Hunter Consulting - Workers' Compensation and Unemployment Compensation Services
Workers' Compensation and Unemployment Compensation Services Hunter provides comprehensive consulting and claims administration in the area of Workers' and Unemployment Compensation. Our objective is to provide aggressive claims services to our clients and their employees.
Contact us to find out more about how we can help you.
Third Party Administrator Established in 1986 by the company's founder Jack Hunter, Hunter Consulting Company has established itself as one of Ohio's premier Third Party Administrators. Learn more
Established in 1986 by the company's founder Jack Hunter, Hunter Consulting Company has established itself as one of Ohio's premier Third Party Administrators. Founded on the principle of providing superior service, Hunter Consulting has grown to be one of the largest Administrators for Self Insured and Retrospective Rated companies.
Our Group Rating Program is the fastest growing program in the State of Ohio offering highly competitive premium discounts while maintaining excellent claims administration services. We have worked very hard at building our reputation based on giving our clients the highest quality and most dependable service in Ohio Workers' Compensation
We are equally proud of our Unemployment Services reputation throughout the United States. For more information, contact us.
Hunter Consulting utilizes HP Quad Xeon servers, the most reliable hardware platform in the industry. These servers run Microsoft's Windows R2012 Server Operating System. Our desktop systems employ Microsoft's 2010 Office Suite of products for day to day business processing. Hunter uses a hosted exchange solution with 99.99% reliability and GFI Faxmaker for inbound/outbound faxing. We use a VOIP system so each employee has dedicated phone and fax numbers.
CMS2015 is Hunter Consulting's custom designed Claims Management Software. This software is designed in-house to allow highly specialized administration of workers' compensation and unemployment compensation claims within the framework of Ohio Workers' Compensation law. CMS2015 allows progressive and cost effective programming to suit the client's specific needs. With this flexibility, workers' compensation and unemployment compensation services can be tailored to fit any client, large or small.
- Integrated "Document Image and Capture System"
- alized claim search by ssn, injury date, last name or combination of search fields.
- Payment / Reserve search
- action detail to include cpt, ucr and ppo detail
- ete notes and form generation history
- date/change tracking
- e capabilities for accurate follow-up
- t access to all claims and paper data
- and calendar functions
- check processing with logos
- auditing functionality to support SAS70 testing
- al UCR reductions per Ohio BWC schedule and PPO auditing
- ive-Pay capabilities with all major banking institutions
- array of self-insured and state funded reporting options
- c reporting capabilities
- Laser reporting by request
- 0-CM and PCS code compliant
- Compliant, audited by Barnes and Denning
Hunter hosts and maintains its corporate web site. This site is continually updated to provide clients with the latest breaking BWC laws, updates, and special events.
Hunter uses GFS Backup rotation to insure data integrity in a disaster recovery situation. All backups are stored offsite for added safety and security. Our recovery plan also allows for continued claims administration in the event of disaster.
Effective January 1st, 2016 Hunter will be migrating our current document management system to OnBase, a proven leader in the document image and capture market. OnBase will integrate seamlessly with our CMS2015 line of business applications and will allow client access to all claims data and documents on-line via the web. OnBase will also allow us to manage your claims even more effectively. Our imaging solution can eliminate the necessity to maintain hard copy files. Audits conducted by the Ohio Bureau of Workers' Compensation can be conducted on-line instead of at the client site, thus saving paper, time and money. Our business applications are continually being updated to reflect the latest changes in Ohio Workers' Compensation law and to provide the latest technological advancements.
Hunter's IT Department is always available to assist clients in all aspects of their Workers' Compensation and unemployment compensation Program.
Hunter Consulting Company provides comprehensive consulting and claims administration in the area of Workers' and Unemployment Compensation. Our objective is to provide aggressive claims services, while being considerate and helpful to our clients and their employees. To accomplish this, we use a team approach with each client being assigned an Account Manager and an Account Executive that are familiar with their operations and procedures.
To control workers' and unemployment compensation costs in today's business environment, a company must control all claims. Many employers today identify a small percentage of claims that are questionable and aggressively go after them while they ignore the remaining majority of “not a problem” claims thinking they will take care of themselves. This simply does not happen! It is our responsibility to aggressively manage all claims and identify those avenues, which will help limit your liability. In our initial program design phase we discuss with you our role in the information process. As with all aspects of our services, we are flexible in how we administer your program.
To serve our client's individual needs, we at Hunter Consulting Company have invested heavily in technology. Our proprietary mix of software and hardware gives us the ability to generate comprehensive management reports in addition to the reports required by the State of Ohio for workers' compensation and unemployment on a national basis. Learn more about our technology.
Self Insured Workers' Compensation
Plan design customized to meet individual client's needs
- Meetings with client to discuss paper management and flow
- Discuss most efficient means of claims reporting to protect your Self-Insurance privilege and deliver benefits to legitimately injured employees
- Written manuals provided to specify responsibilities and for future reference
- Internal audit of claim files to ensure compliance with rules and regulations as required by Ohio Bureau Of Workers' Compensation.
