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OhioBWC - Basics:  Employer questions and answers (Q&As)

Employer questions and answers (Q&As)

Initial coverage

Experience modifier calculations

Premiums/Payroll/Continuous coverage

Financial information

Claims

Self-insurance

Safety & Hygiene

Initial coverage top
1Q. Do I need to have a workers' compensation policy?
1A. If you have any employees, you must have an active workers' compensation policy to insure coverage for those employees against a workplace injury. ORC 4123.01 details the requirements for workers compensation coverage for Ohio employers.
2Q. What if I own my own business, do I still need coverage?
2A. Owners of sole proprietorships, partners in a partnership and individuals incorporated as a corporation (with no employees) are not considered employees and have the option whether or not to cover themselves.
3Q. What are the pros and cons of sole proprietors, partners, individuals incorporated as a corporation (with no employees) or family farm corporate officers electing to cover themselves?
3A. The benefit of elective supplemental coverage is that sole proprietors, partners, individuals incorporated as a corporation (with no employees) or family farm corporate officers can report a work injury against their policy and upon BWC approval of the claim, medical bills and lost time wages can be paid. The liability of elective coverage is that sole proprietors, partners, individuals incorporated as a corporation (with no employees) or family farm corporate officers must report their wages to BWC and pay the appropriate premiums on their net income.
Minimum/Maximum payroll reporting requirements
4Q. If I incorporate my business will I have to get workers' compensation coverage?
4A. All employees including corporate officers, except for individuals incorporated as a corporation with no employees or family farm corporate officers, are considered employees and must have an active workers' compensation policy covering them.
5Q. How do I apply for workers' compensation coverage?
5A. The Application for Ohio Workers' Compensation Coverage U-3 is available to complete and submit online or it can printed and mailed in to BWC. A $120 deposit is required.
Click here to access the online
U-3 Ohio Workers Compensation Coverage application
6Q. What benefits are provided by workers' compensation coverage?
6A. After a claim for a work injury is allowed, the policy will cover payment of medical bills, compensation for lost wages, permanent disability and settlements. To learn more about additional benefits that may be available to injured workers, click below.
Types of Compensation available to Injured Workers
7Q. What can I do to have my coverage reinstated if it lapses?
7A. The employer must pay all outstanding installment billings. When payment is received, coverage will be reinstated. Reinstated coverage is not retroactive but goes into effect the date payment is received.
8Q. If I pay premium for the period of time I first had employees up to the date I took out coverage, will that make my coverage retroactive back to that date?
8A. No. But if an injury occurred prior to an employer taking out coverage, the employer can request that the premium due for the prior to coverage period be applied to the costs of the claim.
9Q. Why do I have to pay premiums for this period if coverage is not retroactive for this period?
9A. ORC 4123-01 states that an employer must have workers' compensation coverage when there are employees working for the business. ORC 4123.37 and OAC 4123-14-02 outline the procedures for collecting premiums for coverage when an employer is non-compliant.
10Q. Do I have to cover an employee if he only works a short time?
10A. Yes. All employees must be covered.
11Q. Can volunteers be covered?
11A. Coverage is not available for individuals who volunteer for private employers including non-profit organizations. However, public employers such as villages, townships etc., are required to obtain coverage for volunteers who provide emergency services. Click below for more information on coverage for volunteers.
Volunteers Performing Emergency Service Duties
Volunteers Performing Non-Emergency Duties
12Q. Why do I keep receiving paperwork when I'm no longer in business?
12A. When an employer stops doing business in Ohio, they must notify BWC in writing to cancel their workers' compensation coverage. If this is not done, BWC will continue to bill installments, assess penalties and send invoices.
Click here for additional information on canceling coverage
13Q. Can I establish coverage online and obtain a certificate of coverage?
13A. Yes, you can establish coverage by completing your application online and paying the $120 application fee. You can obtain a certificate of premium payment, and it can be downloaded and printed.
Click here to access the online coverage application
Certificates can be faxed upon request. Same day coverage can also be obtained by personally applying at one of BWC's customer service offices.
14Q. How can I get the address for my business/company changed?
14A. Employers can now update their name and address online.
Click here to Update Employer Demographics.
15Q. Can employers cancel coverage online?
15A. Yes. If an employer wishes to cancel their entire policy they can do so by accessing their Coverage History through the Employer Policy menu. Once viewing the coverage history the employer is given the option to request cancellation of the policy. Elective coverage can be added or canceled through Elective coverage.
16Q. I can’t find a word for my industry in the keyword search field; what am I doing wrong?
16A. The keyword must be in the selected category (e.g., manufacturing, service, agriculture) Try another category.
18Q.  What happens when I acquire or purchase an existing business?
18A. First, you are responsible for notifying BWC of the succession by completing and submitting Notification of Acquisition/Merger or Purchase/Sale (U-118). For successions taking place on or after Sept. 1, 2006, BWC transfers any and all existing and future liabilities or credits of the former (predecessor) employer as well as the experience rating when a new employer (successor) wholly succeeds another employer in the operation of a business. If the new employer acquires only a portion of the business, BWC only transfers that portion of the former employer’s experience to the new employer. A BWC underwriter will work with the predecessor to obtain payroll and claims to be transferred to the successor's policy.
Claims top
1Q. What happens if one of my employees is injured when I do not have active coverage?
1A. BWC will give the same consideration to the claim as is given to all claims. If the claim is allowed and benefits are subsequently paid, the employer will be responsible to reimburse BWC dollar for dollar for the costs of the claim.
2Q. What is a managed care organization (MCO)?
2A. A managed care organization (MCO) is a private company that an employer contracts to medically manage the workers compensation claims for injured employees. MCOs are an integral part of the Health Partnership Program.
Click here to learn more about Employers and the Health Partnership Program (HPP)
3Q. Do I have to have an MCO?
3A. Yes. Employers are required to select an MCO. Employers who do not select may have an MCO randomly assigned to them.
4Q. What should I do if one of my employees is injured on the job?
4A. Advise the employee to seek medical attention. Contact your MCO to report the injury. If you would like to file your employee's claim with BWC directly, click File a Claim online
5Q. What does benefit type mean?
5A. Benefit type indicates the type of claim. Benefit types can be one of the following:
  • Medical-Only (MO) - a claim filed when seven or fewer calendar days are lost from the job due to an industrial injury or occupational disease;
  • Lost-Time (LT) - a claim filed when eight or more calendar days are lost from the job due to an industrial injury or occupational disease; the days need not be consecutive;

