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(128th General Assembly)
(Amended Substitute House Bill Number 15)
AN ACT
To amend sections 121.52, 4121.12, 4121.125, 4121.62,
4121.70, 4121.75, 4123.29, 4123.34, 4123.35, and
4123.82 of the Revised Code and to amend Section
512.45 of Am. Sub. H.B. 100 of the 127th General
Assembly to create
the Deputy Inspector General
for the Bureau of
Workers' Compensation and
Industrial Commission
Fund; to create the
Competitive Workers' Compensation Task Force; to
make other changes to the Workers'
Compensation
Law; to make appropriations for the
Bureau of
Workers' Compensation and for the
Workers'
Compensation Council for the biennium
beginning
July 1, 2009, and ending June 30, 2011;
and to
provide authorization and conditions for
the
operation of the Bureau's and the Council's
programs.
Be it enacted by the General Assembly of the State of Ohio:
SECTION 101. That sections 121.52, 4121.12, 4121.125,
4121.62, 4121.70, 4121.75, 4123.29, and 4123.34, 4123.35, and
4123.82 of the Revised Code be amended to
read as follows:
Sec. 121.52. There is hereby created in the office of the
inspector general the office of deputy inspector general for the
bureau of workers' compensation and industrial commission. The
inspector general shall appoint the deputy inspector general, and
the deputy inspector general shall serve at the pleasure of the
inspector general. A person employed as the deputy inspector
general shall have the same qualifications as those specified in
section 121.49 of the Revised Code for the inspector general. The
inspector general shall provide professional and clerical
assistance to the deputy inspector general.
The deputy inspector general for the bureau of workers'
compensation and the industrial commission shall investigate
wrongful acts or omissions that have been committed by or are
being committed by officers or employees of the bureau of workers'
compensation and the industrial commission. The deputy inspector
general has the same powers and duties regarding matters
concerning the bureau and the commission as those specified in
sections 121.42, 121.43, and 121.45 of the Revised Code for the
inspector general. Complaints may be filed with the deputy
inspector general in the same manner as prescribed for complaints
filed with the inspector general under section 121.46 of the
Revised Code. All investigations conducted and reports issued by
the deputy inspector general are subject to section 121.44 of the
Revised Code.
There is hereby created in the state treasury the deputy
inspector general for the bureau of workers' compensation and
industrial commission fund, which shall consist of moneys
deposited into it that the inspector general receives from the
administrator of
workers' compensation and receives from the
industrial commission in accordance with this section. The
inspector general shall use the fund to
pay the costs
incurred
by the deputy inspector general in
performing the duties
of the
deputy inspector general as required
under this section.
The members of the industrial commission, bureau of workers'
compensation board of directors, workers' compensation audit
committee, workers' compensation actuarial committee, and workers'
compensation investment committee, and the administrator of
workers' compensation, and employees of the industrial commission
and the bureau shall cooperate with and provide assistance to the
deputy inspector general in the performance of any investigation
conducted by the deputy inspector general. In particular, those
persons shall make their premises, equipment, personnel, books,
records, and papers readily available to the deputy inspector
general. In the course of an investigation, the deputy inspector
general may question any person employed by the industrial
commission or the administrator and any person transacting
business with the industrial commission, the board, the audit
committee, the actuarial committee, the investment committee, the
administrator, or the bureau and may inspect and copy any books,
records, or papers in the possession of those persons or entities,
taking care to preserve the confidentiality of information
contained in responses to questions or the books, records, or
papers that are made confidential by law.
In performing any investigation, the deputy inspector general
shall avoid interfering with the ongoing operations of the
entities being investigated, except insofar as is reasonably
necessary to successfully complete the investigation.
At the conclusion of an investigation conducted by the deputy
inspector general for the bureau of workers' compensation and
industrial commission, the deputy inspector general shall deliver
to the board, the administrator, the industrial commission, and
the governor any case for which remedial action is necessary. The
deputy inspector general shall maintain a public record of the
activities of the office of the deputy inspector general to the
extent permitted under this section, ensuring that the rights of
the parties involved in each case are protected. The inspector
general shall include in the annual report required under section
121.48 of the Revised Code a summary of the activities of the
deputy inspector general during the previous year.
No person shall disclose any information that is designated
as confidential in accordance with section 121.44 of the Revised
Code or any confidential information that is acquired in the
course of an investigation conducted under this section 121.53 of
the
Revised Code to any person who is not legally entitled to
disclosure of that information.
