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To amend sections 4121.30, 4123.20, 4123.29, | 1 |
4123.291, 4123.35, 4123.37, and 4123.411 and to | 2 |
repeal section 4121.18 of the Revised Code to make | 3 |
changes to Ohio's Workers' Compensation Law. | 4 |
Section 1. That sections 4121.30, 4123.20, 4123.29, 4123.291, | 5 |
4123.35, 4123.37, and 4123.411 of the Revised Code be amended to | 6 |
read as follows: | 7 |
Sec. 4121.30. (A) All rules governing the operating | 8 |
procedure of the bureau of workers' compensation and the | 9 |
industrial commission shall be adopted in accordance with Chapter | 10 |
119. of the Revised Code, except that determinations of the | 11 |
bureau, district hearing officers, staff hearing officers, and the | 12 |
commission, with respect to an individual employee's claim to | 13 |
participate in the state insurance fund are governed only by | 14 |
Chapter 4123. of the Revised Code. | 15 |
The administrator of workers' compensation and commission | 16 |
shall proceed jointly, in accordance with Chapter 119. of the | 17 |
Revised Code, including a joint hearing, to adopt joint rules | 18 |
governing the operating procedures of the bureau and commission. | 19 |
20 |
(B) Upon submission to the bureau or the commission of a | 21 |
petition containing not less than fifteen hundred signatures of | 22 |
adult residents of the state, any individual may propose a rule | 23 |
for adoption, amendment, or rescission by the bureau or the | 24 |
commission. If, upon investigation, the bureau or commission is | 25 |
satisfied that the signatures upon the petition are valid, it | 26 |
shall proceed, in accordance with Chapter 119. of the Revised | 27 |
Code, to consider adoption, amendment, or rescission of the rule. | 28 |
(C) The administrator shall | 29 |
electronically all rules adopted by the bureau and the commission | 30 |
31 | |
manner | 32 |
the commission that are currently in force. | 33 |
34 | |
35 |
(D) The rule-making authority granted to the administrator | 36 |
under this section does not limit the commission's rule-making | 37 |
authority relative to its overall adjudicatory policy-making and | 38 |
management duties under this chapter and Chapters 4123., 4127., | 39 |
and 4131. of the Revised Code. The administrator shall not | 40 |
disregard any rule adopted by the commission, provided that the | 41 |
rule is within the commission's rule-making authority. | 42 |
Sec. 4123.20. The administrator of workers' compensation | 43 |
shall | 44 |
available electronically to the public, its classifications, | 45 |
rates, rules, and rules of procedure, and shall furnish the same | 46 |
to any person upon | 47 |
48 | |
49 | |
50 | |
request. | 51 |
Sec. 4123.29. (A) The administrator of workers' | 52 |
compensation, subject to the approval of the bureau of workers' | 53 |
compensation board of directors, shall do all of the following: | 54 |
(1) Classify occupations or industries with respect to their | 55 |
degree of hazard and determine the risks of the different classes | 56 |
according to the categories the national council on compensation | 57 |
insurance establishes that are applicable to employers in this | 58 |
state; | 59 |
(2)(a) Fix the rates of premium of the risks of the classes | 60 |
based upon the total payroll in each of the classes of occupation | 61 |
or industry sufficiently large to provide a fund for the | 62 |
compensation provided for in this chapter and to maintain a state | 63 |
insurance fund from year to year. The administrator shall set the | 64 |
rates at a level that assures the solvency of the fund. Where the | 65 |
payroll cannot be obtained or, in the opinion of the | 66 |
administrator, is not an adequate measure for determining the | 67 |
premium to be paid for the degree of hazard, the administrator may | 68 |
determine the rates of premium upon such other basis, consistent | 69 |
with insurance principles, as is equitable in view of the degree | 70 |
of hazard, and whenever in this chapter reference is made to | 71 |
payroll or expenditure of wages with reference to fixing premiums, | 72 |
the reference shall be construed to have been made also to such | 73 |
other basis for fixing the rates of premium as the administrator | 74 |
may determine under this section. | 75 |
(b) If an employer elects to obtain other-states' coverage | 76 |
pursuant to section 4123.292 of the Revised Code through either | 77 |
the administrator, if the administrator elects to offer such | 78 |
coverage, or an other-states' insurer, calculate the employer's | 79 |
premium for the state insurance fund in the same manner as | 80 |
otherwise required under division (A) of this section and section | 81 |
4123.34 of the Revised Code, except that when the administrator | 82 |
determines the expenditure of wages, payroll, or both upon which | 83 |
to base the employer's premium, the administrator shall use only | 84 |
the expenditure of wages, payroll, or both attributable to the | 85 |
labor performed and services provided by that employer's employees | 86 |
when those employees performed labor and provided services in this | 87 |
state only and to which the other-states' coverage does not apply. | 88 |
(c) The administrator in setting or revising rates shall | 89 |
furnish to employers an adequate explanation of the basis for the | 90 |
rates set. | 91 |
(3) Develop and make available to employers who are paying | 92 |
premiums to the state insurance fund alternative premium plans. | 93 |
Alternative premium plans shall include retrospective rating | 94 |
plans. The administrator may make available plans under which an | 95 |
advanced deposit may be applied against a specified deductible | 96 |
amount per claim and may make available other alternative premium, | 97 |
rate, or discount plans that the administrator determines are | 98 |
necessary to encourage employers to participate in safety or | 99 |
compliance programs, including drug-free workplace, workplace | 100 |
wellness, safety, job development, or claims management. | 101 |
(4)(a) Offer to insure the obligations of employers under | 102 |
this chapter under a plan that groups, for rating purposes, | 103 |
employers, and pools the risk of the employers within the group | 104 |
provided that the employers meet all of the following conditions: | 105 |
(i) All of the employers within the group are members of an | 106 |
organization that has been in existence for at least two years | 107 |
prior to the date of application for group coverage; | 108 |
(ii) The organization was formed for purposes other than that | 109 |
of obtaining group workers' compensation under this division; | 110 |
(iii) The employers' business in the organization is | 111 |
substantially similar such that the risks which are grouped are | 112 |
substantially homogeneous; | 113 |
(iv) The group of employers consists of at least one hundred | 114 |
members or the aggregate workers' compensation premiums of the | 115 |
members, as determined by the administrator, are expected to | 116 |
exceed one hundred fifty thousand dollars during the coverage | 117 |
period; | 118 |
(v) The formation and operation of the group program in the | 119 |
organization will substantially improve accident prevention and | 120 |
claims handling for the employers in the group; | 121 |
(vi) Each employer seeking to enroll in a group for workers' | 122 |
compensation coverage has an industrial insurance account in good | 123 |
standing with the bureau of workers' compensation such that at the | 124 |
time the agreement is processed no outstanding premiums, | 125 |
penalties, or assessments are due from any of the employers. | 126 |
(b) If an organization sponsors more than one employer group | 127 |
to participate in group plans established under this section, that | 128 |
organization may submit a single application that supplies all of | 129 |
the information necessary for each group of employers that the | 130 |
organization wishes to sponsor. | 131 |
(c) In providing employer group plans under division (A)(4) | 132 |
of this section, the administrator shall consider an employer | 133 |
group as a single employing entity for purposes of group rating. | 134 |
No employer may be a member of more than one group for the purpose | 135 |
of obtaining workers' compensation coverage under this division. | 136 |
(d) At the time the administrator revises premium rates | 137 |
pursuant to this section and section 4123.34 of the Revised Code, | 138 |
if the premium rate of an employer who participates in a group | 139 |
plan established under this section changes from the rate | 140 |
established for the previous year, the administrator, in addition | 141 |
to sending the invoice with the rate revision to that employer, | 142 |
shall send a copy of that invoice to the third-party administrator | 143 |
that administers the group plan for that employer's group. | 144 |
(e) In providing employer group plans under division (A)(4) | 145 |
of this section, the administrator shall establish a program | 146 |
designed to mitigate the impact of a significant claim that would | 147 |
come into the experience of a private, state fund group-rated | 148 |
employer or a taxing district employer for the first time and be a | 149 |