6Q. Can employers look up claims using a social security number?
6A. Employers, their designees, and their representatives will be able to enter a social security number and view the claims that are associated with that number. However, they will be limited to viewing only the claims that are associated with their policy number.
7Q. What information can be accessed using a social security number?
7A. The claim number, injured worker name, claim status, benefit type, employer policy number, employer name, MCO, and date of injury are all displayed. A user can link to additional information specific to a particular claim from the window.
8Q. Can employers view a list of all their claims?
8A. Yes, employers can access a list of all of the claims associated with their policy number. They will be able to sort the list according to date of injury, claim status, and benefit type.
9Q. Can employers certify or reject claims online?
9A. Yes, employers, their representatives and their designees can certify or reject claims in a new, pending or allowed appeal status online.
Click here to link to claim certification
10Q. What does it mean if an employer certifies a claim?
10A. By certifying a claim the employer is stating that they are in agreement that the facts reported are correct and valid to the best of their knowledge.
11Q. If an employer certifies a claim, does that mean that the claim will be allowed?
11A. Certification does not mean that BWC will grant the allowance of a claim, just as rejection does not mean that BWC will deny a claim. BWC will conduct an investigation and determine whether the claim should be allowed or denied, regardless of the employer certification
12Q. If BWC makes the claim determination, why do they need employer certification?
12A. Certification can expedite the payment of lost wages for the injured worker off work due to a work related injury or illness. If the employer certifies the claim, payment of lost wages may be made immediately upon issuance of the BWC Claim Allowance Order. Without the employer certification, payment will be held for an appeal period.
13Q. What if an employer does not want to certify a claim?
13A. If an employer does not agree with the allowance of a claim they should check off the box marked "rejection." They should also include a short explanation as to why they are not in agreement with the allowance of the claim.
14Q. What does fund type mean?
14A. The fund type is where the payments issued in a claim come from. Fund types are as follows:
  • OSIF - State Fund;
  • PE - Public Employer;
  • SI - Self-Insured;
  • BL - Black Lung;
  • MF - Marine Fund;
  • APP - Apprentice;
  • CD - Civil Defense;
  • CDF - Contract Coverage;
  • ONG - Ohio National Guard;
  • PWRE - Public Worker Relief Employee;

15Q. What does coverage type mean?
15A. Coverage type indicates the status of employer's policy at the time that the claim was filed. Coverage types are as follows:
  • Covered - policy that had coverage at the time of injury as a result of timely payment of premiums.
  • No coverage - Period of no coverage when an employer fails to pay premiums timely;
  • No record - BWC shows there was no record of coverage for this employer;
  • Bankrupt - An account status showing that the employer's business is bankrupt;

