Workers' Compensation

Workers’ Compensation Insurance in Ohio

Ella Baker
Workers’ Compensation Insurance in Ohio
Reading time 6 Mins
Published on May 1
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The Ohio Bureau of Workers’ Compensation and Your Business

Workers’ Compensation Insurance is a form of insurance that pays missed wages and medical expenses to employees that are injured on the job. The Ohio Bureau of Workers’ Compensation requires that all employers provide this type of workplace insurance for their employees. While the benefits of workers’ compensation insurance are many, perhaps the most important are: the protection of employers against workplace injury lawsuits and the coverage of lost wages and medical expenses of employees injured on the job.

The Ohio Bureau of Workers’ Compensation

While nearly every state requires Workers’ Compensation Insurance for all businesses other than sole proprietorships, partners in a partnership and individuals incorporated as a corporation (with no employees), the state of Ohio’s Bureau of Workers’ Compensation (BWC) has several key and important differences.

While most states require employers to seek coverage through private insurance companies, in Ohio the state is the insurance company. Only Ohio, Washington, Wyoming, and North Dakota operate state-monopolized BWC marketplaces.

In conjunction with the BWC, the state of Ohio mandates that state funded employers work with Managed Care Organizations for the medical management of all claims. Employers may select their preferred MCO partner or allow BWC to assign an MCO partner for them.

Many businesses also choose to work with a third-party administrator (TPA) to manage the potential legal pitfalls of Workers’ Compensation Insurance claims. TPAs are also able to negotiate group ratings for their group of clients, which can provide valuable discounts to employers. Often, TPAs and MCOs work together to help facilitate the return of injured employees to the workplace.

Ohio BWC and Managed Care Organizations

A Managed Care Organization (MCO) is a private company that employers select to medically manage their workers’ compensation claims for injured employees. The Ohio BWC requires all employers that pay into the state fund to have an MCO to manage their claims, and the cost is already built into your premiums. A strong partnership with your MCO is important to ensure your injured workers receive the treatment they need to get back to work as safely and quickly as possible.

Providing medical case management for the duration of the claim, the MCO obtains the initial claim date, works with the medical provider to obtain medical records and physical restrictions, and assists with getting injured workers back to work safely. The MCO monitors all claims and approves the payments throughout the process.

Ohio BWC and Third-Party Administrators

Third-party administrators (TPAs) are advocates for employers. The BWC acts as the representative for injured workers and, although also an insurance company, they do not represent the employer. TPAs don’t fall under the jurisdiction of the BWC, therefore their services are paid for out-of-pocket by the employer. While the Ohio BWC does not require employers to work with a TPA, it is highly recommended for a number of reasons.

The Ohio BWC offers many discount programs to employers and a TPA can offer assistance in selecting the best program for the employer’s needs. Additionally, a TPA can provide future financial projections to help employers prepare for changes in Workers’ Compensation Insurance premiums.

What does Workers’ Compensation Insurance cover?

Workers’ Compensation Insurance exists to provide a safety net for injured workers and their employers. While injury prevention is a key component of the BWC, when injuries do occur, workers’ compensation coverage exists to provide financial and medical assistance to the injured workers and their speedy recovery which will allow them to return to work and regular activity.

The Ohio BWC characterizes claims as accidents, occupational disease, and death.

  • Accident: The most common of all workers’ compensation claims are accidents. These accidents include back injuries, neck and shoulder pain, joint injuries, burns, and eye and ear injuries, among many others. The Ohio BWC encourages and provides the use of safety and training programs to prevent or limit the occurrence of such injuries.
  • Occupational Disease: Regular exposure to chemicals, materials and other elements in the workplace can sometimes lead to the development of particular illnesses or diseases. These can include carpal tunnel syndrome, asbestosis, and certain cancers, among others. The Ohio BWC and OSHA work to limit the exposure of employees to such elements.
  • Death: In the event of an employee death as the direct result of a workplace accident or occupational disease, the employee’s dependents may be eligible for ongoing death benefits. Surviving spouses, children under 18 years old, dependent full-time student children up to 25 years old, and dependent children that are physically or mentally incapacitated (no matter their age) may be eligible for death benefits.

What are the penalties for not having Workers’ Compensation Insurance?

The Ohio BWC mandates that “All employers with one or more employees must carry workers’ compensation coverage”. Ohio law does make a few exceptions for owners or ministers in one of the following categories:

  • Sole proprietor;
  • Partnership;
  • Limited liability company acting as a sole proprietor;
  • Limited liability company acting as a partnership;
  • Family farm corporate officers;
  • Individual incorporated as a corporation with no employees;
  • Ordained or associate ministers of a religious organization

For all others, Workers’ Compensation Insurance is the law. Failing to meet that requirement can result in serious penalties. The Ohio BWC and your MCO will work with you to ensure that your business remains compliant.

If BWC does not receive an employer’s payroll report with premium payment on time, then the employer’s workers’ compensation account will be placed in a lapsed status. Should an accident occur during a period when coverage has lapsed, the injured worker could either sue the employer for all damages and expenses pertinent to the work-related injury or file a claim with BWC. If the claim is allowed, then the employer must reimburse BWC dollar for dollar for the cost of that claim.

In addition, if workers’ compensation coverage has lapsed, BWC assesses penalties to the employer, one for filing the payroll report late and a second for paying the premium late. The penalty for failure to file a payroll report on time is 1 percent ($3 minimum – $15 maximum) of the premium due. Failure to pay the premium on time will result in a $30 flat penalty charge as well as a penalty charge of up to 15 percent of the premium due, depending on the lateness of the payment.

Workers’ Compensation Insurance protects your business and your employees

 

Workers’ Compensation Insurance protects your business from costly litigation, while also protecting your most valuable resource – your employees.

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