Claims Management and Control
Hunter Consulting Company (Hunter) maintains a staff of experienced claims personnel. These professionals are trained to manage claims from the client’s perspective. Their objective is to provide expert services with an ultimate goal of reducing your claim costs. Our claims staff will work closely with you to promote a frequent exchange of information necessary for effective claims management.
A Hunter Account Manager will promptly investigate the incident leading to injury to determine the claim’s merit. Initial contact with the claimant will be established within 24 to 48 hours of receipt of the claim notice, depending on severity. During the investigation process, Hunter will:
- Obtain copies of medical records
- Secure statements from the claimant, fellow employees, or other witnesses
- Order copies of police reports, safety reports, or other appropriate investigation reports
The Hunter Consulting Company reserve philosophy is to accurately present to the client their full exposure as soon as it is known. This requires a thorough review of:
- Attending physician’s diagnosis of the claimant’s condition
- Medical treatment required
- Statutory benefits
- Anticipated duration of a disability
- Case law
- Assessment of damages resulting from legal liability or accident compensability and the most probable outcome based on the case in its entirety
- Establish initial file reserve within 24-48 hours of receipt of the first report The reserve amount is reviewed every 30 days by the Account Manager and adjusted if the facts surrounding the claim warrant a change.
Claims Settlement Negotiations commence as soon as sufficient evidence to establish a fair settlement value exists. During the course of negotiations, our Account Manager will:
- Notify the client of developments
- Maintain proper file documentation
- Coordinate efforts with appropriate parties
Account Managers will determine if a claim may involve a liable third party. The Account Manager is responsible for:
- Identifying the liable third party
- Pursuing subrogation against that party
- Initiating efforts to recover all costs expended on the claim
- Managing the subrogation efforts to conclusion
Our Account Managers are trained to handle much of the medical management as a normal part of their daily claims practice. Under certain circumstances, it may become necessary for a file to be referred to an outside service. Vocational rehabilitation is recommended on a selective basis. A recommendation might be made in situations involving:
- Catastrophic loss
- Protracted period of disability
- Permanent medical restrictions
- Uncooperative or troublesome claimant
The objective of our Claims Management Staff is to manage claimants in order to control the period of temporary total disability. At all times during the claimant’s recovery period, the claims person will:
- Maintain regular contact with the claimant
- Monitor the claimant’s progress
- Consider all return to work options
Client and Employee Communications
Hunter Consulting Company believes that communication is essential to efficient claims management. To promote effective communications, we have established a three-point system of contact. During the normal course of our claims management process, we will maintain regular contact with:
- Treating physician
Accounting and Financial
The benefits can be delivered to your employees in the following ways:
- Vouchers. After review of the claim and calculation of the appropriate benefit, we would issue a voucher to you. Upon receipt, you would then generate a check paying the medical provider or claimant as indicated.
- Checks without signature authority. We would complete the checks for you but would not have power of signature. Thus, they would be returned to you for signature and distribution. Check registers would be provided in the frequency requested.
- Checks with signature authority. We would complete the checks. Upon completion they would be signed and distributed with copies to the appropriate company personnel. Check registers would be provided in the frequency requested.
All contested claims are reviewed upon receipt by the Account Manager assigned to your account. Contact is made with the appropriate company personnel to obtain any necessary information and discuss witnesses, where indicated. The defense strategy is also discussed. Once the matter is scheduled for hearing, if indicated, the company is contacted again to be certain all materials have been received and to finalize preparations for the hearing. After the hearing, written reports detailing the testimony and hearing results will be provided. Attorneys are utilized at hearings before the Industrial Commission.
State Fund Workers' Compensation
No matter how big or small your company may be Hunter Consulting can help design a program to meet the specific needs of your company. In the following pages you will see, in detail, how we can help. Our primary objective is to give you superior service, which in turn will result in substantial monetary savings on your workers’ compensation. Hunter can meet your needs. If you are looking to participate in a “sound” Group Rating program, we administer several. Otherwise we can tailor a program to meet the more intricate of needs in the Retrospective and Self-Insured areas. Our client satisfaction speaks for itself with our 97.8% retention rate.
- Program Design and Implementation
- Claim Management and Control
- Client-Employee Communications
- Deductible Program
- EM Capping
- Retrospective Rating
- Group Rating
- Group Retrospective-Rating
- Drug Free Safety Program (DFSP)
- Handicap Reimbursement
- $15K Medical-Only Program
- Transitional Work
- One Claim Program
- Safety Council Discount
- Salary Continuation
Program Design and Implementation
Meetings with your personnel would be scheduled to discuss paper management and flow. We discuss with you and your personnel all aspects of the claims reporting process to determine the most expeditious and efficient means of delivering benefits to your legitimately injured employees. Suggestions are made, where indicated, to streamline this process.
