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Application for Ohio Workers' Compensation Coverage (U-3)

Employers with one or more employees are required to carry workers' compensation coverage for their employees. Independent contractors and subcontractors also must obtain coverage for their employees. BWC considers officers of a corporation employees for workers' comp purposes, except for an individual incorporated as a corporation (to qualify must have a single/sole owner with no employees).


Required information

Sole proprietor

  • Individual name of owner as business
  • Federal identification number/Social Security number
  • Description of operations, including tools and any raw materials used
  • If employees, first hire date
  • Business demographics
  • Ownership details and demographics for sole owner with 100% ownership
  • Decision for elective coverage 
  • If electing coverage, estimate 12-month payroll
    • Minimum and maximum payroll reporting 
    • Primary job duties of work performed
  • Operations for employees and 12-month estimated payroll
  • Certification for submission
  • $120 non-refundable application fee

Note: If you are unable to complete the application in one sitting, you will have the option to save your progress and return to complete it within 15 days.  You will also have the option to download and print the form upon submission of the completed form.  Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. 


If you have all the required information on hand, simply click the start button to begin.

Start

Individual incorporated as a corporation (I-Corp)

  • Legal business name (match with charter filing)
  • Federal identification number/Social Security number
  • Description of operations, including tools and any raw materials used
  • If employees, first hire date
  • Charter details
    • Charter number
    • Date incorporated
    • State of incorporation
  • Business demographics
  • Ownership details and demographics for sole owner with 100% ownership
  • Decision for elective coverage
  • If electing coverage, estimate 12-month payroll
  • Certification for submission
  • $120 non-refundable application fee

Note: If you are unable to complete the application in one sitting, you will have the option to save your progress and return to complete it within 15 days.  You will also have the option to download and print the form upon submission of the completed form.  Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. 


If you have all the required information on hand, simply click the start button to begin.

Start

Partnership

  • Names of individuals owning partnership
  • Federal identification number/Social Security number
  • Description of operations, including tools and any raw materials used
  • If employees, first hire date 
  • Business demographics
  • Business contact
  • Ownership details and demographics
    • Minimum of two owners must be provided
    • Total ownership must equal 100%
  • Decision for elective coverage 
  • If electing coverage, estimate of 12-month payroll for owner
  • Operations for employees and 12-month estimated payroll
  • Certification for submission
  • $120 non-refundable application fee

Note: If you are unable to complete the application in one sitting, you will have the option to save your progress and return to complete it within 15 days.  You will also have the option to download and print the form upon submission of the completed form.  Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. 


If you have all the required information on hand, simply click the start button to begin.

Start

Limited partnership

  • Legal business name (match with charter filing)
  • Federal identification number/Social Security number
  • Description of operations, including tools and any raw materials used
  • Special employer type? Such as PEO, AEO, or temporary staffing agencies
  • If employees, first hire date 
  • Charter details
    • Charter number
    • Date incorporated
    • State of incorporation
  • Business demographics
  • Business contact
  • Ownership details and demographics
    • Minimum of two owners must be provided
    • Minimum ownership percentage of at least 51%
  • Decision for elective coverage 
  • If electing coverage, estimate of 12-month payroll for owner
  • Operations for employees and 12-month estimated payroll 
  • Certification for submission
  • $120 non-refundable application fee

Note: If you are unable to complete the application in one sitting, you will have the option to save your progress and return to complete it within 15 days.  You will also have the option to download and print the form upon submission of the completed form.  Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. 


If you have all the required information on hand, simply click the start button to begin.

Start

Limited liability company acting as a sole proprietor

  • Legal business name (match with charter filing)
  • Federal identification number/Social Security number
  • Description of operations, including tools and any raw materials used
  • Special employer type? Such as PEO, AEO, or temporary staffing agencies
  • If employees, first hire date 
  • Charter details
    • Charter number
    • Date incorporated
    • State of incorporation
  • Business demographics
  • Business contact
  • Ownership details and demographics for sole owner with 100% ownership
  • Decision for elective coverage 
  • If electing coverage, estimate of 12-month payroll for owner
  • Operations for employees and 12-month estimated payroll 
  • Certification for submission
  • $120 non-refundable application fee

Note: If you are unable to complete the application in one sitting, you will have the option to save your progress and return to complete it within 15 days.  You will also have the option to download and print the form upon submission of the completed form.  Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. 


If you have all the required information on hand, simply click the start button to begin.

