OhioBWC - Employer - Form:  (U-20; U-21) - Introduction

Application for Individual-Retrospective Rating Plan
Private Employers (U-20); Public Employers (U-21)

Introduction to individual-retrospective rating
Individual-retrospective rating is an alternative rating plan that allows the employer to initially pay BWC less premium than it would without the plan.

An employer participating in the individual-retrospective rating plan may earn a possible premium reduction by assuming a portion of the risk. The greater the portion of the risk assumed, the greater potential reduction in premiums.

Additional information

Program info

Required information
  • Policy number
  • Tier type consideration
  • Claim limit
  • Maximum premium
  • Owner/Party/Officer name
  • Owner/Party/Officer title
  • Owner/Party/Officer signature
  • Payroll amount

If you have all the required information on hand, simply click the start button to begin.