An initial audit of your claim files would be conducted. This is done to verify all payments and charges against your risk account. In addition, we identify those claims that qualify for Handicap Reimbursement and, where appropriate, apply for this relief.
A rating inspection of your company’s operations is conducted to verify that the appropriate manual classifications are being utilized.
We review the last two rating periods and protest any incorrect charges or reserves based upon this audit of your claims.
Claim Management and Control
Many employers today aggressively approach only the five percent of their claims that they feel are questionable and assume the remaining ninety five percent will take care of themselves. This simply does not happen.
Unfortunately, the “system” is very liberal and some of those contested claims are going to draw benefits. To control Workers’ Compensation costs in today’s environment, a company must control all their claims, particularly, the ninety five percent of the legitimately injured employees.
At Hunter Consulting Company, we have developed what the average length of disability is for most types of injuries. Every lost time claim is monitored to track this period of disability. We contact the claimant’s doctor on any claim that exceeds the norm to discuss his prognosis and restrictions for return to work. We then discuss with you the options available, whether that may be modified jobs, independent medical exams, or rehabilitation. As your service company, it is our responsibility to identify for you those claims that need attention.
Client and Employee Communications
During the program design, we discuss with you our role in the information process. Our direct communication with your employees can be anything you want it to be. We can be the buffer between you and your employee to limit your administrative overhead or have little or no contact with your employees, depending upon your philosophy and requirements. As with all aspects of our services, we are flexible in how we administer your program.
Under the Deductible Program an employer receives an up-front premium discount in exchange for agreeing to pay a per-claim deductible amount. For claims that occur during that policy year, you would be responsible for the first dollars paid up to the selected deductible amount.
- Must be a private, state-fund employer or a public employer taxing district
- Be Current on any and all premiums or other monies owed to the BWC
Employer must be in good standing with the BWC.
- Must have active coverage by application deadline
- Must be current on premium payments
- May not have cumulative lapses in coverage in excess of 40 days within the 12 months preceding application deadline - deductible levels up to $10,000.
- May not have cumulative lapses in coverage in excess of 15 days within the 5 years preceding the application deadline - deductible levels up to $25,000.
- For deductible levels of $25,000 - $50,000 employers will be required to submit reviewed/audited financial statements for the 3 most recent fiscal years.
- For deductible levels of $100,000 - $200,000 employers are required to submit audited financial statements for the 3 most recent fiscal years.
- Demonstrate financial strength and stability. Additional financial requirements may apply in certain circumstances.
The employer will complete the Application for Deductible Program (U-148) and submit it directly to the Ohio BWC. Private employers wishing to enroll must submit an application by the last business day in April; public employers must submit enrollment applications no later than the last business day in October.
Employers will automatically be enrolled each consecutive year at their current deductible level. If an employer wishes to make changes to their deductible level or withdraw from the program, they must do so during the enrollment period.
EM Capping Program
BWC’s EM capping is designed to minimize the effects of a significant premium increase when an employer becomes penalty rated.
The EM Cap will equal 100% of the employer's EM for the previous year, which can be a Group EM or an Individual EM.
The Ohio BWC will notify employers of their eligibility by mail in late June.
- No more than 40 days of lapses within the 12 months prior to July 1st for private employers and January 1st for public employers
- No more than 45 days past due on any premium payments
- In the first year agree to complete a one-half day industry specific safety course provided by the BWC's Division of Safety & Hygiene.
- Continuing participation after the first year will require completion of 3 hours of online training via the Division of Safety & Hygiene website.
All contested claims are reviewed by the Account Manager assigned to your account upon receipt. Contact is made with the appropriate company personnel to obtain any necessary information and discuss witnesses, where indicated. The defense strategy is also discussed. Once the matter is scheduled for hearing, if indicated, the company is contacted again to be certain all materials have been received and to finalize preparations for the hearing. After the hearing, written reports detailing the testimony and hearing results will be provided.
Any company paying in excess of $200,000.00 in Annual State Fund Premiums should review this program to determine if it would be an appropriate cost control tool. With a retrospective rated program, the employer selects a deductible from $100,000.00 to no claim limit. They self-insure this figure with the Bureau. The Bureau provides excess insurance over that level. Hunter Consulting Company can perform a ten-year cost flow analysis to determine if this program would be appropriate for you.
If you are a small business employer wanting to control your workers’ compensation costs, then the Hunter Consulting group rating program might be your solution.0
The group rating plan allows employers that are substantially similar in business type to merge their individual experiences together, as if they are one large employer, for rate re-calculation purposes. This allows employers to potentially achieve a lower premium rate than they could on their own.
- Hunter Consulting representing a sponsoring organization, such as a chamber of commerce or trade association, reviews your experience to determine if you qualify to be part of a group rating program.
