Effective July 1, 2020, Ohio BWC implemented a new reserve system called ACES. Based on a large sampling of claims, we’ve found that this system can drastically increase reserves for future claims costs - which will then impact premiums and Group Retro performance. A reserve is a dollar amount placed on every claim, in which the insurer (BWC) “reserves” assumed future costs within the claim. The concept of a reserve is considered standard practice in workers’ compensation insurance, even for self-insured employers.
Once a reserve is set, it will not leave the claim until the claimant has ceased medical treatment for at least six (6) months. The only other way to eliminate a reserve is through the process of a settlement. If a claim has a reserve when Ohio BWC’s September “snapshot” is taken - those reserves will be treated as dollars already spent on the claim, impacting premiums for the coming policy year. Lost time claims will see the largest impact, as medical reserves for 2019 were roughly four (4) times paid compensation and are now 19 times paid compensation. This does not necessarily mean your company should consider salary continuation to soften the blow, as all claims have reserves. That should be discussed with your TPA on a case-by-case basis and not used as a remedy to avoid a lost-time claim with BWC.
We are expecting these changes to have an impact on Group Retro refunds for the 2020 policy year and beyond and will keep clients educated on their effects so they can make the best program choice each year.
Please email Matt Matusek if you have any questions. Matt can be reached at mmatusek@spoonerinc.com.
Posted By Brandy King
April 25, 2025
Category: General
Ohio BWC recently announced a new rebate program called Risk Management Essentials (RME). If your company enrolls and meets the requirements, this program could help your business earn additional premium savings of 5% of your annual premium, up to a maximum of $25,000. Both private and public employers who are NOT enrolled in Group Rating or Group Retro can participate in the RME. The policyholder must complete the existing requirements of BWC’s Safety Council Program (attending at least 10 of 12 meetings during the policy year), plus an additional six hours of safety and claims management education provided by the program sponsor. Spooner plans on sponsoring this pilot program so we can offer another option to our clients who don’t qualify for group savings programs. The training must be conducted in-person or virtually in real-time. Other training sessions, like pre-recorded webinars or videos, will not qualify for program credit. In addition, your policy must be in good standing – no lapses over 40 days, current on premium payments, and the most recent True Up completed (and any associated balance paid). Employers will enroll in RME via their third-party administrator, who then submit the applications to BWC by the last business day in May. If you’re a Spooner Inc. client, we’ll notify you if this program could be beneficial for your company in the upcoming 2025 policy year. In the meantime, feel free to reach out to your Client Serv
Posted By Brandy King
April 23, 2025
Category: Mco, Ohio Bwc, Mco Open Enrollment, Managed Care Organization, 2025 Open Enrollment
MCO Open Enrollment will take place Monday, April 28 Friday, May 23, 2025. The opportunity for employers to choose their managed care organization (MCO) for Ohio Workers’ Comp comes only every two years, so employers will not have the opportunity again until 2027. Don’t miss out if you want to make a change! We know May is “busy season” for several industries with the weather warming up, but if you’re anything less than pleased with your MCO – it’s worth making time to take a few meetings and consider your options. With all of the mergers and acquisitions in the Ohio MCO marketplace over the last several years, there are now only nine companies to choose from. Since MCOs aren’t paid directly by employers, there are often low expectations set because no “value” is assigned. It’s true that MCOs are paid by Ohio BWC, but they are paid with a portion of employer premium dollars. Mismanaged claims can also cost you in the long run when those costs enter the experience and impact your premiums. If you want to stay with your current MCO, there is nothing you need to do. We suggest being very cautious of what you sign or agree to during this time period, as some sales tactics can be misleading. You can view BWC’s 2025 MCO Report Card here, and learn more about how to interpret the results
Posted By Brandy King
February 19, 2025
Category: Ohio Bwc, Ohio Safety Congress, Self Insured Assessment, Dfsp, Drug Free Safety Program, Cirp, Claim Impact Reduction, One Claim Program
Employers participating in Ohio BWC’s Drug-Free Safety Program (Basic or Advanced) or a Comparable Program will need to submit their required reports by March 31. The report and instructions for Basic and Advanced participants can be found online here, and the report and instructions for Comparable-Level participants can be found online here. Your report also serves as an application for the next program year. If you have additional questions or concerns about this reporting, or need a resource for training, please reach out to your Client Services Manager at Spooner Inc., or email clientservices@spoonerinc.net. If your policy is enrolled in the Claim Impact Reduction Program (CIRP, formerly known as the One Claim Program), you will need to complete the required training by March 31. A representative from your company must attend a half day class or three hour online class offered by BWC’s Division of Safety & Hygiene. This PDF has additional details about CIRP that first-year participants may find helpful. For self-insured employers, annual self-insured assessments are due February 28th. Ohio Safety Congress registration recently opened as well. This three day educational event is free to attend for employers with an active Ohio BWC policy. The Expo Marketplace will be open Wednesday and Thursday, and we encourage you to come visit us in booth 129! You can register for Ohio Safety Congress
28605 Ranney Parkway
Westlake, Ohio 44145
Phone: 440-249-5260 ext. 153
Hours: 8AM to 5PM