Section 1. That sections 131.02, 1561.31, 2305.25, 2305.252, | 13 |
4121.129, 4123.01, 4123.26, 4123.27, 4123.29, 4123.291, 4123.292, | 14 |
4123.32, 4123.322, 4123.34, 4123.35, 4123.353, 4123.36, 4123.37, | 15 |
4123.40, 4123.41, 4123.411, 4123.47, 4123.511, 4123.512, 4123.54, | 16 |
4123.66, 4123.82, 4123.83, 4125.05, 4729.80, and 4729.86 be | 17 |
amended and sections 4121.443 and 4121.447 of the Revised Code be | 18 |
enacted to read as follows: | 19 |
Sec. 131.02. (A) Except as otherwise provided in section | 20 |
4123.37, section 5703.061, and division (K) of section 4123.511 of | 21 |
the Revised Code, whenever any amount is payable to the state, the | 22 |
officer, employee, or agent responsible for administering the law | 23 |
under which the amount is payable shall immediately proceed to | 24 |
collect the amount or cause the amount to be collected and shall | 25 |
pay the amount into the state treasury or into the appropriate | 26 |
custodial fund in the manner set forth pursuant to section 113.08 | 27 |
of the Revised Code. Except as otherwise provided in this | 28 |
division, if the amount is not paid within forty-five days after | 29 |
payment is due, the officer, employee, or agent shall certify the | 30 |
amount due to the attorney general, in the form and manner | 31 |
prescribed by the attorney general, and notify the director of | 32 |
budget and management thereof. In the case of an amount payable by | 33 |
a student enrolled in a state institution of higher education, the | 34 |
amount shall be certified within the later of forty-five days | 35 |
after the amount is due or the tenth day after the beginning of | 36 |
the next academic semester, quarter, or other session following | 37 |
the session for which the payment is payable. The attorney general | 38 |
may assess the collection cost to the amount certified in such | 39 |
manner and amount as prescribed by the attorney general. If an | 40 |
amount payable to a political subdivision is past due, the | 41 |
political subdivision may, with the approval of the attorney | 42 |
general, certify the amount to the attorney general pursuant to | 43 |
this section. | 44 |
(3) No initial action shall be commenced to collect any tax | 125 |
payable to the state that is administered by the tax commissioner, | 126 |
whether or not such tax is subject to division (B) of this | 127 |
section, or any penalty, interest, or additional charge on such | 128 |
tax, after the expiration of the period ending on the later of the | 129 |
dates specified in divisions (F)(3)(a) and (b) of this section, | 130 |
provided that such period shall be extended by the period of any | 131 |
stay to such collection or by any other period to which the | 132 |
parties mutually agree. If the initial action in aid of execution | 133 |
is commenced before the later of the dates specified in divisions | 134 |
(F)(3)(a) and (b) of this section, any and all subsequent actions | 135 |
may be pursued in aid of execution of judgment for as long as the | 136 |
debt exists. | 137 |
(b) Four years after the assessment of the tax, penalty, | 140 |
interest, or additional charge becomes final. For the purposes of | 141 |
division (F)(3)(b) of this section, the assessment becomes final | 142 |
at the latest of the following: upon expiration of the period to | 143 |
petition for reassessment, or if applicable, to appeal a final | 144 |
determination of the commissioner or decision of the board of tax | 145 |
appeals or a court, or, if applicable, upon decision of the United | 146 |
States supreme court. | 147 |
For the purposes of division (F)(3) of this section, an | 148 |
initial action to collect a tax debt is commenced at the time when | 149 |
any action, including any action in aid of execution on a | 150 |
judgment, commences after a certified copy of the tax | 151 |
commissioner's entry making an assessment final has been filed in | 152 |
the office of the clerk of court of common pleas in the county in | 153 |
which the taxpayer resides or has its principal place of business | 154 |
in this state, or in the office of the clerk of court of common | 155 |
pleas of Franklin county, as provided in section 5739.13, 5741.14, | 156 |
5747.13, or 5751.09 of the Revised Code or in any other applicable | 157 |
law requiring such a filing. If an assessment has not been issued | 158 |
and there is no time limitation on the issuance of an assessment | 159 |
under applicable law, an action to collect a tax debt commences | 160 |
when the action is filed in the courts of this state to collect | 161 |
the liability. | 162 |
Sec. 1561.31. Each deputy mine inspector shall inspect each | 169 |
mine in the inspector's district, the owner, lessee, agent, or | 170 |
operator of which is an employer as defined in section 4123.01 of | 171 |
the Revised Code, or any other mine at which three or more persons | 172 |
work, at intervals not exceeding three months between inspections, | 173 |
and all other mines in the inspector's district as often as | 174 |
practical, noting particularly the location and condition of | 175 |
buildings, the condition of the boiler, machinery, workings of the | 176 |
mine, the traveling ways and haulageways, the circulation and | 177 |
condition of the air and drainage, and the condition of electrical | 178 |
circuits and appliances. The inspector shall make tests for | 179 |
poisonous, explosive, and noxious gases, and shall specifically | 180 |
order compliance with any section of this chapter and Chapters | 181 |
1563., 1565., and 1567. and sections 1509.09, 1509.12, 1509.13, | 182 |
1509.14, 1509.15, 1509.17, and 1509.18 of the Revised Code that | 183 |
the inspector finds is being violated. | 184 |
Upon completion of the inspection of a mine, the inspector | 185 |
shall fill out a report of the conditions found during inspections | 186 |
on a form provided by the chief of the division of mineral | 187 |
resources management, which form shall provide for statements as | 188 |
to whether the laws are being observed or violated, and if | 189 |
violated, the nature and extent thereof, the date of the | 190 |
inspection, the number of persons employed in and about the mine, | 191 |
whether or not a certificate of compliancethe proof of workers' | 192 |
compensation coverage issued pursuant to section 4123.35 of the | 193 |
Revised Code is posted and the date of expiration thereof, and | 194 |
matters, things, and practices that specifically are covered by | 195 |
law, order of the chief, or previous order of the inspector. The | 196 |
inspector shall make this report in quadruplicate or | 197 |
quintuplicate, and send the original to the chief, post a copy at | 198 |
the mine, give a copy to the mine superintendent, and retain a | 199 |
copy for the inspector's files. Where the miners of a mine have a | 200 |
mine safety committee, the inspector shall post one additional | 201 |
copy of the report of that mine at that mine for the use and | 202 |
possession of the committee. The report required by this section | 203 |
shall be known as the inspector's routine report. | 204 |
If an inspector orders compliance with this chapter and | 205 |
Chapters 1563., 1565., and 1567. and sections 1509.09, 1509.12, | 206 |
1509.13, 1509.14, 1509.15, 1509.17, and 1509.18 of the Revised | 207 |
Code, and is assured by the superintendent of the mine to which | 208 |
the order applies that the order will be complied with, the | 209 |
inspector shall revisit the mine within a reasonable period of | 210 |
time and ascertain whether or not the order has been complied | 211 |
with. The inspector shall report the inspector's findings to the | 212 |
chief on a form to be provided by the chief, and take action to | 213 |
enforce compliance. | 214 |
Sec. 2305.252. (A) Proceedings and records within the scope | 330 |
of a peer review committee of a health care entity shall be held | 331 |
in confidence and shall not be subject to discovery or | 332 |
introduction in evidence in any civil action against a health care | 333 |
entity or health care provider, including both individuals who | 334 |
provide health care and entities that provide health care, arising | 335 |
out of matters that are the subject of evaluation and review by | 336 |
the peer review committee. No individual who attends a meeting of | 337 |
a peer review committee, serves as a member of a peer review | 338 |
committee, works for or on behalf of a peer review committee, or | 339 |
provides information to a peer review committee shall be permitted | 340 |
or required to testify in any civil action as to any evidence or | 341 |
other matters produced or presented during the proceedings of the | 342 |
peer review committee or as to any finding, recommendation, | 343 |
evaluation, opinion, or other action of the committee or a member | 344 |
thereof. Information, documents, or records otherwise available | 345 |
from original sources are not to be construed as being unavailable | 346 |
for discovery or for use in any civil action merely because they | 347 |
were produced or presented during proceedings of a peer review | 348 |
committee, but the information, documents, or records are | 349 |
available only from the original sources and cannot be obtained | 350 |
from the peer review committee's proceedings or records. An | 351 |
individual who testifies before a peer review committee, serves as | 352 |
a representative of a peer review committee, serves as a member of | 353 |
a peer review committee, works for or on behalf of a peer review | 354 |
committee, or provides information to a peer review committee | 355 |
shall not be prevented from testifying as to matters within the | 356 |
individual's knowledge, but the individual cannot be asked about | 357 |
the individual's testimony before the peer review committee, | 358 |
information the individual provided to the peer review committee, | 359 |
or any opinion the individual formed as a result of the peer | 360 |
review committee's activities. An order by a court to produce for | 361 |
discovery or for use at trial the proceedings or records described | 362 |
in this section is a final order. | 363 |
(B) Division (A) of this section applies to a peer review | 364 |
committee of the bureau of workers' compensation that is | 365 |
responsible for reviewing the professional qualifications and the | 366 |
performance of providers certified by the bureau to participate in | 367 |
the health partnership program created under sections 4121.44 and | 368 |
4121.441 of the Revised Code, except that the proceedings and | 369 |
records within the scope of the peer review committee are subject | 370 |
to discovery or court subpoena and may be admitted into evidence | 371 |
in any criminal action or administrative or civil action | 372 |
initiated, prosecuted, or adjudicated by the bureau involving an | 373 |
alleged violation of applicable statutes or administrative rules. | 374 |
The bureau may share proceedings and records within the scope of | 375 |
the peer review committee, including claimant records and claim | 376 |
file information, with law enforcement agencies, licensing boards, | 377 |
and other governmental agencies that are prosecuting, | 378 |
adjudicating, or investigating alleged violations of applicable | 379 |
statutes or administrative rules. Recipients of claimant records | 380 |
and claim file information provided by the bureau pursuant to this | 381 |
division shall take appropriate measures to maintain the | 382 |
confidentiality of the information. | 383 |
Sec. 4121.129. (A) There is hereby created the workers' | 384 |
compensation audit committee consisting of at least three members. | 385 |
One member shall be the member of the bureau of workers' | 386 |
compensation board of directors who is a certified public | 387 |
accountant. The board, by majority vote, shall appoint two | 388 |
additional members of the board to serve on the audit committee | 389 |
and may appoint additional members who are not board members, as | 390 |
the board determines necessary. Members of the audit committee | 391 |
serve at the pleasure of the board, and the board, by majority | 392 |
vote, may remove any member except the member of the committee who | 393 |
is the certified public accountant member of the board. The board, | 394 |
by majority vote, shall determine how often the audit committee | 395 |
shall meet and report to the board. If the audit committee meets | 396 |
on the same day as the board holds a meeting, no member shall be | 397 |
compensated for more than one meeting held on that day. The audit | 398 |
committee shall do all of the following: | 399 |
(B) There is hereby created the workers' compensation | 412 |
actuarial committee consisting of at least three members. One | 413 |
member shall be the member of the board who is an actuary. The | 414 |
board, by majority vote, shall appoint two additional members of | 415 |
the board to serve on the actuarial committee and may appoint | 416 |
additional members who are not board members, as the board | 417 |
determines necessary. Members of the actuarial committee serve at | 418 |
the pleasure of the board and the board, by majority vote, may | 419 |
remove any member except the member of the committee who is the | 420 |
actuary member of the board. The board, by majority vote, shall | 421 |
determine how often the actuarial committee shall meet and report | 422 |
to the board. If the actuarial committee meets on the same day as | 423 |
the board holds a meeting, no member shall be compensated for more | 424 |
than one meeting held on that day. The actuarial committee shall | 425 |
do both of the following: | 426 |
(B) The bureau shall issue a written order of summary | 491 |
suspension by certified mail or in person in accordance with | 492 |
section 119.07 of the Revised Code. The order shall not be subject | 493 |
to suspension by the court during pendency of any appeal filed | 494 |
under section 119.12 of the Revised Code. If the provider subject | 495 |
to the summary suspension requests an adjudicatory hearing by the | 496 |
bureau, the date set for the hearing shall be not later than | 497 |
fifteen days, but not earlier than seven days, after the provider | 498 |
requests the hearing, unless otherwise agreed to by both the | 499 |
bureau and the provider. | 500 |
(a) Every person in the service of the state, or of any | 522 |
county, municipal corporation, township, or school district | 523 |
therein, including regular members of lawfully constituted police | 524 |
and fire departments of municipal corporations and townships, | 525 |
whether paid or volunteer, and wherever serving within the state | 526 |
or on temporary assignment outside thereof, and executive officers | 527 |
of boards of education, under any appointment or contract of hire, | 528 |
express or implied, oral or written, including any elected | 529 |
official of the state, or of any county, municipal corporation, or | 530 |
township, or members of boards of education. | 531 |
(b) Every person in the service of any person, firm, or | 552 |
private corporation, including any public service corporation, | 553 |
that (i) employs one or more persons regularly in the same | 554 |
business or in or about the same establishment under any contract | 555 |
of hire, express or implied, oral or written, including aliens and | 556 |
minors, household workers who earn one hundred sixty dollars or | 557 |
more in cash in any calendar quarter from a single household and | 558 |
casual workers who earn one hundred sixty dollars or more in cash | 559 |
in any calendar quarter from a single employer, or (ii) is bound | 560 |
by any such contract of hire or by any other written contract, to | 561 |
pay into the state insurance fund the premiums provided by this | 562 |
chapter. | 563 |
Every person in the service of any independent contractor or | 610 |
subcontractor who has failed to pay into the state insurance fund | 611 |
the amount of premium determined and fixed by the administrator of | 612 |
workers' compensation for the person's employment or occupation or | 613 |
if a self-insuring employer has failed to pay compensation and | 614 |
benefits directly to the employer's injured and to the dependents | 615 |
of the employer's killed employees as required by section 4123.35 | 616 |
of the Revised Code, shall be considered as the employee of the | 617 |
person who has entered into a contract, whether written or verbal, | 618 |
with such independent contractor unless such employees or their | 619 |
legal representatives or beneficiaries elect, after injury or | 620 |
death, to regard such independent contractor as the employer. | 621 |
Any employer may elect to include as an "employee" within | 641 |
this chapter, any person excluded from the definition of | 642 |
"employee" pursuant to division (A)(2) of this section. If an | 643 |
employer is a partnership, sole proprietorship, individual | 644 |
incorporated as a corporation, or family farm corporation, such | 645 |
employer may elect to include as an "employee" within this | 646 |
chapter, any member of such partnership, the owner of the sole | 647 |
proprietorship, the individual incorporated as a corporation, or | 648 |
the officers of the family farm corporation. In the event of an | 649 |
election, the employer shall serve upon the bureau of workers' | 650 |
compensation written notice naming the persons to be covered, | 651 |
include such employee's remuneration for premium purposes in all | 652 |
future payroll reports, and no person excluded from the definition | 653 |
of "employee" pursuant to division (A)(2) of this section, | 654 |
proprietor, individual incorporated as a corporation, or partner | 655 |
shall be deemed an employee within this division until the | 656 |
employer has served such notice. | 657 |
For informational purposes only, the bureau shall prescribe | 658 |
such language as it considers appropriate, on such of its forms as | 659 |
it considers appropriate, to advise employers of their right to | 660 |
elect to include as an "employee" within this chapter a sole | 661 |
proprietor, any member of a partnership, an individual | 662 |
incorporated as a corporation, the officers of a family farm | 663 |
corporation, or a person excluded from the definition of | 664 |
"employee" under division (A)(2) of this section, that they should | 665 |
check any health and disability insurance policy, or other form of | 666 |
health and disability plan or contract, presently covering them, | 667 |
or the purchase of which they may be considering, to determine | 668 |
whether such policy, plan, or contract excludes benefits for | 669 |
illness or injury that they might have elected to have covered by | 670 |
workers' compensation. | 671 |
(2) Every person, firm, professional employer organization as | 677 |
defined in section 4125.01 of the Revised Code, and private | 678 |
corporation, including any public service corporation, that (a) | 679 |
has in service one or more employees or shared employees regularly | 680 |
in the same business or in or about the same establishment under | 681 |
any contract of hire, express or implied, oral or written, or (b) | 682 |
is bound by any such contract of hire or by any other written | 683 |
contract, to pay into the insurance fund the premiums provided by | 684 |
this chapter. | 685 |
All such employers are subject to this chapter. Any member of | 686 |
a firm or association, who regularly performs manual labor in or | 687 |
about a mine, factory, or other establishment, including a | 688 |
household establishment, shall be considered an employee in | 689 |
determining whether such person, firm, or private corporation, or | 690 |
public service corporation, has in its service, one or more | 691 |
