OPERS Independent Contractor/Worker Acknowledgment Summary

This document is an acknowledgment form issued by the Ohio Public Employees Retirement System (OPERS) for individuals who provide personal services to public employers as independent contractors on or after January 7, 2013. The form requires completion within 30 days of beginning service and consists of three sections: personal information collection (name, Social Security number, date of birth, current employer), public employer information (name, contact details, employer code, service description, and service dates), and a formal acknowledgment section outlining the contractor's status and obligations.

The acknowledgment section details critical statutory requirements under Ohio Administrative Code section 145-1-42(A)(2), establishing that independent contractors are not public employees and will not receive OPERS contributions. Key characteristics of independent contractor status include bilateral agreements defining compensation and responsibilities, payment via fee or contractual arrangement, ineligibility for workers' compensation or unemployment benefits, exclusion from payroll, responsibility for own supplies and equipment, lack of employer supervision regarding work methods, and receipt of IRS Form 1099. The form emphasizes that individuals may request an OPERS eligibility determination within five years of service commencement if they dispute their classification, with specific provisions regarding re-employed retirees and the OPERS Health Reimbursement Arrangement (HRA) and Retiree Medical Account (RMA). Signatories acknowledge forfeiture of benefits during contract periods and potential liability for incorrectly paid amounts, with the acknowledgment remaining valid during continuous service to the same employer and potentially extending dispute rights beyond the standard five-year period.