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Workers’ Compensation

Permanent Authorization (AC-2 ) Print
Temporary Authorization to Review Information (AC-3) Print  Online
Employer/Employee Agreement to Select Ohio as the State of Exclusive Remedy for Workers’ Compensation Claims (C-110) Print
Application for Ohio Workers’ Compensation Coverage (U-3) Print  Online
Notification of Policy Update (U-117) Print  Online
Notification of Business Acquisition/Merger or Purchase/Sale (U-118) Print  Online

Unemployment

Unemployment Employer’s Representative Authorization Print
Unemployment Quote Print

Health and Employee Benefits

Sample AOR Print
Group Quoting Census Print
HRA Reimbursement Form Print
Sample COBRA Letter Print
Sample State Contribution Letter OH Print
Marketplace Notice: Employer Offers Coverage Print
Marketplace Notice: Employer Does Not Offer Coverage Print

Human Resources and Compliance

One Minute Survey Print