Start

Limited liability company acting as a partnership

  • Legal business name (match with charter filing)
  • Federal identification number/Social Security number
  • Description of operations, including tools and any raw materials used
  • Special employer type? Such as PEO, AEO, or temporary staffing agencies
  • If employees, first hire date 
  • Charter details
    • Charter number
    • Date incorporated
    • State of incorporation
  • Business demographics
  • Business contact
  • Ownership details and demographics
    • Minimum of two owners must be provided
    • Minimum ownership percentage of at least 51%
  • Decision for elective coverage
  • If electing coverage, estimate of 12-month payroll for owner
  • Operations for employees and 12-month estimated payroll
  • Certification for submission
  • $120 non-refundable application fee

Note: If you are unable to complete the application in one sitting, you will have the option to save your progress and return to complete it within 15 days.  You will also have the option to download and print the form upon submission of the completed form.  Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. 


If you have all the required information on hand, simply click the start button to begin.

Start

Limited liability company acting as a corporation

  • Legal business name (match with charter filing)
  • Federal identification number/Social Security number
  • Description of operations, including tools and any raw materials used
  • Non-profit entity?
  • Special employer type? Such as PEO, AEO, or temporary staffing agencies
  • If employees, first hire date 
  • Charter details
    • Charter number
    • Date incorporated
    • State of incorporation
  • Business demographics
  • Business contact
  • Owner/Officer detail and demographics
    • Minimum to provide at least one owner/officer
  • Operations for employees and 12-month estimated payroll 
  • Certification for submission
  • $120 non-refundable application fee

Note: If you are unable to complete the application in one sitting, you will have the option to save your progress and return to complete it within 15 days.  You will also have the option to download and print the form upon submission of the completed form.  Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. 


If you have all the required information on hand, simply click the start button to begin.

Start

Association

  • Legal business name (match with charter filing)
  • Federal identification number/Social Security number
  • Description of operations, including tools and any raw materials used
  • Non-profit entity?
  • Special employer type? Such as PEO, AEO, or temporary staffing agencies
  • If employees, first hire date 
  • Charter details
    • Charter number
    • Date incorporated
    • State of incorporation
  • Business demographics
  • Business contact
  • Owner/Officer detail and demographics
    • Minimum to provide at least one owner/officer
  • Operations for employees and 12-month estimated payroll 
  • Certification for submission
  • $120 non-refundable application fee

Note: If you are unable to complete the application in one sitting, you will have the option to save your progress and return to complete it within 15 days.  You will also have the option to download and print the form upon submission of the completed form.  Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. 


If you have all the required information on hand, simply click the start button to begin.

Start

Corporation

  • Legal business name (match with charter filing)
  • Federal identification number/Social Security number
  • Description of operations, including tools and any raw materials used
  • Non-profit entity?
  • Special employer type? Such as PEO, AEO, or temporary staffing agencies
  • If employees, first hire date 
  • Charter details
    • Charter number
    • Date incorporated
    • State of incorporation
  • Business demographics
  • Business contact
  • Owner/Officer detail and demographics
    • Minimum to provide at least one owner/officer
  • Operations for employees and 12-month estimated payroll 
  • Certification for submission
  • $120 non-refundable application fee

Note: If you are unable to complete the application in one sitting, you will have the option to save your progress and return to complete it within 15 days.  You will also have the option to download and print the form upon submission of the completed form.  Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. 


If you have all the required information on hand, simply click the start button to begin.

Start

State/Local government

  • Legal business name (match with charter filing)
  • Federal identification number/Social Security number
  • Description of operations, including tools and any raw materials used
  • If employees, first hire date 
  • Business demographics
  • Business contact
  • Owner/Officer detail and demographics
    • Minimum to provide at least one owner/officer
  • Operations for employees and 12-month estimated payroll 
  • Certification for submission
  • $120 non-refundable application fee

Note: If you are unable to complete the application in one sitting, you will have the option to save your progress and return to complete it within 15 days.  You will also have the option to download and print the form upon submission of the completed form.  Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. 


If you have all the required information on hand, simply click the start button to begin.

Start

Domestic household employers

  • Individual name of owner(s) as business
  • Federal identification number/Social Security number
  • Description of operations, including tools and any raw materials used
  • If employees, first hire date 
  • Household demographics
  • Ownership details and demographics for homeowner(s)
  • Operations for employees and 12-month estimated payroll 
  • Certification for submission
  • $120 non-refundable application fee

Note: If you are unable to complete the application in one sitting, you will have the option to save your progress and return to complete it within 15 days.  You will also have the option to download and print the form upon submission of the completed form.  Coverage is not in effect until BWC receives the application and $120 non-refundable application fee. 


If you have all the required information on hand, simply click the start button to begin.

Start