employees and the employer shall report the income derived from | 692 |
such labor to the bureau as part of the payroll of such employer, | 693 |
and such member shall thereupon be entitled to all the benefits of | 694 |
an employee. | 695 |
(E) "Family farm corporation" means a corporation founded for | 724 |
the purpose of farming agricultural land in which the majority of | 725 |
the voting stock is held by and the majority of the stockholders | 726 |
are persons or the spouse of persons related to each other within | 727 |
the fourth degree of kinship, according to the rules of the civil | 728 |
law, and at least one of the related persons is residing on or | 729 |
actively operating the farm, and none of whose stockholders are a | 730 |
corporation. A family farm corporation does not cease to qualify | 731 |
under this division where, by reason of any devise, bequest, or | 732 |
the operation of the laws of descent or distribution, the | 733 |
ownership of shares of voting stock is transferred to another | 734 |
person, as long as that person is within the degree of kinship | 735 |
stipulated in this division. | 736 |
(I)(K) "Sexual conduct" means vaginal intercourse between a | 758 |
male and female; anal intercourse, fellatio, and cunnilingus | 759 |
between persons regardless of gender; and, without privilege to do | 760 |
so, the insertion, however slight, of any part of the body or any | 761 |
instrument, apparatus, or other object into the vaginal or anal | 762 |
cavity of another. Penetration, however slight, is sufficient to | 763 |
complete vaginal or anal intercourse. | 764 |
(B) Except as otherwise provided in division (C) of this | 791 |
section, every private employer
of the state employing one or | 792 |
more employees regularly in the same business, or in or about the | 793 |
same establishment, shall prepare and mailsubmit a payroll report | 794 |
to the bureau at its main office in Columbus a statement | 795 |
containing. Until the policy year commencing July 1, 2015, a | 796 |
private employer shall submit the payroll report in January of | 797 |
each year. For a policy year commencing on or after July 1, 2015, | 798 |
the employer shall submit the payroll report on or before August | 799 |
fifteenth of each year unless otherwise specified by the | 800 |
administrator in rules the administrator adopts. The employer | 801 |
shall include all of the following information in the payroll | 802 |
report, as applicable: | 803 |
The information shall be furnished on a blank to be prepared | 857 |
by the bureau. The bureau shall furnish the blanks to employers | 858 |
free of charge upon request therefor. Every employer receiving | 859 |
from the bureau any blank, with directions to fill out the same, | 860 |
shall cause the same to be properly filled out so as to answer | 861 |
fully and correctly all questions therein propounded, and give all | 862 |
the information therein sought, or if unable to do so, the | 863 |
employer shall give to the bureau in writing good and sufficient | 864 |
reasons for such failure.(C) Beginning August 1, 2015, each | 865 |
employer that is recognized by the administrator as a professional | 866 |
employer organization shall submit a monthly payroll report | 867 |
containing the number of employees employed during the preceding | 868 |
calendar month, the number of those employees employed at each | 869 |
kind of employment, and the aggregate amount of wages paid to | 870 |
those employees. | 871 |
(D) An employer described in division (B) of this section | 872 |
shall submit the payroll report required under this section to the | 873 |
bureau on a form prescribed by the bureau. The bureau may require | 874 |
that the information required to be furnished be verified under | 875 |
oath and returned to the bureau within the period fixed by it or | 876 |
by law. The bureau or any person employed by the bureau for that | 877 |
purpose, may examine, under oath, any employer, or the officer, | 878 |
agent, or employee thereof, for the purpose of ascertaining any | 879 |
information which the employer is required to furnish to the | 880 |
bureau. | 881 |
Sec. 4123.27. Information contained in the annual statement | 894 |
payroll report provided for in section 4123.26 of the Revised | 895 |
Code, and such other information as may be furnished to the bureau | 896 |
of workers' compensation by employers in pursuance of that | 897 |
section, is for the exclusive use and information of the bureau in | 898 |
the discharge of its official duties, and shall not be open to the | 899 |
public nor be used in any court in any action or proceeding | 900 |
pending therein unless the bureau is a party to the action or | 901 |
proceeding; but the. The information contained in the statement | 902 |
payroll report may be tabulated and published by the bureau in | 903 |
statistical form for the use and information of other state | 904 |
departments and the public. No person in the employ of the bureau, | 905 |
except those who are authorized by the administrator of workers' | 906 |
compensation, shall divulge any information secured by the person | 907 |
while in the employ of the bureau in respect to the transactions, | 908 |
property, claim files, records, or papers of the bureau or in | 909 |
respect to the business or mechanical, chemical, or other | 910 |
industrial process of any company, firm, corporation, person, | 911 |
association, partnership, or public utility to any person other | 912 |
than the administrator or to the superior of such employee of the | 913 |
bureau. | 914 |
Notwithstanding the restrictions imposed by this section, the | 915 |
governor, select or standing committees of the general assembly, | 916 |
the auditor of state, the attorney general, or their designees, | 917 |
pursuant to the authority granted in this chapter and Chapter | 918 |
4121. of the Revised Code, may examine any records, claim files, | 919 |
or papers in possession of the industrial commission or the | 920 |
bureau. They also are bound by the privilege that attaches to | 921 |
these papers. | 922 |
The administrator shall report to the director of job and | 923 |
family services or to the county director of job and family | 924 |
services the name, address, and social security number or other | 925 |
identification number of any person receiving workers' | 926 |
compensation whose name or social security number or other | 927 |
identification number is the same as that of a person required by | 928 |
a court or child support enforcement agency to provide support | 929 |
payments to a recipient or participant of public assistance, as | 930 |
that term is defined in section 5101.181 of the Revised Code, and | 931 |
whose name is submitted to the administrator by the director under | 932 |
section 5101.36 of the Revised Code. The administrator also shall | 933 |
inform the director of the amount of workers' compensation paid to | 934 |
the person during such period as the director specifies. | 935 |
Within fourteen days after receiving from the director of job | 936 |
and family services a list of the names and social security | 937 |
numbers of recipients or participants of public assistance | 938 |
pursuant to section 5101.181 of the Revised Code, the | 939 |
administrator shall inform the auditor of state of the name, | 940 |
current or most recent address, and social security number of each | 941 |
person receiving workers' compensation pursuant to this chapter | 942 |
whose name and social security number are the same as that of a | 943 |
person whose name or social security number was submitted by the | 944 |
director. The administrator also shall inform the auditor of state | 945 |
of the amount of workers' compensation paid to the person during | 946 |
such period as the director specifies. | 947 |
(2)(a) Fix the rates of premium of the risks of the classes | 961 |
based upon the total payroll in each of the classes of occupation | 962 |
or industry sufficiently large to provide a fund for the | 963 |
compensation provided for in this chapter and to maintain a state | 964 |
insurance fund from year to year. The administrator shall set the | 965 |
rates at a level that assures the solvency of the fund. Where the | 966 |
payroll cannot be obtained or, in the opinion of the | 967 |
administrator, is not an adequate measure for determining the | 968 |
premium to be paid for the degree of hazard, the administrator may | 969 |
determine the rates of premium upon such other basis, consistent | 970 |
with insurance principles, as is equitable in view of the degree | 971 |
of hazard, and whenever in this chapter reference is made to | 972 |
payroll or expenditure of wages with reference to fixing premiums, | 973 |
the reference shall be construed to have been made also to such | 974 |
other basis for fixing the rates of premium as the administrator | 975 |
may determine under this section. | 976 |
(b) If an employer elects to obtain other-states' coverage, | 977 |
including limited other-states' coverage, pursuant to section | 978 |
4123.292 of the Revised Code through either the administrator, if | 979 |
the administrator elects to offer such coverage, or an | 980 |
other-states' insurer, calculate the employer's premium for the | 981 |
state insurance fund in the same manner as otherwise required | 982 |
under division (A) of this section and section 4123.34 of the | 983 |
Revised Code, except that when the administrator determines the | 984 |
expenditure of wages, payroll, or both upon which to basemay | 985 |
establish in rule an alternative calculation of the employer's | 986 |
premium, the administrator shall use onlyto appropriately account | 987 |
for the expenditure of wages, payroll, or both attributable to the | 988 |
labor performed and services provided by that employer's employees | 989 |
when those employees performed labor and provided services in this | 990 |
state only and to which thein the other state or states for which | 991 |
the employer elects to secure other-states' coverage does not | 992 |
apply. | 993 |
(c) If an employer elects to obtain other-states' coverage | 994 |
pursuant to section 4123.292 of the Revised Code through an | 995 |
other-states' insurer, calculate the employer's premium for the | 996 |
state insurance fund in the same manner as otherwise required | 997 |
under division (A) of this section and section 4123.34 of the | 998 |
Revised Code, except that when the administrator determines the | 999 |
expenditure of wages, payroll, or both upon which to base the | 1000 |
employer's premium, the administrator shall use only the | 1001 |
expenditure of wages, payroll, or both attributable to the labor | 1002 |
performed and services provided by that employer's employees when | 1003 |
those employees performed labor and provided services in this | 1004 |
state only and to which the other-states' coverage does not apply. | 1005 |
The administrator may adopt rules setting forth the information | 1006 |
that an employer electing to obtain other-states' coverage through | 1007 |
an other-states' insurer shall report for purposes of determining | 1008 |
the expenditure of wages, payroll, or both attributable to the | 1009 |
labor performed and services provided in this state. | 1010 |
(e) In providing employer group plans under division (A)(4) | 1066 |
of this section, the administrator shall establish a program | 1067 |
designed to mitigate the impact of a significant claim that would | 1068 |
come into the experience of a private, state fund group-rated | 1069 |
employer or a taxing district employer for the first time and be a | 1070 |
contributing factor in that employer being excluded from a | 1071 |
group-rated plan. The administrator shall establish eligibility | 1072 |
criteria and requirements that such employers must satisfy in | 1073 |
order to participate in this program. For purposes of this | 1074 |
program, the administrator shall establish a discount on premium | 1075 |
rates applicable to employers who qualify for the program. | 1076 |
(6) Make available to every employer who is paying premiums | 1091 |
to the state insurance fund a program whereby the employer or the | 1092 |
employer's agent pays to the claimant or on behalf of the claimant | 1093 |
the first fifteen thousand dollars of a compensable workers' | 1094 |
compensation medical-only claim filed by that claimant that is | 1095 |
related to the same injury or occupational disease. No formal | 1096 |
application is required; however, an employer must elect to | 1097 |
participate by telephoning the bureau after July 1, 1995. Once an | 1098 |
employer has elected to participate in the program, the employer | 1099 |
will be responsible for all bills in all medical-only claims with | 1100 |
a date of injury the same or later than the election date, unless | 1101 |
the employer notifies the bureau within fourteen days of receipt | 1102 |
of the notification of a claim being filed that it does not wish | 1103 |
to pay the bills in that claim, or the employer notifies the | 1104 |
bureau that the fifteen thousand dollar maximum has been paid, or | 1105 |
the employer notifies the bureau of the last day of service on | 1106 |
which it will be responsible for the bills in a particular | 1107 |
medical-only claim. If an employer elects to enter the program, | 1108 |
the administrator shall not reimburse the employer for such | 1109 |
amounts paid and shall not charge the first fifteen thousand | 1110 |
dollars of any medical-only claim paid by an employer to the | 1111 |
employer's experience or otherwise use it in merit rating or | 1112 |
determining the risks of any employer for the purpose of payment | 1113 |
of premiums under this chapter. A certified health care provider | 1114 |
shall extend to an employer who participates in this program the | 1115 |
same rates for services rendered to an employee of that employer | 1116 |
as the provider bills the administrator for the same type of | 1117 |
medical claim processed by the bureau and shall not charge, | 1118 |
assess, or otherwise attempt to collect from an employee any | 1119 |
amount for covered services or supplies that is in excess of that | 1120 |
rate. If an employer elects to enter the program and the employer | 1121 |
fails to pay a bill for a medical-only claim included in the | 1122 |
program, the employer shall be liable for that bill and the | 1123 |
employee for whom the employer failed to pay the bill shall not be | 1124 |
liable for that bill. The administrator shall adopt rules to | 1125 |
implement and administer division (A)(6) of this section. Upon | 1126 |
written request from the bureau, the employer shall provide | 1127 |
documentation to the bureau of all medical-only bills that they | 1128 |
are paying directly. Such requests from the bureau may not be made | 1129 |
more frequently than on a semiannual basis. Failure to provide | 1130 |
such documentation to the bureau within thirty days of receipt of | 1131 |
the request may result in the employer's forfeiture of | 1132 |
participation in the program for such injury. The provisions of | 1133 |
this section shall not apply to claims in which an employer with | 1134 |
knowledge of a claimed compensable injury or occupational disease, | 1135 |
has paid wages in lieu of compensation or total disability. | 1136 |
Sec. 4123.291. (A) An adjudicating committee appointed by | 1149 |
the administrator of workers' compensation to hear any matter | 1150 |
specified in divisions (B)(1) to (7) of this section shall hear | 1151 |
the matter within sixty days of the date on which an employer | 1152 |
files the request, protest, or petition. An employer desiring to | 1153 |
file a request, protest, or petition regarding any matter | 1154 |
specified in divisions (B)(1) to (7) of this section shall file | 1155 |
the request, protest, or petition to the adjudicating committee on | 1156 |
or before twenty-four months after the administrator sends notice | 1157 |
of the determination about which the employer is filing the | 1158 |
request, protest, or petition. | 1159 |
Sec. 4123.292. (A) Notwithstanding sections 4123.35 and | 1193 |
4123.82 of the Revised Code, an employer may elect to obtain | 1194 |
other-states' coverage through an other-states' insurer or, if the | 1195 |
administrator of workers' compensation elects to offer such | 1196 |
coverage, through the administrator pursuant to division (B) of | 1197 |
this section. An employer who elects to obtain other-states' | 1198 |
coverage shall submit a written notice to the administrator | 1199 |
stating that election on a form prescribed by the administrator | 1200 |
and, if the employer elects to obtain that coverage through an | 1201 |
other-states' insurer, the name of the other-states' insurer | 1202 |
through whom the employer has obtained that coverage. If an | 1203 |
employer fails to pay the employer's premium for other-states' | 1204 |
coverage, the administrator shall consider the employer to be | 1205 |
noncompliant for the purposes of having other-states' coverage but | 1206 |
shall not consider the employer to be a noncomplying employer for | 1207 |
purposes of this chapter or Chapter 4121., 4127., or 4131. of the | 1208 |
Revised Code unless the employer otherwise fails to comply with | 1209 |
and the employer's premiums in this state for any and all | 1210 |
noncompliant periods of time shall be calculated in the same | 1211 |
manner as otherwise required under division (A) of section 4123.29 | 1212 |
and section 4123.354123.34 of the Revised Code, using both the | 1213 |
wages reported in this state and the wages that the employer | 1214 |
claimed would be reported to the other-states' insurer for | 1215 |
securing coverage. | 1216 |
(B) The administrator may secureoffer other-states' coverage | 1217 |
to allow an employer who wishes to obtain other-states' coverage | 1218 |
pursuant to this section and who elects to
obtainsecure that | 1219 |
coverage through the administrator for workers' compensation | 1220 |
claims
arising in a state or states other than this state. If the | 1221 |
administrator elects to secure a vehicle through which the | 1222 |
administrator will provide other-states' coverage, the | 1223 |
administrator shall follow the competitive bidding requirements | 1224 |
specified in Chapter 125. of the Revised Code to select one
or | 1225 |
more other-states' insurerinsurers, and the administrator, with | 1226 |
the advice and consent of the bureau of workers' compensation | 1227 |
board of directors, shall award thea contract to provide | 1228 |
other-states' coverage for employers located in this state to the | 1229 |
one or more other-states'
insurerinsurers that isare the lowest | 1230 |
and best bidderbidders. | 1231 |
(C) If the administrator elects to secure other-states' | 1232 |
coverage pursuant to division (B) of this section, the | 1233 |
administrator shall calculate an employer's premium for | 1234 |
other-states' coverage provided through the administrator | 1235 |
separately from calculating any other premiums or assessments | 1236 |
charged under this chapter or Chapter 4121., 4127., or 4131. of | 1237 |
the Revised Code. The administrator shall calculate the employer's | 1238 |
other-states' coverage premium in the same manner the | 1239 |
administrator calculates an employer's premium for the state | 1240 |
insurance fund pursuant to division (A) of section 4123.29 and | 1241 |
section 4123.34 of the Revised Code, except that, when calculating | 1242 |
the employer's premium for other-states' coverage under this | 1243 |
division, the administrator shall do all of the following: | 1244 |
(3) Not take into account the amount of wages, payroll, or | 1254 |
both the employer paid to the employer's employees for performing | 1255 |
