OhioBWC - Basics: (Policy library) - File

 

Policy Name:

Prospective Billing Installment Payments

Policy #:

EP-16-02

Code/Rule Reference

Ohio Administrative Code (OAC) 4123-17-13, 4123-17-14, 4123-17-14.2, 4123-17-16, 4123-17-26, and 4123-14-03.

Effective Date:

July 1, 2023

Approved:

Rex Blateri, Chief of Employer Services

Origin:

Employer Policy

Supersedes:

Prospective Billing Installment Payments policy effective March 26, 2018.

History:

Revised June 8, 2023 and January 16, 2019. New Policy issued July 1, 2015.

Review Date:

July 1, 2028

 

 

I.      Policy Purpose

 

The Bureau of Workers’ Compensation (BWC) provides coverage to an employer only after the payment of required premium. BWC will permit employers to pay premium obligations in installments as outlined in the applicable laws and rules.

 

II.    Applicability

A.    This policy applies to BWC Finance, Employer Services, Call Center, private employers (PA employers), public employer taxing districts (PEC employers), and their authorized representatives.

B.    This policy does not apply to self-insuring (SI), public state (PES), Coal-Workers’ Pneumoconiosis Fund, and Marine Industry Fund employers; alternate employer organizations (AEOs); and professional employer organizations (PEOs).

 

III.   Definitions

A.    Prospective billing: A workers’ compensation insurance practice that provides coverage to the insured only after the payment of premium.

B.    Notice of estimated annual premium (Notice of EAP): A letter sent annually, to PA employers and PEC employers, in which BWC documents the estimated payroll (exposure) for the upcoming policy year. Using the estimated payroll, assigned classification codes, and approved rates, BWC provides the employer with the estimated annual premium.

C.   Installments: A series of premium amounts to be paid at regular intervals.

D.   Invoice: A statement BWC mails to employers to bill for premium and non-premium charges that are owed. An employer may opt to receive an electronic notification instead of a mailed invoice. Such employer will receive an email when a new invoice is issued and may review the invoice online through a BWC e-account.

E.    Grace period: A time frame during which BWC will not impose a penalty for installment payments and true-up payroll reports received after established due dates.

IV.  Policy

A.    Estimated annual premium (EAP).

1.    BWC will estimate annual premium based on the most recent payroll information. EAP will be based on the most recent payroll true-up or subsequent payroll changes that happened before policy renewal. BWC will estimate payroll for employers without a full year of payroll.

2.    BWC will allow an employer to revise estimated payroll for the policy year if the employer can demonstrate “good cause.” Good cause means a substantial reason, one that affords a legal justification or a legal excuse.

a.    Examples of good cause include, but are not limited to:

i.      Furlough days, layoffs, division closings, and relocations out-of-state;

ii.     Combinations and partial transfers; or

iii.    Significant expansions or reductions in payroll, with supporting documentation.

b.    BWC will revise the EAP and the balance of installments for the remainder of the policy year to reflect the new estimated payroll.

c.     BWC will not accept requests to revise estimated payroll for the policy year after the following dates:

i.      PA employers: Last business day of March of the current policy year.

ii.     PEC employers: Last business day of September of the current policy year.

B.    BWC will provide PA employers and PEC employers with a notice of EAP.

1.    PA employers will receive the notice of EAP no later than the first day of May preceding the policy year for which such premium is due.

2.    PEC employers will receive the notice of EAP no later than the last day of October preceding the start of the policy year.

3.    The notice shall include all of the following:

a.    The estimated payroll used by BWC to calculate the employer’s estimated premium due;

b.    Individuals who have elected coverage;

c.     The classification codes in which the employer’s payroll is allocated and the blended rates for each of the classification codes identified;

d.    The employer’s applied experience modifier (EM) used in determining premium due;

e.    The employer’s estimated premium due for the applicable policy year; and

f.      An installment schedule that outlines bill dates and installment amounts.

C.   Operation of installment payment plans.

1.    BWC offers employers premium installment options consisting of one, two, four, six, or twelve payments.

2.    Employers paying annual premiums totaling $250 or less will be billed one installment which must be paid in full prior to the start of the policy year.

3.    There is no penalty for employers paying in advance of the installment payment schedule.

4.    PA employers with annual premiums totaling more than $250 will initially default to a bi-monthly six (6) payment installment plan.

5.    PEC employers with annual premiums totaling more than $250 will initially default to a monthly twelve (12) payment installment plan.

6.    BWC will permit PEC employers to defer installment payments due prior to April 30 of the policy year until April 30.

a.    Such election must occur on or before November 15 of the previous policy year.

b.    BWC will apply a deferment fee of 0.94 per cent to the total amount of the installments that are deferred.

7.    BWC will establish an installment plan for a new employer if the prorated pure premium for the remainder of the current policy period is greater than $250.

8.    BWC will create an invoice for each installment payment that is due.

9.    Each installment payment is due by the date indicated on the invoice.

D.   Early payment discount: BWC provides an early payment discount of two percent (2%) to employers that pay the full twelve (12) month EAP by the applicable due date.

1.    For PA employers the due date is July 1, and for PEC employers the due date is January 1.

2.    The employer must be in an active status as of the due date for the first installment to be eligible for the discount. Active status does not include:

a.    A policy that is a no coverage policy; or

b.    A policy that is lapsed.

3.    The discount cannot reduce the total amount due below the minimum administrative charge as provided in rule OAC 4123-17-26.

4.    The early payment discount will be applied to any outstanding balance and any remaining credit will be refunded to the employer through standard business processes.

E.    Changes in installment payment plans.

1.    A PA employer may change its installment payment plan by logging on to its account on www.bwc.ohio.gov, and making the change, by the May 15 preceding the beginning date of the policy year.

2.    A PEC employer may change its installment plan by logging on to its account on www.bwc.ohio.gov, and making the change, by the November 15 preceding the beginning date of the policy year.

3.    An employer requesting a change to its installment payment plan after the deadlines set forth above must contact BWC.

4.    BWC will not consider changes to installment payment plans after the following dates:

a.    PA employers: Last business day of March of the current policy year.

b.    PEC employers: Last business day of September of the current policy year.

5.    BWC may alter an installment payment plan if it determines such change is appropriate.

F.    Default in installment payment.

1.    An employer paying an installment after the due date, but prior to the expiration of any grace period, will not have its coverage lapsed. The payment must be posted to the employer’s account prior to the expiration of the grace period.

2.    An employer paying an installment after the grace period will have its coverage lapsed. Such lapse will be effective from the first day of the month which falls nearest the due date of the payment. For example, an installment with a due date of June 21 will have a corresponding lapse effective date of July 1.

3.    A new employer that fails to pay its initial installment payment before the expiration of any grace period will have its coverage lapsed back to the initial date of coverage.

4.    BWC will assess penalties for late installment payments in accordance with the Penalties for Late Payment and Reporting policy.

5.    BWC will certify past-due installment payments to the Ohio Attorney General seventy-five (75) days after the payroll true-up due date. See the Payroll True-Up policy for additional information.

G.   Resolution of complaints.

1.    BWC has not identified any extenuating circumstances that apply to installment payment plans.

2.    Employer complaints related to installment payment plans must be processed under the General Employer Complaint Policy.

3.    Employer complaints related to the default of an installment payment are processed under the Retroactive Coverage and Penalty Abatement policy.