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icy
Name:
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Excess
Insurance Requirements and Recovery
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Policy
#:
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SI-04-02
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Code/Rule
Reference
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Ohio
Revised Code (ORC) 4123.82; Ohio Administrative
Code (OAC) 4123-19-03 & 4123-19-14.
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Effective
Date:
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New
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Approved:
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Rex
Blatari
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Origin:
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Self-Insured
Department/Employer Services
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Supersedes:
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N/A
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History:
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New
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Review
Date:
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03/01/2026
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I. Policy Purpose
The Ohio Bureau of Workers' Compensation (BWC)
requires self-insuring (SI) employers to provide information regarding elective
excess insurance, and BWC pursues recovery of eligible claims costs from
defaulted SI employers through these excess insurance policies.
II. Applicability
This policy applies to SI employers, excess insurance
carriers, the Self-Insured Department (SI Department), Central Claims, and the Finance
Division.
III. Definitions
A.
Defaulted
SI Employer:
An SI employer that has stopped meeting the financial obligations of
self-insurance.
B.
Excess
Insurance:
Insurance obtained by an SI employer to cover claims costs that exceeds the
employer’s retention level and complies with ORC 4123.82 and OAC 4123-19-03.
C.
Excess
Insurance Carrier:
An insurance carrier that provides excess insurance coverage for an SI
employer.
D.
Retention
Level:
The amount of claims costs resulting from any one disaster or event that must
be paid before an excess insurance carrier reimburses an SI employer, or in the
event of default, BWC. Pursuant to ORC 4123.82, a retention level must be greater than,
or equal to, fifty thousand dollars ($50,000). Depending on wording contained
in the excess insurance contract, the retention level may apply to an
individual claim or multiple claims arising from the same disaster or event.
Additionally, the retention level may apply only to a portion of claims costs,
such as only indemnity costs.
E.
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.
F.
Self-Insuring
Employer:
An employer that BWC has granted the privilege of paying compensation and
benefits directly.
IV. Policy
A.
If
an SI employer elects to secure excess insurance as permitted in ORC 4123.82,
the SI employer must:
1.
Name
BWC as a beneficiary to the excess insurance contract;
2.
Provide
a complete copy of the excess insurance contract, including declaration page to
BWC; and
3.
Notify
BWC of any material changes to the excess insurance contract.
BWC may require
additional information based on terms contained in, or changes made to, the
excess insurance contract. Excess insurance coverage information must be
updated during the self-insuring employer’s annual renewal of self-insurance.
See Self-Insuring Employer Annual Renewal Policy for more information.
B.
When
There Is A Default Notification:
1.
BWC
will contact any excess insurance carrier of the SI employer to ensure that
policy coverage is in effect, and other requirements of the excess insurance
contract are met;
2.
BWC
will identify claims currently eligible, or that
may become eligible, based on the information provided by the defaulting SI
employer, its authorized representatives, and the excess insurance carrier; and
3.
BWC
will pursue reimbursement for all payments made on all eligible claims, that exceed
the retention level, made directly by BWC.
C.
BWC
may consider payments made by the SI employer prior to default when determining
whether the retention level has been met. The excess insurance contract should
be reviewed when making this determination.
D.
Reimbursements
from excess carriers are applied to cover claims cost under the defaulted
employer’s policy.
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.