labor or providing services for the employer in this state or any | 1256 |
compensation or benefits paid for claims covered by the state | 1257 |
insurance fundNotwithstanding sections 4123.35 and 4123.82 of the | 1258 |
Revised Code, the administrator may offer limited other-states' | 1259 |
coverage to allow an employer who wishes to obtain limited | 1260 |
other-states' coverage pursuant to this section. An employer who | 1261 |
elects to obtain limited other-states' coverage shall submit a | 1262 |
written notice to the administrator stating that election on a | 1263 |
form prescribed by the administrator. | 1264 |
(C)(B) Such special rules as the administrator considers | 1321 |
necessary to safeguard the fund and that are just in the | 1322 |
circumstances, covering the rates to be applied where one employer | 1323 |
takes over the occupation or industry of another or where an | 1324 |
employer first makes application for state insurance, and the | 1325 |
administrator may require that if any employer transfers a | 1326 |
business in whole or in part or otherwise reorganizes the | 1327 |
business, the successor in interest shall assume, in proportion to | 1328 |
the extent of the transfer, as determined by the administrator, | 1329 |
the employer's account and shall continue the payment of all | 1330 |
contributions due under this chapter; | 1331 |
(D)(C) A rule providing that an employer who employs an | 1332 |
employee covered under the federal "Longshore and Harbor Workers' | 1333 |
Compensation Act," 98 Stat. 1639, 33 U.S.C. 901 et seq., and this | 1334 |
chapter and Chapter 4121. of the Revised Code shall be assessed a | 1335 |
premium in accordance with the expenditure of wages, payroll, or | 1336 |
both attributable to only labor performed and services provided by | 1337 |
such an employee when the employee performs labor and provides | 1338 |
services for which the employee is not eligible to receive | 1339 |
compensation and benefits under that federal act. | 1340 |
(1) If, within two months immediately after the expiration of | 1342 |
the six-month period, an employer fails to file a report of the | 1343 |
employer's actual payroll expenditures for the periodpursuant to | 1344 |
section 4123.26 of the Revised Code for private employers or | 1345 |
pursuant to section 4123.41 of the Revised Code for public | 1346 |
employers, the premium
found to beand assessments due from the | 1347 |
employer for the period shall be calculated based on the estimated | 1348 |
payroll of the employer used in calculating the estimated premium | 1349 |
due, increased in an amount equal to one per cent of the premium, | 1350 |
but the increase shall not be less than three nor more than | 1351 |
fifteen dollarsby ten per cent; | 1352 |
(2) The premium determined by the administrator to be due | 1353 |
from an employer shall be payable on or before the end of the | 1354 |
coverage period established by the premium security deposit, or | 1355 |
within the time specified by the administrator if the period for | 1356 |
which the advance premium has been paid is less than eight months. | 1357 |
(a) If an employer fails to pay the premium or assessments when | 1358 |
due for a policy year commencing prior to July 1, 2015, the | 1359 |
administrator may add a late fee penalty of not more than thirty | 1360 |
dollars to the premium plus an additional penalty amount as | 1361 |
follows: | 1362 |
(F)(E) A rule providing that each employer, on the occasion | 1429 |
of instituting coverage under this chapter for an effective date | 1430 |
prior to July 1, 2015, shall submit a premium security deposit. | 1431 |
The deposit shall be calculated equivalent to thirty per cent of | 1432 |
the semiannual premium obligation of the employer based upon the | 1433 |
employer's estimated expenditure for wages for the ensuing | 1434 |
six-month period plus thirty per cent of an additional adjustment | 1435 |
period of two months but only up to a maximum of one thousand | 1436 |
dollars and not less than ten dollars. The administrator shall | 1437 |
review the security deposit of every employer who has submitted a | 1438 |
deposit which is less than the one-thousand-dollar maximum. The | 1439 |
administrator may require any such employer to submit additional | 1440 |
money up to the maximum of one thousand dollars that, in the | 1441 |
administrator's opinion, reflects the employer's current payroll | 1442 |
expenditure for an eight-month period. | 1443 |
(I)(H) A rule providing that if after a final adjudication it | 1456 |
is determined that an employer has failed to pay an obligation, | 1457 |
billing, account, or assessment that is greater than one thousand | 1458 |
dollars on or before its due date, the administrator may | 1459 |
discontinue the employer's coverage in addition to any other | 1460 |
remedies permitted in this chapter, and that the administrator | 1461 |
shall not discontinue an employer's coverage pursuant to this | 1462 |
division prior to a final adjudication regarding the employer's | 1463 |
failure to pay such obligation, billing, account, or assessment on | 1464 |
or before its due date. | 1465 |
Sec. 4123.322. (A) Notwithstanding any provision to the | 1478 |
contrary in section 4123.32 or 4123.41 of the Revised Code, the | 1479 |
administrator of workers' compensation, with the advice and | 1480 |
consent of the bureau of workers' compensation board of directors, | 1481 |
may adopt rules with respect to the collection, maintenance, and | 1482 |
disbursements of the state insurance fund to provide for a system | 1483 |
of prospective payment of workers' compensation premiums. If the | 1484 |
administrator elects to adopt rules establishing a prospective | 1485 |
payment system, those rules shall include all of the following: | 1486 |
(2) A requirement that upon an initial application for | 1495 |
coverage, ana private employer mentioned in division (B)(2) of | 1496 |
section 4123.01 of the Revised Code shall file with the | 1497 |
application an estimate of the employer's payroll for the | 1498 |
unexpired period from the date of application to the period ending | 1499 |
on the following thirtieth day of June or other date as | 1500 |
established by the administrator determines pursuant to division | 1501 |
(A)(1) of this sectionrules the administrator adopts, and shall | 1502 |
pay the amount the administrator determines by rule in order to | 1503 |
establish coverage for the employer as described in division | 1504 |
(B)(12) of section 4121.121 of the Revised Code; | 1505 |
(3) A requirement that, notwithstanding section 4123.26 or | 1506 |
4123.41 of the Revised Code, on or before the first day of January | 1507 |
of each year, or such other date as the administrator establishes, | 1508 |
every employer mentioned in division (B)(1) of section 4123.01 of | 1509 |
the Revised Code, except for a state agency or a state university | 1510 |
or college, shall file with the bureau an estimate of the | 1511 |
employer's payroll for the immediately following twelve-month | 1512 |
period or other period as the administrator establishes; | 1513 |
(4)(2) A requirement that upon an initial application for | 1514 |
coverage, ana public employer mentioned in division (B)(1) of | 1515 |
section 4123.01 of the Revised Code, except for a state agency or | 1516 |
state university or college, shall file with the application an | 1517 |
estimate of the employer's payroll for the unexpired period from | 1518 |
the date of application to the period ending on the following | 1519 |
thirty-first day of December or other date as established by the | 1520 |
administrator determines pursuant to division (A)(3) of this | 1521 |
sectionrules the administrator adopts, and shall pay the amount | 1522 |
the administrator determines by rule in order to establish | 1523 |
coverage for the employer as described in division (B)(12) of | 1524 |
section 4121.121 of the Revised Code; | 1525 |
(8)(5) The establishment of a transition period during which | 1535 |
time the bureau shall determine the adequacy of existing premium | 1536 |
security deposits of employers, the establishment of provisions | 1537 |
for additional premium payments during that transition, the | 1538 |
provision of a credit of those deposits toward the first premium | 1539 |
due from an employer under the rules adopted under divisions | 1540 |
(A)(1) to (7)(4) of this section, the provision of a transition | 1541 |
credit for employers, and the establishment of penalties for late | 1542 |
payment or failure to comply with the rules. | 1543 |
Sec. 4123.34. It shall be the duty of the bureau of workers' | 1556 |
compensation board of directors and the administrator of workers' | 1557 |
compensation to safeguard and maintain the solvency of the state | 1558 |
insurance fund and all other funds specified in this chapter and | 1559 |
Chapters 4121., 4127., and 4131. of the Revised Code. The | 1560 |
administrator, in the exercise of the powers and discretion | 1561 |
conferred upon the administrator in section 4123.29 of the Revised | 1562 |
Code, shall fix and maintain, with the advice and consent of the | 1563 |
board, for each class of occupation or industry, the lowest | 1564 |
possible rates of premium consistent with the maintenance of a | 1565 |
solvent state insurance fund and the creation and maintenance of a | 1566 |
reasonable surplus, after the payment of legitimate claims for | 1567 |
injury, occupational disease, and death that the administrator | 1568 |
authorizes to be paid from the state insurance fund for the | 1569 |
benefit of injured, diseased, and the dependents of killed | 1570 |
employees. In establishing rates, the administrator shall take | 1571 |
into account the necessity of ensuring sufficient money is set | 1572 |
aside in the premium payment security fund to cover any defaults | 1573 |
in premium obligations. The administrator shall observe all of the | 1574 |
following requirements in fixing the rates of premium for the | 1575 |
risks of occupations or industries: | 1576 |
(A) The administrator shall keep an accurate account of the | 1577 |
money paid in premiums by each of the several classes of | 1578 |
occupations or industries, and the losses on account of injuries, | 1579 |
occupational disease, and death of employees thereof, and also | 1580 |
keep an account of the money received from each individual | 1581 |
employer and the amount of losses incurred against the state | 1582 |
insurance fund on account of injuries, occupational disease, and | 1583 |
death of the employees of the employer. | 1584 |
(B) A portion of the money paid into the state insurance fund | 1585 |
shall be set aside for the creation of a surplus fund account | 1586 |
within the state insurance fund. Any references in this chapter or | 1587 |
in Chapter 4121., 4125., 4127., or 4131. of the Revised Code to | 1588 |
the surplus fund, the surplus created in this division, the | 1589 |
statutory surplus fund, or the statutory surplus of the state | 1590 |
insurance fund are hereby deemed to be references to the surplus | 1591 |
fund account. The administrator may transfer the portion of the | 1592 |
state insurance fund to the surplus fund account as the | 1593 |
administrator determines is necessary to satisfy the needs of the | 1594 |
surplus fund account and to guarantee the solvency of the state | 1595 |
insurance fund and the surplus fund account. In addition to all | 1596 |
statutory authority under this chapter and Chapter 4121. of the | 1597 |
Revised Code, the administrator has discretionary and contingency | 1598 |
authority to make charges to the surplus fund account. The | 1599 |
administrator shall account for all charges, whether statutory, | 1600 |
discretionary, or contingency, that the administrator may make to | 1601 |
the surplus fund account. A revision of basic rates shall be made | 1602 |
annually on the first day of July. | 1603 |
Notwithstanding any provision of the law to the contrary, one | 1604 |
hundred eighty days after the effective date on which | 1605 |
self-insuring employers first may elect under division (D) of | 1606 |
section 4121.66 of the Revised Code to directly pay for | 1607 |
rehabilitation expenses, the administrator shall calculate the | 1608 |
deficit, if any, in the portion of the surplus fund account that | 1609 |
is used for reimbursement to self-insuring employers for all | 1610 |
expenses other than handicapped reimbursement under section | 1611 |
4123.343 of the Revised Code. The administrator, from time to | 1612 |
time, may determine whether the surplus fund account has such a | 1613 |
deficit and may assess all self-insuring employers who | 1614 |
participated in the portion of the surplus fund account during the | 1615 |
accrual of the deficit and who during that time period have not | 1616 |
made the election under division (D) of section 4121.66 of the | 1617 |
Revised Code the amount the administrator determines necessary to | 1618 |
reduce the deficit. | 1619 |
RevisionsFor policy years commencing prior to July 1, 2016, | 1620 |
revisions of basic rates for private employers shall be in | 1621 |
accordance with the oldest four of the last five calendar years of | 1622 |
the combined accident and occupational disease experience of the | 1623 |
administrator in the administration of this chapter, as shown by | 1624 |
the accounts kept as provided in this section, excluding. For a | 1625 |
policy year commencing on or after July 1, 2016, revisions of | 1626 |
basic rates for private employers shall be in accordance with the | 1627 |
oldest four of the last five policy years combined accident and | 1628 |
occupational disease experience of the administrator in the | 1629 |
administration of this chapter, as shown by the accounts kept as | 1630 |
provided in this section. | 1631 |
In revising basic rates, the administrator shall exclude the | 1637 |
experience of employers that are no longer active if the | 1638 |
administrator determines that the inclusion of those employers | 1639 |
would have a significant negative impact on the remainder of the | 1640 |
employers in a particular manual classification; and the. The | 1641 |
administrator shall adopt rules, with the advice and consent of | 1642 |
the board, governing rate revisions, the object of which shall be | 1643 |
to make an equitable distribution of losses among the several | 1644 |
classes of occupation or industry, which rules shall be general in | 1645 |
their application. | 1646 |
The fund shall be in the custody of the treasurer of state. | 1660 |
All investment earnings of the fund shall be deposited in the | 1661 |
fund. Disbursements from the fund shall be made by the bureau of | 1662 |
workers' compensation upon order of the administrator to the state | 1663 |
insurance fund. The use of the moneys held by the premium payment | 1664 |
security fund account is restricted to reimbursement to the state | 1665 |
insurance fund of premiums due and uncollected in excess of an | 1666 |
employer's premium security deposit. The moneys constituting the | 1667 |
premium payment security fund shall be maintained without regard | 1668 |
to or reliance upon any other fund. This section does not prevent | 1669 |
the deposit or investment of the premium payment security fund | 1670 |
with any other fund created by this chapter, but the premium | 1671 |
payment security fund is separate and distinct for every other | 1672 |
purpose and a strict accounting thereof shall be maintained. | 1673 |
Sec. 4123.35. (A) Except as provided in this section, and | 1703 |
until the policy year commencing July 1, 2015, every private | 1704 |
employer mentioned in division (B)(2) of section 4123.01 of the | 1705 |
Revised Code, and every publicly owned utility shall pay | 1706 |
semiannually in the months of January and July into the state | 1707 |
insurance fund the amount of annual premium the administrator of | 1708 |
workers' compensation fixes for the employment or occupation of | 1709 |
the employer, the amount of which premium to be paid by each | 1710 |
employer to be determined by the classifications, rules, and rates | 1711 |
made and published by the administrator. The employer shall pay | 1712 |
semiannually a further sum of money into the state insurance fund | 1713 |
as may be ascertained to be due from the employer by applying the | 1714 |
rules of the administrator, and a. | 1715 |
Except as otherwise provided in this section, for a policy | 1716 |
year commencing on or after July 1, 2015, every private employer | 1717 |
and every publicly owned utility shall pay annually in the month | 1718 |
of June immediately preceding the policy year into the state | 1719 |
insurance fund the amount of estimated annual premium the | 1720 |
administrator fixes for the employment or occupation of the | 1721 |
employer, the amount of which estimated premium to be paid by each | 1722 |
employer to be determined by the classifications, rules, and rates | 1723 |
made and published by the administrator. The employer shall pay a | 1724 |
further sum of money into the state insurance fund as may be | 1725 |
ascertained to be due from the employer by applying the rules of | 1726 |
the administrator. Upon receipt of the payroll report required by | 1727 |
division (B) of section 4123.26 of the Revised Code, the | 1728 |
administrator shall adjust the premium and assessments charged to | 1729 |
each employer for the difference between estimated gross payrolls | 1730 |
and actual gross payrolls, and any balance due to the | 1731 |
administrator shall be immediately paid by the employer. Any | 1732 |
balance due the employer shall be credited to the employer's | 1733 |
account. | 1734 |
A receipt or certificate certifying that payment has been | 1742 |
made, along with a written notice as is required in section | 1743 |
4123.54 of the Revised Code, shall be
mailed immediatelyissued | 1744 |
to the employer by the bureau of workers' compensation. The | 1745 |
receipt or certificate is prima-facie evidence of the payment of | 1746 |
the premium, and the proper. The administrator shall provide each | 1747 |
employer written proof of workers' compensation coverage as is | 1748 |
required in section 4123.83 of the Revised Code. Proper posting of | 1749 |
the notice constitutes the employer's compliance with the notice | 1750 |
requirement mandated in section 4123.544123.83 of the Revised | 1751 |
Code. | 1752 |
If the administrator adopts rules to establish a prospective | 1753 |
payment of premium under section 4123.322 of the Revised Code, | 1754 |
every employer mentioned in division (B)(2) of section 4123.01 of | 1755 |
the Revised Code and every publicly owned utility shall pay into | 1756 |
the state insurance fund the amount of premium the administrator | 1757 |
fixes for the employment or occupation of the employer, the amount | 1758 |
of which premium to be paid by each employer to be determined by | 1759 |
the classifications, rules, and rates made and published by the | 1760 |
administrator and based upon the estimates and reconciliations | 1761 |
required by the rules the administrator adopts under section | 1762 |
4123.322 of the Revised Code. | 1763 |
Division (A) of this section providing for the payment of | 1775 |
premiums semiannually does not apply to any employer who was a | 1776 |
subscriber to the state insurance fund prior to January 1, 1914, | 1777 |
or, until July 1, 2015, who may first become a subscriber to the | 1778 |
fund in any month other than January or July. Instead, the | 1779 |
semiannual premiums shall be paid by those employers from time to | 1780 |
time upon the expiration of the respective periods for which | 1781 |
payments into the fund have been made by them.
