (TWB-1) with BWC.

2.    The TWB-1 must be signed by the chief executive officer (CEO) or a designated management representative who will certify to BWC that the employer will comply with all program requirements.

3.    BWC will automatically renew the employer for each subsequent program period provided the employer meets all eligibility requirements in section IV.A. of this policy.

4.    Application deadlines are outlined in OAC 4123-17-74, Appendix A and B:

a.    For PA employers, the application deadline is the last business day of May prior to the upcoming July 1 program period.

b.    For PEC employers, the application deadline is the last business day of November prior to the upcoming January 1 program period.

5.    An employer who opts out, voluntarily withdraws, or is removed  must file a new TWB-1 to participate in a future program period.

D.   Operation of program.

1.    To successfully implement a transitional work plan, the employer must:

a.    Obtain documentation from the physician of record or treating physician releasing the IW to return to work (RTW) with restrictions.

b.    Utilize the transitional work service offering on BWC’s website to complete a Transitional Work Offer and Acceptance Form (TWB-2) or use a document equivalent to the TWB-2.

c.     Print the completed TWB-2, or equivalent document, sign and date the form, and submit the form to the IW for his or her signature and date.

2.    Fax the TWB-2 form, or equivalent document, signed and dated by the employer and IW to their MCO using the fax number on page two of the TWB-2.

3.    Calculation and payment of the Transitional Work Performance Bonus.

a.    To qualify for the Transitional Work Performance Bonus an employer must:

i.      Have coverage that is in an active status at the time of calculation; and

ii.     Timely report actual payroll for the preceding policy year 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.

b.    BWC will evaluate all claims with injury dates that occur during the applicable program period to determine transitional work potential and utilization. See the Medical Policy Transitional Work Developer; Transitional Work Grant & Transitional Work Bonus policies for additional information.

c.     The Transitional Work Performance Bonus calculation date, or “snapshot,” occurs six months after the end of the applicable program period. This delayed review provides the employer the opportunity to utilize transitional work in claims that occur late in the program period.

d.    The employer’s Transitional Work Performance Bonus will be based on how successfully the employer utilized transitional work in claims that had the potential for transitional work.

e.    BWC calculates the employer’s percentage of claims with potential for transitional work in which transitional work was utilized.

i.      This percentage is multiplied by a percentage of the employer’s pure premium for the applicable program period, as outlined in the Appendix of OAC 4123-17-75.

ii.     The employer may receive a Transitional Work Performance Bonus of up to ten percent (10%) of its pure premium. BWC posts the Transitional Work Performance Bonus as a credit to the employer’s account. The Transitional Work Performance Bonus is refunded to the employer after any account balance is absorbed.

f.      The Transitional Work Performance Bonus and the incentives earned through participation in other Destination: Excellence programs cannot reduce an employer’s premium due below the amount of the minimum administrative charge as set forth in OAC 4123-17-26.

g.    BWC will not issue a Transitional Work Performance Bonus to an employer paying only the minimum administrative charge for the applicable program period.

h.    Rate adjustments made to an employer’s account after the issuance of the Transitional Work Performance Bonus may result in recalculation of the Transitional Work Performance Bonus.

4.    BWC will require an employer to repay any Transitional Work Performance Bonus the employer was not entitled to receive.

5.    An employer may, during its participation in the Transitional Work Performance Bonus program, participate in other compatible BWC programs. Employer program compatibility is outlined in OAC 4123-17-74, Appendix C.

E.    Exit or removal from program.

1.    An employer may voluntarily withdraw from the Transitional Work Performance Bonus program by notifying BWC in writing.

2.    BWC will remove an employer from the Transitional Work Performance Bonus program who fails to timely report actual payroll for the preceding policy year and pay any premium due upon reconciliation of estimated premium and actual premium. BWC will not remove an employer if BWC receives the payroll report, and the employer pays premium associated with such report before the expiration of any grace period.

3.    An employer who voluntarily withdraws or is removed from the Transitional Work Performance Bonus program will not be eligible for a Transitional Work Performance Bonus for that program period.

4.    An employer who elects to opt out of the Transitional Work Performance Bonus program for the subsequent policy year must notify BWC in writing by the application deadline as set forth in OAC 4123-17-74.

F.    Combinations and transfers.

1.    Predecessor: Enrolled in the Transitional Work Performance Bonus program.

Successor: New employer without prior coverage.

Action: BWC automatically enrolls the successor in the Transitional Work Performance Bonus program. The successor is responsible for completing program requirements. Successor is transferred predecessor’s rights and obligations under the Transitional Work Performance Bonus program. Any Transitional Work Performance Bonus for predecessor’s participation is based on predecessor’s pure premium for the policy year.

2.    Predecessor: Enrolled in the Transitional Work Performance Bonus program.

Successor: Not enrolled in the Transitional Work Performance Bonus program (includes a self-insuring employer).

Action: Successor is not enrolled in the Transitional Work Performance Bonus program. Successor is transferred predecessor’s rights and obligations under the Transitional Work Performance Bonus program, however, any Transitional Work Performance Bonus will be based on predecessor’s pure premium for the policy year.

3.    Predecessor: Not enrolled in the Transitional Work Performance Bonus program.

Successor: Enrolled in the Transitional Work Performance Bonus program.

Action: Successor remains eligible for the Transitional Work Performance Bonus program for the entire policy year.

4.    Predecessor: Enrolled in the Transitional Work Performance Bonus program

Successor: Enrolled in the Transitional Work Performance Bonus program.

Action: Successor remains eligible for the Transitional Work Performance Bonus program for the entire policy year. Successor is transferred predecessor’s rights and obligations under the Transitional Work Performance Bonus program. Any Transitional Work Performance Bonus for predecessor’s participation will be based on predecessor’s pure premium for the policy year.

5.    Predecessor: Enrolled in the Transitional Work Performance Bonus program

Successor: Debtor-in-possession.

Action: An individual employer who is participating in the Transitional Work Performance Bonus program and becomes a debtor-in-possession during the policy year remains eligible for the Transitional Work Performance Bonus program for the entire policy year.

6.    Partial transfer.

Predecessor: Enrolled in the Transitional Work Performance Bonus program.

Successor: Not enrolled in the Transitional Work Performance Bonus program.

Action: The predecessor remains eligible for the Transitional Work Performance Bonus program for the entire policy year. Claims incurred prior to the date of the partial transfer will be included in the predecessor’s Transitional Work Performance Bonus calculation. The successor will remain in its current rating plan and be responsible for any claims incurred from the part of the predecessor entity transferred, beginning on the date of the partial transfer.

G.   Resolution of complaints.

1.    Employer complaints filed due to program eligibility issues (e.g., lapse days, coverage status) are addressed by the Employer Programs Unit. Employer complaints filed due to transitional work plan issues (e.g., employer believes the employer did not get appropriate credit for a RTW) are addressed by the Transitional Work Unit.

2.    An employer, whose application for the Transitional Work Performance Bonus program has been denied, or who disagrees with BWC’s Transitional Work Performance Bonus determination, may file an appeal to BWC’s Adjudicating Committee pursuant to ORC 4123.291 and OAC 4123-14-06.

3.    BWC has not identified any program-specific extenuating circumstances that apply to the Transitional Work Performance Bonus program. Employer complaints will be processed under the General Employer Complaint Policy.