If an Ohio employer wants to participate in a BWC sponsored discount program, they need to partner with a TPA (third-party administrator). Failure to do so can cost employers thousands, if not tens of thousands, in additional premiums annually.
In addition to getting employers discounts on their workers’ comp premiums, TPAs work for the employer – not for BWC. Your TPA should be advocating on your behalf to manage all aspects of your workers’ comp claims and policy, including (but not limited to):
If you rely on your TPA to manage workers’ comp claims (and you should be – you’ve paid them to!), you need a service agreement in place to protect you and provide terms for your relationship. Have you read your contract with your TPA? Do you even have one?
If your TPA doesn’t have a service contract that spells out what services they are providing, ask them why that is. Often, we see that employers just get an invoice from their TPA with the amount due. In the event of a claim, do you know if you’re paying your TPA for anything more than a discount? Due to TPAs holding the key to BWC sponsored discount programs –many Ohio employers don’t realize that their TPA’s main objective should be claims management, not simply filing paperwork.
We often talk to employers who have been automatically re-enrolled for the Group Rating program they were in last year, without any discussion of other programs. With changes made recently by Ohio BWC, the Group Rating program has become less valuable and employers may save up to 40% more by participating in a program like Group Retro. The summer prior to the policy year in question is the best time to talk to your TPA about renewal options, or to look at other TPAs that might offer a more valuable partnership. For example, in the summer of 2021 – you should be looking ahead at options for the 2022 policy year. Your current TPA will send your renewal as much as 14 months in advance – so be cautious about signing paperwork and writing checks to them if you’re not sure you want to continue that partnership.
If you’re waiting until you have a claim to find out the level of service your TPA provides, it may already be too late.
Posted By Brandy King
January 07, 2025
Category: Ohio BWC, Group Retro, 20018 Group Retro, 2019 Group Retro, Group Retro Refunds Withheld
The team at Spooner Risk Control Services, Kent Elastomer Products, Inc. and Roetzel & Andress have scored another win in the fight to get businesses the Group Retro refunds they’ve earned. Background: At the end of 2020, we shared Ohio BWC’s decision to withhold Group Retro refunds owed to participating employers for the 2018 and 2019 policy years. This was based on the concept that employers were already returned 100% of premiums for those years via dividends released to Ohio employers in April and October of 2020. However, dividend distribution and Group Retro refunds are governed by different rules, and different portions of the Ohio Revised Code. We appealed this decision in August 2020, kicking off a legal battle with Ohio BWC that will continue into 2025. After the victory for Group Retro participants in February 2023, BWC appealed the magistrate’s ruling, stating five objections. A hearing was held on November 19, 2024 by the 10th District Court of Appeals, and four of the five objections were overruled. For the reasons detailed here, the court again ruled in favor of Ohio businesses granted a limited writ of mandamus (meaning BWC is obligated to pay out Group Retro refunds). Hellbent on not paying these earned program refunds to employers, BWC chose to file yet another appeal on December 30, 2024 arguing their reasoning for withholding the refunds. From here, the matter will be referred to the Supreme Court of
Posted By Brandy King
December 16, 2024
Category: Non Compete, Employment Law, Non Solicitation Agreement, Ohio
FTC’s Non-Compete Ban Blocked, But Gray Area Remains In early 2023, the Federal Trade Commission (FTC) introduced and finalized a rule banning the use of non-competes. Employers, Chambers of Commerce and trade organizations rallied against the new rule claiming it was anti-employer, some going as far as calling it “blatantly awful.” As expected, the change was met with litigation and in August of 2024, the ban was struck down by a federal judge in Texas who claimed the FTC overstepped its authority by issuing the rule. A non-compete (or non-competition agreement) is an agreement in which the employee agrees not to engage in conduct or activities that could increase competition for their employer. These types of arrangements are prevalent in finance, healthcare, design, tech and all types of sales or business development roles. They’re meant to protect things like trade secrets, privileged info and client retention. Non-competes aren’t the same as non-solicitation clauses. These agreements err more toward not calling on your former clients in your new role. Here’s an example of differentiating between the two. Non-Compete: “Upon leaving ABC Company, you may not engage in a similar role for another insurance company within a 50-mile radius.” Non-Solicitation: “Upon leaving ABC Company, you may not solicit (contact/call on) clients of ABC Company in your new role with another insurance company.” For now, bo
Posted By Brandy King
December 16, 2024
Category: Contribution Limits, Employee Benefits, Retirement Plans, HSA, FSA, ACA
ACA Updates & Reminders It’s almost time for ACA reporting! There aren’t any major changes this year, but here are some items to be aware of for the 2024 tax year. The employee distribution deadline for the 1095-C forms is March 3, 2025. Since the 2023 tax year, the IRS requires all employers with more than ten (10) forms to report electronically. Employers can complete this either directly through the IRS website or through a third-party provider. Corrected forms are also required to be submitted electronically. If you’re submitting 10 or fewer forms, you can still file on paper. The deadline for this is February 28, 2025. The deadline for e-filing 1095-C and 1094-C forms to the IRS is March 31, 2025. Keep in mind that there could be additional ACA state reporting requirements for your organization with differing deadlines. The states to pay special attention to are California, New Jersey, Massachusetts, Rhode Island, and the District of Columbia. Updated penalties and affordability percentages. The ACA penalizes Applicable Large Employers (ALEs) that don’t offer what’s considered affordable coverage to full-time employees (FTEs). The affordability percentage is the maximum amount of an employee’s pay that “Employee Only” coverage can cost the employee in order to be considered affordable by ACA. For 2024, that percentage is 8.39%. The affordability percentage will jump to 9.02% for 2025, and the associated fines will
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