After July 1, 2015, | 1782 |
an employer who first becomes a subscriber to the fund on any day | 1783 |
other than the first day of July shall pay premiums according to | 1784 |
rules adopted by the administrator, with the advice and consent of | 1785 |
the bureau of workers' compensation board of directors, for the | 1786 |
remainder of the policy year for which the coverage is effective. | 1787 |
The administrator, with the advice and consent of the board, | 1788 |
shall adopt rules to permit employers to make periodic payments of | 1789 |
the semiannual premium and assessment due under this division. The | 1790 |
rules shall include provisions for the assessment of interest | 1791 |
charges, where appropriate, and for the assessment of penalties | 1792 |
when an employer fails to make timely premium payments. The | 1793 |
administrator, in the rules the administrator adopts, may set an | 1794 |
administrative fee for these periodic payments. An employer who | 1795 |
timely pays the amounts due under this division is entitled to all | 1796 |
of the benefits and protections of this chapter. Upon receipt of | 1797 |
payment, the bureau immediately shall mailissue a receipt or | 1798 |
certificate to the employer certifying that payment has been made, | 1799 |
which receipt is prima-facie evidence of payment. Workers' | 1800 |
compensation coverage under this chapter continues uninterrupted | 1801 |
upon timely receipt of payment under this division. | 1802 |
(B) Employers who will abide by the rules of the | 1807 |
administrator and who may be of sufficient financial ability to | 1808 |
render certain the payment of compensation to injured employees or | 1809 |
the dependents of killed employees, and the furnishing of medical, | 1810 |
surgical, nursing, and hospital attention and services and | 1811 |
medicines, and funeral expenses, equal to or greater than is | 1812 |
provided for in sections 4123.52, 4123.55 to 4123.62, and 4123.64 | 1813 |
to 4123.67 of the Revised Code, and who do not desire to insure | 1814 |
the payment thereof or indemnify themselves against loss sustained | 1815 |
by the direct payment thereof, upon a finding of such facts by the | 1816 |
administrator, may be granted the privilege to pay individually | 1817 |
compensation, and furnish medical, surgical, nursing, and hospital | 1818 |
services and attention and funeral expenses directly to injured | 1819 |
employees or the dependents of killed employees, thereby being | 1820 |
granted status as a self-insuring employer. The administrator may | 1821 |
charge employers who apply for the status as a self-insuring | 1822 |
employer a reasonable application fee to cover the bureau's costs | 1823 |
in connection with processing and making a determination with | 1824 |
respect to an application. | 1825 |
The administrator may waive the requirements of divisions | 1866 |
(B)(1)(a) and (b) of this section and the requirement of division | 1867 |
(B)(1)(e) of this section that the financial records, documents, | 1868 |
and data be certified by a certified public accountant. The | 1869 |
administrator shall adopt rules establishing the criteria that an | 1870 |
employer shall meet in order for the administrator to waive the | 1871 |
requirements of divisions (B)(1)(a), (b), and (e) of this section. | 1872 |
Such rules may require additional security of that employer | 1873 |
pursuant to division (E) of section 4123.351 of the Revised Code. | 1874 |
(C) A board of county commissioners described in division (G) | 1944 |
of section 4123.01 of the Revised Code, as an employer, that will | 1945 |
abide by the rules of the administrator and that may be of | 1946 |
sufficient financial ability to render certain the payment of | 1947 |
compensation to injured employees or the dependents of killed | 1948 |
employees, and the furnishing of medical, surgical, nursing, and | 1949 |
hospital attention and services and medicines, and funeral | 1950 |
expenses, equal to or greater than is provided for in sections | 1951 |
4123.52, 4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised | 1952 |
Code, and that does not desire to insure the payment thereof or | 1953 |
indemnify itself against loss sustained by the direct payment | 1954 |
thereof, upon a finding of such facts by the administrator, may be | 1955 |
granted the privilege to pay individually compensation, and | 1956 |
furnish medical, surgical, nursing, and hospital services and | 1957 |
attention and funeral expenses directly to injured employees or | 1958 |
the dependents of killed employees, thereby being granted status | 1959 |
as a self-insuring employer. The administrator may charge a board | 1960 |
of county commissioners described in division (G) of section | 1961 |
4123.01 of the Revised Code that applies for the status as a | 1962 |
self-insuring employer a reasonable application fee to cover the | 1963 |
bureau's costs in connection with processing and making a | 1964 |
determination with respect to an application. All employers | 1965 |
granted such status shall demonstrate sufficient financial and | 1966 |
administrative ability to assure that all obligations under this | 1967 |
section are promptly met. The administrator shall deny the | 1968 |
privilege where the employer is unable to demonstrate the | 1969 |
employer's ability to promptly meet all the obligations imposed on | 1970 |
the employer by this section. The administrator shall consider, | 1971 |
but is not limited to, the following factors, where applicable, in | 1972 |
determining the employer's ability to meet all of the obligations | 1973 |
imposed on the board as an employer by this section: | 1974 |
(D) The administrator shall require a surety bond from all | 2005 |
self-insuring employers, issued pursuant to section 4123.351 of | 2006 |
the Revised Code, that is sufficient to compel, or secure to | 2007 |
injured employees, or to the dependents of employees killed, the | 2008 |
payment of compensation and expenses, which shall in no event be | 2009 |
less than that paid or furnished out of the state insurance fund | 2010 |
in similar cases to injured employees or to dependents of killed | 2011 |
employees whose employers contribute to the fund, except when an | 2012 |
employee of the employer, who has suffered the loss of a hand, | 2013 |
arm, foot, leg, or eye prior to the injury for which compensation | 2014 |
is to be paid, and thereafter suffers the loss of any other of the | 2015 |
members as the result of any injury sustained in the course of and | 2016 |
arising out of the employee's employment, the compensation to be | 2017 |
paid by the self-insuring employer is limited to the disability | 2018 |
suffered in the subsequent injury, additional compensation, if | 2019 |
any, to be paid by the bureau out of the surplus created by | 2020 |
section 4123.34 of the Revised Code. | 2021 |
(E) In addition to the requirements of this section, the | 2022 |
administrator shall make and publish rules governing the manner of | 2023 |
making application and the nature and extent of the proof required | 2024 |
to justify a finding of fact by the administrator as to granting | 2025 |
the status of a self-insuring employer, which rules shall be | 2026 |
general in their application, one of which rules shall provide | 2027 |
that all self-insuring employers shall pay into the state | 2028 |
insurance fund such amounts as are required to be credited to the | 2029 |
surplus fund in division (B) of section 4123.34 of the Revised | 2030 |
Code. The administrator may adopt rules establishing requirements | 2031 |
in addition to the requirements described in division (B)(2) of | 2032 |
this section that a public employer shall meet in order to qualify | 2033 |
for self-insuring status. | 2034 |
Employers shall secure directly from the bureau central | 2035 |
offices application forms upon which the bureau shall stamp a | 2036 |
designating number. Prior to submission of an application, an | 2037 |
employer shall make available to the bureau, and the bureau shall | 2038 |
review, the information described in division (B)(1) of this | 2039 |
section, and public employers shall make available, and the bureau | 2040 |
shall review, the information necessary to verify whether the | 2041 |
public employer meets the requirements listed in division (B)(2) | 2042 |
of this section. An employer shall file the completed application | 2043 |
forms with an application fee, which shall cover the costs of | 2044 |
processing the application, as established by the administrator, | 2045 |
by rule, with the bureau at least ninety days prior to the | 2046 |
effective date of the employer's new status as a self-insuring | 2047 |
employer. The application form is not deemed complete until all | 2048 |
the required information is attached thereto. The bureau shall | 2049 |
only accept applications that contain the required information. | 2050 |
(F) The bureau shall review completed applications within a | 2051 |
reasonable time. If the bureau determines to grant an employer the | 2052 |
status as a self-insuring employer, the bureau shall issue a | 2053 |
statement, containing its findings of fact, that is prepared by | 2054 |
the bureau and signed by the administrator. If the bureau | 2055 |
determines not to grant the status as a self-insuring employer, | 2056 |
the bureau shall notify the employer of the determination and | 2057 |
require the employer to continue to pay its full premium into the | 2058 |
state insurance fund. The administrator also shall adopt rules | 2059 |
establishing a minimum level of performance as a criterion for | 2060 |
granting and maintaining the status as a self-insuring employer | 2061 |
and fixing time limits beyond which failure of the self-insuring | 2062 |
employer to provide for the necessary medical examinations and | 2063 |
evaluations may not delay a decision on a claim. | 2064 |
(2) Multiply the quotient in division (J)(1) of this section | 2119 |
by the total amount of paid compensation for the previous calendar | 2120 |
year that is attributable to the individual self-insuring employer | 2121 |
for whom the assessment is being determined. Each self-insuring | 2122 |
employer shall pay the assessment that results from this | 2123 |
calculation, unless the assessment resulting from this calculation | 2124 |
falls below a minimum assessment, which minimum assessment the | 2125 |
administrator shall determine on the first day of July of each | 2126 |
year with the advice and consent of the bureau of workers' | 2127 |
compensation board of directors, in which event, the self-insuring | 2128 |
employer shall pay the minimum assessment. | 2129 |
The administrator shall calculate the assessment for the | 2136 |
portion of the surplus fund under division (B) of section 4123.34 | 2137 |
of the Revised Code that is used for handicapped reimbursement in | 2138 |
the same manner as set forth in divisions (J)(1) and (2) of this | 2139 |
section except that the administrator shall calculate the total | 2140 |
assessment for this portion of the surplus fund only on the basis | 2141 |
of those self-insuring employers that retain participation in the | 2142 |
handicapped reimbursement program and the individual self-insuring | 2143 |
employer's proportion of paid compensation shall be calculated | 2144 |
only for those self-insuring employers who retain participation in | 2145 |
the handicapped reimbursement program. The administrator, as the | 2146 |
administrator determines appropriate, may determine the total | 2147 |
assessment for the handicapped portion of the surplus fund in | 2148 |
accordance with sound actuarial principles. | 2149 |
The administrator shall calculate the assessment for the | 2150 |
portion of the surplus fund under division (B) of section 4123.34 | 2151 |
of the Revised Code that under division (D) of section 4121.66 of | 2152 |
the Revised Code is used for rehabilitation costs in the same | 2153 |
manner as set forth in divisions (J)(1) and (2) of this section, | 2154 |
except that the administrator shall calculate the total assessment | 2155 |
for this portion of the surplus fund only on the basis of those | 2156 |
self-insuring employers who have not made the election to make | 2157 |
payments directly under division (D) of section 4121.66 of the | 2158 |
Revised Code and an individual self-insuring employer's proportion | 2159 |
of paid compensation only for those self-insuring employers who | 2160 |
have not made that election. | 2161 |
The administrator shall calculate the assessment for the | 2162 |
portion of the surplus fund under division (B) of section 4123.34 | 2163 |
of the Revised Code that is used for reimbursement to a | 2164 |
self-insuring employer under division (H) of section 4123.512 of | 2165 |
the Revised Code in the same manner as set forth in divisions | 2166 |
(J)(1) and (2) of this section except that the administrator shall | 2167 |
calculate the total assessment for this portion of the surplus | 2168 |
fund only on the basis of those self-insuring employers that | 2169 |
retain participation in reimbursement to the self-insuring | 2170 |
employer under division (H) of section 4123.512 of the Revised | 2171 |
Code and the individual self-insuring employer's proportion of | 2172 |
paid compensation shall be calculated only for those self-insuring | 2173 |
employers who retain participation in reimbursement to the | 2174 |
self-insuring employer under division (H) of section 4123.512 of | 2175 |
the Revised Code. | 2176 |
(L) Every self-insuring employer shall certify, in affidavit | 2190 |
form subject to the penalty for perjury, to the bureau the amount | 2191 |
of the self-insuring employer's paid compensation for the previous | 2192 |
calendar year. In reporting paid compensation paid for the | 2193 |
previous year, a self-insuring employer shall exclude from the | 2194 |
total amount of paid compensation any reimbursement the | 2195 |
self-insuring employer receives in the previous calendar year from | 2196 |
the surplus fund pursuant to section 4123.512 of the Revised Code | 2197 |
for any paid compensation. The self-insuring employer also shall | 2198 |
exclude from the paid compensation reported any amount recovered | 2199 |
under section 4123.931 of the Revised Code and any amount that is | 2200 |
determined not to have been payable to or on behalf of a claimant | 2201 |
in any final administrative or judicial proceeding. The | 2202 |
self-insuring employer shall exclude such amounts from the paid | 2203 |
compensation reported in the reporting period subsequent to the | 2204 |
date the determination is made. The administrator shall adopt | 2205 |
rules, in accordance with Chapter 119. of the Revised Code, that | 2206 |
provide for all of the following: | 2207 |
(M) As used in this section, "paid compensation" means all | 2246 |
amounts paid by a self-insuring employer for living maintenance | 2247 |
benefits, all amounts for compensation paid pursuant to sections | 2248 |
4121.63, 4121.67, 4123.56, 4123.57, 4123.58, 4123.59, 4123.60, and | 2249 |
4123.64 of the Revised Code, all amounts paid as wages in lieu of | 2250 |
such compensation, all amounts paid in lieu of such compensation | 2251 |
under a nonoccupational accident and sickness program fully funded | 2252 |
by the self-insuring employer, and all amounts paid by a | 2253 |
self-insuring employer for a violation of a specific safety | 2254 |
standard pursuant to Section 35 of Article II, Ohio Constitution | 2255 |
and section 4121.47 of the Revised Code. | 2256 |
(O) The administrator may grant a self-insuring employer the | 2264 |
privilege to self-insure a construction project entered into by | 2265 |
the self-insuring employer that is scheduled for completion within | 2266 |
six years after the date the project begins, and the total cost of | 2267 |
which is estimated to exceed one hundred million dollars or, for | 2268 |
employers described in division (R) of this section, if the | 2269 |
construction project is estimated to exceed twenty-five million | 2270 |
dollars. The administrator may waive such cost and time criteria | 2271 |
and grant a self-insuring employer the privilege to self-insure a | 2272 |
construction project regardless of the time needed to complete the | 2273 |
construction project and provided that the cost of the | 2274 |
construction project is estimated to exceed fifty million dollars. | 2275 |
A self-insuring employer who desires to self-insure a construction | 2276 |
project shall submit to the administrator an application listing | 2277 |
the dates the construction project is scheduled to begin and end, | 2278 |
the estimated cost of the construction project, the contractors | 2279 |
and subcontractors whose employees are to be self-insured by the | 2280 |
self-insuring employer, the provisions of a safety program that is | 2281 |
specifically designed for the construction project, and a | 2282 |
statement as to whether a collective bargaining agreement | 2283 |
governing the rights, duties, and obligations of each of the | 2284 |
parties to the agreement with respect to the construction project | 2285 |
exists between the self-insuring employer and a labor | 2286 |
organization. | 2287 |
