Key Takeaways
- Ohio has a STATE MONOPOLY workers' compensation system administered by the Bureau of Workers' Compensation (BWC)
- Ohio BWC is one of four remaining state monopoly workers' comp funds in the U.S.
- Private employers MUST obtain coverage from BWC or qualify for self-insurance
- Employers cannot purchase workers' comp from private insurers in Ohio
- The Industrial Commission of Ohio adjudicates disputed claims
Ohio Workers' Compensation Insurance
Ohio has a unique state monopoly workers' compensation system—one of only four remaining in the United States.
Ohio Bureau of Workers' Compensation (BWC)
The BWC is Ohio's exclusive workers' compensation insurer:
State Monopoly System
| Feature | Details |
|---|---|
| Exclusive Provider | BWC provides all workers' comp insurance |
| No Private Insurance | Cannot buy from private insurers |
| Mandatory | Coverage required for employers |
| Self-Insurance | Available with BWC approval |
Exam Tip: Ohio BWC is a STATE MONOPOLY. This is different from most states where private insurers compete to sell workers' comp.
Other State Monopoly States
Only 4 states have monopoly workers' comp funds:
- Ohio (BWC)
- North Dakota
- Washington
- Wyoming
Who Must Have Coverage
Ohio requires workers' compensation for most employers:
Coverage Requirements
| Employer Type | Requirement |
|---|---|
| Private employers with 1+ employees | REQUIRED |
| Public employers | REQUIRED |
| Household employers | Required if $160+/quarter |
| Agricultural employers | Required if 1+ regular employee |
| Sole proprietors | Optional (can elect coverage) |
Penalties for Non-Compliance
- Stop work orders
- Fines up to $10,000 or more
- Criminal prosecution possible
- Personal liability for claims
- BWC can pursue reimbursement
Coverage Options
Ohio employers have limited options for obtaining workers' comp:
BWC Coverage
| Option | Description |
|---|---|
| State Fund | Standard coverage through BWC |
| Group Rating | Employers pool for experience rating |
| Retrospective Rating | Premium adjusted based on actual losses |
| Deductible Programs | Reduce premium with deductible |
Self-Insurance
Large employers may self-insure with BWC approval:
- Must demonstrate financial ability
- Surety bond or security deposit required
- Subject to BWC oversight
- Must pay claims directly
- Can use third-party administrators
BWC Premium Determination
BWC sets workers' comp rates:
Rating Factors
| Factor | Impact |
|---|---|
| Classification | Based on type of work |
| Payroll | Premium based on payroll |
| Experience Modification | Based on claims history |
| Industry | Risk varies by industry |
Experience Rating
- Based on 3-year claims history
- Good experience = lower mod = lower premium
- Bad experience = higher mod = higher premium
- Encourages workplace safety
Industrial Commission of Ohio
The Industrial Commission handles disputed claims:
Functions
- Adjudicates contested claims
- Hears appeals from BWC decisions
- Determines permanent disability
- Sets policy on claim procedures
Benefits
Ohio workers' comp provides:
Benefit Types
| Benefit | Description |
|---|---|
| Medical Care | All reasonable treatment |
| Temporary Total | 72% of wages (up to max) |
| Permanent Partial | Based on impairment |
| Permanent Total | Career ending injuries |
| Death Benefits | To dependents |
Waiting Period
- 7-day waiting period for wage loss benefits
- Medical benefits begin immediately
- Retroactive to day one if disability exceeds 14 days
Can Ohio employers purchase workers' compensation insurance from private insurers?
Which Ohio agency adjudicates disputed workers' compensation claims?