Ohio BWC State Insurance Fund Manual

Governor John R. Kasich BWC Administrator/CEO Stephen Buehrer

Ohio BWC State Insurance Fund Manual

(July 1, 2012 ? June 30, 2013) Rating rules Premium rates Index of classifications

30 W. Spring St. Columbus, OH 43215-2256

Governor John R. Kasich Administrator/CEO Stephen Buehrer

1-800-OHIOBWC

This updated 2012 ? 2013 State Insurance Fund Manual reflects additions or changes to rating rules, manual classifications and rates that became effective since BWC last published it ? August 2010. The rates for private employers and public employer state agencies, as published in this manual, became effective July 1, 2012. The rates for public employer taxing districts, as published in this manual, became effective Jan. 1, 2012.

While BWC has made every effort to ensure the accuracy of the information in this publication, it may not be in official rule form and may not contain the most recent rule changes. BWC updates the State Insurance Fund Manual at least annually to provide the most up-to-date information on rating rules. BWC files the official rules with the Ohio Secretary of State and with the Ohio Legislative Service Commission.

Programs and Services

BWC programs BWC doesn't just process claims; it works to prevent injuries from ever occurring. BWC offers a variety of programs and services to prevent accidents, reduce your workers' compensation costs and offer you options and choices. So, take advantage and save. Information on BWC programs and services is available at or by calling 1-800-OHIOBWC. You can learn about BWC's safety programs and materials available in the Safety Services section of this manual.

Black lung coverage BWC offers this coverage to Ohio Coal Mine Operators and any other Ohio employers required to secure coverage for the payment of black lung benefits under the Federal Coal Mine Health and Safety Act. Alternatively, The U.S. Department of Labor may authorize an Ohio employer to self-insure its obligations under the Act or obtain the appropriate coverage from a private insurer.

Deductible program* This program helps employers lower their premiums by offering an up-front premium discount when employers agree to take on a per claim deductible. Employers who effectively manage their workers' compensation claims and related costs will see a financial benefit. However, if an employer does not manage claim costs, the deductible can exceed premium savings. Please see Rule 4123-17-72 on pages 109 to 128.

Drug-Free Safety Program (DFSP)* BWC designed its new program to focus first on integrating a company's drug-free efforts into its holistic approach to workplace safety. The intent remains to help employers prevent workplace accidents and injuries attributed to substance use with the most important change being a safety review to determine the state of safety in the employer's workplace. Other noteworthy changes include accident-analysis training for supervisors, accident reporting and a safety action plan to address gaps in safety identified by the safety review. The program requirements consist of implementing six components with the goal of limiting workplace injuries. ? Safety processes (noted above) ? Written DFSP policy ? Employee education ? Supervisor training ? Alcohol and other drug testing ? Employee assistance

DFSP has a Basic and an Advanced level with the latter marked by additional requirements such as completing a safety action plan within 60 days of the start of the program year, conducting 15-percent random drug testing and offering a second chance to employees testing positive and a substance assessment. Please see Rule 4123-17-58 on pages 86 to 96.

EM Capping* This cap on an individual employer's experience modifier (EM) minimizes the effects of a significant premium increase for employers that become penalty rated. The EM Cap will equal 100 percent of the previous year's published EM whether it was an individual or group EM. Please see Rule 4123-17-03 on pages 20 and 21.

$15,000 Medical Only* Enrolled employers may pay up to the first $15,000 in medical bills on any medical-only claim. These claim costs are paid directly by the employer and are not included in the employer's experience. However, unlike the deductible program, no premium discount is given. When an employer chooses to participate in the $15,000 Medical-Only Program, the employer agrees to pay bills within 30 days. The company's managed care organization (MCO) cannot authorize treatment or pay medical bills. Once an employer enrolls in the $15K program, the employer is responsible for the medical bills in all medical-only claims (claims with seven or fewer lost days from work) with injury dates after the enrollment effective date. Please see Rule 4123-17-59 on pages 90 to 91.

* Information on these programs is available on BWC's website: .

Programs and Services

Group-experience-rating* The group-experience-rating plan allows employers who are substantially similar in terms of industry, to group together, to potentially achieve lower premium rates than they could otherwise achieve as individual employers. Employers do this by enrolling in a group with a BWC-certified sponsoring organization. Please see Rules 4123-17-61 through 4123-17-68 on pages 96 to 106.

Group-retrospective-rating* Group-retrospective-rating is a voluntary performance-based incentive program. BWC-certified sponsors create groups of employers who practice effective workplace safety and claims management to achieve lower premiums than they could as individuals. Employers continue to pay their own individual premiums and have the opportunity to receive retrospective-premium adjustments based upon the combined performance of the group. Depending on that performance, the participating employers can receive either a premium refund or assessment. See Rule 4123-17-73 on pages 128 to 135.

Individual-retrospective-rating* Individual-retrospective-rated employers agree to assume a portion of the risk in exchange for a reduction in premiums. See Rules 4123-17-41 through 4123-17-54 on pages 66 to 83.