Upon approval of the application, the self-insuring employer | 2310 |
is responsible for the administration and payment of all claims | 2311 |
under this chapter and Chapter 4121. of the Revised Code for the | 2312 |
employees of the contractor and subcontractors covered under the | 2313 |
certificate who receive injuries or are killed in the course of | 2314 |
and arising out of employment on the construction project, or who | 2315 |
contract an occupational disease in the course of employment on | 2316 |
the construction project. For purposes of this chapter and Chapter | 2317 |
4121. of the Revised Code, a claim that is administered and paid | 2318 |
in accordance with this division is considered a claim against the | 2319 |
self-insuring employer listed in the certificate. A contractor or | 2320 |
subcontractor included under the certificate shall report to the | 2321 |
self-insuring employer listed in the certificate, all claims that | 2322 |
arise under this chapter and Chapter 4121. of the Revised Code in | 2323 |
connection with the construction project for which the certificate | 2324 |
is issued. | 2325 |
A self-insuring employer who complies with this division is | 2326 |
entitled to the protections provided under this chapter and | 2327 |
Chapter 4121. of the Revised Code with respect to the employees of | 2328 |
the contractors and subcontractors covered under a certificate | 2329 |
issued under this division for death or injuries that arise out | 2330 |
of, or death, injuries, or occupational diseases that arise in the | 2331 |
course of, those employees' employment on that construction | 2332 |
project, as if the employees were employees of the self-insuring | 2333 |
employer, provided that the self-insuring employer also complies | 2334 |
with this section. No employee of the contractors and | 2335 |
subcontractors covered under a certificate issued under this | 2336 |
division shall be considered the employee of the self-insuring | 2337 |
employer listed in that certificate for any purposes other than | 2338 |
this chapter and Chapter 4121. of the Revised Code. Nothing in | 2339 |
this division gives a self-insuring employer authority to control | 2340 |
the means, manner, or method of employment of the employees of the | 2341 |
contractors and subcontractors covered under a certificate issued | 2342 |
under this division. | 2343 |
The contractors and subcontractors included under a | 2353 |
certificate issued under this division shall identify in their | 2354 |
payroll records the employees who are considered the employees of | 2355 |
the self-insuring employer listed in that certificate for purposes | 2356 |
of this chapter and Chapter 4121. of the Revised Code, and the | 2357 |
amount that those employees earned for employment on the | 2358 |
construction project that is the subject of that certificate. | 2359 |
Notwithstanding any provision to the contrary under this chapter | 2360 |
and Chapter 4121. of the Revised Code, the administrator shall | 2361 |
exclude the payroll that is reported for employees who are | 2362 |
considered the employees of the self-insuring employer listed in | 2363 |
that certificate, and that the employees earned for employment on | 2364 |
the construction project that is the subject of that certificate, | 2365 |
when determining those contractors' or subcontractors' premiums or | 2366 |
assessments required under this chapter and Chapter 4121. of the | 2367 |
Revised Code. A self-insuring employer issued a certificate under | 2368 |
this division shall include in the amount of paid compensation it | 2369 |
reports pursuant to division (L) of this section, the amount of | 2370 |
paid compensation the self-insuring employer paid pursuant to this | 2371 |
division for the previous calendar year. | 2372 |
(2) Whether the safety program that is specifically designed | 2418 |
for the construction project provides for the safety of employees | 2419 |
employed on the construction project, is applicable to all | 2420 |
contractors and subcontractors who perform labor or work or | 2421 |
provide materials for the construction project, and has as a | 2422 |
component, a safety training program that complies with standards | 2423 |
adopted pursuant to the "Occupational Safety and Health Act of | 2424 |
1970," 84 Stat. 1590, 29 U.S.C.A. 651, and provides for continuing | 2425 |
management and employee involvement; | 2426 |
(4) Within ninety days after the last day of each fiscal | 2476 |
year, obtain a written report prepared by a member of the American | 2477 |
academy of actuaries, certifying whether the reserved funds | 2478 |
described in division (A)(1) of this section are sufficient to | 2479 |
cover the costs the public employer may potentially incur to | 2480 |
remain in compliance with this chapter and Chapter 4121. of the | 2481 |
Revised Code, are computed in accordance with accepted loss | 2482 |
reserving standards, and are fairly stated in accordance with | 2483 |
sound loss reserving principles. | 2484 |
Sec. 4123.36. Whenever an employer fails to pay a premium | 2490 |
due,and the administrator of workers' compensation determines the | 2491 |
employer's account to be uncollectible, the administrator shall | 2492 |
cover the default in excess of the employer's premium security | 2493 |
deposit by transfer of money from the premium payment security | 2494 |
fund account to the state insurance fund. The transfer establishes | 2495 |
coverage of the employer for the immediately completed six-month | 2496 |
period together with the ensuing two-month adjustment period and | 2497 |
the employer is not liable to respond in damages at common law or | 2498 |
by statute for injuries or death of any employees wherever | 2499 |
occurring during that eight-month period. Payments from the | 2500 |
premium payment security fund may not be used to cover a default | 2501 |
of an employer with respect to any period longer than eight | 2502 |
months. Thereafter, the employer shall be considered a | 2503 |
noncomplying employer under this chapter and shall not be entitled | 2504 |
to the benefits and protection of this chapter until the employer | 2505 |
again establishes coverage pursuant to this chapter through | 2506 |
reimbursement to the premium payment security fund for the money | 2507 |
paid to the state insurance fund, on account of the default, | 2508 |
payment of any semiannual premium obligations due but in default, | 2509 |
and submission of a new premium security deposit pursuant to | 2510 |
section 4123.32 of the Revised Code. | 2511 |
If the administrator of workers' compensation finds that any | 2515 |
person, firm, or private corporation, including any public service | 2516 |
corporation, is, or has been at any time after January 1, 1923, an | 2517 |
amenable employer and has not complied with section 4123.35 of the | 2518 |
Revised Code the administrator shall determine the period during | 2519 |
which the person, firm, or corporation was an amenable employer | 2520 |
and shall forthwith give notice of the determination to the | 2521 |
employer. Within twenty days thereafter the employer shall furnish | 2522 |
the bureau with the payroll covering the period included in the | 2523 |
determination and, if the employer is an amenable employer at the | 2524 |
time of the determination, shall pay a premium security deposit | 2525 |
for the eight months next succeeding the date of the determination | 2526 |
and shall pay into the state insurance fund the amount of premium | 2527 |
and assessments applicable to such payroll.
If the administrator | 2528 |
determines that the employer is an amenable employer prior to the | 2529 |
policy year commencing July 1, 2015, the administrator may require | 2530 |
the employer to pay a premium security deposit. | 2531 |
If the employer does not furnish the payroll and pay the | 2532 |
applicable premium, assessments, and, if applicable, the premium | 2533 |
security deposit within the twenty days, the administrator shall | 2534 |
forthwith make an assessment of the premiumamounts due from the | 2535 |
employer for the period the administrator determined the employer | 2536 |
to be an amenable employer including the premium security deposit | 2537 |
according to section 4123.32 of the Revised Code if the employer | 2538 |
is an amenable employer at the time of the determination, basing | 2539 |
the assessment upon the information in the possession of the | 2540 |
administrator. | 2541 |
The administrator shall give to the employer assessed written | 2542 |
notice of the assessment. The notice shall be mailed to the | 2543 |
employer at the employer's residence or usual place of business by | 2544 |
certified mail. Unless the employer to whom the notice of | 2545 |
assessment is directed files with the bureau within twenty days | 2546 |
after receipt thereof, a petition in writing, verified under oath | 2547 |
by the employer, or the employer's authorized agent having | 2548 |
knowledge of the facts, setting forth with particularity the items | 2549 |
of the assessment objected to, together with the reason for the | 2550 |
objections, the assessment shall become conclusive and the amount | 2551 |
thereof shall be due and payable from the employer so assessed to | 2552 |
the state insurance fund. When a petition objecting to an | 2553 |
assessment is filed the bureau shall assign a time and place for | 2554 |
the hearing of the same and shall notify the petitioner thereof by | 2555 |
certified mail. When an employer files a petition the assessment | 2556 |
made by the administrator shall become due and payable ten days | 2557 |
after notice of the finding made at the hearing has been sent by | 2558 |
certified mail to the party assessed. An appeal may be taken from | 2559 |
any finding to the court of common pleas of Franklin county upon | 2560 |
the execution by the party assessed of a bond to the state in | 2561 |
double the amount found due and ordered paid by the bureau | 2562 |
conditioned that the party will pay any judgment and costs | 2563 |
rendered against it for the premium. | 2564 |
When no petition objecting to an assessment is filed or when | 2565 |
a finding is made affirming or modifying an assessment after | 2566 |
hearing, a certified copy of the assessment as affirmed or | 2567 |
modified may be filed by the administrator in the office of the | 2568 |
clerk of the court of common pleas in any county in which the | 2569 |
employer has property or in which the employer has a place of | 2570 |
business. The clerk, immediately upon the filing of the | 2571 |
assessment, shall enter a judgment for the state against the | 2572 |
employer in the amount shown on the assessment. The judgment may | 2573 |
be filed by the clerk in a loose leaf book entitled "special | 2574 |
judgments for state insurance fund." The judgment shall bear the | 2575 |
same rate of interest, have the same effect as other judgments, | 2576 |
and be given the same preference allowed by law on other judgments | 2577 |
rendered for claims for taxes. An assessment or judgment under | 2578 |
this section shall not be a bar to the adjustment of the | 2579 |
employer's account upon the employer furnishing the employer's | 2580 |
payroll records to the bureau. | 2581 |
In fixing the amount of contribution to be made by the state | 2611 |
and each of its departments, agencies, and instrumentalities, the | 2612 |
administrator shall classify departments, agencies, and | 2613 |
instrumentalities into such groups as will equitably determine the | 2614 |
contributions in accordance with their
expected individual | 2615 |
accident experience so that the state and its departments, | 2616 |
agencies, and instrumentalities contribute an amount sufficient to | 2617 |
meet individual obligations and maintain a solvent public | 2618 |
insurance fundthe obligations of the participants in total. | 2619 |
Sec. 4123.41. (A) By(1) For policy years that begin prior | 2626 |
to January 1, 2016, by the first day of January of each year, the | 2627 |
bureau of workers' compensation shall furnish to the county | 2628 |
auditor of each county and the chief fiscal officer of each taxing | 2629 |
district in a county and of each district activity and institution | 2630 |
mentioned in section 4123.39 of the Revised Code forms containing | 2631 |
the premium rates applicable to the county, district, district | 2632 |
activity, or institution as an employer, on which to report the | 2633 |
amount of money expended by the county, district, district | 2634 |
activity, or institution during the previous twelve calendar | 2635 |
months for the services of employees under this chapter. | 2636 |
After the conclusion of each policy year, the county auditor | 2652 |
of each county and the chief fiscal officer of each taxing | 2653 |
district in a county and of each district activity and institution | 2654 |
mentioned in section 4123.39 of the Revised Code shall, on or | 2655 |
before the fifteenth day of February immediately following the | 2656 |
conclusion of the policy year, report the amount of money expended | 2657 |
by the county, district, district activity, or institution during | 2658 |
the policy year for the services of employees under this chapter. | 2659 |
The bureau shall adjust the premium and assessments charged to the | 2660 |
employer for the difference between estimated gross payrolls and | 2661 |
actual gross payrolls, and the employer immediately shall pay any | 2662 |
balance due to the bureau. Any balance due the employer shall be | 2663 |
credited to the employer's account. | 2664 |
(C) The legislative body of any county, district, district | 2706 |
activity, or institution may reimburse the fund from which the | 2707 |
workers' compensation payments are made by transferring to the | 2708 |
fund from any other fund of the county, district, district | 2709 |
activity, or institution, the proportionate amount of the payments | 2710 |
that should be chargeable to the fund, whether the fund is derived | 2711 |
from taxation or otherwise. The proportionate amount of the | 2712 |
payments chargeable to the fund may be based on payroll, relative | 2713 |
exposure, relative loss experience, or any combination of these | 2714 |
factors, as determined by the legislative body. | 2715 |
(E) The bureau may investigate the correctness of the | 2752 |
information provided by the county auditor and chief fiscal | 2753 |
officer under division (B)(A) of this section, and if the bureau | 2754 |
determines at any time that the county, district, district | 2755 |
activity, or institution has not reported the correct information, | 2756 |
the administrator of workers' compensation may make deductions or | 2757 |
additions as the facts warrant and take those facts into | 2758 |
consideration in determining the current or future contributions | 2759 |
to be made by the county, district, district activity, or | 2760 |
institution. If the county, district, district activity, or | 2761 |
institution does not furnish the report in the time required by | 2762 |
this section, the administrator may fix the amount of contribution | 2763 |
the county, district, district activity, or institution must make | 2764 |
and certify that amount for payment. | 2765 |
(F) TheFor payments of premium and assessments for a policy | 2766 |
year prior to the policy year commencing January 1, 2015, the | 2767 |
administrator shall provide a discount to any county, district, | 2768 |
district activity, or institution that pays its total amount due | 2769 |
to the public insurance fund on or before the fifteenth day of May | 2770 |
of each year as its proper contribution for premiums. The | 2771 |
administrator shall base the discount provided under this division | 2772 |
on the savings generated by the early payment to the public | 2773 |
insurance fund. The administrator may provide the discount through | 2774 |
a refund to the county, district, district activity, or | 2775 |
institution or an offset against the future contributions due to | 2776 |
the public insurance fund from the county, district, district | 2777 |
activity, or institution. | 2778 |
(H) If the administrator adopts rules for the prospective | 2784 |
payment of premium as permitted under section 4123.322 of the | 2785 |
Revised Code, every employer mentioned in division (B)(1) of | 2786 |
section 4123.01 of the Revised Code, except for a state agency or | 2787 |
a state university or college as defined in section 4123.32 of the | 2788 |
Revised Code, shall pay into the state insurance fund the amount | 2789 |
of premium the administrator fixes for the employment or | 2790 |
occupation of the employer, the amount of which premium to be paid | 2791 |
by each employer to be determined by the classifications, rules, | 2792 |
and rates made and published by the administrator and based upon | 2793 |
the estimates and reconciliations required by the rules the | 2794 |
administrator adopts under section 4123.322 of the Revised Code. | 2795 |
Sec. 4123.411. (A) For the purpose of carrying out sections | 2796 |
4123.412 to 4123.418 of the Revised Code, the administrator of | 2797 |
workers' compensation, with the advice and consent of the bureau | 2798 |
of workers' compensation board of directors, shall levy an | 2799 |
