OPERS Independent Contractor Form_fillable PDF Form (6).pdf

This document is an Ohio Public Employees Retirement System (OPERS) Independent Contractor/Worker Acknowledgment form designed for individuals providing personal services to a public employer on or after January 7, 2013, who are not considered public employees. The form requires independent contractors to acknowledge their classification and understand that no retirement system contributions will be made on their behalf. Contractors must complete this form within 30 days of beginning services, and it outlines specific criteria defining an independent contractor, such as being paid by contractual arrangement, not being eligible for employee benefits, and providing their own supplies and equipment.

The form details critical implications for independent contractors, including potential limitations on future retirement system interactions. Specifically, contractors may be ineligible for OPERS Health Reimbursement Arrangement (HRA) and Retiree Medical Account (RMA) benefits. The document emphasizes that if a contractor disagrees with their classification, they can request a determination from OPERS within five years of beginning services. The form also notes that if a contractor begins work with an employer after retirement, there may be restrictions on benefit allowances and potential financial liabilities related to compensation.