Sec. 4121.12. (A) There is hereby created the bureau of
workers'
compensation board of directors consisting of eleven
members to be appointed by the governor with the advice and
consent of
the senate. One member shall be
an individual who, on
account of the individual's previous vocation, employment, or
affiliations,
can be classed as a representative of employees; two
members shall be individuals who, on account of their previous
vocation, employment, or affiliations, can be classed as
representatives of employee organizations and at least one of
these two individuals shall be a member of the executive committee
of the largest statewide labor federation; three members
shall be
individuals who, on account of their previous vocation,
employment,
or affiliations, can be classed as representatives of
employers, one of whom
represents self-insuring employers, one of
whom is a state fund employer who employs one hundred or more
employees, and one of whom is a state fund employer who employs
less than one hundred employees; two members shall be individuals
who, on account of their vocation, employment, or affiliations,
can be classed as investment and securities experts who have
direct experience in the management, analysis, supervision, or
investment of assets and are residents of this state; one member
who shall be a certified public accountant; one member who shall
be an actuary who is a member in good standing with the American
academy of actuaries or who is an associate or fellow with the
society of actuaries; and one member shall represent the public
and also be an individual
who, on account of the individual's
previous vocation, employment, or
affiliations, cannot be classed
as either predominantly representative of
employees or of
employers. The
governor shall select the chairperson of the
board
who shall serve as chairperson at the pleasure of the
governor.
None of the members of the board, within one year immediately
preceding the member's appointment, shall have been employed by
the bureau of workers'
compensation or by any person, partnership,
or corporation that has provided to the bureau services of a
financial or investment nature, including the management,
analysis, supervision, or investment of assets.
(B) Of the initial appointments made to the
board, the
governor shall appoint the member who represents
employees, one
member who
represents employers, and the member who
represents
the public to a term
ending one year after the effective date of
this amendment June 11, 2007; one member who represents
employers,
one member
who represents employee organizations, one member who
is an
investment and securities expert, and the member who is a
certified public accountant to a term ending two years after the
effective date of this amendment June 11, 2007; and one member who
represents
employers, one member who represents employee
organizations, one
member who is an investment and securities
expert, and the member
who is an actuary to a term
ending three
years after the effective
date of this amendment June 11, 2007.
Thereafter, terms of office shall
be for
three years, with each
term ending on the same day of the same
month as did the term that
it succeeds. Each member shall hold
office from
the date of the
member's appointment until the end of
the term for
which the
member was appointed.
Members may be reappointed. Any member appointed to fill a
vacancy occurring
prior to the expiration date of the term for
which the
member's predecessor was appointed shall hold office as
a member for the
remainder of that term. A member shall continue
in office subsequent to the
expiration date of the member's term
until a successor takes
office or until a period of sixty days has
elapsed, whichever
occurs first.
(C) In making appointments to the board, the governor shall
select the members from the list of names
submitted by the
workers' compensation board of directors
nominating committee
pursuant to this division. The
nominating committee shall submit
to the governor a list containing four separate names for each of
the members on
the board. Within
fourteen days after the
submission of the list, the governor
shall appoint individuals
from the list.
Within sixty At least thirty days after prior to a vacancy
occurring as a result of
the expiration of a term and within
thirty days after other
vacancies occurring on the board, the
nominating
committee shall
submit an initial list containing four
names for each vacancy.
Within
fourteen days after the submission
of the initial list, the
governor either shall appoint
individuals from that list or
request the nominating committee to
submit another list of four
names for each member the governor
has not appointed from the
initial list, which list the
nominating committee shall submit to
the governor within fourteen
days after the governor's request.
The governor then shall
appoint, within seven days after the
submission of the second
list, one of the individuals from either
list to fill the vacancy
for which the governor has not made an
appointment from the
initial list. If the governor appoints an individual to fill a
vacancy occurring as a result of the expiration of a term, the
individual appointed shall begin serving as a member of the board
when the term for which the individual's predecessor was appointed
expires or immediately upon appointment by the governor, whichever
occurs later. With respect to the filling of
vacancies, the
nominating committee shall provide the governor
with a list of
four individuals who are, in the judgment of the
nominating
committee, the
most fully qualified to accede to
membership on
the
board.
