Policy
Name:
|
Transitional
Work Bonus
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Policy #:
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EP-20-02
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Code/Rule
Reference
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ORC 4125.01. OAC 4123-6-01, 4123-6-02.2, 4123-17-14, 4123-17-15, 4123-17-16, 4123-17-55; 4123-17-74, and Appendices A, B, and C; 4123-17-75 and Appendix.
|
Effective
Date:
|
July 1,
2023
|
Approved:
|
Rex
Blateri, Chief of Employer Services
|
Origin:
|
Employer
Policy
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Supersedes:
|
Transitional
Work Performance Bonus dated July 1, 2021.
|
History:
|
Revised June
27, 2023; March 30, 2022; August 22, 2019; December 29, 2016; May 12, 2015.
New policy issued October 25, 2013.
|
Review
Date:
|
July 1,
2028
|
I. Policy Purpose
The
Ohio Bureau of Workers’ Compensation (BWC) provides a Transitional Work Bonus
to eligible employers that meet program requirements in accordance with all
applicable laws and rules. This policy addresses Employer Services’
administration of the Transitional Work Bonus. Medical Policy’s Transitional
Work Bonus policy is found here.
II. Applicability
This
policy applies to employers, authorized representatives, BWC Employer Programs,
BWC Transitional Work Unit, and BWC Regional Employer Management Services.
III. Definitions
A.
Alternate
employer organization (AEO):
A sole proprietor, partnership, association, limited liability company, or
corporation that enters into an agreement with one or more client employers for
the purposes of providing human resource management services and sharing
employer responsibility and liability. AEO does not include a temporary service
agency. ORC 4133.01(A).
B.
Client employer: A sole proprietor, partnership,
association, limited liability company, or corporation that enters into an AEO
agreement and shares employee responsibility and liability with an AEO, or that
enters into a Professional Employer Organization (PEO) agreement and is
assigned shared employees by the PEO. OAC 4123-17-15.
C.
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. ORC 4125.01(D).
D.
Program period: The policy year an employer
participates in the Transitional Work Bonus program.
E.
Pure premium: The employer’s calculated premiums
before any administrative costs or Disabled Workers’ Relief Fund (DWRF)
assessments are added.
F.
Transitional
work: 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(Y).
IV. Policy
A.
Eligibility criteria.
1.
The employer must be
a state-fund private employer (PA employer) or a public employer taxing
district (PEC employer).
2.
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, which 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; and
d.
Report actual
payroll for the preceding policy year and pay any premium due upon
reconciliation of estimated premium and actual premium for that policy year.
See the Payroll True-Up policy for additional information.
3.
The following
employers are not eligible for the Transitional Work Bonus program:
a.
State agencies;
b.
Self-insuring
employers; and
c.
Employers paying
only the minimum administrative charge for the applicable payroll period.
4.
An employer who is
determined to be ineligible for the Transitional Work Bonus program may apply
for a subsequent program period if the employer becomes eligible.
B.
AEO and PEO participation.
An AEO or a PEO may participate in the Transitional Work Bonus program as
follows.
1.
For Transitional
Work Bonus calculation purposes, BWC assigns eligible claims to the employer of
record on the date of injury, regardless of a subsequent AEO agreement
termination or a subsequent PEO agreement termination or change to the PEO
agreement.
2.
Transitional work
may be provided under a transitional work program of either the AEO or the
client employer, or the PEO or the client employer.
C.
Application requirements
and 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 of the employer who certifies to BWC that the employer will
comply with all program requirements.
3.
BWC automatically
renews the employer for each subsequent program period provided the employer
meets all eligibility requirements in section IV.A. of this policy.
4.
Application deadlines:
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.
Calculation and
payment of the Transitional Work Bonus.
a.
To qualify for the
Transitional Work Bonus an employer must:
i.
Have coverage that
is in an active status at the time of calculation; and
ii.
Report actual
payroll for the program period 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.
c.