- The sponsoring organization submits a list of employers who are members of each group to the BWC by the required application deadline.
- The employers of the group must be businesses that are substantially similar.
- The group must substantially improve accident prevention and claims handling, which must be annually documented.
- The group must consist of at least 100 individual employers or the combined premiums of the employers must exceed $150,000
Employers must be current on any and all undisputed premiums, administrative costs, assessments, fines and monies due to the BWC.
- Must be current on the payment schedule of any part-pay agreements.
- The employer cannot have cumulative lapses in coverage exceeding 40 days within 12 months preceding the group rating application deadline.
- Must be in active coverage status by the application deadline, and remain in active coverage status through the beginning of the policy year.
The sponsoring organization will have each new employer complete the Employer Statement for Group Rating Plan (AC-26). The sponsoring organization representative will then submit all employer application forms to BWC with the entire group packet. The group rating plan is for premium rates for the one policy year. Employers must re-apply every year in a timely manner and are subject to eligibility requirements.
The sponsoring organization will submit newly formed groups each year on the Monday before Thanksgiving for Private Employers or the last business day in May for Public Employers.
Under the Group Retrospective-Rating Program, employers can band together through a sponsoring organization and earn refunds (or be charged assessments) based on performance. Employers will pay their individual premiums for the initial policy year and at 12, 24, and 36 months after the initial policy year the BWC will review the claims costs and standard premium of the group as a whole. If the review indicates a decrease in premium then each employer in the group will receive a refund, but if the premium has increased an assessment will be issued.
- Must be a private, state-fund employer or a public employer taxing district
- Be Current on any and all premiums or other monies owed to the BWC
- Employer must be in good standing with the BWC.
- Must have active coverage by the application deadline
- Must be current on premium payments
- :May not have cumulative lapses of more than 40 days in the past 12 months
The sponsoring organization will have each new employer complete the Employer Statement for Group Retrospective Rating Plan (U-153). The sponsoring organization representative will then submit all employer application forms to BWC with the entire group packet. The group rating plan is for premium rates for the one policy year. Employers must re-apply every year in a timely manner and are subject to eligibility requirements.
The sponsoring organization will submit newly formed groups each year by the last business day in January for Private employers or the last business day in July for public employers.
Drug Free Safety Program
BWC’s DFSP is designed to help employers establish safer and more cost-effective workplaces. Private employers can participate in a program year from July 1 to June 30; public employers can participate in the January 1 to December 31 program.
Private employers must submit the U-140 prior to May 31st for the program year beginning July 1st and Public employers must submit the U-140 prior to Spetember 30th for the program year beginning January 1st.Eligibility
- Only State Fund employers may participate.
- Employer must be in good standing with the BWC.
- Must be current on all premium payments at time of application and throughout the policy year
- May not have cumulative lapses of more than 40 days in the past 12 months
- Must continue to meet all eligibility requirements during participation in the program.
- Basic Level - 4% Discount
- Advanced Level - 7% Discount
- Increased productivity
- Fewer accidents
- Decreased severity of accidents
- Reduction in use of workers' compensation medical benefits by substance users
- Decrease in theft
- Protecting the bottom line
Handicap reimbursement is designed to encourage employers to hire and retain an employee with a handicap condition or an employee with a military service handicap. If a handicapped employee suffers a lost-time industrial injury/disease and files a workers’ compensation claim, the employer may request a percentage of the costs in the claim be removed from their experience.Purpose
Handicap reimbursement is granted when it is determined that a pre-existing handicap condition prolonged or delayed normal recovery. If a handicap reimbursement is granted, a percentage of the claim costs will be charged to the statutory surplus fund instead of the employer’s experience.Benefits
- The percentage granted, ranging from 0 to 100 percent, is deducted from the experience of the employer and subsequently charged to the statutory surplus fund.
- Handicap reimbursement applications are considered even when a claim is settled.
- Hunter Consulting Company account managers review medical documentation to identify any pre-existing condition in any claim with disability compensation and/or salary continuation payments.
- If a qualifying condition is identified, Hunter Consulting begins to establish documentation to show the extent the pre-existing condition prolonged or delayed normal recovery.
- If there is significant supporting documentation Hunter will file an Application for Handicap Reimbursement (CHP-4A) for consideration by the BWC.
- Hunter may represent the employer at a BWC administrator hearing to establish the relationship between the pre-existing condition and the subsequent injury be way of aggravation or delayed recovery by medial proof on file.
- The BWC administrator decides the percentage of the reimbursement and issues an order directing the BWC’s Risk Technical Department to adjust the employer’s premium for the time the claim remains in the employer’s experience period. The percentage award is entered into the records of the employer’s state fund risk account.
