Rule 4123-17-61 | Criteria for group experience rating.
(A) The administrator shall offer a plan that groups employers for rating purposes. Individual employers shall retain their separate risk identity but shall be pooled and grouped for experience rating purposes only.
(B) In establishing a group for group experience rating purposes, the sponsoring group organization or individual employers in the group must satisfy all of the following requirements and must meet all the sponsorship rules as provided in rule 4123-17-61.1 of the Administrative Code:
(1) All of the individual employers within the group must be governing members of the sponsoring organization or the affiliate organization.
(2) An individual employer must have a policy in good standing with the bureau. "Policy in good standing" means the individual employer is current on all payments due to the bureau and is in compliance with bureau laws, rules, and regulations at the time of enrollment or reenrollment.
(3) The employers' business in the organization must be substantially similar such that the risks which are grouped are substantially homogeneous. A group shall be considered substantially homogeneous if the main operating classification codes of the risks as determined by the premium obligations for the rating year beginning two years prior to the coverage period are assigned to the same or similar industry groups, as determined by appendix A to rule 4123-17-05 of the Administrative Code. Industry groups seven and nine as well as eight and nine, and industry groups two and four as well as four, and six are considered similar.
(a) The bureau may allow an individual employer to move to a more homogeneous group, after September thirtieth for private employer groups and March thirty-first for pubic employer taxing district groups but before the first day of the policy year, if the individual employer:
(i) Is without a full year of recorded premium;
(ii) Is reclassified as a result of an audit; or
(iii) Fully or partially combines with another employer.
(b) An individual employer member of a continuing group who initially satisfied the homogeneous requirement shall not be disqualified from participation in the continuing group for failure to continue to satisfy such requirement.
(4) The group of employers must consist of at least one hundred individual members or a group where the aggregate workers' compensation premiums of the members are, as determined by the administrator, expected to exceed one hundred fifty thousand dollars during the policy year for which the application for group rating is made.
(5) As of the deadline for application for group experience rating set forth in appendix A and in appendix B to rule 4123-17-74 of the Administrative Code, each individual employer seeking to enroll in a group for workers' compensation coverage must meet the following requirements:
(a) The individual employer must be current with respect to all payments due the bureau, as defined in paragraph (A)(1)(b) of rule 4123-17-14 of the Administrative Code;
(b) The individual employer must be current on the payment schedule of any part-pay agreement into which it has entered for payment of premiums or assessment obligations;
(c) The individual employer cannot have cumulative lapses in workers' compensation coverage in excess of forty days within the prior twelve months; and
(d) The individual employer must report actual payroll for the preceding policy year and pay any premium due upon reconciliation of estimated premium and actual premium for that policy year.
(6) Cancellations, transfers, and combinations.
(a) An individual employer whose coverage status becomes cancelled or combined during the rating year may not continue to participate in group experience rating. The effective date of the removal from the group experience rating program shall be on the first day of the next policy year, unless the date of cancellation or combination is determined to be the first day of the policy year, in which case the individual employer shall be removed from group as of the actual date of cancellation or combination. An individual employer who becomes active and obtains coverage after the group experience rating application deadline may not participate in group experience rating for that year except as defined in rule 4123-17-66 of the Administrative Code.
(b) An individual employer that obtains initial coverage after the group experience rating application deadline as set forth in appendix A and in appendix B to rule 4123-17-74 of the Administrative Code and for which a transfer of experience is indicated under rule 4123-17-02 of the Administrative Code may not participate in group experience rating for that year except as defined in rule 4123-17-66 of the Administrative Code.
(7) Payroll reporting and premium reconciliation. An individual employer must report actual payroll for the preceding policy year and pay any premium due upon reconciliation of estimated premium and actual premium for that policy year no later than the date set forth in rule 4123-17-14 of the Administrative Code. An individual employer will be deemed to have met this requirement if the bureau receives the payroll report and the employer pays premium associated with the payroll report before the expiration of any grace period established by the administrator pursuant to paragraph (B) of rule 4123-17-16 of the Administrative Code.
(a) An individual employer removed from group experience rating for failure to meet these criteria will be rerated for the full policy year at the individual employers base-rate or experience-modified rate as determined by their expected losses for the policy year.
(b) The group shall retain, for the policy year, the experience of any employer removed from group experience rating for failure to meet these criteria.
(C) In providing employer group plans under section 4123.29 of the Revised Code, the bureau shall consider an employer group as a single employing entity for purposes of group experience rating. No employer may be a member of more than one group for the purpose of obtaining workers' compensation coverage.
Last updated July 27, 2023 at 8:46 AM