assessment against all employers at a rate, of at least five but | 2800 |
not to exceed ten cents per one hundred dollars of payroll, such | 2801 |
rate to be determined annually for each employer group listed in | 2802 |
divisions (A)(1) to (3) of this section, which will produce an | 2803 |
amount no greater than the amount the administrator estimates to | 2804 |
be necessary to carry out such sections for the period for which | 2805 |
the assessment is levied. In the event the amount produced by the | 2806 |
assessment is not sufficient to carry out such sections the | 2807 |
additional amount necessary shall be provided from the income | 2808 |
produced as a result of investments made pursuant to section | 2809 |
4123.44 of the Revised Code. | 2810 |
After the completion of each policy year that commences on or | 2834 |
after July 1, 2015, for private fund employers or that commences | 2835 |
on or after January 1, 2015, for counties and taxing district | 2836 |
employers therein, the assessments levied under this section shall | 2837 |
be adjusted for the difference between estimated gross payrolls | 2838 |
and actual gross payrolls reported by the employer on the payroll | 2839 |
report submitted by a private employer pursuant to section 4123.26 | 2840 |
of the Revised Code, or, for a public employer, submitted pursuant | 2841 |
to section 4123.41 of the Revised Code. | 2842 |
(B) For all injuries and disabilities occurring on or after | 2853 |
January 1, 1987, the administrator, for the purposes of carrying | 2854 |
out sections 4123.412 to 4123.418 of the Revised Code, shall levy | 2855 |
an assessment against all employers at a rate per one hundred | 2856 |
dollars of payroll, such rate to be determined annually for each | 2857 |
classification of employer in each employer group listed in | 2858 |
divisions (A)(1) to (3) of this section, which will produce an | 2859 |
amount no greater than the amount the administrator estimates to | 2860 |
be necessary to carry out such sections for the period for which | 2861 |
the assessment is levied. The administrator annually shall | 2862 |
establish the contributions due from employers for the disabled | 2863 |
workers' relief fund at rates as low as possible but that will | 2864 |
assure sufficient moneys to guarantee the payment of any claims | 2865 |
against that fund. | 2866 |
Sec. 4123.47. (A) The administrator of workers' compensation | 2879 |
shall have an actuarial auditsanalysis of the state insurance | 2880 |
fund and all other funds specified in this chapter and Chapters | 2881 |
4121., 4127., and 4131. of the Revised Code made at least once | 2882 |
each year. The
auditsanalysis shall be made and certified by | 2883 |
recognized insurance, credentialed property or casualty actuaries | 2884 |
who shall be selected by the bureau of workers' compensation board | 2885 |
of directors. The audits shall cover the premium rates, | 2886 |
classifications, and all other matters involving the | 2887 |
administration of the state insurance fund and all other funds | 2888 |
specified in this chapter and Chapters 4121., 4127., and 4131. of | 2889 |
the Revised Code. The expense of the
auditsanalysis shall be paid | 2890 |
from the state insurance fund. The administrator shall make copies | 2891 |
of the
auditsanalysis available to the workers' compensation | 2892 |
audit committee at no charge and to the public at cost. | 2893 |
(B) The auditor of state annually shall conduct an audit of | 2894 |
the administration of this chapter by the industrial commission | 2895 |
and the bureau of workers' compensation and the safety and hygiene | 2896 |
fund. The cost of the audit shall be charged to the administrative | 2897 |
costs of the bureau as defined in section 4123.341 of the Revised | 2898 |
Code. The audit shall include audits of all fiscal activities, | 2899 |
claims processing and handling, and employer premium collections. | 2900 |
The auditor shall prepare a report of the audit together with | 2901 |
recommendations and transmit copies of the report to the | 2902 |
industrial commission, the board, the administrator, the governor, | 2903 |
and to the general assembly. The auditor shall make copies of the | 2904 |
report available to the public at cost. | 2905 |
Sec. 4123.511. (A) Within seven days after receipt of any | 2912 |
claim under this chapter, the bureau of workers' compensation | 2913 |
shall notify the claimant and the employer of the claimant of the | 2914 |
receipt of the claim and of the facts alleged therein. If the | 2915 |
bureau receives from a person other than the claimant written or | 2916 |
facsimile information or information communicated verbally over | 2917 |
the telephone indicating that an injury or occupational disease | 2918 |
has occurred or been contracted which may be compensable under | 2919 |
this chapter, the bureau shall notify the employee and the | 2920 |
employer of the information. If the information is provided | 2921 |
verbally over the telephone, the person providing the information | 2922 |
shall provide written verification of the information to the | 2923 |
bureau according to division (E) of section 4123.84 of the Revised | 2924 |
Code. The receipt of the information in writing or facsimile, or | 2925 |
if initially by telephone, the subsequent written verification, | 2926 |
and the notice by the bureau shall be considered an application | 2927 |
for compensation under section 4123.84 or 4123.85 of the Revised | 2928 |
Code, provided that the conditions of division (E) of section | 2929 |
4123.84 of the Revised Code apply to information provided verbally | 2930 |
over the telephone. Upon receipt of a claim, the bureau shall | 2931 |
advise the claimant of the claim number assigned and the | 2932 |
claimant's right to representation in the processing of a claim or | 2933 |
to elect no representation. If the bureau determines that a claim | 2934 |
is determined to be a compensable lost-time claim, the bureau | 2935 |
shall notify the claimant and the employer of the availability of | 2936 |
rehabilitation services. No bureau or industrial commission | 2937 |
employee shall directly or indirectly convey any information in | 2938 |
derogation of this right. This section shall in no way abrogate | 2939 |
the bureau's responsibility to aid and assist a claimant in the | 2940 |
filing of a claim and to advise the claimant of the claimant's | 2941 |
rights under the law. | 2942 |
The administrator, with the advice and consent of the bureau | 2951 |
of workers' compensation board of directors, may adopt rules that | 2952 |
identify specified medical conditions that have a historical | 2953 |
record of being allowed whenever included in a claim. The | 2954 |
administrator may grant immediate allowance of any medical | 2955 |
condition identified in those rules upon the filing of a claim | 2956 |
involving that medical condition and may make immediate payment of | 2957 |
medical bills for any medical condition identified in those rules | 2958 |
that is included in a claim. If an employer contests the allowance | 2959 |
of a claim involving any medical condition identified in those | 2960 |
rules, and the claim is disallowed, payment for the medical | 2961 |
condition included in that claim shall be charged to and paid from | 2962 |
the surplus fund created under section 4123.34 of the Revised | 2963 |
Code. | 2964 |
(B)(1) Except as provided in division (B)(2) of this section, | 2965 |
in claims other than those in which the employer is a | 2966 |
self-insuring employer, if the administrator determines under | 2967 |
division (A) of this section that a claimant is or is not entitled | 2968 |
to an award of compensation or benefits, the administrator shall | 2969 |
issue an order no later than twenty-eight days after the sending | 2970 |
of the notice under division (A) of this section, granting or | 2971 |
denying the payment of the compensation or benefits, or both as is | 2972 |
appropriate to the claimant. Notwithstanding the time limitation | 2973 |
specified in this division for the issuance of an order, if a | 2974 |
medical examination of the claimant is required by statute, the | 2975 |
administrator promptly shall schedule the claimant for that | 2976 |
examination and shall issue an order no later than twenty-eight | 2977 |
days after receipt of the report of the examination. The | 2978 |
administrator shall notify the claimant and the employer of the | 2979 |
claimant and their respective representatives in writing of the | 2980 |
nature of the order and the amounts of compensation and benefit | 2981 |
payments involved. The employer or claimant may appeal the order | 2982 |
pursuant to division (C) of this section within fourteen days | 2983 |
after the date of the receipt of the order. The employer and | 2984 |
claimant may waive, in writing, their rights to an appeal under | 2985 |
this division. | 2986 |
(2) Notwithstanding the time limitation specified in division | 2987 |
(B)(1) of this section for the issuance of an order, if the | 2988 |
employer certifies a claim for payment of compensation or | 2989 |
benefits, or both, to a claimant, and the administrator has | 2990 |
completed the investigation of the claim, the payment of benefits | 2991 |
or compensation, or both, as is appropriate, shall commence upon | 2992 |
the later of the date of the certification or completion of the | 2993 |
investigation and issuance of the order by the administrator, | 2994 |
provided that the administrator shall issue the order no later | 2995 |
than the time limitation specified in division (B)(1) of this | 2996 |
section. | 2997 |
(D) Upon the timely filing of an appeal of the order of the | 3023 |
district hearing officer issued under division (C) of this | 3024 |
section, the commission shall refer the claim file to an | 3025 |
appropriate staff hearing officer according to its rules adopted | 3026 |
under section 4121.36 of the Revised Code. The staff hearing | 3027 |
officer shall hold a hearing within forty-five days after the | 3028 |
filing of an appeal under this division and issue a decision | 3029 |
within seven days after holding the hearing under this division. | 3030 |
The staff hearing officer shall notify the parties and their | 3031 |
respective representatives in writing of the staff hearing | 3032 |
officer's order. Any party may appeal an order issued under this | 3033 |
division pursuant to division (E) of this section within fourteen | 3034 |
days after receipt of the order under this division. | 3035 |
(E) Upon the filing of a timely appeal of the order of the | 3036 |
staff hearing officer issued under division (D) of this section, | 3037 |
the commission or a designated staff hearing officer, on behalf of | 3038 |
the commission, shall determine whether the commission will hear | 3039 |
the appeal. If the commission or the designated staff hearing | 3040 |
officer decides to hear the appeal, the commission or the | 3041 |
designated staff hearing officer shall notify the parties and | 3042 |
their respective representatives in writing of the time and place | 3043 |
of the hearing. The commission shall hold the hearing within | 3044 |
forty-five days after the filing of the notice of appeal and, | 3045 |
within seven days after the conclusion of the hearing, the | 3046 |
commission shall issue its order affirming, modifying, or | 3047 |
reversing the order issued under division (D) of this section. The | 3048 |
commission shall notify the parties and their respective | 3049 |
representatives in writing of the order. If the commission or the | 3050 |
designated staff hearing officer determines not to hear the | 3051 |
appeal, within fourteen days after the expiration of the period in | 3052 |
which an appeal of the order of the staff hearing officer may be | 3053 |
filed as provided in division (D) of this section, the commission | 3054 |
or the designated staff hearing officer shall issue an order to | 3055 |
that effect and notify the parties and their respective | 3056 |
representatives in writing of that order. | 3057 |
(3) The administrator is a party and may appear and | 3077 |
participate at all administrative proceedings on behalf of the | 3078 |
state insurance fund. However, in cases in which the employer is | 3079 |
represented, the administrator shall neither present arguments nor | 3080 |
introduce testimony that is cumulative to that presented or | 3081 |
introduced by the employer or the employer's representative. The | 3082 |
administrator may file an appeal under this section on behalf of | 3083 |
the state insurance fund; however, except in cases arising under | 3084 |
section 4123.343 of the Revised Code, the administrator only may | 3085 |
appeal questions of law or issues of fraud when the employer | 3086 |
appears in person or by representative. | 3087 |
(K) Upon the final administrative or judicial determination | 3123 |
under this section or section 4123.512 of the Revised Code of an | 3124 |
appeal of an order to pay compensation, if a claimant is found to | 3125 |
have received compensation pursuant to a prior order which is | 3126 |
reversed upon subsequent appeal, the claimant's employer, if a | 3127 |
self-insuring employer, or the bureau, shall withhold from any | 3128 |
amount to which the claimant becomes entitled pursuant to any | 3129 |
claim, past, present, or future, under Chapter 4121., 4123., | 3130 |
4127., or 4131. of the Revised Code, the amount of previously paid | 3131 |
compensation to the claimant which, due to reversal upon appeal, | 3132 |
the claimant is not entitled, pursuant to the following criteria: | 3133 |
The administrator and self-insuring employers, as | 3147 |
appropriate, are subject to the repayment schedule of this | 3148 |
division only with respect to an order to pay compensation that | 3149 |
was properly paid under a previous order, but which is | 3150 |
subsequently reversed upon an administrative or judicial appeal. | 3151 |
The administrator and self-insuring employers are not subject to, | 3152 |
but may utilize, the repayment schedule of this division, or any | 3153 |
other lawful means, to collect payment of compensation made to a | 3154 |
person who was not entitled to the compensation due to fraud as | 3155 |
determined by the administrator or the industrial commission. | 3156 |
Sec. 4123.512. (A) The claimant or the employer may appeal | 3191 |
an order of the industrial commission made under division (E) of | 3192 |
section 4123.511 of the Revised Code in any injury or occupational | 3193 |
disease case, other than a decision as to the extent of disability | 3194 |
to the court of common pleas of the county in which the injury was | 3195 |
inflicted or in which the contract of employment was made if the | 3196 |
injury occurred outside the state, or in which the contract of | 3197 |
employment was made if the exposure occurred outside the state. If | 3198 |
no common pleas court has jurisdiction for the purposes of an | 3199 |
appeal by the use of the jurisdictional requirements described in | 3200 |
this division, the appellant may use the venue provisions in the | 3201 |
Rules of Civil Procedure to vest jurisdiction in a court. If the | 3202 |
claim is for an occupational disease, the appeal shall be to the | 3203 |
court of common pleas of the county in which the exposure which | 3204 |
caused the disease occurred. Like appeal may be taken from an | 3205 |
order of a staff hearing officer made under division (D) of | 3206 |
section 4123.511 of the Revised Code from which the commission has | 3207 |
refused to hear an appeal. The appellant shall file the notice of | 3208 |
appeal with a court of common pleas within sixty days after the | 3209 |
date of the receipt of the order appealed from or the date of | 3210 |
receipt of the order of the commission refusing to hear an appeal | 3211 |
of a staff hearing officer's decision under division (D) of | 3212 |
section 4123.511 of the Revised Code. The filing of the notice of | 3213 |
the appeal with the court is the only act required to perfect the | 3214 |
appeal. | 3215 |
Notwithstanding anything to the contrary in this section, if | 3220 |
the commission determines under section 4123.522 of the Revised | 3221 |
Code that an employee, employer, or their respective | 3222 |
representatives have not received written notice of an order or | 3223 |
decision which is appealable to a court under this section and | 3224 |
which grants relief pursuant to section 4123.522 of the Revised | 3225 |
Code, the party granted the relief has sixty days from receipt of | 3226 |
the order under section 4123.522 of the Revised Code to file a | 3227 |
notice of appeal under this section. | 3228 |
The administrator of workers' compensation, the claimant, and | 3233 |
the employer shall be parties to the appeal and the court, upon | 3234 |
the application of the commission, shall make the commission a | 3235 |
party. The party filing the appeal shall serve a copy of the | 3236 |
notice of appeal on the administrator at the central office of the | 3237 |
bureau of workers' compensation in Columbus. The administrator | 3238 |
shall notify the employer that if the employer fails to become an | 3239 |