contributing factor in that employer being excluded from a | 150 |
group-rated plan. The administrator shall establish eligibility | 151 |
criteria and requirements that such employers must satisfy in | 152 |
order to participate in this program. For purposes of this | 153 |
program, the administrator shall establish a discount on premium | 154 |
rates applicable to employers who qualify for the program. | 155 |
(f) In no event shall division (A)(4) of this section be | 156 |
construed as granting to an employer status as a self-insuring | 157 |
employer. | 158 |
(g) The administrator shall develop classifications of | 159 |
occupations or industries that are sufficiently distinct so as not | 160 |
to group employers in classifications that unfairly represent the | 161 |
risks of employment with the employer. | 162 |
(5) Generally promote employer participation in the state | 163 |
insurance fund through the regular dissemination of information to | 164 |
all classes of employers describing the advantages and benefits of | 165 |
opting to make premium payments to the fund. To that end, the | 166 |
administrator shall regularly make employers aware of the various | 167 |
workers' compensation premium packages developed and offered | 168 |
pursuant to this section. | 169 |
(6) Make available to every employer who is paying premiums | 170 |
to the state insurance fund a program whereby the employer or the | 171 |
employer's agent pays to the claimant or on behalf of the claimant | 172 |
the first fifteen thousand dollars of a compensable workers' | 173 |
compensation medical-only claim filed by that claimant that is | 174 |
related to the same injury or occupational disease. No formal | 175 |
application is required; however, an employer must elect to | 176 |
participate by telephoning the bureau after July 1, 1995. Once an | 177 |
employer has elected to participate in the program, the employer | 178 |
will be responsible for all bills in all medical-only claims with | 179 |
a date of injury the same or later than the election date, unless | 180 |
the employer notifies the bureau within fourteen days of receipt | 181 |
of the notification of a claim being filed that it does not wish | 182 |
to pay the bills in that claim, or the employer notifies the | 183 |
bureau that the fifteen thousand dollar maximum has been paid, or | 184 |
the employer notifies the bureau of the last day of service on | 185 |
which it will be responsible for the bills in a particular | 186 |
medical-only claim. If an employer elects to enter the program, | 187 |
the administrator shall not reimburse the employer for such | 188 |
amounts paid and shall not charge the first fifteen thousand | 189 |
dollars of any medical-only claim paid by an employer to the | 190 |
employer's experience or otherwise use it in merit rating or | 191 |
determining the risks of any employer for the purpose of payment | 192 |
of premiums under this chapter. A certified health care provider | 193 |
shall extend to an employer who participates in this program the | 194 |
same rates for services rendered to an employee of that employer | 195 |
as the provider bills the administrator for the same type of | 196 |
medical claim processed by the bureau and shall not charge, | 197 |
assess, or otherwise attempt to collect from an employee any | 198 |
amount for covered services or supplies that is in excess of that | 199 |
rate. If an employer elects to enter the program and the employer | 200 |
fails to pay a bill for a medical-only claim included in the | 201 |
program, the employer shall be liable for that bill and the | 202 |
employee for whom the employer failed to pay the bill shall not be | 203 |
liable for that bill. The administrator shall adopt rules to | 204 |
implement and administer division (A)(6) of this section. Upon | 205 |
written request from the bureau, the employer shall provide | 206 |
documentation to the bureau of all medical-only bills that they | 207 |
are paying directly. Such requests from the bureau may not be made | 208 |
more frequently than on a semiannual basis. Failure to provide | 209 |
such documentation to the bureau within thirty days of receipt of | 210 |
the request may result in the employer's forfeiture of | 211 |
participation in the program for such injury. The provisions of | 212 |
this section shall not apply to claims in which an employer with | 213 |
knowledge of a claimed compensable injury or occupational disease, | 214 |
has paid wages in lieu of compensation or total disability. | 215 |
(B) The administrator, with the advice and consent of the | 216 |
board, by rule, may | 217 |
or discount plans, including any of the following: | 218 |
(1) Grant an employer who makes the employer's semiannual | 219 |
premium payment at least one month prior to the last day on which | 220 |
the payment may be made without penalty, a discount as the | 221 |
administrator fixes from time to time; | 222 |
(2) Levy a minimum annual administrative charge upon risks | 223 |
where semiannual premium reports develop a charge less than the | 224 |
administrator considers adequate to offset administrative costs of | 225 |
processing; | 226 |
(3) Establish any other alternative premium, rate, or | 227 |
discount plans the administrator considers necessary. | 228 |
Sec. 4123.291. (A) An adjudicating committee appointed by | 229 |
the administrator of workers' compensation to hear any matter | 230 |
specified in divisions (B)(1) to (7) of this section shall hear | 231 |
the matter within sixty days of the date on which an employer | 232 |
files the request, protest, or petition. An employer desiring to | 233 |
file a request, protest, or petition regarding any matter | 234 |
specified in divisions (B)(1) to (7) of this section shall file | 235 |
the request, protest, or petition to the adjudicating committee on | 236 |
or before twenty-four months after the administrator sends notice | 237 |
of the determination about which the employer is filing the | 238 |
request, protest, or petition. | 239 |
(B) An employer who is adversely affected by a decision of an | 240 |
adjudicating committee appointed by the administrator may appeal | 241 |
the decision of the committee to the administrator or the | 242 |
administrator's designee. The employer shall file the appeal in | 243 |
writing within thirty days after the employer receives the | 244 |
decision of the adjudicating committee. The administrator or the | 245 |
designee shall hear the appeal and hold a hearing, provided that | 246 |
the decision of the adjudicating committee relates to one of the | 247 |
following: | 248 |
(1) An employer request for a waiver of a default in the | 249 |
payment of premiums pursuant to section 4123.37 of the Revised | 250 |
Code; | 251 |
(2) An employer request for the settlement of liability as a | 252 |
noncomplying employer under section 4123.75 of the Revised Code; | 253 |
(3) An employer petition objecting to | 254 |
255 | |
rules adopted pursuant to that section; | 256 |
(4) An employer request for the abatement of penalties | 257 |
assessed pursuant to section 4123.32 of the Revised Code and the | 258 |
rules adopted pursuant to that section; | 259 |
(5) An employer protest relating to an audit finding or a | 260 |
determination of a manual classification, experience rating, or | 261 |
transfer or combination of risk experience; | 262 |
(6) Any decision relating to any other risk premium matter | 263 |
under Chapters 4121., 4123., and 4131. of the Revised Code; | 264 |
(7) An employer petition objecting to the amount of security | 265 |
required under division (C) of section 4125.05 of the Revised Code | 266 |
and the rules adopted pursuant to that section. | 267 |
(C) The bureau of workers' compensation board of directors, | 268 |
based upon recommendations of the workers' compensation actuarial | 269 |
committee, shall establish the policy for all adjudicating | 270 |
committee procedures, including, but not limited to, specific | 271 |
criteria for manual premium rate adjustment. | 272 |
Sec. 4123.35. (A) Except as provided in this section, every | 273 |
employer mentioned in division (B)(2) of section 4123.01 of the | 274 |
Revised Code, and every publicly owned utility shall pay | 275 |
semiannually in the months of January and July into the state | 276 |
insurance fund the amount of annual premium the administrator of | 277 |
workers' compensation fixes for the employment or occupation of | 278 |
the employer, the amount of which premium to be paid by each | 279 |
employer to be determined by the classifications, rules, and rates | 280 |
made and published by the administrator. The employer shall pay | 281 |
semiannually a further sum of money into the state insurance fund | 282 |
as may be ascertained to be due from the employer by applying the | 283 |
rules of the administrator, and a receipt or certificate | 284 |
certifying that payment has been made, along with a written notice | 285 |
as is required in section 4123.54 of the Revised Code, shall be | 286 |
mailed immediately to the employer by the bureau of workers' | 287 |
compensation. The receipt or certificate is prima-facie evidence | 288 |
of the payment of the premium, and the proper posting of the | 289 |
notice constitutes the employer's compliance with the notice | 290 |