In order for the name of an individual to be submitted to the
governor under this division, the nominating committee shall
approve the
individual by an affirmative vote of a majority of its
members.
(D) All members of the board shall receive
their reasonable
and necessary expenses pursuant to section 126.31 of the Revised
Code while
engaged in the
performance of their duties as members
and also shall receive an annual salary not to exceed sixty
thousand dollars in total, payable on the following basis:
(1) Except as provided in division
(D)(2) of this section, a
member shall receive
two thousand five hundred
dollars during a
month in which the
member attends one or
more meetings of the
board
and shall receive no payment during a month in which the
member attends no
meeting of the board.
(2) A member may receive no more than thirty
thousand dollars
per year to compensate the member for attending meetings of the
board,
regardless of the number of meetings held by the board
during a
year
or the number of meetings in excess of twelve within
a
year that the member
attends.
(3) Except as provided in division (D)(4) of this section, if
a member serves on the workers' compensation audit committee,
workers' compensation actuarial committee, or the workers'
compensation investment committee, the member shall receive two
thousand five hundred dollars during a month in which the member
attends one or more meetings of the committee on which the member
serves and shall receive no payment during any month in which the
member attends no meeting of that committee.
(4) A member may receive no more than thirty thousand dollars
per year to compensate the member for attending meetings of any of
the committees specified in division (D)(3) of this section,
regardless of the number of meetings held by a committee during a
year or the number of committees on which a member serves.
The chairperson of the board shall set the meeting dates of
the
board as necessary to perform the duties of the board under
this
chapter and Chapters 4123., 4125., 4127., 4131., and 4167.
of
the Revised
Code. The board shall meet at least twelve times a
year. The administrator of
workers' compensation shall
provide
professional and
clerical assistance to the board, as the board
considers
appropriate.
(E) Before entering upon the duties of office, each appointed
member of the board shall take an oath of office as required by
sections 3.22 and 3.23 of the Revised Code and file in the office
of the secretary of state the bond required under section 4121.127
of the Revised Code.
(F) The board shall:
(1) Establish the overall administrative policy for the
bureau for the purposes of this chapter and Chapters 4123., 4125.,
4127., 4131., and 4167. of the Revised Code;
(2) Review progress of the bureau in meeting its
cost and
quality objectives and in complying with this chapter
and
Chapters
4123., 4125., 4127., 4131., and 4167. of the Revised Code;
(3) Submit an annual report
to the president of the senate,
the speaker of the house of representatives,
the governor, and the
workers' compensation council and include all of the following in
that report:
(a) An evaluation of the cost and quality objectives of the
bureau;
(b) A statement of the net assets available for the provision
of compensation and benefits under this chapter and Chapters
4123., 4127., and 4131. of the Revised Code as of the last day of
the fiscal year;
(c) A statement of any changes that occurred in the net
assets available, including employer premiums and net investment
income, for the provision of compensation and benefits and payment
of administrative expenses, between the first and last day of the
fiscal year immediately preceding the date of the report;
(d) The following information for each of the six consecutive
fiscal years occurring previous to the report:
(i) A schedule of the net assets available for compensation
and benefits;
(ii) The annual cost of the payment of compensation and
benefits;
(iii) Annual administrative expenses incurred;
(iv) Annual employer premiums allocated for the provision of
compensation and benefits.
(e) A description of any significant changes that occurred
during the six years for which the board provided the information
required under division (F)(3)(d) of this section that affect the
ability of the board to compare that information from year to
year.
(4) Review all independent financial audits of the bureau.
The
administrator shall provide access to records of the bureau to
facilitate the
review required under this division.
(5) Study issues as requested by the administrator or the
governor;
(6) Contract with all of the following:
(a) An independent actuarial firm to assist the board
in
making recommendations to the administrator regarding premium
rates;
(b) An outside investment counsel to assist the workers'
compensation investment committee in fulfilling its duties;
(c) An independent fiduciary counsel to assist the board in
the performance of its duties.
(7) Approve the investment policy developed by the workers'
compensation investment committee pursuant to section 4121.129 of
the Revised Code if the policy satisfies the requirements
specified in section 4123.442 of the Revised Code.
(8) Review and
publish the investment policy no less than
annually and make copies available to interested parties.
(9) Prohibit, on a prospective basis, any
specific investment
it finds to be contrary to the investment
policy approved by the
board.
