Understanding Self-Insured Employers
A significant number of employers in Ohio are "self-insured" for workers' compensation purposes. These employers must adhere to the rules and regulations set forth by the Ohio Bureau of Workers' Compensation (BWC) and the Industrial Commission.
Specifically, they must comply with Ohio Administrative Code Section 4123-19-03 and Ohio Revised Code Section 4123.35.
Differences in Claim Processing
For a claimant, a primary distinction between a self-insured claim and a "state fund" claim lies in who makes the initial determinations. In a self-insured claim, the employer makes these decisions, not the Bureau of Workers' Compensation.
If a dispute arises, a c-86 motion can be filed. This motion compels the Industrial Commission to hear the matter and issue a formal decision.
Industrial Commission's Role
Much of our work at McKenzie & Snyder is conducted at the Industrial Commission. It is at this level that decisions made by a self-insured employer can be reversed. This includes decisions regarding:
- Compensation
- Medical treatment
- Allowances
Employer Self-Insurance Requirements
To qualify as a self-insured employer, several requirements must be met. These include, but are not limited to, the following:
- Having a minimum of 500 employees in Ohio.
- Demonstrating financial stability.
- Possessing the ability to administer a self-insured program.
- Having a qualified BWC certified Qualified Health Plan (QHP).
Addressing Self-Insured Employer Issues
The BWC has a dedicated self-insured department to help address concerns with self-insured employers. You may also contact our office at 513-737-5180 to discuss such issues.