requirement mandated in section 4123.54 of the Revised Code. | 291 |
The bureau of workers' compensation shall verify with the | 292 |
secretary of state the existence of all corporations and | 293 |
organizations making application for workers' compensation | 294 |
coverage and shall require every such application to include the | 295 |
employer's federal identification number. | 296 |
An employer as defined in division (B)(2) of section 4123.01 | 297 |
of the Revised Code who has contracted with a subcontractor is | 298 |
liable for the unpaid premium due from any subcontractor with | 299 |
respect to that part of the payroll of the subcontractor that is | 300 |
for work performed pursuant to the contract with the employer. | 301 |
Division (A) of this section providing for the payment of | 302 |
premiums semiannually does not apply to any employer who was a | 303 |
subscriber to the state insurance fund prior to January 1, 1914, | 304 |
or who may first become a subscriber to the fund in any month | 305 |
other than January or July. Instead, the semiannual premiums shall | 306 |
be paid by those employers from time to time upon the expiration | 307 |
of the respective periods for which payments into the fund have | 308 |
been made by them. | 309 |
The administrator shall adopt rules to permit employers to | 310 |
make periodic payments of the semiannual premium due under this | 311 |
division. The rules shall include provisions for the assessment of | 312 |
interest charges, where appropriate, and for the assessment of | 313 |
penalties when an employer fails to make timely premium payments. | 314 |
An employer who timely pays the amounts due under this division is | 315 |
entitled to all of the benefits and protections of this chapter. | 316 |
Upon receipt of payment, the bureau immediately shall mail a | 317 |
receipt or certificate to the employer certifying that payment has | 318 |
been made, which receipt is prima-facie evidence of payment. | 319 |
Workers' compensation coverage under this chapter continues | 320 |
uninterrupted upon timely receipt of payment under this division. | 321 |
Every public employer, except public employers that are | 322 |
self-insuring employers under this section, shall comply with | 323 |
sections 4123.38 to 4123.41, and 4123.48 of the Revised Code in | 324 |
regard to the contribution of moneys to the public insurance fund. | 325 |
(B) Employers who will abide by the rules of the | 326 |
administrator and who may be of sufficient financial ability to | 327 |
render certain the payment of compensation to injured employees or | 328 |
the dependents of killed employees, and the furnishing of medical, | 329 |
surgical, nursing, and hospital attention and services and | 330 |
medicines, and funeral expenses, equal to or greater than is | 331 |
provided for in sections 4123.52, 4123.55 to 4123.62, and 4123.64 | 332 |
to 4123.67 of the Revised Code, and who do not desire to insure | 333 |
the payment thereof or indemnify themselves against loss sustained | 334 |
by the direct payment thereof, upon a finding of such facts by the | 335 |
administrator, may be granted the privilege to pay individually | 336 |
compensation, and furnish medical, surgical, nursing, and hospital | 337 |
services and attention and funeral expenses directly to injured | 338 |
employees or the dependents of killed employees, thereby being | 339 |
granted status as a self-insuring employer. The administrator may | 340 |
charge employers who apply for the status as a self-insuring | 341 |
employer a reasonable application fee to cover the bureau's costs | 342 |
in connection with processing and making a determination with | 343 |
respect to an application. | 344 |
All employers granted status as self-insuring employers shall | 345 |
demonstrate sufficient financial and administrative ability to | 346 |
assure that all obligations under this section are promptly met. | 347 |
The administrator shall deny the privilege where the employer is | 348 |
unable to demonstrate the employer's ability to promptly meet all | 349 |
the obligations imposed on the employer by this section. | 350 |
(1) The administrator shall consider, but is not limited to, | 351 |
the following factors, where applicable, in determining the | 352 |
employer's ability to meet all of the obligations imposed on the | 353 |
employer by this section: | 354 |
(a) The employer employs a minimum of five hundred employees | 355 |
in this state; | 356 |
(b) The employer has operated in this state for a minimum of | 357 |
two years, provided that an employer who has purchased, acquired, | 358 |
or otherwise succeeded to the operation of a business, or any part | 359 |
thereof, situated in this state that has operated for at least two | 360 |
years in this state, also shall qualify; | 361 |
(c) Where the employer previously contributed to the state | 362 |
insurance fund or is a successor employer as defined by bureau | 363 |
rules, the amount of the buyout, as defined by bureau rules; | 364 |
(d) The sufficiency of the employer's assets located in this | 365 |
state to insure the employer's solvency in paying compensation | 366 |
directly; | 367 |
(e) The financial records, documents, and data, certified by | 368 |
a certified public accountant, necessary to provide the employer's | 369 |
full financial disclosure. The records, documents, and data | 370 |
include, but are not limited to, balance sheets and profit and | 371 |
loss history for the current year and previous four years. | 372 |
(f) The employer's organizational plan for the administration | 373 |
of the workers' compensation law; | 374 |
(g) The employer's proposed plan to inform employees of the | 375 |
change from a state fund insurer to a self-insuring employer, the | 376 |
procedures the employer will follow as a self-insuring employer, | 377 |
and the employees' rights to compensation and benefits; and | 378 |
(h) The employer has either an account in a financial | 379 |
institution in this state, or if the employer maintains an account | 380 |
with a financial institution outside this state, ensures that | 381 |
workers' compensation checks are drawn from the same account as | 382 |
payroll checks or the employer clearly indicates that payment will | 383 |
be honored by a financial institution in this state. | 384 |
The administrator may waive the requirements of divisions | 385 |
(B)(1)(a) and (b) of this section and the requirement of division | 386 |
(B)(1)(e) of this section that the financial records, documents, | 387 |
and data be certified by a certified public accountant. The | 388 |
administrator shall adopt rules establishing the criteria that an | 389 |
employer shall meet in order for the administrator to waive the | 390 |
requirement of division (B)(1)(e) of this section. Such rules may | 391 |
require additional security of that employer pursuant to division | 392 |
(E) of section 4123.351 of the Revised Code. | 393 |
The administrator shall not grant the status of self-insuring | 394 |
employer to the state, except that the administrator may grant the | 395 |
status of self-insuring employer to a state institution of higher | 396 |
education, | 397 |
requirements of division (B)(2) of this section. | 398 |
(2) When considering the application of a public employer, | 399 |
except for a board of county commissioners described in division | 400 |
(G) of section 4123.01 of the Revised Code, a board of a county | 401 |
hospital, or a publicly owned utility, the administrator shall | 402 |
verify that the public employer satisfies all of the following | 403 |
requirements as the requirements apply to that public employer: | 404 |
(a) For the two-year period preceding application under this | 405 |
section, the public employer has maintained an unvoted debt | 406 |
capacity equal to at least two times the amount of the current | 407 |
annual premium established by the administrator under this chapter | 408 |
for that public employer for the year immediately preceding the | 409 |
year in which the public employer makes application under this | 410 |
section. | 411 |
(b) For each of the two fiscal years preceding application | 412 |
under this section, the unreserved and undesignated year-end fund | 413 |
balance in the public employer's general fund is equal to at least | 414 |
five per cent of the public employer's general fund revenues for | 415 |
the fiscal year computed in accordance with generally accepted | 416 |
accounting principles. | 417 |
(c) For the five-year period preceding application under this | 418 |
section, the public employer, to the extent applicable, has | 419 |
complied fully with the continuing disclosure requirements | 420 |
established in rules adopted by the United States securities and | 421 |
exchange commission under 17 C.F.R. 240.15c 2-12. | 422 |
(d) For the five-year period preceding application under this | 423 |
section, the public employer has not had its local government fund | 424 |
distribution withheld on account of the public employer being | 425 |
indebted or otherwise obligated to the state. | 426 |
(e) For the five-year period preceding application under this | 427 |
section, the public employer has not been under a fiscal watch or | 428 |
fiscal emergency pursuant to section 118.023, 118.04, or 3316.03 | 429 |
