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Policy
Name:
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Self-Insuring
Employer Annual Renewal
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Policy
#:
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SI-18-01
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Code/Rule
Reference
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Ohio
Revised Code (ORC) 4123.35 & 4123.82; Ohio Administrative Code (OAC) 4123-19-03, 4123-19-05, 4123-19-08, & 4123-19-14.
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Effective
Date:
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New
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Approved:
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Rex
Blatari
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Origin:
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Self-Insured
Department/Employer Services
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Supersedes:
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N/A
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History:
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New
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Review
Date:
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03/01/2026
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I. Policy Purpose
Active self-insuring (SI) employers are
required to meet annual financial and administrative requirements to maintain
the privilege of self-insurance.
II. Applicability
This policy applies to active SI employers,
their authorized representatives, and the Self-Insured Department (SI Department).
III. Definitions
A.
Certificate
of Employer’s Right to Pay Compensation Directly (SI-1): Bureau of Workers’
Compensation (BWC) certification that an employer has met the requirements to
be self-insured.
B.
Excess
Insurance:
Insurance obtained by an SI employer to cover claims costs that exceed the
employer’s retention level and complies with ORC 4123.82 (B)(1) and OAC 4123-19-03.
C.
Self-Insuring
Employer (SI Employer): An employer that BWC has granted the privilege of paying
compensation and benefits directly.
D.
Self-Insured
Review Panel (SIRP):
A three-person panel appointed by the Administrator to provide SI employers
with hearings on matters referred to the panel, or as requested by the
employer.
E.
Self-Insured
Risk Profile Matrix:
The chart showing criteria used to determine if an SI employer is to provide
additional security. The level of security required is based on the employer’s
level of financial default risk, and level of claims risk, defined by
outstanding reserves. The Self-Insured Risk Profile Matrix can be reviewed here.
IV. Policy
A.
Renewal
Application
1.
SI
employers are required to complete the annual Application for Renewal of
Authorization to Operate as a Self-Insured Policy (SI-7) online ninety (90)
days prior to the annual renewal date. BWC will not accept hard copy
applications.
2.
Any
changes to the employer’s organizational structure or name must be included
with the SI-7.
3.
SI
employers must submit the current audited financial statements prepared in
accordance with Generally Accepted Accounting Principles (GAAP).
4.
If
an SI employer has excess insurance* coverage, the SI employer must submit:
a.
A complete
copy of the excess insurance coverage contract, if not previously submitted;
and
b.
The
declaration page.
*See Excess Insurance
Recovery Policy for more information.
B.
Renewal
Requirements
1.
The
SI employer must demonstrate its continued financial ability to pay all claims
costs and administrative costs. Additional security may be required based on
the self-insured risk profile
matrix.
2.
The
SI employer must demonstrate compliance with all claims and administrative
requirements, including:
a.
Resolution
of all outstanding claims complaints;
b.
A
satisfactory rating on the most recent BWC compliance audit report; and
c.
All
assessments and penalties must be current, with no outstanding balances.
3.
The
SI employer’s organizational structure and name must match BWC and Secretary of
State records.
C.
Determination
1.
The
SI Department will issue the SI-1 if the SI employer satisfies all renewal
requirements.
2.
In
the event of non-renewal, the employer is notified in writing and has thirty
(30) days to obtain state fund coverage.
3.
The
employer may file a written appeal of the SI Department’s non-renewal
notification to the SIRP within fourteen (14) days of receipt of the decision.
V. Resolution of
Complaints
A.
Any
complaints or disputes related to this policy must be submitted in writing to
the SI Department, via mail or email, as detailed in the Self-Insured Employer
Dispute/Protest Policy.
Ohio Bureau of Workers'
Compensation
Self-Insured Department
30 W. Spring St., 22nd
Floor
Columbus, Ohio
43215-2256
Email: siinq@bwc.state.oh.us
B.
The
SI employer may file a written appeal of the SI Department’s decision to the
SIRP.