BWC One Claim Program
Introduction

BWC’s One Claim Program (OCP) is open to private, state-fund employers currently enrolled in a group-experience-rating program.

To participate in the OCP, an employer must have a single significant claim entering your experience for the first time from the green year. A significant claim is one whose total cost exceeds the expected losses for an employer based on size and industry — also known as total limited losses (TLL) — calculated for that policy year. An employer may only designate one significant, lost-time claim every four years.

In addition to the one significant claim, an employer may carry up to three medical-only claims in their experience. The sum total of these medical-only claims must not exceed the TLL. As the medical-only claims move out of your experience another may enter, so long as you never have more than four total claims in your experience.

Program Discount

If an employer qualifies and participates in the program, they will receive a 40-percent discount off of their base rate. The program also provides an opportunity for you to work closer with your managed care organization, third-party administrator and BWC representatives to better manage claims and work to prevent future claims. A strong relationship with workers’ compensation partners and effective claims management can help you get back into a group-experience-rating program faster.

Participation Requirements

Each year the employer is in the program, they must attend two BWC-approved, all-day training courses each policy year. Also, you may not have any outstanding balances, and you must be in compliance with BWC rules and law. Additional eligibility requirements may also apply.
If you continue to meet eligibility requirements, you can remain in the OCP up to four years. If you fail to continually meet the eligibility requirements, BWC will remove you from the program. Should this occur, then BWC will give you your individual experience modifier(EM).

You may choose to opt out at the beginning of each policy year. If you choose to opt out, you must notify BWC by the preceding March 31. Then, your EM will be based on your individual experience. If the one significant, lost-time claim remains in your experience and you continue to meet the OCP requirements, you may re-enter the program.