16Q. How do I view the notes, correspondence or exam information for my claim?
16A. From the BWC home page, click on Your claim, View notes, Sign on, Enter claim number, View notes information. Injured workers, Employers, authorized representatives, online designees and managed care organizations (MCOs) have to be associated with the claim.
17Q. Why didn’t I receive a particular piece of correspondence?
17A. Check to make sure BWC has your correct mailing address.
Financial information top
1Q. What is Quick Pay?
1A. Quick Pay offers employers the option of paying their coverage application fee, installment and true-up payments online by using a credit card. BWC accepts VISA, MasterCard, or American Express.
2Q. Is there a minimum or maximum payment required to use Quick Pay?
2A. When using Quick Pay to apply for coverage online, the non-refundable application fee is $120.
For Accounts Receivable, there is no minimum or maximum payment amount.

When using Quick Pay for Payroll/Paid compensation, the minimum payment is $120. There is no maximum.
3Q. Can an employer use more than one credit card to pay premiums online?
3A. Multiple cards may be used if there is not enough available credit to pay the entire premium using one card.
4Q. What information do I need to have to use Quick Pay?
4A. Employers using Quick Pay are required to input their credit card type, number and expiration date. They also must input the amount to be paid, their name as it appears on the credit card and the billing address.
5Q. Is credit card information secure using Quick Pay?
5A. All of the credit card information that is entered is encrypted to ensure that financial information remains secure.
6Q. How long does it take to process a payment using Quick Pay?
6A. Credit card payments made online before 11 a.m. will be posted to your account within one business day. Payments made after 11 a.m. will be posted to your account within two business days.

