Ohio Bureau of Workers' Compensation - PEO Unit

Form UA-1 L: Professional Employer Organization Limited Registration Application

$100

• List of officers
• States in which the PEO is licensed or registered as a PEO, its licenses or registration number and state agency
  that issues it (attach a copy of most recent certification)
• PEO client listing

Form UA-1 L: Professional Employer Organization Limited Registration Application (Renewal)

$100

Annually by December 31.

• List of officers
• States in which the PEO is licensed or registered as a PEO, its licenses or registration number and state agency
  that issues it (attach a copy of most recent certification)
• PEO client listing

$1,000

Contact BWC's PEO unit at 614-466-6773 for a copy of the application form.

• A list of each of the PEO's client employers current as of the date of registration
• The address of the PEO's principal place of business and the address of each office it maintains in Ohio
• A list of each state in which the PEO has operated in the preceding five years, and the name, corresponding with each state, under which the PEO operated in each state, including any alternative names, names of predecessors, and if known, successor business entities
• A list of all corporate officers of the PEO
• A list of all related corporate entities
• The most recent financial statement prepared and audited by an independent certified public accountant authorized to practice in the jurisdiction in which that accountant is located. Such financial statement must be no older than 13 months at the time it is submitted to the bureau.

$250 for each PEO policy.

Annually by December 31.

Renewal forms are sent in the mail.

• A list of each of the PEO's client employers current as of the date of registration
• The address of the PEO's principal place of business and the address of each office it maintains in Ohio
• A list of each state in which the PEO has operated in the preceding five years, and the name, corresponding with each state, under which the PEO operated in each state, including any alternative names, names of predecessors, and if known, successor business entities
• A list of all corporate officers of the PEO
• A list of all related corporate entities

Email financial statements to: BWCPEOFinancials@ohio.gov

$0

Annually within 180 days of the close of the PEO’s fiscal year.

PEOs must submit GAAP-audited (Generally Accepted Accounting Principles) financial statements every year.

Form UA-3: Professional Employer Organization Client Relationship Notification

$0

Within 30 days of any new PEO agreements, a change in reporting, or the termination of a PEO agreement.

$0

Biannually by June 30 and December 31.

PEOs must semi-annually submit a report of its client employers and total workforce to the bureau.

Online

By the 15th day of each month.

PEOs must pay premiums and report actual payroll each month.