State Fund TPA
Ohio MCO
Behind every good outcome
About Careworks Comp
Cost Savings Eligibility
State Fund TPA
Ohio MCO
About Careworks Comp
Cost Savings Eligibility
Forms and Agreements
Safety Resources
Training
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Forms and Agreements
Permanent Authorization
Temporary Authorization to Review Information (AC-3)
Salary Continuation Agreement
Request for Temporary Total Compensation
Wage Statement
First Report of Injury, Occupational Disease or Death
Physician’s Report of Work Ability
Application for the One Claim Program
Application for Drug-Free Safety Program
Application for the Deductible Program
Application for Ohio Workers’ Compensation Coverage
Private Employer Participation Agreements
2019 CareWorks Comp Group Rating Participation Agreement
2019 CareWorks Comp Group Retrospective Rating Plan Participation Agreement
2020 CareWorks Comp Group Rating Participation Agreement
2020 CareWorks Comp Group Retrospective Rating Participation Agreement
2021 CareWorks Comp Group Rating Participation Agreement
2021 CareWorks Comp Group Retrospective Rating Participation Agreement
Public Employer Participation Agreements
2021 CareWorks Comp Public Group Participation Agreement
2021 CareWorks Comp Public Group Retro Participation Agreement
NFIB Group Rating and Group Retrospective Rating Participation Agreements
2020 NFIB Group Amendment
2020 NFIB Group Participation Agreement (starting 3/1)
2020 NFIB Group Participation Agreement (starting 1/1)
2020 NFIB Group Retro Participation Agreement (starting 3/1)
2020 NFIB Group Retro Participation Agreement (starting 1/1)
2021 NFIB Group Retro Participation Agreement (starting 3/1)
2021 NFIB Group Retro Participation Agreement (starting 1/1)
2021 NFIB Group Participation Agreement (starting 3/1)
2021 NFIB Group Participation Agreement (starting 1/1)
2021 NFIB Group Amendment
NFIB Select Program Plus Participation Agreements
2020 NFIB Select Program Plus Amendment
2020 NFIB Select Program Plus Participation Agreement (starting 1/1)
2020 NFIB Select Program Plus Participation Agreement (starting 3/1)
2021 NFIB Select Program Plus Participation Agreement (starting 3/1)
2021 NFIB Select Program Plus Participation Agreement (starting 1/1)
2021 NFIB Select Program Plus Amendment
Safety Resources
Ohio Safety Resources