7Q. Does an employer have to pay the entire premium due when using Quick Pay?
7A. No, employers do not have to pay the entire amount if they use Quick Pay. They can pay a portion of the amount due and send in the remainder of the premium with a check and a copy of the invoice to BWC. Employers must send the remaining balance to BWC by the established deadlines, per your installment schedule, to avoid a lapse in coverage and penalties.
8Q. Can I update payroll (exposure) and pay premium online?
8A. Private and public state-fund employers can update their payroll (exposure) by contacting BWC. Your estimated annual premium (EAP) and installment schedule will be updated based on your changes. All unbilled installments will be adjusted accordingly. Employers can pay their installments online using Quick Pay.
9Q. Can employers obtain a breakdown of the costs associated with each claim?
9A. Yes, employers can view the costs associated with individual claims. They are broken down into medical, indemnity, and reserve costs. Each of these is further broken down into risk and surplus costs. The subrogation amount and handicapped percentage are also listed. In addition, the claim present value and total unlimited charges are also displayed.
10Q. What do I currently owe BWC?
10A. Account balances and balance detail is available through Accounts Receivable Balance Information.
11Q. What have I paid to BWC?
11A. Payment transactions can be viewed through Accounts Receivable Transaction History.
12Q. Why do I have a credit balance?
12A. Account balances and balance detail is available through Accounts Receivable Balance Detail.
13Q. How can I view past payroll reports?
13A. Past payroll reports can be viewed in Accounts Receivable Transaction History then select Payroll or you can view specific payroll periods in Payroll Period Transaction History.
14Q. Why have I been billed for non-compliance claims?
14A. An injury occurred during a period when you did not have active coverage with BWC.
15Q. What is an Attorney General balance?
15A. Any unpaid balance older than sixty days that has been certified to the Ohio Attorney General's office for collection.
16Q. What have I been billed for VSSR awards?
16A. Claims transactions can be viewed through Accounts Receivable Transaction History by transaction type.
17Q. My credit card was declined. What should I do?
17A. You should contact your credit card company for information about why your card was declined. You can mail your payment to BWC, make the payment at your local customer service office or try again to pay online.
18Q. Today is the due date for reporting payroll. If I pay online today, will it be considered timely?
18A. Yes.
Premiums/Payroll/Continuous coverage top
1Q. How much does workers' compensation coverage cost?
1A. Workers' compensation rates are based on the industrial pursuit of the employer. The gross wages of the employees being insured are multiplied by the rate to calculate the premium to be paid.
2Q. How often are premiums due?
2A. Premiums are calculated yearly based off of a July 1 to June 30 policy year and spread evenly over the course of the year based off of the installment plan the employer chooses. BWC will send a letter notifying the employer of its estimated annual premium (EAP) and the installment plan in May of each year. If the exposures need adjusted to correct the EAP or the number of installments needs changed, the employer can contact BWC to make those changes prior to the first billing due July 1.
3Q. Is the $120 application fee applied to the premiums due BWC? Can I apply my deposit to premiums due?
3A. Yes, BWC will apply the $120 to the first installment billing.
Q. What period of time does the installment payment cover?
A. The installment payment covers the period of time from when the payment is due until the next installment is invoiced and due. If payment is not received by the due date, coverage will lapse and will not be reinstated until payment for all invoiced installments are received.
Q. What if my premium is late?
A. If the premium is not received by the due date, the policy will automatically lapse. A lapse notice will be sent out. If the employer does not respond, BWC will continue to invoice the installments for that policy year but coverage will not be reinstated until all outstanding premiums are paid to BWC.
9Q. Why did I receive a no coverage penalty billing on my policy? Payroll report for a period of time before I took out coverage?
9A. If an indication is made on the coverage application that the employer has hired employees prior to applying for coverage, a no coverage penalty is calculated and invoiced to the employer. The penalty is based off of the period of time when the employer did not have coverage, when the employer finally applied for coverage and the 12-month estimated payroll from the coverage application.
10Q. What is true-up reporting?
10A. True-up is when the employer reports the actual payroll for the policy year. If there's a difference in the employer's actual payroll and what was used to calculate their estimated annual premium (EAP), the employer will either be refunded or invoiced the difference in premiums.
Click here to view a list of reportable payroll
11Q. What if I don't have my new certificate of coverage and my old one is about to expire?
11A. Contact BWC. We will verify your premium payment dates and either mail or fax your certificate to you.
12Q. Are there payroll limitations for corporate officers?
12A. Yes. Payroll for corporate officers, except for individuals incorporated as a corporation or family farm corporate officers, who do not elect coverage, is to be reported up to the maximum required payroll.
Minimum/Maximum payroll reporting requirements
13Q. Can I pay my premiums in installments?
13A. Yes, there are several pay options available to the employer. Click here to look up the installment options. Also, an employer can apply for a premium payment plan. For step-by step instructions, download and print the Extended Payment Plan.
14Q. If I have a credit on my account can I get a refund?
14A. Yes. If your account is active and there are not outstanding installments due BWC, your refund will be released
15Q. Can I deduct my account credit from the premiums I owe?
15A. It is not advisable for an employer to deduct a credit from the installment premiums that are due. The employer should pay the actual installment due and request BWC refund any credit.
16Q. How can I find out the manual classifications and rates for my company?
16A. This information is available through BWC's automated voice response line. Call 1-800-644-6292, and follow the options. Or, you may contact BWC and speak with an employer services customer representative.
17Q. I don't understand the invoice I received.
17A. Contact BWC for policy/account specific inquiries.
18Q. Can an employer change or add manual classifications online when reporting payroll?
18A. Employers should contact BWC if they need to add or change a manual number when reporting payroll.
19Q. Are employers now required to true-up online?
19A. No. Employers are encouraged to complete the true-up process here on the website; however, if the employer requires personal assistance, they can call the customer contact center at 1-800-644-6292.
24Q. Can any employer obtain a certificate of coverage online?
24A. Yes, a certificate of coverage is issued at the time the policy is issued or the first renewal installment payment is received. Once the original has been generated the certificate can be reprinted anytime. After the initial issuance of the certificate, it's up to the customer to confirm if coverage has remained active or not.