The Transitional
Work Bonus calculation date occurs six months after the end of the applicable
program period. This delayed review provides the employer the opportunity to use
transitional work in claims that occur late in the program period.
d.
The employer’s Transitional
Work 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 used.
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 Bonus of up to ten percent (10%) of its pure
premium. BWC posts the Transitional Work Bonus as a credit to the employer’s
account. The Transitional Work Bonus is refunded to the employer after any
account balance is absorbed.
f.
The Transitional
Work Bonus and the incentives earned through participation in other bonus
and rebate incentive 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 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 Bonus
may result in recalculation of the Transitional Work Bonus.
2.
BWC will require an
employer to repay any Transitional Work Bonus the employer was not entitled to
receive.
3.
An employer may,
during its participation in the Transitional Work Bonus program, participate in
other compatible BWC programs. Employer program compatibility is outlined in
OAC 4123-17-74, Appendix C.
4.
See Medical Policy’s
Transitional Work Bonus policy for information about BWC’s monitoring
of participating employer utilization of transitional work plans for bonus
payment calculation.
E.
Exit or removal from
program.
1.
An employer may
voluntarily withdraw from the Transitional Work Bonus program by notifying BWC.
2.
BWC will remove an
employer from the Transitional Work Bonus program for the current program
period 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 Bonus program is
not eligible for a Transitional Work Bonus for that program period.
4.
An employer who
elects to opt out of the Transitional Work Bonus program for the subsequent program
period must notify BWC by the application deadline as set forth in OAC 4123-17-74.
F.
Combinations and
transfers.
1.
Predecessor: Enrolled
in the Transitional Work Bonus program.
Successor: New employer without prior
coverage.
Action: Successor is not eligible for
the Transitional Work Bonus program until the next program period. Successor is
transferred predecessor’s rights and obligations under the Transitional Work
Bonus program. Any Transitional Work Bonus for predecessor’s participation is
based on predecessor’s pure premium for the policy year.
2.
Predecessor: Enrolled
in the Transitional Work Bonus program.
Successor: Not enrolled in the
Transitional Work Bonus program, includes a self-insuring employer.
Action: Successor is not enrolled in the
Transitional Work Bonus program. Successor is transferred predecessor’s rights
and obligations under the Transitional Work Bonus program; however, any
Transitional Work Bonus is based on predecessor’s pure premium for the policy
year.
3.
Predecessor: Not
enrolled in the Transitional Work Bonus program.
Successor: Enrolled in the Transitional
Work Bonus program.
Action: Successor remains eligible for
the Transitional Work Bonus program for the entire policy year.
4.
Predecessor: Enrolled
in the Transitional Work Bonus program
Successor: Enrolled in the Transitional
Work Bonus program.
Action: Successor remains eligible for
the Transitional Work Bonus program for the entire policy year. Successor is
transferred predecessor’s rights and obligations under the Transitional Work
Bonus program. Any Transitional Work Bonus for predecessor’s participation is
based on predecessor’s pure premium for the policy year.
5.
Predecessor: Enrolled
in the Transitional Work Bonus program
Successor: Debtor-in-possession.
Action: An individual employer who is participating
in the Transitional Work Bonus program and becomes a debtor-in-possession
during the policy year remains eligible for the Transitional Work Bonus program
for the entire policy year.
6.
Partial transfer.
Predecessor: Enrolled in the
Transitional Work Bonus program.
Successor: Not enrolled in the
Transitional Work Bonus program.
Action: The predecessor remains eligible
for the Transitional Work Bonus program for the entire policy year. Claims
incurred prior to the date of the partial transfer are included in the
predecessor’s Transitional Work Bonus calculation. The successor remains in its
current rating plan and is 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 receive
appropriate credit for a return to work (RTW), are addressed by the
Transitional Work Unit.
2.
An employer, whose
application for the Transitional Work Bonus program has been denied, or who
disagrees with BWC’s Transitional Work 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 Bonus program. Employer complaints are processed under the General Employer Complaint Policy.