OPERS Independent Contractor Form_fillable PDF Form.pdf

This is an Ohio Public Employees Retirement System (OPERS) Independent Contractor/Worker Acknowledgment form that must be completed by individuals providing personal services to Ohio public employers who are classified as independent contractors rather than public employees. The form must be submitted within 30 days of beginning services and includes sections for personal information, public employer details, and service dates. The document outlines eight specific criteria that define an independent contractor under Ohio Administrative Code section 145-1-42(A)(2), including having a bilateral agreement, being paid by contractual arrangement, and not being eligible for employee benefits.

The form serves as official acknowledgment that the contractor understands they will not receive OPERS contributions or benefits for their services. Contractors have up to five years to request a determination of their employment classification status if they disagree with their independent contractor designation. The form must be retained by both the public employer and OPERS, as failure to maintain this documentation may extend the contractor's right to request classification determination beyond the standard five-year period. The form also includes special provisions regarding retirees who return to work as independent contractors and their eligibility for health reimbursement arrangements.