of the Revised Code. | 430 |
(f) For the public employer's fiscal year preceding | 431 |
application under this section, the public employer has obtained | 432 |
an annual financial audit as required under section 117.10 of the | 433 |
Revised Code, which has been released by the auditor of state | 434 |
within seven months after the end of the public employer's fiscal | 435 |
year. | 436 |
(g) On the date of application, the public employer holds a | 437 |
debt rating of Aa3 or higher according to Moody's investors | 438 |
service, inc., or a comparable rating by an independent rating | 439 |
agency similar to Moody's investors service, inc. | 440 |
(h) The public employer agrees to generate an annual | 441 |
accumulating book reserve in its financial statements reflecting | 442 |
an actuarially generated reserve adequate to pay projected claims | 443 |
under this chapter for the applicable period of time, as | 444 |
determined by the administrator. | 445 |
(i) For a public employer that is a hospital, the public | 446 |
employer shall submit audited financial statements showing the | 447 |
hospital's overall liquidity characteristics, and the | 448 |
administrator shall determine, on an individual basis, whether the | 449 |
public employer satisfies liquidity standards equivalent to the | 450 |
liquidity standards of other public employers. | 451 |
(j) Any additional criteria that the administrator adopts by | 452 |
rule pursuant to division (E) of this section. | 453 |
The administrator may adopt rules establishing the criteria | 454 |
that a public employer shall satisfy in order for the | 455 |
administrator to waive any of the requirements listed in divisions | 456 |
(B)(2)(a) to (j) of this section. The rules may require additional | 457 |
security from that employer pursuant to division (E) of section | 458 |
4123.351 of the Revised Code. The administrator shall not waive | 459 |
any of the requirements listed in divisions (B)(2)(a) to (j) of | 460 |
this section for a public employer who does not satisfy the | 461 |
criteria established in the rules the administrator adopts. | 462 |
(C) A board of county commissioners described in division (G) | 463 |
of section 4123.01 of the Revised Code, as an employer, that will | 464 |
abide by the rules of the administrator and that may be of | 465 |
sufficient financial ability to render certain the payment of | 466 |
compensation to injured employees or the dependents of killed | 467 |
employees, and the furnishing of medical, surgical, nursing, and | 468 |
hospital attention and services and medicines, and funeral | 469 |
expenses, equal to or greater than is provided for in sections | 470 |
4123.52, 4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised | 471 |
Code, and that does not desire to insure the payment thereof or | 472 |
indemnify itself against loss sustained by the direct payment | 473 |
thereof, upon a finding of such facts by the administrator, may be | 474 |
granted the privilege to pay individually compensation, and | 475 |
furnish medical, surgical, nursing, and hospital services and | 476 |
attention and funeral expenses directly to injured employees or | 477 |
the dependents of killed employees, thereby being granted status | 478 |
as a self-insuring employer. The administrator may charge a board | 479 |
of county commissioners described in division (G) of section | 480 |
4123.01 of the Revised Code that applies for the status as a | 481 |
self-insuring employer a reasonable application fee to cover the | 482 |
bureau's costs in connection with processing and making a | 483 |
determination with respect to an application. All employers | 484 |
granted such status shall demonstrate sufficient financial and | 485 |
administrative ability to assure that all obligations under this | 486 |
section are promptly met. The administrator shall deny the | 487 |
privilege where the employer is unable to demonstrate the | 488 |
employer's ability to promptly meet all the obligations imposed on | 489 |
the employer by this section. The administrator shall consider, | 490 |
but is not limited to, the following factors, where applicable, in | 491 |
determining the employer's ability to meet all of the obligations | 492 |
imposed on the board as an employer by this section: | 493 |
(1) The board as an employer employs a minimum of five | 494 |
hundred employees in this state; | 495 |
(2) The board has operated in this state for a minimum of two | 496 |
years; | 497 |
(3) Where the board previously contributed to the state | 498 |
insurance fund or is a successor employer as defined by bureau | 499 |
rules, the amount of the buyout, as defined by bureau rules; | 500 |
(4) The sufficiency of the board's assets located in this | 501 |
state to insure the board's solvency in paying compensation | 502 |
directly; | 503 |
(5) The financial records, documents, and data, certified by | 504 |
a certified public accountant, necessary to provide the board's | 505 |
full financial disclosure. The records, documents, and data | 506 |
include, but are not limited to, balance sheets and profit and | 507 |
loss history for the current year and previous four years. | 508 |
(6) The board's organizational plan for the administration of | 509 |
the workers' compensation law; | 510 |
(7) The board's proposed plan to inform employees of the | 511 |
proposed self-insurance, the procedures the board will follow as a | 512 |
self-insuring employer, and the employees' rights to compensation | 513 |
and benefits; | 514 |
(8) The board has either an account in a financial | 515 |
institution in this state, or if the board maintains an account | 516 |
with a financial institution outside this state, ensures that | 517 |
workers' compensation checks are drawn from the same account as | 518 |
payroll checks or the board clearly indicates that payment will be | 519 |
honored by a financial institution in this state; | 520 |
(9) The board shall provide the administrator a surety bond | 521 |
in an amount equal to one hundred twenty-five per cent of the | 522 |
projected losses as determined by the administrator. | 523 |
(D) The administrator shall require a surety bond from all | 524 |
self-insuring employers, issued pursuant to section 4123.351 of | 525 |
the Revised Code, that is sufficient to compel, or secure to | 526 |
injured employees, or to the dependents of employees killed, the | 527 |
payment of compensation and expenses, which shall in no event be | 528 |
less than that paid or furnished out of the state insurance fund | 529 |
in similar cases to injured employees or to dependents of killed | 530 |
employees whose employers contribute to the fund, except when an | 531 |
employee of the employer, who has suffered the loss of a hand, | 532 |
arm, foot, leg, or eye prior to the injury for which compensation | 533 |
is to be paid, and thereafter suffers the loss of any other of the | 534 |
members as the result of any injury sustained in the course of and | 535 |
arising out of the employee's employment, the compensation to be | 536 |
paid by the self-insuring employer is limited to the disability | 537 |
suffered in the subsequent injury, additional compensation, if | 538 |
any, to be paid by the bureau out of the surplus created by | 539 |
section 4123.34 of the Revised Code. | 540 |
(E) In addition to the requirements of this section, the | 541 |
administrator shall make and publish rules governing the manner of | 542 |
making application and the nature and extent of the proof required | 543 |
to justify a finding of fact by the administrator as to granting | 544 |
the status of a self-insuring employer, which rules shall be | 545 |
general in their application, one of which rules shall provide | 546 |
that all self-insuring employers shall pay into the state | 547 |
insurance fund such amounts as are required to be credited to the | 548 |
surplus fund in division (B) of section 4123.34 of the Revised | 549 |
Code. The administrator may adopt rules establishing requirements | 550 |
in addition to the requirements described in division (B)(2) of | 551 |
this section that a public employer shall meet in order to qualify | 552 |
for self-insuring status. | 553 |
Employers shall secure directly from the bureau central | 554 |
offices application forms upon which the bureau shall stamp a | 555 |
designating number. Prior to submission of an application, an | 556 |
employer shall make available to the bureau, and the bureau shall | 557 |
review, the information described in division (B)(1) of this | 558 |
section, and public employers shall make available, and the bureau | 559 |
shall review, the information necessary to verify whether the | 560 |
public employer meets the requirements listed in division (B)(2) | 561 |
of this section. An employer shall file the completed application | 562 |
forms with an application fee, which shall cover the costs of | 563 |
processing the application, as established by the administrator, | 564 |
by rule, with the bureau at least ninety days prior to the | 565 |
effective date of the employer's new status as a self-insuring | 566 |
employer. The application form is not deemed complete until all | 567 |
the required information is attached thereto. The bureau shall | 568 |