Claims that have deductible compensation paid in them may be eligible, including Temporary Total disability, Permanent Total disability, Death Benefits and Salary Continuation. Employers not eligible for the handicap reimbursement are non-complying employers and out-of-business employers, self-insuring employers who have opted out of the program and did not list the claim on the buyout agreement, bankrupt employers (requests are reviewed on a case by case basis; some bankrupt employers may qualify for a reimbursement), and state agencies and universities.Application Deadlines
State Fund Employer claims must be filed by 6/30 of the sixth year after the date of injury.
Example: 2006 injury must have application filed by 6/30/2012
Public Employer claims must be filed by 12/31 of the fifth year after the date of
Example: 2006 injury must have application filed by 12/31/2011
Self-Insuring Employers still in the program must file claims by five years from the date of
Example: 2006 injury must be file by date of injury in 2011.
$15K Medical-Only Program
The BWC’s $15,000 Medical-Only Program offers employers the opportunity to pay the first $15,000 of medical bills in the claims with seven or fewer lost days from work.How it Works
- The program automatically covers all medical only claims.
- The employer can decide to have a specific qualifying claims excluded from the program.
- While the program covers the claim the Managed Care Organization (MCO) will not manage the claim.
- If a claim changes to lost time, indicating eight or more days lost from work, the BWC will remove the claim from the program.
- Once the medical bills reach the $15,000 limit, the employer must notify the BWC to have the claim removed from the program.
- Employers should remember some injuries will logically cost more than the limit, therefore, the claim should be removed from the program before reaching $15,000.
- Must be an active state fund employer
- Inform all employees and medical providers of the employer’s participation in the program so the provider sends the bills to the employer.
- Pay bills to the provider within 30 days.
- Pay the amount billed or the amount agreed upon by the provider.
- Remain current on any BWC premiums, assessments or other monies due.
A transitional work program is a progressive, individualized return-to-work program focused on transitioning injured workers with temporary limitations back to their original jobs. Implementation can significantly reduce worker’s compensation costs by allowing injured workers to perform transitional work duties during their recovery. The program offers injured employees a productive work option – as opposed to just light duty – that maintains positive morale for all your employees.Benefits
- Employers can realize direct cost savings with a reduction in overall employee absences.
- Employers can eliminate the need to hire and train replacement employees, avoiding the unnecessary delays and inefficiencies created when valuable employees are missing.
- By returning injured workers to work as quickly and safely as possible, the potential for legal complications is lessened.
- By experiencing minimal lost time, BWC claim reserves are reduced or prevented entirely.
- If an employer is prepared to offer transitional duty, we recommend that the offer be made to the injured worker in writing via certified mail and copies of the offer sent to the BWC, the MCO, and Hunter Consulting.
- If an injured workers physician of record agrees to the transitional duty position that the employer has to offer and the injured worker refuses to accept the transitional duty position, ongoing compensation may be terminated.
- To benefit fully from this cost control strategy, the employer must pay the injured worker their normal wages/salary from the onset of the injury. If paying the injured worker at a lower rate, the injured worker may have the option to file for wage loss compensation. Wage loss can carry a high reserve charge and adversely affect an employer’s premium dollars. By paying the normal wages/salary from the beginning the BWC will not add a reserve.
- Obtain restrictions from the treating physician
- Determine what tasks the employee may be able to perform
Offer the modified work to an employee in writing, specifically detailing:
- Time & Place to start
- Task to Perform
- Rate of pay
Once an employee is back on modified duty, employers cannot forget about them. It is important to obtain regular updates on employee’s injury and on performance of assigned tasks.
Modified/Transitional/Light Duty is simply providing an injured worker with tasks they can perform with the restrictions of their injuries. Statistics show that claim costs can be reduced by 21% to 33% when return-to-work occurs within the first 3 weeks. In addition, claim costs tend to increase by more than 50% if the injured worker is off longer than 90 days.
One Claim Program
If one significant claim enters your experience and leads to your group sponsor no longer qualifying you for group rating, the BWC One Claim Program may be able to help.Basics
The One Claim Program (OCP) is a voluntary rate program for private, state fund employers participating in a group rating plan. It is designed to help employers with minimal claims lessen the impact of one uncharacteristic claim. Eligible employers will receive a 20% discount off their base rate the first year of participation, 15% the second year, 10% the third year, and 5% the fourth and fifth year of participation.Benefits
- In addition to the discount, the OCP provides an opportunity for employers to work with their Managed Care Organization (MCO) and Hunter Consulting to gain a better understanding of claims management and work to prevent future claims
- Employers may also participate in the Drug Free Workplace Program and stack that discount on top of the OCP base rate discount. Employers participating in OCP cannot participate in the Premium Discount Program.
To be eligible for the OCP, a participant must:
- Be a state fund employer
- Be enrolled in a group rating program
- Have a single significant claim entering their experience that prevents them from being renewed in their group rating program
- Not have more than 3 medical only claims in addition to the one significant claim during the past five years
- Be current on any premiums, assessments or other monies due to the BWC
- Cannot have days of lapsed coverage in excess of 40 days within the last 12 months preceding the application deadline.