Marine fund coverage BWC offers this coverage to maritime employers who are required to secure coverage for potential claims arising under the Longshore and Harbor Workers' Compensation Act. The U.S. Department of Labor may grant self-insured status to some employers, and employers may also purchase Longshore Coverage through a private carrier.

One Claim Program* Employers facing the removal from group rating due to the impact of one significant claim may be eligible to participate in BWC's One Claim Program. Private, state-fund employers with up to three minor medical-only claims in the past five years and one significant claim coming into their experience for the first time from the green year may receive a 40-percent discount by joining this program. Please see Rule 4123-17-71 on pages 108 and 109.

Self-insurance* Self-insurance is designed for large employers with the financial and administrative ability to self-manage and pay their own workers' compensation claims. They pay various assessments to BWC based on the amount of their paid compensation and contribute to a guarantee fund. Please see rules 4123-17-32 on pages 54 to 56, 4123-17-40 on page 66 and 4123-19-01 through 4123-19-16 on pages 151 to 154.

Temporary Construction EM .99 Cap Employers are eligible to receive a temporary .99 EM if: ? Their payroll primarily falls under construction industry manuals as of July 1, 2007; ? The employer had an experience modifier of less than or equal to 1.0 in the preceding policy year. ? The experience modifier initially calculated for the employer for the current policy year is greater than 1.0 and not more than 1.5.

Employers opting to receive this temporary cap are responsible for the full premium assessment based on the actual calculated EM for each employer. This option will be available until BWC transitions to the adoption of a split-experienced-rating plan. BWC requires employers to work with its Division of Safety & Hygiene consultants to develop and implement a BWC-approved safety program tailored to the employer's business specialization and trade that is consistent with the 10-Step Business Plan for Safety. Employers choosing to opt OUT shall notify BWC by Sept. 30, 2011, using the Agreement for Construction EM .99 Cap (U-108). BWC will remove employers from the program who fail to have a safety program implementation plan that is consistent with the 10-Step Business Plan for Safety by Oct. 31, 2011.

* Information on these programs is available on BWC's Web site: .

Programs and Services

10-Step Business Plan for Safety* This plan provides employers with a guide for developing effective safety and health-management approaches to accident prevention and cost containment. The plan's guidelines help employers develop, implement and manage a comprehensive workplace safety and health program. See Rule 4123-17-70 on pages 106 to 108.

* Information on and applications for these programs are available on BWC's Web site: .

Rev. July 2012

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Insurance Fund Manual

PREFACE

This manual provides employers essential information concerning their relationship with the state fund. It contains: ? The rules for rating employers; ? Rules of procedures for establishing coverage; ? An alphabetical index of employer classifications; ? A table of basic rates for each classification; ? A numerical index of the classifications.

The general rating rules cover such subjects as: ? The premium rates applicable to the employer; ? Eligibility for experience rating; ? Reporting of payroll for premium purposes; ? Premium security deposit; ? Auditing of the employer's records; ? Transfer of coverage from an employer to its successor.

The rules of procedure set forth in the manual state the manner in which an employer establishes workers' compensation coverage in the state fund.

Ohio law requires BWC classify occupations and industries according to the hazard they present. There are approximately 534 classifications of hazard. The number may vary slightly from year to year. When an employer establishes coverage, an underwriter assigns a classification or classifications to the employer. He or she designates the classification according to the type of operation that exists. If the employer later adds to, eliminates from or changes the nature of operations, BWC may need to add, eliminate or change one or more of the assigned classifications.

The alphabetical index contains an alphabetized listing of employer operations. It also includes a reference to the applicable classification of hazard. A number known as the manual number identifies the classification. BWC uses the number to simplify reference since a full description is cumbersome. BWC lists the premium rates by manual number and uses manual numbers on the payroll reports.

The alphabetical list of employer operations cannot be complete in every detail. If you should not find the operation you seek, check for it under another common designation. For example, you will not find filling station in the alphabetical listing, but you will find gasoline or oil dealers and drivers.

The table of premium rates includes a numerical listing of the classifications by manual number. The table shows the basic premium rate for each classification. Each year BWC computes a basic rate for each classification. It does this by using data from the oldest four of the latest five calendar years of loss experience in that classification. The effective date of the annual rate revision is July 1. At that time, BWC makes any changes in the number or type of classification. It also updates any changes in rules.

The Marine Industry Fund and Coal-Workers' Pneumoconiosis Fund (black lung) rates are expressed in their respective rate tables. The manual states rates in terms of an amount per $100 of the covered employer's applicable payroll. The rates listed include administrative costs. The Disabled Workers' Relief Fund (DWRF) assessment is not applicable to payroll reported under these two types of coverage. BWC may adjust or revise these rates at any time during the year. However, BWC will likely revise rates annually on July 1 concurrent with state-fund (private employer) rates.

The manual expresses private employer rates in the rate table in terms of an amount per $100 of the covered employer's applicable payroll. The employer must pay assessments for administrative cost and the DWRF in addition to the premium contribution.