only accept applications that contain the required information. | 569 |
(F) The bureau shall review completed applications within a | 570 |
reasonable time. If the bureau determines to grant an employer the | 571 |
status as a self-insuring employer, the bureau shall issue a | 572 |
statement, containing its findings of fact, that is prepared by | 573 |
the bureau and signed by the administrator. If the bureau | 574 |
determines not to grant the status as a self-insuring employer, | 575 |
the bureau shall notify the employer of the determination and | 576 |
require the employer to continue to pay its full premium into the | 577 |
state insurance fund. The administrator also shall adopt rules | 578 |
establishing a minimum level of performance as a criterion for | 579 |
granting and maintaining the status as a self-insuring employer | 580 |
and fixing time limits beyond which failure of the self-insuring | 581 |
employer to provide for the necessary medical examinations and | 582 |
evaluations may not delay a decision on a claim. | 583 |
(G) The administrator shall adopt rules setting forth | 584 |
procedures for auditing the program of self-insuring employers. | 585 |
The bureau shall conduct the audit upon a random basis or whenever | 586 |
the bureau has grounds for believing that a self-insuring employer | 587 |
is not in full compliance with bureau rules or this chapter. | 588 |
The administrator shall monitor the programs conducted by | 589 |
self-insuring employers, to ensure compliance with bureau | 590 |
requirements and for that purpose, shall develop and issue to | 591 |
self-insuring employers standardized forms for use by the | 592 |
self-insuring employer in all aspects of the self-insuring | 593 |
employers' direct compensation program and for reporting of | 594 |
information to the bureau. | 595 |
The bureau shall receive and transmit to the self-insuring | 596 |
employer all complaints concerning any self-insuring employer. In | 597 |
the case of a complaint against a self-insuring employer, the | 598 |
administrator shall handle the complaint through the | 599 |
self-insurance division of the bureau. The bureau shall maintain a | 600 |
file by employer of all complaints received that relate to the | 601 |
employer. The bureau shall evaluate each complaint and take | 602 |
appropriate action. | 603 |
The administrator shall adopt as a rule a prohibition against | 604 |
any self-insuring employer from harassing, dismissing, or | 605 |
otherwise disciplining any employee making a complaint, which rule | 606 |
shall provide for a financial penalty to be levied by the | 607 |
administrator payable by the offending self-insuring employer. | 608 |
(H) For the purpose of making determinations as to whether to | 609 |
grant status as a self-insuring employer, the administrator may | 610 |
subscribe to and pay for a credit reporting service that offers | 611 |
financial and other business information about individual | 612 |
employers. The costs in connection with the bureau's subscription | 613 |
or individual reports from the service about an applicant may be | 614 |
included in the application fee charged employers under this | 615 |
section. | 616 |
(I) The administrator, notwithstanding other provisions of | 617 |
this chapter, may permit a self-insuring employer to resume | 618 |
payment of premiums to the state insurance fund with appropriate | 619 |
credit modifications to the employer's basic premium rate as such | 620 |
rate is determined pursuant to section 4123.29 of the Revised | 621 |
Code. | 622 |
(J) On the first day of July of each year, the administrator | 623 |
shall calculate separately each self-insuring employer's | 624 |
assessments for the safety and hygiene fund, administrative costs | 625 |
pursuant to section 4123.342 of the Revised Code, and for the | 626 |
portion of the surplus fund under division (B) of section 4123.34 | 627 |
of the Revised Code that is not used for handicapped | 628 |
reimbursement, on the basis of the paid compensation attributable | 629 |
to the individual self-insuring employer according to the | 630 |
following calculation: | 631 |
(1) The total assessment against all self-insuring employers | 632 |
as a class for each fund and for the administrative costs for the | 633 |
year that the assessment is being made, as determined by the | 634 |
administrator, divided by the total amount of paid compensation | 635 |
for the previous calendar year attributable to all amenable | 636 |
self-insuring employers; | 637 |
(2) Multiply the quotient in division (J)(1) of this section | 638 |
by the total amount of paid compensation for the previous calendar | 639 |
year that is attributable to the individual self-insuring employer | 640 |
for whom the assessment is being determined. Each self-insuring | 641 |
employer shall pay the assessment that results from this | 642 |
calculation, unless the assessment resulting from this calculation | 643 |
falls below a minimum assessment, which minimum assessment the | 644 |
administrator shall determine on the first day of July of each | 645 |
year with the advice and consent of the bureau of workers' | 646 |
compensation board of directors, in which event, the self-insuring | 647 |
employer shall pay the minimum assessment. | 648 |
In determining the total amount due for the total assessment | 649 |
against all self-insuring employers as a class for each fund and | 650 |
the administrative assessment, the administrator shall reduce | 651 |
proportionately the total for each fund and assessment by the | 652 |
amount of money in the self-insurance assessment fund as of the | 653 |
date of the computation of the assessment. | 654 |
The administrator shall calculate the assessment for the | 655 |
portion of the surplus fund under division (B) of section 4123.34 | 656 |
of the Revised Code that is used for handicapped reimbursement in | 657 |
the same manner as set forth in divisions (J)(1) and (2) of this | 658 |
section except that the administrator shall calculate the total | 659 |
assessment for this portion of the surplus fund only on the basis | 660 |
of those self-insuring employers that retain participation in the | 661 |
handicapped reimbursement program and the individual self-insuring | 662 |
employer's proportion of paid compensation shall be calculated | 663 |
only for those self-insuring employers who retain participation in | 664 |
the handicapped reimbursement program. The administrator, as the | 665 |
administrator determines appropriate, may determine the total | 666 |
assessment for the handicapped portion of the surplus fund in | 667 |
accordance with sound actuarial principles. | 668 |
The administrator shall calculate the assessment for the | 669 |
portion of the surplus fund under division (B) of section 4123.34 | 670 |
of the Revised Code that under division (D) of section 4121.66 of | 671 |
the Revised Code is used for rehabilitation costs in the same | 672 |
manner as set forth in divisions (J)(1) and (2) of this section, | 673 |
except that the administrator shall calculate the total assessment | 674 |
for this portion of the surplus fund only on the basis of those | 675 |
self-insuring employers who have not made the election to make | 676 |
payments directly under division (D) of section 4121.66 of the | 677 |
Revised Code and an individual self-insuring employer's proportion | 678 |
of paid compensation only for those self-insuring employers who | 679 |
have not made that election. | 680 |
The administrator shall calculate the assessment for the | 681 |
portion of the surplus fund under division (B) of section 4123.34 | 682 |
of the Revised Code that is used for reimbursement to a | 683 |
self-insuring employer under division (H) of section 4123.512 of | 684 |
the Revised Code in the same manner as set forth in divisions | 685 |
(J)(1) and (2) of this section except that the administrator shall | 686 |
calculate the total assessment for this portion of the surplus | 687 |
fund only on the basis of those self-insuring employers that | 688 |
retain participation in reimbursement to the self-insuring | 689 |
employer under division (H) of section 4123.512 of the Revised | 690 |
Code and the individual self-insuring employer's proportion of | 691 |
paid compensation shall be calculated only for those self-insuring | 692 |
employers who retain participation in reimbursement to the | 693 |
self-insuring employer under division (H) of section 4123.512 of | 694 |
the Revised Code. | 695 |
An employer who no longer is a self-insuring employer in this | 696 |
state or who no longer is operating in this state, shall continue | 697 |
to pay assessments for administrative costs and for the portion of | 698 |
the surplus fund under division (B) of section 4123.34 of the | 699 |
Revised Code that is not used for handicapped reimbursement, based | 700 |
upon paid compensation attributable to claims that occurred while | 701 |
the employer was a self-insuring employer within this state. | 702 |
(K) There is hereby created in the state treasury the | 703 |
self-insurance assessment fund. All investment earnings of the | 704 |
fund shall be deposited in the fund. The administrator shall use | 705 |
the money in the self-insurance assessment fund only for | 706 |
administrative costs as specified in section 4123.341 of the | 707 |