(10) Vote to open each investment class and allow the
administrator to invest in an investment class only if the board,
by a majority vote, opens that class;
(11) After opening a class but prior to the administrator
investing in that class, adopt rules establishing due diligence
standards for employees of the bureau to follow when investing in
that class and establish policies and procedures to review and
monitor the performance and value of each investment class;
(12) Submit a report annually on the performance and value of
each investment class to the governor, the president and minority
leader of the senate, and the speaker and minority leader of the
house of representatives, and the workers' compensation council.
(13) Advise and consent on all of the following:
(a) Administrative rules the administrator submits
to it
pursuant to division (B)(5) of section 4121.121 of the Revised
Code for
the
classification of occupations or industries, for
premium rates and
contributions, for the amount to be credited to
the surplus fund, for rules
and systems of rating, rate revisions,
and merit rating;
(b) The duties and authority conferred upon the
administrator
pursuant to section 4121.37 of the Revised Code;
(c) Rules the administrator adopts for the health partnership
program and the qualified health plan system, as provided in
sections 4121.44,
4121.441, and 4121.442 of the Revised Code;
(d) Rules the administrator submits to it pursuant to Chapter
4167. of the Revised Code regarding the public employment risk
reduction program and the protection of public health care workers
from exposure incidents.
As used in this division, "public health care worker" and
"exposure incident" have the same meanings as in section 4167.25
of the Revised Code.
(14) Perform all duties required under this chapter and
Chapters 4123., 4125., 4127., 4131., and 4167. of the Revised
Code;
(15) Meet with the governor on an annual basis to discuss the
administrator's performance of the duties specified in this
chapter and Chapters 4123., 4125., 4127., 4131., and 4167. of the
Revised Code;
(16) Develop and participate in a bureau of workers'
compensation board of directors education program that consists of
all of the following:
(a) An orientation component for newly appointed members;
(b) A continuing education component for board members who
have served for at least one year;
(c) A curriculum that includes education about each of the
following topics:
(i) Board member duties and responsibilities;
(ii) Compensation and benefits paid pursuant to this chapter
and Chapters 4123., 4127., and 4131. of the Revised Code;
(iii) Ethics;
(iv) Governance processes and procedures;
(v) Actuarial soundness;
(vi) Investments;
(vii) Any other subject matter the board believes is
reasonably related to the duties of a board member.
(17) Submit the program developed pursuant to division
(F)(16) of this section to the workers' compensation council for
approval;
(18) Hold all sessions, classes, and other events for the
program developed pursuant to division (F)(16) of this section in
this state.
(G) The board may do both of the following:
(1) Vote to close any investment class;
(2) Create any committees in addition to the workers'
compensation audit committee, the workers' compensation actuarial
committee, and the workers' compensation investment committee that
the board determines are necessary to assist the board in
performing its duties.
(H) The office of a member of the board who is convicted of
or pleads guilty to a felony, a theft offense as defined in
section 2913.01 of the Revised Code, or a violation of section
102.02, 102.03, 102.04, 2921.02, 2921.11, 2921.13, 2921.31,
2921.41, 2921.42, 2921.43, or 2921.44 of the Revised Code shall be
deemed vacant. The vacancy shall be filled in the same manner as
the original appointment. A person who has pleaded guilty to or
been convicted of an offense of that nature is ineligible to be a
member of the board. A member who receives a bill of indictment
for any of the offenses specified in this section shall be
automatically suspended from the board pending resolution of the
criminal matter.
(I) For the purposes of division (G)(1) of section 121.22 of
the Revised Code, the meeting between the governor and the board
to review the administrator's performance as required under
division (F)(15) of this section shall be considered a meeting
regarding the employment of the administrator.
Sec. 4121.125. (A) The bureau of workers' compensation board
of directors, based upon recommendations of the workers'
compensation actuarial committee, may contract with one or more
outside actuarial firms
and other professional persons, as the
board
determines necessary, to assist the board in
measuring the
performance of Ohio's workers' compensation system
and in
comparing Ohio's workers' compensation system to other
state and
private workers' compensation systems. The board, actuarial firm
or firms, and professional persons
shall make such measurements
and comparisons using accepted
insurance industry standards,
including, but not limited to,
standards promulgated by the
National Council on
Compensation Insurance.
(B) The board may contract with one or more
outside
firms to
conduct management and financial audits of the workers'
compensation
system, including audits of the reserve fund
belonging to the state insurance
fund, and to establish objective
quality management principles and methods by
which to review the
performance of the workers' compensation system.