active party to the appeal, then the administrator may act on | 3240 |
behalf of the employer and the results of the appeal could have an | 3241 |
adverse effect upon the employer's premium rates. | 3242 |
(C) The attorney general or one or more of the attorney | 3243 |
general's assistants or special counsel designated by the attorney | 3244 |
general shall represent the administrator and the commission. In | 3245 |
the event the attorney general or the attorney general's | 3246 |
designated assistants or special counsel are absent, the | 3247 |
administrator or the commission shall select one or more of the | 3248 |
attorneys in the employ of the administrator or the commission as | 3249 |
the administrator's attorney or the commission's attorney in the | 3250 |
appeal. Any attorney so employed shall continue the representation | 3251 |
during the entire period of the appeal and in all hearings thereof | 3252 |
except where the continued representation becomes impractical. | 3253 |
The claimant shall, within thirty days after the filing of | 3257 |
the notice of appeal, file a petition containing a statement of | 3258 |
facts in ordinary and concise language showing a cause of action | 3259 |
to participate or to continue to participate in the fund and | 3260 |
setting forth the basis for the jurisdiction of the court over the | 3261 |
action. Further pleadings shall be had in accordance with the | 3262 |
Rules of Civil Procedure, provided that service of summons on such | 3263 |
petition shall not be required and provided that the claimant may | 3264 |
not dismiss the complaint without the employer's consent if the | 3265 |
employer is the party that filed the notice of appeal to court | 3266 |
pursuant to this section. The clerk of the court shall, upon | 3267 |
receipt thereof, transmit by certified mail a copy thereof to each | 3268 |
party named in the notice of appeal other than the claimant. Any | 3269 |
party may file with the clerk prior to the trial of the action a | 3270 |
deposition of any physician taken in accordance with the | 3271 |
provisions of the Revised Code, which deposition may be read in | 3272 |
the trial of the action even though the physician is a resident of | 3273 |
or subject to service in the county in which the trial is had. The | 3274 |
bureau of workers' compensation shall pay the cost of the | 3275 |
stenographic deposition filed in court and of copies of the | 3276 |
stenographic deposition for each party from the surplus fund and | 3277 |
charge the costs thereof against the unsuccessful party if the | 3278 |
claimant's right to participate or continue to participate is | 3279 |
finally sustained or established in the appeal. In the event the | 3280 |
deposition is taken and filed, the physician whose deposition is | 3281 |
taken is not required to respond to any subpoena issued in the | 3282 |
trial of the action. The court, or the jury under the instructions | 3283 |
of the court, if a jury is demanded, shall determine the right of | 3284 |
the claimant to participate or to continue to participate in the | 3285 |
fund upon the evidence adduced at the hearing of the action. | 3286 |
(F) The cost of any legal proceedings authorized by this | 3291 |
section, including an attorney's fee to the claimant's attorney to | 3292 |
be fixed by the trial judge, based upon the effort expended, in | 3293 |
the event the claimant's right to participate or to continue to | 3294 |
participate in the fund is established upon the final | 3295 |
determination of an appeal, shall be taxed against the employer or | 3296 |
the commission if the commission or the administrator rather than | 3297 |
the employer contested the right of the claimant to participate in | 3298 |
the fund. The attorney's fee shall not exceed forty-two hundred | 3299 |
dollars. | 3300 |
(H)(1) An appeal from an order issued under division (E) of | 3307 |
section 4123.511 of the Revised Code or any action filed in court | 3308 |
in a case in which an award of compensation or medical benefits | 3309 |
has been made shall not stay the payment of compensation or | 3310 |
medical benefits under the award, or payment for subsequent | 3311 |
periods of total disability or medical benefits during the | 3312 |
pendency of the appeal. If, in a final administrative or judicial | 3313 |
action, it is determined that payments of compensation or | 3314 |
benefits, or both, made to or on behalf of a claimant should not | 3315 |
have been made, the amount thereof shall be charged to the surplus | 3316 |
fund account under division (B) of section 4123.34 of the Revised | 3317 |
Code. In the event the employer is a state risk, the amount shall | 3318 |
not be charged to the employer's experience, and the administrator | 3319 |
shall adjust the employer's account accordingly. In the event the | 3320 |
employer is a self-insuring employer, the self-insuring employer | 3321 |
shall deduct the amount from the paid compensation the | 3322 |
self-insuring employer reports to the administrator under division | 3323 |
(L) of section 4123.35 of the Revised Code.
If an employer is a | 3324 |
state risk and has paid an assessment for a violation of a | 3325 |
specific safety requirement, and, in a final administrative or | 3326 |
judicial action, it is determined that the employer did not | 3327 |
violate the specific safety requirement, the administrator shall | 3328 |
reimburse the employer from the surplus fund account under | 3329 |
division (B) of section 4123.34 of the Revised Code for the amount | 3330 |
of the assessment the employer paid for the violation. | 3331 |
(b) Payments made under division (H)(1) of this section shall | 3346 |
be charged to the surplus fund account under division (B) of | 3347 |
section 4123.34 of the Revised Code. If the employer of the | 3348 |
employee who is the subject of a claim described in division | 3349 |
(H)(2)(a) of this section is a state fund employer, the payments | 3350 |
made under that division shall not be charged to the employer's | 3351 |
experience. If that employer is a self-insuring employer, the | 3352 |
self-insuring employer shall deduct the amount from the paid | 3353 |
compensation the self-insuring employer reports to the | 3354 |
administrator under division (L) of section 4123.35 of the Revised | 3355 |
Code. | 3356 |
(3) A self-insuring employer may elect to pay compensation | 3361 |
and benefits under this section directly to an employee or an | 3362 |
employee's dependents by filing an application with the bureau of | 3363 |
workers' compensation not more than one hundred eighty days and | 3364 |
not less than ninety days before the first day of the employer's | 3365 |
next six-month coverage period. If the self-insuring employer | 3366 |
timely files the application, the application is effective on the | 3367 |
first day of the employer's next six-month coverage period, | 3368 |
provided that the administrator shall compute the employer's | 3369 |
assessment for the surplus fund account due with respect to the | 3370 |
period during which that application was filed without regard to | 3371 |
the filing of the application. On and after the effective date of | 3372 |
the employer's election, the self-insuring employer shall pay | 3373 |
directly to an employee or to an employee's dependents | 3374 |
compensation and benefits under this section regardless of the | 3375 |
date of the injury or occupational disease, and the employer shall | 3376 |
receive no money or credits from the surplus fund account on | 3377 |
account of those payments and shall not be required to pay any | 3378 |
amounts into the surplus fund account on account of this section. | 3379 |
The election made under this division is irrevocable. | 3380 |
(2) Caused by the employee being intoxicated or under the | 3401 |
influence of a controlled substance not prescribed by a physician | 3402 |
where the intoxication or being under the influence of the | 3403 |
controlled substance not prescribed by a physician was the | 3404 |
proximate cause of the injury, is entitled to receive, either | 3405 |
directly from the employee's self-insuring employer as provided in | 3406 |
section 4123.35 of the Revised Code, or from the state insurance | 3407 |
fund, the compensation for loss sustained on account of the | 3408 |
injury, occupational disease, or death, and the medical, nurse, | 3409 |
and hospital services and medicines, and the amount of funeral | 3410 |
expenses in case of death, as are provided by this chapter. | 3411 |
(B) For the purpose of this section, provided that an | 3412 |
employer has posted written notice to employees that the results | 3413 |
of, or the employee's refusal to submit to, any chemical test | 3414 |
described under this division may affect the employee's | 3415 |
eligibility for compensation and benefits pursuant to this chapter | 3416 |
and Chapter 4121. of the Revised Code, there is a rebuttable | 3417 |
presumption that an employee is intoxicated or under the influence | 3418 |
of a controlled substance not prescribed by the employee's | 3419 |
physician and that being intoxicated or under the influence of a | 3420 |
controlled substance not prescribed by the employee's physician is | 3421 |
the proximate cause of an injury under either of the following | 3422 |
conditions: | 3423 |
(H)(1) Whenever, with respect to an employee of an employer | 3542 |
who is subject to and has complied with this chapter, there is | 3543 |
possibility of conflict with respect to the application of | 3544 |
workers' compensation laws because the contract of employment is | 3545 |
entered into and all or some portion of the work is or is to be | 3546 |
performed in a state or states other than Ohio, the employer and | 3547 |
the employee may agree to be bound by the laws of this state or by | 3548 |
the laws of some other state in which all or some portion of the | 3549 |
work of the employee is to be performed. The agreement shall be in | 3550 |
writing and shall be filed with the bureau of workers' | 3551 |
compensation within ten days after it is executed and shall remain | 3552 |
in force until terminated or modified by agreement of the parties | 3553 |
similarly filed. If the agreement is to be bound by the laws of | 3554 |
this state and the employer has complied with this chapter, then | 3555 |
the employee is entitled to compensation and benefits regardless | 3556 |
of where the injury occurs or the disease is contracted and the | 3557 |
rights of the employee and the employee's dependents under the | 3558 |
laws of this state are the exclusive remedy against the employer | 3559 |
on account of injury, disease, or death in the course of and | 3560 |
arising out of the employee's employment. If the agreement is to | 3561 |
be bound by the laws of another state and the employer has | 3562 |
complied with the laws of that state, the rights of the employee | 3563 |
and the employee's dependents under the laws of that state are the | 3564 |
exclusive remedy against the employer on account of injury, | 3565 |
disease, or death in the course of and arising out of the | 3566 |
employee's employment without regard to the place where the injury | 3567 |
was sustained or the disease contracted. If an employer and an | 3568 |
employee enter into an agreement under this division, the fact | 3569 |
that the employer and the employee entered into that agreement | 3570 |
shall not be construed to change the status of an employee whose | 3571 |
continued employment is subject to the will of the employer or the | 3572 |
employee, unless the agreement contains a provision that expressly | 3573 |
changes that status. | 3574 |
(2) If any employee or the employee's dependents pursue | 3575 |
workers' compensation benefits or recover damages from the | 3576 |
employer under the laws of another state, the amount awarded or | 3577 |
recovered, whether paid or to be paid in future installments, | 3578 |
shall be credited on the amount of any award of compensation or | 3579 |
benefits made to the employee or the employee's dependents by the | 3580 |
bureau. If an employee or the employee's dependents pursue or | 3581 |
receive an award of compensation or benefits under this chapter or | 3582 |
Chapter 4121., 4127., or 4131. of the Revised Code for the same | 3583 |
injury, occupational disease, or death for which the employee or | 3584 |
the employee's dependents previously pursued workers' compensation | 3585 |
benefits and received a decision on the merits as defined in | 3586 |
section 4123.542 of the Revised Code under the laws of another | 3587 |
state or recovered damages under the laws of another state, the | 3588 |
claim shall be disallowed and the administrator or any | 3589 |
self-insuring employer, by any lawful means, may collect
thefrom | 3590 |
the employee or the employee's dependents any of the following: | 3591 |
(3) If an employee or the employee's dependents receive an | 3600 |
award of compensation or benefits under this chapter or Chapter | 3601 |
4121., 4127., or 4131. of the Revised Code and subsequently | 3602 |
receives workers' compensation benefits or damages under the laws | 3603 |
of another state for the same injury, occupational disease, or | 3604 |
death the claim under this chapter or Chapter 4121., 4127., or | 3605 |
4131. of the Revised Code shall be disallowed. The administrator | 3606 |
or anya self-insuring employer also, by any lawful means, may | 3607 |
collect from the employee or the employee's dependents anyor | 3608 |
other-states' insurer any of the following: | 3609 |
(4) If the employee's employer pays premiums into the state | 3625 |
insurance fund, the administrator shall not charge the amount of | 3626 |
compensation or benefits the administrator collects pursuant to | 3627 |
this division (H)(2) or (3) of this section to the employer's | 3628 |
experience. If the administrator collects any costs, penalties, | 3629 |
interest, awards, or attorney's fees incurred by a state fundan | 3630 |
employer in contesting or responding to any claim pursuant to | 3631 |
division (H)(2) or (3) of this section, the administrator shall | 3632 |
forward the amount of such costs, penalties, interest, awards, and | 3633 |
attorney's fees the administrator collectscollected to that | 3634 |
employer. If the employee's employer is a self-insuring employer, | 3635 |
the self-insuring employer shall deduct the amount of compensation | 3636 |
or benefits the self-insuring employer collects pursuant to this | 3637 |
division from the paid compensation the self-insuring employer | 3638 |
reports to the administrator under division (L) of section 4123.35 | 3639 |
of the Revised Code. | 3640 |
(3) Except as otherwise stipulated in division (H)(4) of this | 3641 |
section, if(5) If an employee is a resident of a state other than | 3642 |
this state and is insured under the workers' compensation law or | 3643 |
similar laws of a state other than this state, the employee and | 3644 |
the employee's dependents are not entitled to receive compensation | 3645 |
or benefits under this chapter, on account of injury, disease, or | 3646 |
death arising out of or in the course of employment while | 3647 |
temporarily within this state, and the rights of the employee and | 3648 |
the employee's dependents under the laws of the other state are | 3649 |
the exclusive remedy against the employer on account of the | 3650 |
injury, disease, or death. | 3651 |
(a) The laws of the other state limit the ability of an | 3655 |
employee who is a resident of this state and is covered by this | 3656 |
chapter and Chapter 4123. of the Revised Code, or the employee's | 3657 |
dependents, to receive compensation or benefits under the other | 3658 |
state's workers' compensation law on account of injury, disease, | 3659 |
or death incurred by the employee that arises out of or in the | 3660 |
course of the employee's employment while temporarily within that | 3661 |
state in the same manner as specified in division (H)(3) of this | 3662 |
section for an employee who is a resident of a state other than | 3663 |
this state, or the employee's dependents; | 3664 |
(5)(6) An employee, or the dependent of an employee, who | 3671 |
elects to receive compensation and benefits under this chapter or | 3672 |
Chapter 4121., 4127., or 4131. of the Revised Code for a claim may | 3673 |
not receive compensation and benefits under the workers' | 3674 |
compensation laws of any state other than this state for that same | 3675 |
claim. For each claim submitted by or on behalf of an employee, | 3676 |
the administrator or, if the employee is employed by a | 3677 |
self-insuring employer, the self-insuring employer, shall request | 3678 |
the employee or the employee's dependent to sign an election that | 3679 |
affirms the employee's or employee's dependent's acceptance of | 3680 |
electing to receive compensation and benefits under this chapter | 3681 |
or Chapter 4121., 4127., or 4131. of the Revised Code for that | 3682 |
claim that also affirmatively waives and releases the employee's | 3683 |
or the employee's dependent's right to file for and receive | 3684 |
compensation and benefits under the laws of any state other than | 3685 |
this state for that claim. The employee or employee's dependent | 3686 |
