SELF-INSURED CLIENT? [LOGIN HERE]

group experience rating renewal

Renew your  2025 Group Experience Rating

Renew by October 15, 2024 so you continue to benefit from workers’ compensation premium savings. 

 RENEW NOW

2025 Group Experience Rating Renewal

To renew your participation in the 2025 V+A Risk Services Group Rating Plan, please complete the fields and profile questions below. The deadline for renewal is October 15, 2024.

Questions? Click here to connect with our team.

your full name*
COMPANY NAME* 
your title or position*
your Email*
OHIO BWC POLICY NUMBER (FOUND IN THE PACKET WE MAILED YOU)*
1.
IS YOUR COMPANY A PROFESSIONAL EMPLOYER ORGANIZATION (PEO) OR HAS IT BEEN AFFILIATED WITH A PEO IN THE PAST 2 YEARS?*
YES
NO

2.
Has your company acquired, merged or taken over the assets, employees of book of business of another company during the past 5 years?*

yes
no

3.
Has your company closed an existing policy and re-opened under another policy?*

YES
NO
4.
Within the next 2 years, does your organization plan to merge with or purchase another business or sell or restructure your current business?*
YES
NO
5.
Has your company been audited by BWC during the past 5 years or are you currently undergoing an audit?*
YES
NO
5A.
IF YES, did the audit result in a change in manual classification?
YES
NO
5B.
IF YES, Did the audit result in penalties or a change in how you report your payroll?
YES
NO

6.
Are there any issues pending an adjudication hearing with the BWC?*

YES
NO
7.
Does this company, or any of its owners, own or operate any other entities in the State of Ohio under different BWC policies?*
YES
NO

7A.
If yes, list name & policy number

8.
Have you reported your payroll to another company or another unit of your company or has BWC reassigned all or part of your payroll to another company or another unit of your company?*
YES
NO
CERTIFICATION:
 SUBMIT YOUR ENROLLMENT