(C) The board shall do all of the following:
(1) Contract to have prepared annually by or under the
supervision of an actuary a report that meets the requirements
specified under division (E) of this section and that consists of
an actuarial valuation of the assets, liabilities, and funding
requirements of the state insurance fund and all other funds
specified in this chapter and Chapters 4123., 4127., and 4131. of
the Revised Code;
(2) Require that the actuary or person supervised by an
actuary referred to in division (C)(1) of this section complete
the valuation in accordance with the actuarial standards of
practice promulgated by the actuarial standards board of the
American academy of actuaries;
(3) Submit the report referred to in division (C)(1) of this
section to the workers' compensation council and the standing
committees of the house of representatives and the senate with
primary responsibility for workers' compensation legislation not
later than on or before the first day of September November
following the year for which
the valuation was made;
(4) Have an actuary or a person who provides actuarial
services under the supervision of an actuary, at such time as the
board determines, and at least once during the five-year period
that commences on the effective date of this amendment September
10, 2007, and once
within each five-year period thereafter,
conduct an actuarial
investigation of the experience of
employers, the mortality,
service, and injury rate of employees,
and the payment of
temporary total disability, permanent partial
disability, and
permanent total disability under sections 4123.56
to 4123.58 of
the Revised Code to update the actuarial
assumptions used in the
report required by division (C)(1) of
this section;
(5) Submit the report required under division (F) of this
section to the council and the standing committees of the house of
representatives and the senate with primary responsibility for
workers' compensation legislation not later than the first day of
November following the fifth year of the period that the report
covers;
(6) Have prepared by or under the supervision of an actuary
an actuarial analysis of any introduced legislation expected to
have a measurable financial impact on the workers' compensation
system;
(7) Submit the report required under division (G) of this
section to the legislative service commission, the standing
committees of the house of representatives and the senate with
primary responsibility for workers' compensation legislation, and
the council not later than sixty days after the date of
introduction of the legislation.
(D) The administrator of workers' compensation and the
industrial commission shall
compile information and provide access
to records of the bureau
and the industrial commission to the
board to the extent
necessary for fulfillment of both of the
following
requirements:
(1) Conduct of the measurements and comparisons
described in
division (A) of this section;
(2) Conduct of the management and financial audits and
establishment of the principles and methods described in division
(B) of this section.
(E) The firm or person with whom the board contracts pursuant
to division (C)(1) of this section shall prepare a report of the
valuation and submit the report to the board. The firm or person
shall include all of the following information in the report that
is required under division (C)(1) of this section:
(1) A summary of the compensation and benefit provisions
evaluated;
(2) A summary of the census data and financial information
used in the valuation;
(3) A description of the actuarial assumptions, actuarial
cost method, and asset valuation method used in the valuation;
(4) A summary of findings that includes a statement of the
actuarial accrued compensation and benefit liabilities and
unfunded actuarial accrued compensation and benefit liabilities;
(5) A schedule showing the effect of any changes in the
compensation and benefit provisions, actuarial assumptions, or
cost methods since the previous annual actuarial valuation report
was submitted to the board.
(F) The actuary or person whom the board designates to
conduct an actuarial investigation under division (C)(4) of this
section shall prepare a report of the actuarial investigation and
shall submit the report to the board. The actuary or person shall
prepare the report and make any recommended changes in actuarial
assumptions in accordance with the actuarial standards of practice
promulgated by the actuarial standards board of the American
academy of actuaries. The actuary or person shall include all of
the following information in the report:
(1) A summary of relevant decrement and economic assumption
experience;
(2) Recommended changes in actuarial assumptions to be used
in subsequent actuarial valuations required by division (C)(1) of
this section;
(3) A measurement of the financial effect of the recommended
changes in actuarial assumptions.
(G) The actuary or person whom the board designates to
conduct the actuarial analysis under division (C)(6) of this
section shall prepare a report of the actuarial analysis and shall
submit that report to the board. The actuary or person shall
complete the analysis in accordance with the actuarial standards
of practice promulgated by the actuarial standards board of the
American academy of actuaries. The actuary or person shall include
all of the following information in the report:
(1) A summary of the statutory changes being evaluated;
(2) A description of or reference to the actuarial
assumptions and actuarial cost method used in the report;
(3) A description of the participant group or groups included
in the report;
(4) A statement of the financial impact of the legislation,
including the resulting increase, if any, in employer premiums, in
actuarial accrued liabilities, and, if an increase in actuarial
accrued liabilities is predicted, the per cent of premium increase
that would be required to amortize the increase in those
liabilities as a level per cent of employer premiums over a period
not to exceed thirty years.