shall sign the election form within twenty-eight days after the | 3687 |
administrator or self-insuring employer submits the request or the | 3688 |
administrator or self-insuring employer shall suspenddismiss that | 3689 |
claim until the administrator or self-insuring employer receives | 3690 |
the signed election form. | 3691 |
(I) If an employee who is covered under the federal | 3692 |
"Longshore and Harbor Workers' Compensation Act," 98 Stat. 1639, | 3693 |
33 U.S.C. 901 et seq., is injured or contracts an occupational | 3694 |
disease or dies as a result of an injury or occupational disease, | 3695 |
and if that employee's or that employee's dependents' claim for | 3696 |
compensation or benefits for that injury, occupational disease, or | 3697 |
death is subject to the jurisdiction of that act, the employee or | 3698 |
the employee's dependents are not entitled to apply for and shall | 3699 |
not receive compensation or benefits under this chapter and | 3700 |
Chapter 4121. of the Revised Code. The rights of such an employee | 3701 |
and the employee's dependents under the federal "Longshore and | 3702 |
Harbor Workers' Compensation Act," 98 Stat. 1639, 33 U.S.C. 901 et | 3703 |
seq., are the exclusive remedy against the employer for that | 3704 |
injury, occupational disease, or death. | 3705 |
If the administrator approves the employer's proof of | 3739 |
coverage submitted under division (K) of this section, a | 3740 |
professional athlete or coach who is an employee of the employer | 3741 |
and the dependents of the professional athlete or coach are not | 3742 |
entitled to apply for and shall not receive compensation or | 3743 |
benefits under this chapter and Chapter 4121. of the Revised Code. | 3744 |
The rights of such an athlete or coach and the dependents of such | 3745 |
an athlete or coach under the laws of the state where the policy | 3746 |
was issued are the exclusive remedy against the employer for the | 3747 |
athlete or coach if the athlete or coach suffers an injury or | 3748 |
contracts an occupational disease in the course of employment, or | 3749 |
for the dependents of the athlete or the coach if the athlete or | 3750 |
coach is killed as a result of an injury or dies as a result of an | 3751 |
occupational disease, regardless of the location where the injury | 3752 |
was suffered or the occupational disease was contracted. | 3753 |
Sec. 4123.66. (A) In addition to the compensation provided | 3754 |
for in this chapter, the administrator of workers' compensation | 3755 |
shall disburse and pay from the state insurance fund the amounts | 3756 |
for medical, nurse, and hospital services and medicine as the | 3757 |
administrator deems proper and, in case death ensues from the | 3758 |
injury or occupational disease, the administrator shall disburse | 3759 |
and pay from the fund reasonable funeral expenses in an amount not | 3760 |
to exceed fifty-five hundred dollars. The bureau of workers' | 3761 |
compensation shall reimburse anyone, whether dependent, volunteer, | 3762 |
or otherwise, who pays the funeral expenses of any employee whose | 3763 |
death ensues from any injury or occupational disease as provided | 3764 |
in this section. The administrator may adopt rules, with the | 3765 |
advice and consent of the bureau of workers' compensation board of | 3766 |
directors, with respect to furnishing medical, nurse, and hospital | 3767 |
service and medicine to injured or disabled employees entitled | 3768 |
thereto, and for the payment therefor. In case an injury or | 3769 |
industrial accident that injures an employee also causes damage to | 3770 |
the employee's eyeglasses, artificial teeth or other denture, or | 3771 |
hearing aid, or in the event an injury or occupational disease | 3772 |
makes it necessary or advisable to replace, repair, or adjust the | 3773 |
same, the bureau shall disburse and pay a reasonable amount to | 3774 |
repair or replace the same. | 3775 |
(B) The administrator, in the rules the administrator adopts | 3776 |
pursuant to division (A) of this section, may adopt rules | 3777 |
specifying the circumstances under which the bureau may make | 3778 |
immediate payment for the first fill of prescription drugs for | 3779 |
medical conditions identified in an application for compensation | 3780 |
or benefits under section 4123.84 or 4123.85 of the Revised Code | 3781 |
that occurs prior to the date the administrator issues an initial | 3782 |
determination order under division (B) of section 4123.511 of the | 3783 |
Revised Code. If the claim is ultimately disallowed in a final | 3784 |
administrative or judicial order, and if the employer is a state | 3785 |
fund employer who pays assessments into the surplus fund account | 3786 |
created under section 4123.34 of the Revised Code, the payments | 3787 |
for medical services made pursuant to this division for the first | 3788 |
fill of prescription drugs shall be charged to and paid from the | 3789 |
surplus fund account and not charged through the state insurance | 3790 |
fund to the employer against whom the claim was filed. | 3791 |
(C)(1) If an employer or a welfare plan has provided to or on | 3792 |
behalf of an employee any benefits or compensation for an injury | 3793 |
or occupational disease and that injury or occupational disease is | 3794 |
determined compensable under this chapter, the employer or a | 3795 |
welfare plan may request that the administrator reimburse the | 3796 |
employer or welfare plan for the amount the employer or welfare | 3797 |
plan paid to or on behalf of the employee in compensation or | 3798 |
benefits. The administrator shall reimburse the employer or | 3799 |
welfare plan for the compensation and benefits paid if, at the | 3800 |
time the employer or welfare plan provides the benefits or | 3801 |
compensation to or on behalf of employee, the injury or | 3802 |
occupational disease had not been determined to be compensable | 3803 |
under this chapter and if the employee was not receiving | 3804 |
compensation or benefits under this chapter for that injury or | 3805 |
occupational disease. The administrator shall reimburse the | 3806 |
employer or welfare plan in the amount that the administrator | 3807 |
would have paid to or on behalf of the employee under this chapter | 3808 |
if the injury or occupational disease originally would have been | 3809 |
determined compensable under this chapter. If the employer is a | 3810 |
merit-rated employer, the administrator shall adjust the amount of | 3811 |
premium next due from the employer according to the amount the | 3812 |
administrator pays the employer. The administrator shall adopt | 3813 |
rules, in accordance with Chapter 119. of the Revised Code, to | 3814 |
implement this division. | 3815 |
Sec. 4123.82. (A) All contracts and agreements are void | 3818 |
which undertake to indemnify or insure an employer against loss or | 3819 |
liability for the payment of compensation to workers or their | 3820 |
dependents for death, injury, or occupational disease occasioned | 3821 |
in the course of the workers' employment, or which provide that | 3822 |
the insurer shall pay the compensation, or which indemnify the | 3823 |
employer against damages when the injury, disease, or death arises | 3824 |
from the failure to comply with any lawful requirement for the | 3825 |
protection of the lives, health, and safety of employees, or when | 3826 |
the same is occasioned by the willful act of the employer or any | 3827 |
of the employer's officers or agents, or by which it is agreed | 3828 |
that the insurer shall pay any such damages. No license or | 3829 |
authority to enter into any such agreements or issue any such | 3830 |
policies of insurance shall be granted or issued by any public | 3831 |
authority in this state. Any corporation organized or admitted | 3832 |
under the laws of this state to transact liability insurance as | 3833 |
defined in section 3929.01 of the Revised Code may by amendment of | 3834 |
its articles of incorporation or by original articles of | 3835 |
incorporation, provide therein for the authority and purpose to | 3836 |
make insurance in states, territories, districts, and counties, | 3837 |
other than the state of Ohio, and in the state of Ohio in respect | 3838 |
of contracts permitted by division (B) of this section, | 3839 |
indemnifying employers against loss or liability for payment of | 3840 |
compensation to workers and employees and their dependents for | 3841 |
death, injury, or occupational disease occasioned in the course of | 3842 |
the employment and to insure and indemnify employers against loss, | 3843 |
expense, and liability by risk of bodily injury or death by | 3844 |
accident, disability, sickness, or disease suffered by workers and | 3845 |
employees for which the employer may be liable or has assumed | 3846 |
liability. | 3847 |
(1) No contract because of that division is void which | 3849 |
undertakes to indemnify a self-insuring employer against all or | 3850 |
part of such employer's loss in excess of at least fifty thousand | 3851 |
dollars from any one disaster or event arising out of the | 3852 |
employer's liability under this chapter, but no insurance | 3853 |
corporation shall, directly or indirectly, represent an employer | 3854 |
in the settlement, adjudication, determination, allowance, or | 3855 |
payment of claims. The superintendent of insurance shall enforce | 3856 |
this prohibition by such disciplinary orders directed against the | 3857 |
offending insurance corporation as the superintendent of insurance | 3858 |
deems appropriate in the circumstances and the administrator of | 3859 |
workers' compensation shall enforce this prohibition by such | 3860 |
disciplinary orders directed against the offending employer as the | 3861 |
administrator deems appropriate in the circumstances, which orders | 3862 |
may include revocation of the insurance corporation's right to | 3863 |
enter into indemnity contracts and revocation of the employer's | 3864 |
status as a self-insuring employer. | 3865 |
(2) The administrator may enter into a contract of indemnity | 3866 |
with any such employer upon such terms, payment of such premium, | 3867 |
and for such amount and form of indemnity as the administrator | 3868 |
determines and the bureau of workers' compensation board of | 3869 |
directors may procure reinsurance of the liability of the public | 3870 |
and private funds under this chapter, or any part of the liability | 3871 |
in respect of either or both of the funds, upon such terms and | 3872 |
premiums or other payments from the fund or funds as the | 3873 |
administrator deems prudent in the maintenance of a solvent fund | 3874 |
or funds from year to year. When making the finding of fact which | 3875 |
the administrator is required by section 4123.35 of the Revised | 3876 |
Code to make with respect to the financial ability of an employer, | 3877 |
no contract of indemnity, or the ability of the employer to | 3878 |
procure such a contract, shall be considered as increasing the | 3879 |
financial ability of the employer. | 3880 |
Sec. 4123.83. Each employer paying premiums into the state | 3893 |
insurance fund or electing directly to pay compensation to the | 3894 |
employer's injured employees or the dependents of the employer's | 3895 |
killed employees as provided in section 4123.35 of the Revised | 3896 |
Code, shall post conspicuously in the employer's place or places | 3897 |
of employment notices, which shall be furnished in adequate number | 3898 |
at least annually by the bureau of workers' compensation at the | 3899 |
time of the payment of the premium, stating the fact that the | 3900 |
employer has made the payment, the date thereof, and period for | 3901 |
which the payment is made. The notice shall state that it is proof | 3902 |
of workers' compensation coverage, or that the employer has | 3903 |
complied with section 4123.35 of the Revised Code, and has been | 3904 |
authorized by the administrator of workers' compensation directly | 3905 |
to compensate employees or dependents, and the date of the | 3906 |
authorization. The notice shall indicate that coverage is | 3907 |
contingent on continued payment of premiums and assessments due. | 3908 |
The notice, when posted, constitutes sufficient notice to the | 3909 |
employer's employees of the fact that the employer has made | 3910 |
paymentcarries workers' compensation coverage or that the | 3911 |
employer has complied with the elective provisions of section | 3912 |
4123.35 of the Revised Code. | 3913 |
Sec. 4125.05. (A) Not later than thirty days after November | 3914 |
5, 2004, or not later than thirty days after the formation of a | 3915 |
professional employer organization, whichever date occurs later, a | 3916 |
professional employer organization operating in this state shall | 3917 |
register with the administrator of workers' compensation on forms | 3918 |
provided by the administrator. Following initial registration, | 3919 |
each professional employer organization shall register with the | 3920 |
administrator annually on or before the thirty-first day of | 3921 |
December. Commonly owned or controlled applicants may register as | 3922 |
a professional employer organization reporting entity or register | 3923 |
individually. Registration as a part of a professional employer | 3924 |
organization reporting entity shall not disqualify an individual | 3925 |
professional employer organization from participating in a | 3926 |
group-rated plan under division (A)(4) of section 4123.29 of the | 3927 |
Revised Code. | 3928 |
(D)(1) The administrator, with the advice and consent of the | 3983 |
bureau of workers' compensation board of directors, shallmay | 3984 |
adopt rules in accordance with Chapter 119. of the Revised Code to | 3985 |
require, in addition to the requirement under division (B)(8) of | 3986 |
this section and except as otherwise specified in division (D)(2) | 3987 |
of this section, a professional employer organization to provide | 3988 |
security in the form of a bond or letter of credit assignable to | 3989 |
the Ohio bureau of workers' compensation not to exceed an amount | 3990 |
equal to the premiums and assessments incurred for the two most | 3991 |
recent payroll periodspolicy year, prior to any discounts or | 3992 |
dividends, to meet the financial obligations of the professional | 3993 |
employer organization pursuant to this chapter and Chapters 4121. | 3994 |
and 4123. of the Revised Code. | 3995 |
(F) Except to the extent necessary for the administrator to | 4017 |
administer the statutory duties of the administrator and for | 4018 |
employees of the state to perform their official duties, all | 4019 |
records, reports, client lists, and other information obtained | 4020 |
from a professional employer organization and professional | 4021 |
employer organization reporting entity under divisions (A), (B), | 4022 |
and (C) of this section are confidential and shall be considered | 4023 |
trade secrets and shall not be published or open to public | 4024 |
inspection. | 4025 |
(I) A financial statement required under division (B)(7) of | 4032 |
this section for initial registration shall be the most recent | 4033 |
financial statement of the professional employer organization or | 4034 |
professional employer organization reporting entity of which the | 4035 |
professional employer organization is a member and shall not be | 4036 |
older than thirteen months. For each registration renewal, the | 4037 |
professional employer organization shall file the required | 4038 |
financial statement within one hundred eighty days after the end | 4039 |
of the professional employer organization's or professional | 4040 |
employer organization reporting entity's fiscal year. A | 4041 |
professional employer organization may apply to the administrator | 4042 |
for an extension beyond that time if the professional employer | 4043 |
organization provides the administrator with a letter from the | 4044 |
professional employer organization's auditor stating the reason | 4045 |
for delay and the anticipated completion date. | 4046 |
(10) On receipt of a request from the medical director of a | 4123 |
managed care organization that has entered into a data security | 4124 |
agreement with the board required by section 4121.447 of the | 4125 |
Revised Code, the board shall provide to the medical director | 4126 |
information from the database relating to a claimant under Chapter | 4127 |
4121., 4123., 4127., or 4131. of the Revised Code assigned to the | 4128 |
managed care organization, including information in the database | 4129 |
related to prescriptions for the claimant that were not covered or | 4130 |
reimbursed under Chapter 4121., 4123., 4127., or 4131. of the | 4131 |
Revised Code. | 4132 |
Section 2. That existing sections 131.02, 1561.31, 2305.25, | 4221 |
2305.252, 4121.129, 4123.01, 4123.26, 4123.27, 4123.29, 4123.291, | 4222 |
4123.292, 4123.32, 4123.322, 4123.34, 4123.35, 4123.353, 4123.36, | 4223 |
4123.37, 4123.40, 4123.41, 4123.411, 4123.47, 4123.511, 4123.512, | 4224 |
4123.54, 4123.66, 4123.82, 4123.83, 4125.05, 4729.80, and 4729.86 | 4225 |
and section 4121.419 of the Revised Code are hereby repealed. | 4226 |