State Employers to Select Managed Care Organizations

Open Enrollment begins after a year off caused by COVID-19 pandemic

By Deborah Rutledge

Following a COVID-19 pandemic delay last spring, Ohio employers this spring will get their chance again to choose a new Managed Care Organization (MCO), the partner they are required to have to manage their workers’ compensation medical claims.

The window of time for MCO Open Enrollment occurs every two years but was postponed when it was last due in 2020 so that employers could focus on managing their businesses during the pandemic, the Ohio Bureau of Workers’ Compensation (BWC) said in a news release.

Despite the postponement, the bureau still provided its MCO Report Card, which it publishes annually at to help employers evaluate their MCO options.

This time, the enrollment period will be May 3 to May 28.

There are 10 MCOs from which employers can choose to manage the medical side of claims when their employees are hurt on the job.

The Ohio Bureau of Workers’ Compensation contractually partners with those MCOs in the medical management of workers’ compensation claims. MCOs are paid by the bureau through premiums that employers pay to its state fund. The bureau provides workers’ compensation insurance to about 245,000 private employers and 4,000 public employers, such as cities, counties and schools.

Established in 1912, the Ohio Bureau of Workers’ Compensation is one of the largest state-run insurance systems in the country. It employs almost 1,800 people and oversees assets of about $28 billion, according to the bureau.

There are just a handful of states that provide their own state program for workers’ compensation coverage, and Ohio is one of them, meaning that private insurance companies are not allowed to offer workers’ compensation coverage.

In Ohio, employers must follow the state’s coverage requirements through the state fund that provides cash benefits and/or medical care for employees injured at work. With applied-for permission, though, some employers do self-insure. It is required by state law that all Ohio employers must provide coverage to employees in the event of a workplace injury.

In addition to the MCO Report Card, the Ohio BWC provides an MCO selection guide, although it is recommended that employers also call the MCOs to experience their responsiveness, service levels and differentiation from other MCOs.

Expert safety consultations a best-kept secret

The delay likely has allowed employers to take a good, slightly longer look at their MCOs, a Bureau of Workers’ Compensation spokesman noted. While they are at it, employers might also explore the ways that the BWC can improve their safety efforts—all covered by the premiums they pay the Ohio BWC, he said.

Employers can schedule consultations by expert safety consultants through the bureau’s Division of Safety and Hygiene, and they can also apply for a number of safety grants through the BWC.

In 2017, Cincinnati’s MadTree Brewing Co. used a $40,000 safety grant from BWC to buy production equipment that can help prevent injuries.

According to the bureau’s website, MadTree used the grant to buy a dry-hop injection system and an in-line bottle labeler and inkjet coder. With the injection system, workers would no longer need to climb ladders to add hops to fermentation tanks. The labeler reduced the risk for repetitive stress injuries.

More help in trying times

While Open Enrollment was delayed in the past year, the bureau—at the request of Gov. Mike DeWine—further eased the impact of COVID-19 pandemic on the state’s businesses through its board-approved issuance of almost $8 billion in dividends in April, October and December.

The dividend distributions were made possible by BWC’s healthy investment returns on employer premiums, a declining number of injury claims and prudent fiscal management, the BWC website noted. The December dividend was almost four times the premium that employers paid in policy year 2019.

The website also credits employers who work to improve workplace safety and reduce injury claims. It further notes that even in a market downturn, the bureau could provide the year’s dividends while still maintaining the funds to take care of injured workers for years to come.

“We’re happy to be in the position to assist employers across the state during these challenging times,” BWC interim administrator/CEO John Logue said at the time of the last distribution. “It’s our hope these dollars will keep businesses open and safe and people employed.”

In December, 178,415 private and public employers covered by the State Insurance Fund were eligible for a $5 billion dividend through a combination of checks in the mail and credits to their BWC accounts. BWC first applied the dividend to an employer’s unpaid balance, then sent a check for the rest. The dividend followed a $1.54 billion dividend in April and one for $1.34 billion in October.

Premium rate cuts are another way that the Ohio BWC reduced workers’ compensation costs for employers. The bureau reduced rates for public employers a net 7.9 percent on Jan. 1. For private employers, it reduced rates a net 7.1 percent, effective July 1.

To help mitigate the spread of the COVID-19 illness, the Ohio BWC also provided businesses with reusable cloth face masks. By the end of June, the bureau will have sent up to 46 million face masks as part of its Protecting Ohio’s Workforce – We’ve Got You Covered initiative to weaken COVID-19’s spread.

Responding to the initiative, at least two employers in Northeast Ohio invested in equipment and workers to produce and distribute 23 million masks through the end of May 2021.