Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-61 - Criteria for group experience rating

Current through all regulations passed and filed through July 1, 2024
(A)
			 The administrator of workers' compensation shall
			 offer a plan that groups employers for rating purposes. Individual employers
			 shall retain their separate risk identity but shall be pooled and grouped for
			 experience rating purposes only.
(B) In establishing a group for group
			 experience rating purposes, the sponsoring group organization or individual
			 employers in the group must satisfy all of the following requirements and must
			 meet all the sponsorship rules as provided in rule
			 4123-17-61.1 of the
			 Administrative Code:
(1) All of the individual
			 employers within the group must be governing members of the sponsoring
			 organization or the affiliate organization.
(2) An individual employer must have a policy
			 in good standing with the bureau of workers'
			 compensation. "Policy in good standing" means the individual employer is
			 current on all payments due to the bureau and is in compliance with bureau
			 laws, rules, and regulations at the time of enrollment or
			 reenrollment.
(3) The employers'
			 business in the organization must be substantially similar such that the
			 
									employers which are grouped are substantially
			 homogeneous. A group shall be considered substantially homogeneous if the main
			 operating classification codes of the 
									employers as determined by the premium
			 obligations for the rating year beginning two years prior to the coverage
			 period are assigned to the same or similar industry groups, as determined by
			 appendix A to rule
			 4123-17-05 of the Administrative
			 Code. Industry groups seven and nine as well as eight and nine, and industry
			 groups two and four as well as four and
			 six, are considered similar.
(a) The bureau may allow an individual
			 employer to move to a more homogeneous group, after September thirtieth for
			 private employer groups and March thirty-first for 
										public employer
			 taxing district groups but before the first day of the policy year, if the
			 individual employer:
(i) Is without a full
			 year of recorded premium;
(ii) Is
			 reclassified as a result of an audit; or
(iii) Fully or partially combines with
			 another employer.
(b) An
			 individual employer member of a continuing group who initially satisfied the
			 homogeneous requirement shall not be disqualified from participation in the
			 continuing group for failure to continue to satisfy such requirement.
(4) The group of employers must
			 consist of at least one hundred individual members or a group where the
			 aggregate workers' compensation premiums of the members are, as determined by
			 the administrator, expected to exceed one hundred fifty thousand dollars during
			 the policy year for which the application for group rating is made.
(5) As of the deadline for application for
			 group experience rating set forth in appendix A and in appendix B to rule
			 4123-17-74 of the Administrative
			 Code, each individual employer seeking to enroll in a group for workers'
			 compensation coverage must meet the following requirements:
(a) The individual employer must be current
			 with respect to all payments due the bureau, as defined in paragraph (A)(1)(b)
			 of rule 4123-17-14 of the Administrative
			 Code;
(b) The individual employer
			 must be current on the payment schedule of any part-pay agreement into which it
			 has entered for payment of premiums or assessment obligations;
(c) The individual employer cannot have
			 cumulative lapses in workers' compensation coverage in excess of forty days
			 within the prior twelve months; and
(d) The individual employer must report
			 actual payroll for the preceding policy year and pay any premium due upon
			 reconciliation of estimated premium and actual premium for that policy
			 year.
(6)
									New employers electing to apply for group experience
			 rating program.
(a)
										The following definitions apply to this rule,
(i)
											"New employer"
			 means an employer creating one or more jobs in the state of Ohio for which any
			 of the following is true:
(a)
												The employer is a new business entity made amenable to
			 Ohio workers' compensation laws by such job creation; or
(b)
												The employer is
			 an out of state employer that has not had prior operations in Ohio and has not
			 had prior workers' compensation insurance coverage in Ohio.
(ii)
											"Initial rating year" means the rating year including the
			 date on which the new employer's Ohio workers' compensation coverage becomes
			 effective.
(b)
										If a new employer elects to apply for the group
			 experience rating program under this rule, the administrator shall waive the
			 application deadlines set forth in appendix A and appendix B to rule
			 4123-17-74 of the Administrative
			 Code and allow the new employer to apply for the group experience rating
			 program.
(i)
											To
			 apply for the group experience rating program, the new employer must file an
			 AC-26 form for the group with the sponsoring organization.
(ii)
											Upon receipt of
			 an AC-26 form from a new employer, a sponsoring organization shall:
(a)
												Not permit a new
			 employer to participate in a group unless the new employer meets homogeneity
			 requirements set forth in paragraph (B)(3) of this rule:
(b)
												Notify the bureau
			 of the addition of a new employer to the group within thirty days of the date
			 the bureau assigns a policy number to the new employer; and
(c)
												Electronically
			 submit to the bureau a new employer's AC-26 form with a statement identifying
			 the group in which a new employer is being placed for the new employer's
			 initial rating year.
(iii)
											For new
			 employers electing to participate in the group experience rating program
			 between the twenty-ninth day before the applicable group experience rating
			 deadline. as set forth in appendix A and appendix B of rule
			 4123-17-74 of the Administrative
			 Code. and the last day of the initial rating year. inclusive. the sponsoring
			 organization shall, within thirty days of the date the bureau assigns a policy
			 number to the new employer, and in addition to the requirements of paragraph
			 (B)(6)(b)(ii) of this rule, submit to the bureau a statement identifying the
			 group in which the new employer is being placed for the rating year immediately
			 following the new employer's initial rating year.
(c)
										The new
			 employer's participation in the group experience rating program in rating years
			 subsequent to the initial rating year for which the new employer was admitted
			 to a group pursuant to the administrator's waiver in paragraph (B)(6)(b) of
			 this rule is subject to all requirements for participation in the group
			 experience rating program set forth in rules
			 4123-17-61 through
			 4123-17-68 of the Administrative
			 Code.
(7) Cancellations,
			 transfers, and combinations.
(a) An individual
			 employer whose coverage status becomes cancelled or combined during the rating
			 year may not continue to participate in group experience rating. The effective
			 date of the removal from the group experience rating program shall be on the
			 first day of the next policy year, unless the date of cancellation or
			 combination is determined to be the first day of the policy year, in which case
			 the individual employer shall be removed from group as of the actual date of
			 cancellation or combination. An individual employer who becomes active and
			 obtains coverage after the group experience rating application deadline may not
			 participate in group experience rating for that year except as defined in rule
			 4123-17-66 of the Administrative
			 Code.
(b) An individual employer
			 that obtains initial coverage after the group experience rating application
			 deadline as set forth in appendix A and in appendix B to rule
			 4123-17-74 of the Administrative
			 Code and for which a transfer of experience is indicated under rule
			 4123-17-02 of the Administrative
			 Code may not participate in group experience rating for that year except as
			 defined in rule
			 4123-17-66 of the Administrative
			 Code.
(8) Payroll reporting
			 and premium reconciliation. An individual employer must report actual payroll
			 for the preceding policy year and pay any premium due upon reconciliation of
			 estimated premium and actual premium for that policy year no later than the
			 date set forth in rule
			 4123-17-14 of the Administrative
			 Code. An individual employer will be deemed to have met this requirement if the
			 bureau receives the payroll report and the employer pays premium associated
			 with the payroll report before the expiration of any grace period established
			 by the administrator pursuant to paragraph (B) of rule
			 4123-17-16 of the Administrative
			 Code.
(a) An individual employer removed from
			 group experience rating for failure to meet these criteria will be rerated for
			 the full policy year at the individual employer's base-rate or
			 experience-modified rate as determined by their expected losses for the policy
			 year.
(b) The group shall retain,
			 for the policy year, the experience of any employer removed from group
			 experience rating for failure to meet these criteria.