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OhioBWC - Basics:  Alternative rating plans

Alternative rating plans

Self-insuring employers are those employers who have applied for and been granted the authority to administer their own workers’ compensation claims. Self-insuring employers agree to abide by BWC and the Industrial Commission’s rules and regulations and to provide accurate and timely payments of compensation and benefits subject to the provisions of those rules. (Reference OAC 4123-19-03 and ORC 4123.35) Self-insuring employers pay benefits directly to their injured employees and service providers and do not pay workers' compensation premiums into the Ohio State Insurance Fund. Disputes in self-insured claims are referred to the Ohio Industrial Commission. Self-insurance is considered a privilege and BWC monitors the activity of all self-insuring employers in Ohio to ensure that benefits are paid fairly, promptly and in accordance with Ohio law. Injured workers who feel their self-insuring employer is not operating in compliance with the rules governing self-insurance are eligible to file a complaint which BWC's self-insured department will investigate.

Qualifications to become a self-insuring employer
In order to be granted the privilege of self-insurance, an employer must meet several requirements, including:

  • Have two year’s experience with the state insurance fund;
  • Operate a BWC-certified Qualified Health Plan (QHP);
  • Demonstrate strong financial stability;
  • Possess the ability to administer workers’ compensation insurance;
  • Maintain an account with a financial institution in Ohio, or draw compensation checks from the same account as the payroll checks.

An employer wishing to become self-insured must complete an application and submit it to BWC. The application must include:

  • All financial records, documents and data necessary to provide a full financial disclosure (as audited by a certified public accountant);
  • A balance sheet and a profit and loss statement for the year and the previous four years;
  • An organizational plan for claims processing;
  • A proposed plan to inform employees of the change from state fund to self-insuring including procedures employees are to follow when filing for compensation and benefits.

Applications for self-insurance are heard by the Self-Insured Review Panel. Once a decision is made the panel signs a resolution either approving or denying the request. If approved, BWC assigns a new policy number to the employer. This number should then be used on all future correspondence with BWC.

Click here for more information about becoming a self-insuring employer.

Group-experience rating
The group-experience-rating plan allows employers who operate similar businesses to group together to potentially achieve lower premium rates than they could individually. While every employer’s situation is unique, group-experience rating could save an employer as much as 53 percent in premiums.

Each group is sponsored by an organization, such as a trade association or chamber of commerce. Each sponsoring organization requires members to pay a membership fee.

The sponsoring organization must submit a safety plan to BWC each year. The group must demonstrate common purpose and possess results from safety and loss-control practices.

The sponsoring organization forms the group and has control over which members will participate. BWC adjusts rates for group members taken as a whole, as if the group was one big company. Each year, BWC reviews each group-experience rating application to ensure each group meets the criteria for group-experience rating.

Click here for more information on general group-experience-rating requirements.

Individual-retrospective rating
The individual-retrospective rating plan allows an employer to assume a portion of the risk in return for a possible reduction in premiums. The greater the assumed risk, the greater the potential reduction in premiums.

Employers who have a consistent claims history and proven safety practices will benefit the most from individual-retrospective rating. The employer can customize the plan to control the amount of risk assumed and the potential savings by selecting the maximum premium and maximum claims costs he or she is willing to pay. Employers may benefit from individual-retrospective rating because of lower initial premiums and realized cash flow advantages, which increase as premiums are saved.

The drawbacks of individual-retrospective rating may outweigh the advantages for some employers. For example, if an employer incurred high losses in a rating year, actual premiums could double.

Click here for more information on individual-retrospective rating.