Revised Code. | 708 |
(L) Every self-insuring employer shall certify, in affidavit | 709 |
form subject to the penalty for perjury, to the bureau the amount | 710 |
of the self-insuring employer's paid compensation for the previous | 711 |
calendar year. In reporting paid compensation paid for the | 712 |
previous year, a self-insuring employer shall exclude from the | 713 |
total amount of paid compensation any reimbursement the | 714 |
self-insuring employer receives in the previous calendar year from | 715 |
the surplus fund pursuant to section 4123.512 of the Revised Code | 716 |
for any paid compensation. The self-insuring employer also shall | 717 |
exclude from the paid compensation reported any amount recovered | 718 |
under section 4123.931 of the Revised Code and any amount that is | 719 |
determined not to have been payable to or on behalf of a claimant | 720 |
in any final administrative or judicial proceeding. The | 721 |
self-insuring employer shall exclude such amounts from the paid | 722 |
compensation reported in the reporting period subsequent to the | 723 |
date the determination is made. The administrator shall adopt | 724 |
rules, in accordance with Chapter 119. of the Revised Code, that | 725 |
provide for all of the following: | 726 |
(1) Establishing the date by which self-insuring employers | 727 |
must submit such information and the amount of the assessments | 728 |
provided for in division (J) of this section for employers who | 729 |
have been granted self-insuring status within the last calendar | 730 |
year; | 731 |
(2) If an employer fails to pay the assessment when due, the | 732 |
administrator may add a late fee penalty of not more than five | 733 |
hundred dollars to the assessment plus an additional penalty | 734 |
amount as follows: | 735 |
(a) For an assessment from sixty-one to ninety days past due, | 736 |
the prime interest rate, multiplied by the assessment due; | 737 |
(b) For an assessment from ninety-one to one hundred twenty | 738 |
days past due, the prime interest rate plus two per cent, | 739 |
multiplied by the assessment due; | 740 |
(c) For an assessment from one hundred twenty-one to one | 741 |
hundred fifty days past due, the prime interest rate plus four per | 742 |
cent, multiplied by the assessment due; | 743 |
(d) For an assessment from one hundred fifty-one to one | 744 |
hundred eighty days past due, the prime interest rate plus six per | 745 |
cent, multiplied by the assessment due; | 746 |
(e) For an assessment from one hundred eighty-one to two | 747 |
hundred ten days past due, the prime interest rate plus eight per | 748 |
cent, multiplied by the assessment due; | 749 |
(f) For each additional thirty-day period or portion thereof | 750 |
that an assessment remains past due after it has remained past due | 751 |
for more than two hundred ten days, the prime interest rate plus | 752 |
eight per cent, multiplied by the assessment due. | 753 |
(3) An employer may appeal a late fee penalty and penalty | 754 |
assessment to the administrator. | 755 |
For purposes of division (L)(2) of this section, "prime | 756 |
interest rate" means the average bank prime rate, and the | 757 |
administrator shall determine the prime interest rate in the same | 758 |
manner as a county auditor determines the average bank prime rate | 759 |
under section 929.02 of the Revised Code. | 760 |
The administrator shall include any assessment and penalties | 761 |
that remain unpaid for previous assessment periods in the | 762 |
calculation and collection of any assessments due under this | 763 |
division or division (J) of this section. | 764 |
(M) As used in this section, "paid compensation" means all | 765 |
amounts paid by a self-insuring employer for living maintenance | 766 |
benefits, all amounts for compensation paid pursuant to sections | 767 |
4121.63, 4121.67, 4123.56, 4123.57, 4123.58, 4123.59, 4123.60, and | 768 |
4123.64 of the Revised Code, all amounts paid as wages in lieu of | 769 |
such compensation, all amounts paid in lieu of such compensation | 770 |
under a nonoccupational accident and sickness program fully funded | 771 |
by the self-insuring employer, and all amounts paid by a | 772 |
self-insuring employer for a violation of a specific safety | 773 |
standard pursuant to Section 35 of Article II, Ohio Constitution | 774 |
and section 4121.47 of the Revised Code. | 775 |
(N) Should any section of this chapter or Chapter 4121. of | 776 |
the Revised Code providing for self-insuring employers' | 777 |
assessments based upon compensation paid be declared | 778 |
unconstitutional by a final decision of any court, then that | 779 |
section of the Revised Code declared unconstitutional shall revert | 780 |
back to the section in existence prior to November 3, 1989, | 781 |
providing for assessments based upon payroll. | 782 |
(O) The administrator may grant a self-insuring employer the | 783 |
privilege to self-insure a construction project entered into by | 784 |
the self-insuring employer that is scheduled for completion within | 785 |
six years after the date the project begins, and the total cost of | 786 |
which is estimated to exceed one hundred million dollars or, for | 787 |
employers described in division (R) of this section, if the | 788 |
construction project is estimated to exceed twenty-five million | 789 |
dollars. The administrator may waive such cost and time criteria | 790 |
and grant a self-insuring employer the privilege to self-insure a | 791 |
construction project regardless of the time needed to complete the | 792 |
construction project and provided that the cost of the | 793 |
construction project is estimated to exceed fifty million dollars. | 794 |
A self-insuring employer who desires to self-insure a construction | 795 |
project shall submit to the administrator an application listing | 796 |
the dates the construction project is scheduled to begin and end, | 797 |
the estimated cost of the construction project, the contractors | 798 |
and subcontractors whose employees are to be self-insured by the | 799 |
self-insuring employer, the provisions of a safety program that is | 800 |
specifically designed for the construction project, and a | 801 |
statement as to whether a collective bargaining agreement | 802 |
governing the rights, duties, and obligations of each of the | 803 |
parties to the agreement with respect to the construction project | 804 |
exists between the self-insuring employer and a labor | 805 |
organization. | 806 |
A self-insuring employer may apply to self-insure the | 807 |
employees of either of the following: | 808 |
(1) All contractors and subcontractors who perform labor or | 809 |
work or provide materials for the construction project; | 810 |
(2) All contractors and, at the administrator's discretion, a | 811 |
substantial number of all the subcontractors who perform labor or | 812 |
work or provide materials for the construction project. | 813 |
Upon approval of the application, the administrator shall | 814 |
mail a certificate granting the privilege to self-insure the | 815 |
construction project to the self-insuring employer. The | 816 |
certificate shall contain the name of the self-insuring employer | 817 |
and the name, address, and telephone number of the self-insuring | 818 |
employer's representatives who are responsible for administering | 819 |
workers' compensation claims for the construction project. The | 820 |
self-insuring employer shall post the certificate in a conspicuous | 821 |
place at the site of the construction project. | 822 |
The administrator shall maintain a record of the contractors | 823 |
and subcontractors whose employees are covered under the | 824 |
certificate issued to the self-insured employer. A self-insuring | 825 |
employer immediately shall notify the administrator when any | 826 |
contractor or subcontractor is added or eliminated from inclusion | 827 |
under the certificate. | 828 |
Upon approval of the application, the self-insuring employer | 829 |
is responsible for the administration and payment of all claims | 830 |
under this chapter and Chapter 4121. of the Revised Code for the | 831 |
employees of the contractor and subcontractors covered under the | 832 |
certificate who receive injuries or are killed in the course of | 833 |
and arising out of employment on the construction project, or who | 834 |
contract an occupational disease in the course of employment on | 835 |
the construction project. For purposes of this chapter and Chapter | 836 |
4121. of the Revised Code, a claim that is administered and paid | 837 |
in accordance with this division is considered a claim against the | 838 |
self-insuring employer listed in the certificate. A contractor or | 839 |
subcontractor included under the certificate shall report to the | 840 |
self-insuring employer listed in the certificate, all claims that | 841 |
arise under this chapter and Chapter 4121. of the Revised Code in | 842 |
connection with the construction project for which the certificate | 843 |
is issued. | 844 |
A self-insuring employer who complies with this division is | 845 |
entitled to the protections provided under this chapter and | 846 |
Chapter 4121. of the Revised Code with respect to the employees of | 847 |