The numerical index of classifications sets forth the types of employer operations included in each classification. Throughout the manual, BWC uses the term Not Otherwise Classified (NOC). This designation indicates the classification is available for that particular operation. This occurs only if the operation is not specifically set forth as a part of another classification. For example, BWC assigns commercial-machine shops, NOC, manual 3632. Agricultural implement manufacturing in manual 3507 includes the machine shop used in connection with that activity. BWC encourages employers to present any questions they may have on the subjects covered in the manual. Call 614-752-8318 for actuarial matters. This includes premium rates for classifications. Call 1-800-OHIOBWC for policy processing matters. This includes certificates of coverage, classifications, establishment, transfer or cancellation of coverage and out of state employment. It also includes payroll reports and premium payments, premium security deposits, and remittance and refunds. In addition, compliance with the law regarding the payment of premiums, audits and other account maintenance matters fall under policy processing.

Copyrighted material from the National Council on Compensation Insurance (NCCI) contained in this manual is reprinted with permission of the National Council on Compensation Insurance, all rights reserved.

Rev. July 2012

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Insurance Fund Manual

Local customer service offices can provide information for all policy and claims questions. To find the customer service office in your area, log on to , and click on: ? Contact; ? Automatic office locator.

Employers should ask their employer-management team in their local customer service office for help on how to better manage workers' compensation costs.

By calling toll-free 1-800-OHIOBWC and listening to the options you can reach key information areas and customer service representatives ready to respond to inquiries. Automated information is available from 7 a.m. to 7 p.m. Information is also available in Spanish. Use this toll-free number to inquire about an employer's account or to obtain other information about: ? Certificates of coverage; ? Claims information; ? Classifications; ? Establishment, transfer or cancellation of coverage; ? Experience issues; ? Forms and publications; ? Out of state employment; ? Payroll reports and premium payment; ? Premium security deposits; ? Remittance and refunds; ? $15,000 medical only.

For more detailed information on any of the programs listed below call 1-800-OHIOBWC. BWC's customer service staff can facilitate having this information sent to you. You may also contact BWC's forms and publications department directly to place an order via the toll-free number or directly by calling 614-466-4871. You can order information about: ? Deductible program; ? DFSP; ? EM capping; ? Group-experience rating; ? Group-retrospective rating; ? Individual-retrospective rating; ? One Claim Program; ? Temporary .99 EM construction cap; ? 10-Step Business Plan for Safety.

For safety and hygiene-related assistance, please call the toll-free number, and listen to the options. The direct line phone number for BWC's main administrative office for the Division of Safety & Hygiene is 614-995-8622.

For self-insurance assistance, please use the toll-free number, and listen to the options to speak with staff of the self-insured department.

Rev. July 2012

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Insurance Fund Manual

BWC's main office is located at 30 W. Spring St., Columbus, OH 43215-2256. The telephone number for general information is 614-644-6292. BWC's state-wide toll-free number is 1-800-OHIOBWC. In addition to the central office in Columbus, BWC maintains customer service offices for the convenience of the public. You may obtain forms at the customer service offices listed below.

Cambridge

61501 Southgate Road, Cambridge, OH 43725

Injury management (claims)

800-644-6292

Safety and employer services

740-435-4210

Canton 400 Third St. SE., Suite 2, Canton, OH 44702-1102

Injury management (claims) Safety and employer services

330-438-0638 330-471-0937

Cleveland Frank J. Lausche Building, 615 Superior Ave., Sixth floor, Cleveland, Injury management (claims) OH 44113-1889 Serves Cuyahoga county (Cleveland metro area). Safety and employer services

216-787-3050 216-787-3060

Columbus 30 W. Spring St., 11th floor, Columbus, OH 43215-2256

Injury management (claims) Safety and employer services

614-728-5416 614-752-4538

Dayton 3401 Park Center Drive, Suite 100, Dayton, OH 45414

3401 Park Center Drive, Suite 140, Dayton, OH 45414

Injury management (claims) Safety services Employer services

800-644-6292 937-264-5230 937-264-5217

Garfield Heights 4800 E. 131st St., Suite A, Garfield Heights, OH 44105-7132

Injury management (claims) Safety and employer services

216-584-0100 216-584-0115

Governor's Hill 8650 Governor's Hill Drive, Suite 400

Cincinnati, OH 45249-1389

Injury management (claims) Safety and employer services

513-583-4400 513-583-4403

Hamilton One Renaissance Center, 345 High St., Sixth floor,

Hamilton, OH 45011-6055

Injury management (claims) Safety and employer services

513-785-4500 513-785-4510

Lima 2025 E. Fourth St., Lima, OH 45804-4101

Injury management (claims) Safety and employer services

419-227-3127 419-227-4116

Logan 1225 W. Hunter St., Logan, OH 43138-0630

Injury management (claims) Safety and employer services

740-385-5607 740-385-9848

Mansfield The Tappan Building, 240 Tappan Drive N., Suite A,

Mansfield, OH 44906-1367

Injury management (claims) Safety and employer services

419-747-4090 419-529-4528

Portsmouth 1005 Fourth St., Portsmouth, OH 45662-4315

Toledo 1 Government Center, Suite 1136, 11th floor, Toledo, OH 43604-2229

Injury management (claims) Safety and employer services

Injury management (claims) Safety and employer services

740-353-2187 740-353-3419

419-245-2700 419-245-2474

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