(5) A statement of whether the employer premiums paid to the
bureau of workers' compensation after the proposed change is
enacted are expected to be sufficient to satisfy the funding
objectives established by the board.
(H) The board may, at any time, request an actuary to make
any studies or actuarial valuations to determine the adequacy of
the premium rates established by the administrator in accordance
with sections 4123.29 and 4123.34 of the Revised Code, and may
adjust those rates as recommended by the actuary.
(I) The board shall have an independent auditor, at least
once every ten years, conduct a fiduciary performance audit of the
investment program of the bureau of workers' compensation. That
audit shall include an audit of the investment policies approved
by the board and investment procedures of the bureau. The board
shall submit a copy of that audit to the auditor of state.
(J) The administrator, with the advice and consent of the
board, shall employ an internal auditor who shall report findings
directly to the board, workers' compensation audit committee, and
administrator, except that the internal auditor shall not report
findings directly to the administrator when those findings involve
malfeasance, misfeasance, or nonfeasance on the part of the
administrator. The board and the workers' compensation audit
committee may request and review internal audits conducted by the
internal auditor.
(K) The administrator
shall pay the expenses incurred by the
board to
effectively fulfill its duties and exercise its powers
under
this section as the administrator pays other operating
expenses
of the bureau.
Sec. 4121.62. (A) The authority granted to the
administrator
of workers' compensation pursuant to sections
4121.61 to 4121.69
of the Revised Code includes the authority to
do all of the
following:
(1) Contract with any public or private person for the
rendition of rehabilitation services;
(2) Take actions and utilize money in the state insurance
fund as necessary to obtain federal funds and assistance in the
maximum amounts and most advantageous proportions and terms
possible;
(3) Conduct rehabilitation educational programs for
employers
and employees;
(4) Establish within the bureau of workers' compensation a
rehabilitation division under the supervision of a director of
rehabilitation appointed by and responsible to the administrator.
(B) The director of the division established is in the
unclassified civil service of the state. The appointing
authority
may designate up to three positions at each facility
under the
jurisdiction of the division, and up to six positions
in the
division which are part of the director's immediate staff
as being
in the unclassified service of the state as long as the
administrator determines that the positions are primarily and
distinctively administrative, managerial, or professional. All
other full-time employees of the division are in the classified
civil service.
(C) The administrator shall establish fees for use of
services offered by the division of rehabilitation, including,
without limitation, the expense of providing rehabilitation
services, counseling, and training. The administrator shall
adopt
rules, in accordance with Chapter 119. of the Revised Code,
which
establish the specific services the division offers and the
amount
of the fee for those services, which amount shall be based
upon
the actual cost of the division providing the services to
the
employer and employee.
(D) Nothing in sections 4121.61 to 4121.69 of the Revised
Code shall be interpreted to grant authority to the administrator
to require a claimant to utilize a public provider of
rehabilitation services, counseling, or training.
Sec. 4121.70. (A) There is hereby created the
labor-management government
advisory council consisting of twelve
fifteen
members appointed as follows:
(1) The governor, with the advice and consent of the
senate,
shall appoint three members who, by training and
vocation, are
representative of labor and three members who, by
training and
vocation, are representative of employers.
(2) Ex officio, the chairpersons of the standing committees
of
the house of representatives and the senate to which
legislation
concerned with workers' compensation is customarily
referred. A
chairperson may designate the vice-chairperson of the
committee to serve
instead.
(3) One person who by training and vocation represents
labor
and one person who by training and vocation represents
employers
of differing political parties appointed by the speaker
of the
house of representatives.
(4) One person who by training and vocation represents
labor
and one person who by training and vocation represents
employers
of differing political parties appointed by the
president of the
senate.
(5) One person who by training and vocation represents
nonprofit vocational rehabilitation services providers that
deliver services to injured workers, appointed by the speaker of
the house of representatives;
(6) One person who by training and vocation represents
nonprofit vocational rehabilitation services providers that
deliver services to injured workers, appointed by the president of
the senate;
(7) The governor, with the advice and consent of the senate,
shall apoint one member who, by training and vocation, represents
a nonprofit association of vocational rehabilitation services
providers that deliver services to injured workers.