To remain eligible, employers must:
- Not allow the total cost of the three medical only claims to exceed their expected losses calculated for that policy year
- Attend a half-day course offered by the BWC's Division of Safety & Hygiene.
- Remain current on any premiums, assessments or monies due to BWC
- Not have any lapses in workers’ compensation coverage
Private employers must enroll by the last business day in January and public employers by the last business day in July.
Safety Council Discount Program
The Ohio Bureau of Workers’ Compensation offers a discount program for participating in you area safety council. 83 safety councils participate in this program which promotes strategies to increase safety and health in both the workplace and the community. Participating employers would have the opportunity to receive a 2% rebate for participation.Eligibility
To qualify for a two percent participation rebate employers must meet the following
- Enroll with the local safety council by July 31.
Attend 10 meetings or events.
- At least 8 through the local safety council
- Credit for 2 meetings may be obtained by attendance of Ohio Safety Congress, DSH safety training courses or industry-specific training.
- The CEO (highest ranking officer) must attend one safety council sponsored function or meeting (CEO attendance counts as credit toward one of 10 meetings required).
- Submit semi-annual reports for the calendar year.
Employers can also earn an additional 2 percent performance bonus for reducing either frequency or severity of claims by 10 percent, or with maintenance of both frequency and severity at zero. An employer must meet all eligibility requirements to be eligible for a performance discount.
Salary Continuation Program
Salary continuation, also known as Wages in Lieu of Temporary Total Disability (TTD), is a privilege granted by the BWC that allows employers to pay an injured worker their normal wages while they are unable to work due to a work-related injury.Purpose
A reserve is set on all active lost-time claims. This reserve is added to the compensation and medical paid in a claim to develop your total modified losses, which is then used to determine an employer’s experience rate and subsequent premium. If an employer pays salary continuation in a claim and avoids compensation from being paid by the BWC, it prevents a reserve from being established in the claim.Benefits
- Avoids costly reserves
- Can lower premiums
- Decreased wait time for workers compensation checks to begin
- Supports communication between the employer and injured worker
- May discourage need for injured worker to seek legal advice
- Initially, salary continuation may be recommended when lost time does not exceed 12 weeks. However, the cost of continuing an injured worker’s salary can sometimes outweigh potential savings. Hunter Consulting Company will make a recommendation on each specific situation.
- The BWC allows an employer to pay salary continuation, but an injured worker can still file a permanent partial award, schedule loss award, permanent total disability, facial disfigurement or death benefits and a reserve will be assigned to a claim, regardless of previous salary continuation being paid.
- The injured worker is not required to accept salary continuation.
- Decision to pay salary continuation must be made at the onset of the claim, as it cannot be paid once the BWC has issued TTD.
- Salary continuation must be paid immediately so there is no lapse in pay for the injured worker.
- The employer must notify the BWC within 48 hours and Hunter immediately that they are paying salary continuation.
- BWC form C-55 (Salary Continuation Agreement) must be completed by the employer and injured worker and then provided to the BWC. The employer may be asked to submit payment summary and wage information in writing as a follow up. The C-55 form to document payment of salary continuation can be obtained from the BWC claims service specialist (CSS), the BWC website or from Hunter.
- The employer must report the return to work within 72 hours (3 business days). Failure to do so may impact the employer’s eligibility to participate in the salary continuation program.
- The employer must notify BWC immediately if salary continuation is stopped for any reason. The CSS will investigate to determine the injured worker’s continued eligibility to receive TTD.Discounts
Practice a consistent policy of continuing wages in all claims that meet your list of parameters. You do not want to be accused of discrimination. You should consult with your legal counsel so that a policy is carefully developed and followed consistently. It is also recommended that you contact your Claims Examiner at Hunter to review the specifics of the claims and ask them to answer any questions you may have regarding salary continuation.
Subrogation is the process by which the BWC collects medical and compensation costs paid on behalf of an injured worker when a third party causes the injury. For subrogation to occur an injured worker must collect a judgment or settlement from the third party.Details
Ohio statute gives a right of subrogation to the BWC, self insuring employers and certain employers who contract for the direct payment of medical services. This allows the BWC or self insuring employer the right to collect back the costs of the claim from the person or entity who caused the accident. Recoverable costs include all past, present, and estimated future payments of compensation, medical benefits, rehabilitation costs or death benefits paid to or on behalf of the claimant.What claims can be subrogatedM
- Premises liability (slip and fall not on company property)
- Product liability ( machine malfunction)
- Medical malpractice
- Construction site accidents (caused by third party)
- Dog bites or animal attacks
- Automobile accidents
Subrogation referrals are made in many ways. Any party to claim can make a referral to the subrogation department including the BWC itself, the managed care organization, attorneys, insurance companies or Hunter Consulting. A good referral should include
- Claimant name and date of injury
- Third party name and insurance carrier
- Name of attorney representing claimant
The BWC is normally notified at the time the injured worker settles the third party claim. The subrogation department will then negotiate the settlement of the BWC lien with the injured worker or representative and the insurance company. Most claims will be resolved at this point, and the subrogation department will have a settlement release signed by the injured worker, and receive a check representing the amount of the BWC lien.
