OhioBWC - Basics: (Policy library) - File


Policy Name:

Self-Insuring Employer Annual Renewal

Policy #:


Code/Rule Reference

Ohio Revised Code (ORC) 4123.35 & 4123.82; Ohio Administrative Code (OAC) 4123-19-03, 4123-19-05, 4123-19-08, & 4123-19-14.

Effective Date:



Rex Blatari


Self-Insured Department/Employer Services





Review Date:




I.       Policy Purpose


Active self-insuring (SI) employers are required to meet annual financial and administrative requirements to maintain the privilege of self-insurance.


II.     Applicability


This policy applies to active SI employers, their authorized representatives, and the Self-Insured Department (SI Department).


III.    Definitions

A.     Certificate of Employer’s Right to Pay Compensation Directly (SI-1):  Bureau of Workers’ Compensation (BWC) certification that an employer has met the requirements to be self-insured.

B.     Excess Insurance:  Insurance obtained by an SI employer to cover claims costs that exceed the employer’s retention level and complies with ORC 4123.82 (B)(1) and OAC 4123-19-03.

C.    Self-Insuring Employer (SI Employer):  An employer that BWC has granted the privilege of paying compensation and benefits directly.

D.    Self-Insured Review Panel (SIRP):  A three-person panel appointed by the Administrator to provide SI employers with hearings on matters referred to the panel, or as requested by the employer.

E.     Self-Insured Risk Profile Matrix:  The chart showing criteria used to determine if an SI employer is to provide additional security.  The level of security required is based on the employer’s level of financial default risk, and level of claims risk, defined by outstanding reserves.  The Self-Insured Risk Profile Matrix can be reviewed here.

IV.   Policy

A.     Renewal Application

1.     SI employers are required to complete the annual Application for Renewal of Authorization to Operate as a Self-Insured Policy (SI-7) online ninety (90) days prior to the annual renewal date. BWC will not accept hard copy applications.

2.     Any changes to the employer’s organizational structure or name must be included with the SI-7.

3.     SI employers must submit the current audited financial statements prepared in accordance with Generally Accepted Accounting Principles (GAAP).

4.     If an SI employer has excess insurance* coverage, the SI employer must submit: 

a.     A complete copy of the excess insurance coverage contract, if not previously submitted; and

b.     The declaration page.


*See Excess Insurance Recovery Policy for more information.


B.     Renewal Requirements

1.     The SI employer must demonstrate its continued financial ability to pay all claims costs and administrative costs.  Additional security may be required based on the self-insured risk profile matrix.

2.     The SI employer must demonstrate compliance with all claims and administrative requirements, including:

a.     Resolution of all outstanding claims complaints;

b.     A satisfactory rating on the most recent BWC compliance audit report; and

c.      All assessments and penalties must be current, with no outstanding balances.

3.     The SI employer’s organizational structure and name must match BWC and Secretary of State records. 


C.    Determination

1.     The SI Department will issue the SI-1 if the SI employer satisfies all renewal requirements.

2.     In the event of non-renewal, the employer is notified in writing and has thirty (30) days to obtain state fund coverage.

3.     The employer may file a written appeal of the SI Department’s non-renewal notification to the SIRP within fourteen (14) days of receipt of the decision.


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 Employer Dispute/Protest Policy.


Ohio Bureau of Workers' Compensation

Self-Insured Department

30 W. Spring St., 22nd Floor

Columbus, Ohio 43215-2256

Email: siinq@bwc.state.oh.us


B.     The SI employer may file a written appeal of the SI Department’s decision to the SIRP.