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OhioBWC - Basics: (Policy library) - File

Self-Insured Disabled Workers’ Relief Fund (DWRF) Assessment

Policy Name:

Self-Insured Disabled Workers’ Relief Fund (DWRF) Assessment

Policy #:

SI-16-03

Code/Rule Reference:

Ohio Revised Code (ORC) 4123.411 &

Ohio Administrative Codes (OAC) 4123-17-29 and 4123-17-15.5

Effective Date:

August 1, 2015

Origin:

Self-Insured Department/Employer Services

Supersedes:

N/A

History:

New

Review Date:

August 1, 2020

 

I.           Policy Purpose

This policy defines the requirements of a self-insuring employer to reimburse the BWC for Disabled Workers’ Relief Fund (DWRF) claim costs.

II.          Applicability

The policy applies to employers that have been granted the privilege of self-insurance and the BWC Self-Insured Department.

III.         Definitions

A.    DWRF: Disabled Workers’ Relief Fund.

B.    SI: Self-Insured.

C.    SI employer: Self-insuring employer.

D.    SI-PEO: Professional Employer Organization that has been granted the privilege to self-insure for workers’ compensation purposes.

E.    Client Employer: Employer with an active State Insurance Fund policy that has been approved to participate in a PEO agreement with a SI-PEO.

IV.       Policy

A.    Pursuant to ORC 4123.411, the BWC shall pay to employees any amounts of DWRF due and shall semi-annually bill the SI employer for all amounts paid to a participant.

B.    Pursuant to OAC 4123-17-29, a SI employer shall reimburse the BWC for DWRF payments made on or after August 22, 1986, in claims in which it is the employer of record, without regard to the date the employer was granted self-insured status.

C.    Specifics on the determination of DWRF benefits, calculation of benefits, and payment of benefits can be found in the Disabled Workers’ Relief Fund Policy.

D.    SI employers shall be billed on a semi-annual basis for any DWRF payments made by the BWC during the previous six-month period for all claims associated with the SI policy.

1.     DWRF payments made during a given six-month period, January 1 through June 30 or July 1 through December 31, will be billed in conjunction with the semi-annual self-insured assessments in February and August of each year.

2.     A SI employer will be billed for any DWRF payments made by BWC having a warrant date (paid date) on or after the effective date of self-insurance.

3.     Pursuant to OAC 4123-17-32 (L), if a SI employer fails to remit payment for DWRF reimbursements by the invoice due date a late penalty will be assessed.

a.  Additional penalty may be assessed if the billing remains unpaid for sixty-one days or more.

b. SI employers that do not reimburse BWC timely for DWRF payments shall be subject to non-renewal or revocation of their SI status.

E.    The requirement of a SI employer to reimburse the BWC for DWRF payments is established by the following criteria:

1.     A state fund policy that is granted self-insurance will be combined into the newly established SI policy.

a.     The SI employer will assume responsibility to reimburse BWC dollar-for-dollar for any future DWRF payments, for the life of any claim, regardless of the date of injury.  This includes:

                                                      i.         Any claim incurred as the employer of record before being granted self-insurance;

                                                     ii.         And, any claim incurred by a predecessor state fund policy that was combined into the newly granted SI employer prior to becoming self-insured.

2.     A state fund employer that was previously owned or recently purchased by the SI employer and is approved to participate as part of an active SI policy.

a.     Upon the approval of an entity to be either merged into or added as a subsidiary to the policy of an active SI employer, the state fund policy of that employer will be combined into the policy of the SI employer.

b.     The SI employer will assume responsibility to reimburse BWC dollar-for-dollar for any future DWRF payments for the life of any claim, regardless of the date of injury, in which the entity being added is the employer of record. 

                                                    i.         As determined by the SI department, an asset-only acquisition of a state fund entity by an existing SI employer will not be combined into the SI policy and therefore the reimbursement of DWRF payments on claims associated with that entity will not transfer to the SI employer.

3.     When an SI employer is acquired by another SI employer.

a.     When a SI employer acquires all of another SI employer, the policy of the acquired SI employer will be combined into the policy of the acquiring employer. The acquiring SI employer will become responsible for any DWRF obligations for:

                                                    i.         Any claim, where the acquired SI policy is the policy of record.

                                                  ii.         Any claim incurred, where a predecessor acquired state fund policy is the employer of record, and that policy was combined with the acquired SI policy.

4.     A SI employer acquires a part of another SI employer.

a.     If a SI employer acquires part of another SI policy (i.e. a subsidiary, division) there will be no combination processed.

                                                    i.         Where the acquired entity is the employer of record, the SI employer from which the entity or entities were acquired will remain responsible for any DWRF obligations for claims incurred prior to the effective date of the acquisition.

5)   A subsidiary entity of a SI employer returns to the state insurance fund.

a.     DWRF costs associated with claims where the employer of record is the state fund policy of that subsidiary entity, prior to becoming self-insured, will remain the responsibility of the SI employer.

b.     DWRF costs associated with claims incurred during the period the subsidiary entity was self-insured, will continue to be the responsibility of the SI employer.

6)   A SI-PEO.

a.     In addition to the requirements outlined in sections (D1-5) of this policy, a PEO granted the authority to self-insure, will be responsible for DWRF reimbursements associated with its client employers for lease type “All under PEO policy”.

i.       DWRF costs associated with a client employer’s state fund policy, prior to the effective date of the PEO agreement, will become the responsibility of the self-insuring PEO to reimburse dollar-for-dollar, beginning with the effective date of the PEO agreement.

ii.     DWRF costs for a given six-month period, January 1 through June 30 or July 1 through December 31, may be prorated for a situation where a client relationship was made effective or terminated during the semi-annual period.

iii.    Upon the effective date of the termination of the PEO relationship, the DWRF costs associated with the former client employer’s state fund policy will remain with the client employer, and the SI-PEO is no longer responsible to reimburse BWC.

iv.    DWRF costs associated with claims incurred during the period the client employer was in a PEO agreement will continue to be the responsibility of the PEO to reimburse dollar-for-dollar.

 

V.   Resolution of Complaints

 

A.    Any complaints or disputes related to this policy must be submitted in writing to the SI department via mail or email as detailed in the Self-Insured Resolution of Complaints Policy.

Ohio Bureau of Workers’ Compensation

Attn. Self-Insured Department

30 W. Spring St., 22nd Floor

Columbus, Ohio 43215-2256

Email: SIINQ@bwc.state.oh.us.

B.    The SI department will issue a formal written response to any complaint. If the complaint is not resolved as a result of the formal response issued by the SI department, a written request that the issue be referred to the Self-Insured Review Panel (SIRP) may be submitted by the SI employer or SI-PEO.

 

 


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