A state where employers must buy workers’-comp coverage from the state itself. There are four: Ohio, Washington, Wyoming and North Dakota.
In most of the country, workers’ compensation coverage is sold by private carriers or a competitive state fund. In four states, employers must buy it from the state fund itself — or self-insure:
A single dominant payer means one rule book, one fee schedule and one set of habits to learn — which is genuinely easier than juggling twenty carriers. But each of the four routes bills differently. Ohio inserts an MCO between you and the fund, which exists in no other state. Washington splits between the fund and self-insured employers. North Dakota assigns you the work. Wyoming has no private market at all.
“Monopolistic” describes the insurance market, not the billing workflow. The workflow still has to be learned state by state.
The state pages carry each jurisdiction’s payer, form, channel, fee basis and clock — including the forty-seven that are not monopolistic.
Fifteen minutes, your state’s codes on screen — or start the trial and poke around on your own.