the contractors and subcontractors covered under a certificate | 848 |
issued under this division for death or injuries that arise out | 849 |
of, or death, injuries, or occupational diseases that arise in the | 850 |
course of, those employees' employment on that construction | 851 |
project, as if the employees were employees of the self-insuring | 852 |
employer, provided that the self-insuring employer also complies | 853 |
with this section. No employee of the contractors and | 854 |
subcontractors covered under a certificate issued under this | 855 |
division shall be considered the employee of the self-insuring | 856 |
employer listed in that certificate for any purposes other than | 857 |
this chapter and Chapter 4121. of the Revised Code. Nothing in | 858 |
this division gives a self-insuring employer authority to control | 859 |
the means, manner, or method of employment of the employees of the | 860 |
contractors and subcontractors covered under a certificate issued | 861 |
under this division. | 862 |
The contractors and subcontractors included under a | 863 |
certificate issued under this division are entitled to the | 864 |
protections provided under this chapter and Chapter 4121. of the | 865 |
Revised Code with respect to the contractor's or subcontractor's | 866 |
employees who are employed on the construction project which is | 867 |
the subject of the certificate, for death or injuries that arise | 868 |
out of, or death, injuries, or occupational diseases that arise in | 869 |
the course of, those employees' employment on that construction | 870 |
project. | 871 |
The contractors and subcontractors included under a | 872 |
certificate issued under this division shall identify in their | 873 |
payroll records the employees who are considered the employees of | 874 |
the self-insuring employer listed in that certificate for purposes | 875 |
of this chapter and Chapter 4121. of the Revised Code, and the | 876 |
amount that those employees earned for employment on the | 877 |
construction project that is the subject of that certificate. | 878 |
Notwithstanding any provision to the contrary under this chapter | 879 |
and Chapter 4121. of the Revised Code, the administrator shall | 880 |
exclude the payroll that is reported for employees who are | 881 |
considered the employees of the self-insuring employer listed in | 882 |
that certificate, and that the employees earned for employment on | 883 |
the construction project that is the subject of that certificate, | 884 |
when determining those contractors' or subcontractors' premiums or | 885 |
assessments required under this chapter and Chapter 4121. of the | 886 |
Revised Code. A self-insuring employer issued a certificate under | 887 |
this division shall include in the amount of paid compensation it | 888 |
reports pursuant to division (L) of this section, the amount of | 889 |
paid compensation the self-insuring employer paid pursuant to this | 890 |
division for the previous calendar year. | 891 |
Nothing in this division shall be construed as altering the | 892 |
rights of employees under this chapter and Chapter 4121. of the | 893 |
Revised Code as those rights existed prior to September 17, 1996. | 894 |
Nothing in this division shall be construed as altering the rights | 895 |
devolved under sections 2305.31 and 4123.82 of the Revised Code as | 896 |
those rights existed prior to September 17, 1996. | 897 |
As used in this division, "privilege to self-insure a | 898 |
construction project" means privilege to pay individually | 899 |
compensation, and to furnish medical, surgical, nursing, and | 900 |
hospital services and attention and funeral expenses directly to | 901 |
injured employees or the dependents of killed employees. | 902 |
(P) A self-insuring employer whose application is granted | 903 |
under division (O) of this section shall designate a safety | 904 |
professional to be responsible for the administration and | 905 |
enforcement of the safety program that is specifically designed | 906 |
for the construction project that is the subject of the | 907 |
application. | 908 |
A self-insuring employer whose application is granted under | 909 |
division (O) of this section shall employ an ombudsperson for the | 910 |
construction project that is the subject of the application. The | 911 |
ombudsperson shall have experience in workers' compensation or the | 912 |
construction industry, or both. The ombudsperson shall perform all | 913 |
of the following duties: | 914 |
(1) Communicate with and provide information to employees who | 915 |
are injured in the course of, or whose injury arises out of | 916 |
employment on the construction project, or who contract an | 917 |
occupational disease in the course of employment on the | 918 |
construction project; | 919 |
(2) Investigate the status of a claim upon the request of an | 920 |
employee to do so; | 921 |
(3) Provide information to claimants, third party | 922 |
administrators, employers, and other persons to assist those | 923 |
persons in protecting their rights under this chapter and Chapter | 924 |
4121. of the Revised Code. | 925 |
A self-insuring employer whose application is granted under | 926 |
division (O) of this section shall post the name of the safety | 927 |
professional and the ombudsperson and instructions for contacting | 928 |
the safety professional and the ombudsperson in a conspicuous | 929 |
place at the site of the construction project. | 930 |
(Q) The administrator may consider all of the following when | 931 |
deciding whether to grant a self-insuring employer the privilege | 932 |
to self-insure a construction project as provided under division | 933 |
(O) of this section: | 934 |
(1) Whether the self-insuring employer has an organizational | 935 |
plan for the administration of the workers' compensation law; | 936 |
(2) Whether the safety program that is specifically designed | 937 |
for the construction project provides for the safety of employees | 938 |
employed on the construction project, is applicable to all | 939 |
contractors and subcontractors who perform labor or work or | 940 |
provide materials for the construction project, and has as a | 941 |
component, a safety training program that complies with standards | 942 |
adopted pursuant to the "Occupational Safety and Health Act of | 943 |
1970," 84 Stat. 1590, 29 U.S.C.A. 651, and provides for continuing | 944 |
management and employee involvement; | 945 |
(3) Whether granting the privilege to self-insure the | 946 |
construction project will reduce the costs of the construction | 947 |
project; | 948 |
(4) Whether the self-insuring employer has employed an | 949 |
ombudsperson as required under division (P) of this section; | 950 |
(5) Whether the self-insuring employer has sufficient surety | 951 |
to secure the payment of claims for which the self-insuring | 952 |
employer would be responsible pursuant to the granting of the | 953 |
privilege to self-insure a construction project under division (O) | 954 |
of this section. | 955 |
(R) As used in divisions (O), (P), and (Q), "self-insuring | 956 |
employer" includes the following employers, whether or not they | 957 |
have been granted the status of being a self-insuring employer | 958 |
under division (B) of this section: | 959 |
(1) A state institution of higher education; | 960 |
(2) A school district; | 961 |
(3) A county school financing district; | 962 |
(4) An educational service center; | 963 |
(5) A community school established under Chapter 3314. of the | 964 |
Revised Code; | 965 |
(6) A municipal power agency as defined in section 3734.058 | 966 |
of the Revised Code. | 967 |
(S) As used in this section: | 968 |
(1) "Unvoted debt capacity" means the amount of money that a | 969 |
public employer may borrow without voter approval of a tax levy; | 970 |
(2) "State institution of higher education" means the state | 971 |
universities listed in section 3345.011 of the Revised Code, | 972 |
community colleges created pursuant to Chapter 3354. of the | 973 |
Revised Code, university branches created pursuant to Chapter | 974 |
3355. of the Revised Code, technical colleges created pursuant to | 975 |
Chapter 3357. of the Revised Code, and state community colleges | 976 |
created pursuant to Chapter 3358. of the Revised Code. | 977 |
Sec. 4123.37. | 978 |
(1) "Amenable employer" has the same meaning as "employer" as | 979 |
defined in division (J) of section 4123.32 of the Revised Code. | 980 |
(2) "Assessment" means any determination by the administrator | 981 |
of workers' compensation that a specific sum of money is owed by | 982 |
an employer under this chapter or Chapter 4121., 4127., or 4131. | 983 |
of the Revised Code, except for amounts owed by an employer | 984 |
pursuant to section 4123.75 of the Revised Code. | 985 |
(B) If the administrator | 986 |
any person, firm, or private corporation, including any public | 987 |
service corporation, is, or has been at any time after January 1, | 988 |
1923, an amenable employer and has not complied with section | 989 |
4123.35 of the Revised Code the administrator shall determine the | 990 |
period during which the person, firm, or corporation was an | 991 |
amenable employer and shall forthwith give notice of the | 992 |
