4123-17-43 Application for retrospective rating plan.

(A) All operations of an employer electing retrospective rating are subject to retrospective rating.

(B) The application must be filed on a bureau application form for the the retrospective rating plan. The application must be completed in its entirety, including but not limited to the selection of a per-claim limit and maximum premium per cent. The absence of pertinent information will result in the application being rejected.

(C) The application and all other required information must be filed by the application deadline in any bureau office. An application for a retrospective rating plan is applicable to only one policy year. Continuation of a plan for subsequent years is subject to filing of an application on a yearly basis and the meeting of eligibility requirements each year.

(D) All changes to the original application must be filed on another application form for the retrospective rating plan prior to the filing deadline. Any changes made must be completed in writing and signed by an officer of the company, and be filed prior to the filing deadline. Any changes received by the bureau of workers' compensation after the filing deadline will not be accepted. The latest application form or rescission received by the bureau prior to the filing deadline will be used in determining the premium obligation.

Effective: 11/15/2010
Promulgated Under: 111.15
Statutory Authority: 4121.12 , 4121.121
Rule Amplifies: 4123.29 , 4123.34
Prior Effective Dates: 7/1/88, 10/2/90, 7/1/97