Claims which cannot successfully be resolved may be referred for mediation within BWC by the administrator’s designee. Claims which are not successfully mediated will be referred to the attorney general for collection.Collection
The amount collected is credited to the employer’s risk at the time of recovery, and may result in the reduction of the employer’s premium. BWC’s right of recovery is tied to the injured worker’s third party claim and it may take two years or longer to collect.
Frequently Asked Questions
Q. What is group rating?
A. Group rating is a program employers can use to reduce their workers’ compensation costs. The Ohio Bureau of Workers' Compensation permits employers to join together and be “rated” as a group through a sponsoring organization (such as chamber of commerce or trade association) to save money.
Q. Are all group rating plans the same?
A. No. Some group rating plans inflate their projected savings and are not large enough to form stable groups. When this occurs, employers find their actual savings are less than anticipated. The SOCA/Hunter plan does not inflate projected savings and is large enough to form stable groups in 6 of the 10 industry groups.
Q. What if I have not qualified for group rating in the past?
A.Your eligibility for group rating may change from year to year, meaning that even if you have not qualified in the past, you could qualify for SOCA/Hunter.
Q. Am I required to join a sponsoring organization to be in group rating?
A. Yes. You must become a member of one of the 87 SOCA chambers. Their membership fees are considerably less than other sponsoring organizations and each of the chambers have a variety of other benefits to offer. See www.joinsoca.com
Q. What if I am currently in another group rating plan?
A. You may switch plans on an annual basis, so you can save more money. Just complete an AC3 (temporary authorization) form, which you can obtain from your local SOCA chamber. The enrollment period for group rating ends in February. The group rating year begins in July and continues through the end of June.
Q. How much can I save?
A. The SOCA/Hunter group rating program discounts are set in accordance with the Ohio BWC's pre-set maximum. The 2011 program reflected a maximum discount of 51%.
Q. How do I compare group rating plans?
A. In return for submitting a completed AC3 form, you will receive group rating enrollment information with savings projections for the upcoming group rating year. We can assist you in comparing service coverage and related costs.
Q. What benefits do I get with my SOCA/Hunter Group Rating Program?
A. With your SOCA membership, you can receive:
- Free Safety Seminars twice a year
- $1,000 Defense Fund
- Low cost health insurance programs including dental & vision coverage
- Short & Long term disability coverage
- Various benefits offered by the individual SOCA chambers
- Cost-effective claims management by experienced professionals
- Representation at hearings before the Industrial Commission of Ohio
- Workers’ compensation education through Hunter Consulting seminars and newsletters
- Access to unemployment compensation consultation and representation
Unemployment Insurance provides cash benefits to workers who have become unemployed through no fault of their own. These benefits are paid to the employee by the State agency and charged back to the worker’s base period employers. These unemployment costs are totally paid by the employer. These costs vary from State to State and are based upon each individual employer’s experience.
The Southern Ohio Chamber Alliance since its inception has grown from five to nearly 100 Chambers of Commerce offering value-added benefits including workers' compensation group rating program, health insurance, eye care, dental programs and more.
The Ohio Roofing Contractors Association is the only association in Ohio dedicated to the sole purpose of working for the roofing contractor. ORCA is designed to help you stay informed about current issues as well as providing access to benefits and services.
The EPC is a public entity purchasing cooperative coordinating the purchasing power of over 100 member school districts in 15 counties in southwestern Ohio. Millions of tax dollars are saved annually in such commodity areas as food service, paper, light bulbs, busses, janitorial supplies, natural gas and property & casualty insurances. The EPC also administers an employee benefits Plan covering 10,000 employees and sponsors a Workers' Compensation group rating program. More info on the EPC can be found at www.epcschools.org
The Tri-County Restaurant Association is a non-profit organization designed to promote the food industry in Carroll, Stark and Tuscarawas Counties. Promoting our member restaurants through the Tourist Map and Member Directory as well as networking events. www.thetcra.com
Established in 1988 to enhance local independent electrical contractors’ success, IEC strives to develop a professional workforce by focusing on safety, communicating clearly with government, promoting ethical business practices, providing leadership for the electrical industry, and educating its member employees through a 4-year apprenticeship program. www.iec-cincy.com
The Ohio Craft Brewers Association was founded as a not-for-profit organization in 2008 to unify the Ohio brewing community, market Ohio manufactured beers throughout the state and beyond, and monitor and promote a strong beer industry in Ohio. The Ohio Craft Brewers Association also organizes statewide events that showcase the rich brewing industry and stellar beers being produced in Ohio. www.ohiocraftbeer.org
We now have an alternate solution to your worker’s compensation premium woes. Our new partner, Teamworx, is a Self-Insured Professional Employer Organization (PEO) that can help you control and reduce your Ohio workers’ compensation expenses. Now, you can take back your workers’ compensation program, and SAVE 20-30% off what you are currently paying the BWC. Partnering with Teamworx can increase your profitability and reduce your liability. Teamworx can assume many of the time consuming and complex human resource functions and give you time to grow your business. Teamworx can be the perfect solution for your small to mid-sized business by offering you a PEO option. While in their program there is NO workers’ compensation experience (claims) attached to your Ohio workers’ compensation policy (Teamworx will assume all the risk and work with the BWC on your behalf).