Certificate of coverage reprint
26Q. Can employers make changes to their true-up reports once it has been submitted to BWC online?
26A. No, once the employer submits the true-up report to BWC, the employer will not be able to make any changes. If an employer wants to make changes they should contact BWC.
27Q. Why did BWC change from its manual classification system to the National Council of Compensation Insurance (NCCI) manual classification system?
27A. NCCI classifications represent a more equitable premium rate structure than the BWC system. Also, the NCCI system is a more accurate and understandable classification system, which will allow employers to better classify the functions of their businesses.
Self-Insurance top
1Q. Can self-insuring employers report paid compensation online?
1A. Self-insuring employers can report their paid compensation online. The SI-40 is now available for online completion.
2Q. Are self-insuring employers now required to report paid compensation online?
2A. Yes, per Ohio Administrative Code 4123-19-03 (J), all employers granted the privilege of self-insurance shall annually report paid compensation electronically via this website. Click here to report now.
3Q. Can I view paid compensation reports?
3A. Paid compensation can be viewed in Paid compensation history.
4Q. How can I view my financial transactions?
4A. Financial transactions with BWC can be viewed through Accounts receivable transaction history.
5Q. Is my company eligible to become self-insuring?
5A. To qualify for self-insuring status, an employer must meet several requirements. These include:
  • Two years experience with the state insurance fund;
  • The ability to demonstrate strong financial stability;
  • An account with a financial institution in Ohio;
  • OR draw compensation checks from the same account as the payroll checks;
  • A BWC-certified Qualified Health Plan (QHP) or Medical Management Plan.
For more information regarding self-insurance, click here.
Experience modifier calculations top
1Q. How do claims settlements, handicap reimbursements or good claim management practices affect my rates? Can the BWC provide scenarios to help me understand the impact these strategies have on my experience modifier?
1A. The employer services specialist (ESS) assigned to your policy can demonstrate scenarios, how they impact the experience modifier, assist in understanding how your rates are determined and the basics of claim cost management. To find your ESS, call 1-800-644-6292, and follow the options, or contact your local BWC customer service office.
2Q. Which claims should I settle, and what is the effect on my upcoming rates?
2A. Call 1-800-OHIOBWC, and follow the options to speak with your employer services specialist.
3Q. I am trying to apply a settlement to a specific claim on my experience, but after applying the settlement, I am not seeing a change to the experience modifier. Why?
3A. This could be due to many reasons. For example, there may still be a maximum value for the claim, and a settlement above that amount will not have an effect.
4Q. How much of a handicap reimbursement should I apply to a claim?
4A. The handicap reimbursements vary by the claim. BWC determines the actual amount of the reimbursement after we receive your request and review the claim.
Safety & Hygiene top
1Q. Why doesn't the policy number I am using allow me access to this service offering?
1A. Double check your policy number. You must be in an active, reinstated, or debtor in possession (DIP) status to view this screen.
2Q. I submitted my request online and haven’t gotten a response in two business days. What do I do now?
2A. Call 1-800-OHIOBWC and follow the options to speak with someone from the Division of Safety & Hygiene.
3Q. Where do I find the section of the Web site to request safety consulting services?
3A. Please call 1-800-OHIOBWC, and follow the options and someone will walk you through it.
Wellness Grant Program top
1Q. Why is the Workplace Wellness Grant program a four-year program?
1A. Wellness experts state that it takes at least three years to realize a return-on-investment (ROI) from workplace wellness programs. So, we decided to make it a four-year program because we realized it would take time for the employer and the vendor to create a program and implement it. Three years is also a sufficient amount of time to observe a reduction in health care and workers' compensation costs.
2Q. Why has BWC decided to award $15,000?
2A. Based on a survey and focus groups we conducted with wellness program vendors, the cost of a wellness program is $100-$150 per participating employee. To assist an employer with jump-starting a wellness program, we offer the most money up front and then taper funds as times goes on. We created this funding scheme to reflect the ROI employers realize in the long run.
3Q. Why does BWC require an annual reporting process?
3A. We ask questions that any employer participating in an effective wellness program should be able to answer. We're interested in measuring the outcomes of employers' wellness programs. So, we require specific data elements. This way, we can observe both the ROI for it and its customers, and whether workplace wellness programs impact the health of the workforce.
4Q. Can employers use health-risk appraisals (HRAs) and biometric screenings conducted prior to applying for the grant program?
4A. Yes. However, these tools can only date back three months prior to approval of the grant. Anything older than three months would skew our data analysis regarding the effectiveness of the program.
5Q. Can employers contract with multiple vendors?
5A. Yes. We understand some vendors may only provide limited services such as only administering a health-risk appraisal and biometric screenings, or only program planning and execution. As long as the employer appropriately collects and reports the data we request, the employer may contract with multiple vendors.
6Q. How does an employer select a vendor?
6A. BWC has provided vendor selection guidelines on our Workplace wellness grant overview page. Third-party administrators (TPAs) are another resource. They may already be knowledgeable about existing vendors that best fit your company's needs.

Once you start actively seeking a potential vendor, bring a copy of the application, particularly the data collection section, with you to meetings. Then, you'll put the vendor on notice as to our expectations for the program.
7Q. Must all participating employees be full-time employees?
7A. No. Both part-time and full-time employees may participate in the program.
Note: Temporary workers (including student interns) and independent contractors are not eligible to participate.
8Q. How long will it take to receive the grant funds?
8A. Up to three weeks from the time BWC receives the HRAs and biometrics.
9Q. How does workplace wellness impact absenteeism?
9A. Studies show that workers who participate in wellness programs have reduced sick days. The health-care costs associated with those sick days were reduced as well. A few studies also have shown that reduced sick days translate to lower workers' compensation costs by as much as 30 percent.
10Q. Can employees who did not participate the previous year participate the upcoming year?
10A. Yes. However, the employee must wait until the next year's cycle begins. An employee may not join the program mid-year.


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