determination to the employer. Within twenty days thereafter the | 993 |
employer shall furnish the bureau of workers' compensation with | 994 |
the payroll covering the period included in the determination and, | 995 |
if the employer is an amenable employer at the time of the | 996 |
determination, shall pay a premium security deposit for the eight | 997 |
months next succeeding the date of the determination and shall pay | 998 |
into the state insurance fund the amount of premium applicable to | 999 |
such payroll. | 1000 |
If the employer does not furnish the payroll and pay the | 1001 |
applicable premium and premium security deposit within the twenty | 1002 |
days, the administrator shall forthwith make an assessment of the | 1003 |
premium due from the employer for the period the administrator | 1004 |
determined the employer to be an amenable employer including the | 1005 |
premium security deposit according to section 4123.32 of the | 1006 |
Revised Code if the employer is an amenable employer at the time | 1007 |
of the determination, basing the | 1008 |
information in the possession of the administrator. | 1009 |
(C) The administrator shall give to the employer assessed | 1010 |
written notice of | 1011 |
demand for payment in accordance with this division. The notice | 1012 |
shall be mailed to the employer at the employer's residence or | 1013 |
usual place of business by certified mail. Unless the employer to | 1014 |
whom the notice of assessment is directed files with the bureau | 1015 |
within twenty days after receipt thereof, a petition in writing, | 1016 |
verified under oath by the employer, or the employer's authorized | 1017 |
agent having knowledge of the facts, setting forth with | 1018 |
particularity the items of the assessment objected to, together | 1019 |
with the reason for the objections, the assessment shall become | 1020 |
conclusive and the amount thereof shall be due and payable from | 1021 |
the employer so assessed | 1022 |
petition objecting to an assessment is filed the bureau shall | 1023 |
assign a time and place for the hearing of the same and shall | 1024 |
notify the petitioner thereof
| 1025 |
files a petition the assessment made by the administrator shall | 1026 |
become due and payable ten days after the bureau sends notice of | 1027 |
the finding made at the hearing
| 1028 |
to the party assessed. An employer may first appeal an adverse | 1029 |
decision to the administrator or the designee of the administrator | 1030 |
as provided in section 4123.291 of the Revised Code, and | 1031 |
subsequently an appeal may be taken from any finding to the court | 1032 |
of common pleas of Franklin county upon the execution by the party | 1033 |
assessed of a bond to the state in
| 1034 |
and ordered paid by the bureau conditioned that the party will pay | 1035 |
any judgment and costs rendered against it for the
| 1036 |
assessment. | 1037 |
(D) When no petition objecting to an assessment is filed or | 1038 |
when a finding is made affirming or modifying an assessment after | 1039 |
hearing, a certified copy of the assessment as affirmed or | 1040 |
modified may be filed by the administrator in the office of the | 1041 |
clerk of the court of common pleas in any county in which the | 1042 |
employer has property or in which the employer has a place of | 1043 |
business. The clerk, immediately upon the filing of the | 1044 |
assessment, shall enter a judgment for the state against the | 1045 |
employer in the amount shown on the assessment. The judgment may | 1046 |
be filed by the clerk in a loose leaf book entitled "special | 1047 |
judgments for state insurance fund." The judgment shall bear the | 1048 |
same rate of interest, have the same effect as other judgments, | 1049 |
and be given the same preference allowed by law on other judgments | 1050 |
rendered for claims for taxes. An assessment or judgment under | 1051 |
this section shall not be a bar to the adjustment of the | 1052 |
employer's account upon the employer furnishing the employer's | 1053 |
payroll records to the bureau. | 1054 |
(E) The administrator, for good cause shown, may waive a | 1055 |
default in the payment of premium where the default is of less | 1056 |
than sixty days' duration, and upon payment by the employer of the | 1057 |
premium for the period, the employer and the employer's employees | 1058 |
are entitled to all of the benefits and immunities provided by | 1059 |
this chapter. | 1060 |
Sec. 4123.411. (A) For the purpose of carrying out sections | 1061 |
4123.412 to 4123.418 of the Revised Code, the administrator of | 1062 |
workers' compensation, with the advice and consent of the bureau | 1063 |
of workers' compensation board of directors, shall levy an | 1064 |
assessment against all employers at a rate | 1065 |
not to exceed ten cents per one hundred dollars of payroll, such | 1066 |
rate to be determined annually for each employer group listed in | 1067 |
divisions (A)(1) to (3) of this section, which will produce an | 1068 |
amount no greater than the amount the administrator estimates to | 1069 |
be necessary to carry out such sections for the period for which | 1070 |
the assessment is levied. In the event the amount produced by the | 1071 |
assessment is not sufficient to carry out such sections the | 1072 |
additional amount necessary shall be provided from the income | 1073 |
produced as a result of investments made pursuant to section | 1074 |
4123.44 of the Revised Code. | 1075 |
Assessments shall be levied according to the following | 1076 |
schedule: | 1077 |
(1) Private fund employers, except self-insuring | 1078 |
employers--in January and July of each year upon gross payrolls of | 1079 |
the preceding six months; | 1080 |
(2) Counties and taxing district employers therein, except | 1081 |
county hospitals that are self-insuring employers--in January of | 1082 |
each year upon gross payrolls of the preceding twelve months; | 1083 |
(3) The state as an employer--in January, April, July, and | 1084 |
October of each year upon gross payrolls of the preceding three | 1085 |
months. | 1086 |
Amounts assessed in accordance with this section shall be | 1087 |
collected from each employer as prescribed in rules the | 1088 |
administrator adopts. | 1089 |
The moneys derived from the assessment provided for in this | 1090 |
section shall be credited to the disabled workers' relief fund | 1091 |
created by section 4123.412 of the Revised Code. The administrator | 1092 |
shall establish by rule classifications of employers within | 1093 |
divisions (A)(1) to (3) of this section and shall determine rates | 1094 |
for each class so as to fairly apportion the costs of carrying out | 1095 |
sections 4123.412 to 4123.418 of the Revised Code. | 1096 |
(B) For all injuries and disabilities occurring on or after | 1097 |
January 1, 1987, the administrator, for the purposes of carrying | 1098 |
out sections 4123.412 to 4123.418 of the Revised Code, shall levy | 1099 |
an assessment against all employers at a rate per one hundred | 1100 |
dollars of payroll, such rate to be determined annually for each | 1101 |
classification of employer in each employer group listed in | 1102 |
divisions (A)(1) to (3) of this section, which will produce an | 1103 |
amount no greater than the amount the administrator estimates to | 1104 |
be necessary to carry out such sections for the period for which | 1105 |
the assessment is levied. The administrator annually shall | 1106 |
establish the contributions due from employers for the disabled | 1107 |
workers' relief fund at rates as low as possible but that will | 1108 |
assure sufficient moneys to guarantee the payment of any claims | 1109 |
against that fund. | 1110 |
Amounts assessed in accordance with this division shall be | 1111 |
billed at the same time premiums are billed and credited to the | 1112 |
disabled workers' relief fund created by section 4123.412 of the | 1113 |
Revised Code. The administrator shall determine the rates for each | 1114 |
class in the same manner as the administrator fixes the rates for | 1115 |
premiums pursuant to section 4123.29 of the Revised Code. | 1116 |
(C) For a self-insuring employer, the bureau of workers' | 1117 |
compensation shall pay to employees who are participants | 1118 |
regardless of the date of injury, any amounts due to the | 1119 |
participants under section 4123.414 of the Revised Code and shall | 1120 |
bill the self-insuring employer, semiannually, for all amounts | 1121 |
paid to a participant. | 1122 |
Section 2. That existing sections 4121.30, 4123.20, 4123.29, | 1123 |
4123.291, 4123.35, 4123.37, and 4123.411 and section 4121.18 of | 1124 |
the Revised Code are hereby repealed. | 1125 |
Section 3. Section 4123.35 of the Revised Code is presented | 1126 |
in this act as a composite of the section as amended by Sub. H.B. | 1127 |
123, Am. Sub. H.B. 153, and Sub. S.B. 171 of the 129th General | 1128 |
Assembly. The General Assembly, applying the principle stated in | 1129 |
division (B) of section 1.52 of the Revised Code that amendments | 1130 |
are to be harmonized if reasonably capable of simultaneous | 1131 |
operation, finds that the composite is the resulting version of | 1132 |
the section in effect prior to the effective date of the section | 1133 |
as presented in this act. | 1134 |