For more information on the services offered by Teamworx, please visit their website at www.teamworxhr.com.
Are You Looking to Improve Your Payroll Situation? We have partnered with Paycor, Inc., an Ohio based full service payroll processing company, headquartered in Cincinnati. Paycor's 175 associates process payroll, prepare payroll taxes and provide other employee administration services related to issuing, correcting and processing timely payroll checks to over 4,500 clients.
Providing superior client service has always been Paycor's number one goal. In fact, they consider themselves a payroll processing firm, rather than a "data processing firm." In other words, Paycor treats their clients as people, not numbers.
Paycor's well rounded services include calculating and filing Ohio workers' compensation premiums as well as any and all local, state and federal taxes. These valuable timesaving services ensure you stay in compliance so you can focus on other important areas of your business.
Working partners can help you develop and maintain a drug-free workplace by working with you on compliance needs and assisting you in qualifying for workers' compensation and insurance discounts, as well as grants and other special finding. You may also buffer your company's legal exposure with the consultation, products and services that Working Partners provides. Working Partners is the only organization focused solely on helping employers implement comprehensive, effective drug-free workplace programs.
IronRoad, a Human Resources Outsourcing Company (HRO), has served businesses in the Midwest since 1997. IronRoad helps employers focus on their business objectives by outsourcing transactional tasks that do not generate revenue and if not managed properly, can result in decreased profitability and productivity.
IronRoad clients range in their size and scope of operations. The common denominator is that they all have employees. IronRoad clients range from as few as 10 employees to as large as several hundred.
IronRoad serves their clients consistently with integrity, respect and commitment through their model of servant leadership.
Check out the latest BWC Updates:
- Emergency Exits and Routes Safety
- SAMPLE Notice of Estimated Annual Premium and Premium Payment Schedule
- Enforcement a Key to a Successful Safety Program
- OSHA Announces Major Changes in Injury and Illness Reporting and Recording Requirements
- OSHA Recordkeeping Fact Sheet
- Preventing Accidents Before They Happen
- Safe Use of Respirators
- Private Employers - BWC Timeline for Prospective Billing
- Public Employers - BWC Timeline for Prospective Billing
- Planning for Success
- Raising the Bar for Safety
- Safety - Have To vs Want To
- Conducting Effective Ongoing Safety Training
- OSHA Announces Proposed Rule Change for Workplace Injuries and Illnesses
- Implementing a Culture Based Safety Program
- Management Safety Responsibility & Accountability
- Changes in the Hazard Communication Standard
- FREE Spring Safety Training for Private Employers
- Safe Use of Respirators
- Private Employers FREE Spring 2016 Safety Training
- LIVE TO WORK ANOTHER DAY
- Preventing Heat Related Illnesses
- Implementing A Safety Training Plan
- Safety Accountability
- Keeping Up With The Changes in OSHA - FREE Private Employer Safety Training
- For the up to date information on San Allen, Inc., et al v. Ohio Bureau of Workers’ Compensation please visit http://www.ohiobwclawsuit.com/
Self-Insured & State Fund Forms Click on the links below to download the forms, they are in PDF format.
Group Rating Forms
- Standard Power of Attorney for all States
- Alabama Power of Attorney
- Arizona Power of Attorney
- Colorado Power of Attorney
- Illinois Power of Attorney
- Iowa Power of Attorney
- Kansas Power of Attorney
- Nevada Power of Attorney
- North Carolina Power of Attorney
- Ohio Power of Attorney
- Oklahoma Power of Attorney
- Pennsylvania Power of Attorney
- Maine Power of Attorney
- Missouri Power of Attorney
- Nevada Power of Attorney
- North Carolina Power of Attorney
- Vermont Power of Attorney
- Wyoming Power of Attorney
Hunter Consulting Company is always interested in motivated, hard-working, skilled individuals looking for a career dealing with some aspect of Workers' Compensation and Unemployment Compensation. A Workers' Compensation background is a plus along with computer skills, a medical background and strong communication skills. Hunter Consulting Company has an excellent benefits package including such things as 401K, health insurance (single or family), life insurance, and paid vacations. We are committed to:
- Promotion from within the company