(B) Members appointed by the governor shall serve for a
term
of six years with each term ending on the same day of the
year in
which the member was first appointed, except that each
member
shall serve for a period of sixty additional days at the
end of
the member's term or until the member's successor is appointed and
qualifies, whichever date occurs first. Of the members first
appointed to the council by the governor, one member each
representing labor and management shall serve an initial term of
two years, one member each representing labor and management
shall
serve a term of four years, and the remaining two members
shall
serve full six-year terms. The members initially appointed
by the
speaker of the house of representatives and the president
of the
senate shall serve a term of six years. Thereafter,
members shall
be appointed to and serve full six-year terms. Members are
eligible for reappointment to any number of additional terms.
Legislative members shall serve a term that coincides with
the two-year legislative session in which they are first
appointed
with each term ending on the thirty-first day of
December of the
even-numbered year. Legislative members are
eligible for
reappointment.
Vacancies on the council shall be filled in the same
manner
as the original appointment. All members of the
council
shall
serve without additional compensation but shall be
reimbursed by
the bureau of workers' compensation for actual and
necessary
expenses.
The council shall advise the bureau of workers' compensation
board of directors
and the administrator of workers' compensation
on the quality and
effectiveness of rehabilitation services and
make recommendations
pertaining to the bureau's rehabilitation
program, including the
operation of that program.
The labor-management government advisory council shall
recommend to the administrator three candidates for the position
of director of rehabilitation. The candidates shall be chosen
for
their ability and background in the field of rehabilitation.
The
administrator shall select a director from the list of
candidates.
Sec. 4121.75. (A) There is hereby created in the
legislative
branch of government the workers'
compensation
council, which is
created for the purpose of
reviewing the
soundness of the
workers' compensation system and
legislation
involving or
affecting the workers' compensation
system. The
council shall not
be involved in the daily operations
and
oversight of the bureau
of workers' compensation or the
industrial commission. Members of
the council shall be appointed
as follows:
(1) Three members of the senate, appointed by the president
of the senate, not more than two of whom may be members of the
same political party;
(2) Three members of the house of representatives, appointed
by the speaker of the house of representatives, not more than two
of whom may be members of the same political party;
(3) Five members jointly appointed by the president of the
senate and the speaker of the house of representatives, not more
than three of whom shall be members of the same political party,
one of whom One member, appointed by the speaker of the house of
representatives, who shall represent employers who employ one
hundred or
more
employees, one of whom;
(4) One member, appointed by the president of the senate,
shall represent employers who employ
less than
one hundred
employees, one of whom;
(5) One member, appointed by the speaker of the house of
representatives, who shall represent
employees, one of whom;
(6) One member, appointed by the president of the senate, who
shall represent injured workers, and one of
whom;
(7) One member, who shall represent the public and also be an
individual who, on
account of the individual's previous vocation,
employment, or
affiliations, cannot be classed as either
predominantly
representative of employees or of employers and who
the speaker of the house of representatives and the president of
the senate, shall alternate in the appointment of for a term. Of
these
(8) Of the five
members appointed in divisions (A)(3), (4),
(5), (6), and (7) of this section, at least one shall be a person
with investment expertise.
(B) The council also shall consist of the chairperson of the
industrial commission and the administrator of workers'
compensation, who shall be nonvoting ex officio members of the
council.
(C) The president of the senate and the speaker of the house
of representatives shall make the initial appointments required
under divisions (A)(1) and (2) of this section not later than
thirty days after September 10,
2007. The members
of the council
who are appointed from the
membership of the senate
and the
house of representatives shall
serve during their terms as
members of the general assembly.
Notwithstanding the adjournment
of the general assembly of which
the member is a member or the
expiration of the member's term as
a member of such general
assembly, a member shall continue in
office subsequent to the
expiration date of the member's term on
the council until the
member's successor takes office or until a
period of sixty days
has elapsed, whichever occurs first.
(D) The president of the senate and the speaker of the house
of representatives shall make the initial appointments required
under division (A)(3) of this section not later than ninety days
after September 10, 2007. Of
these initial
appointments to the
council, one member shall be
appointed for a
term ending one
year after September 10, 2007, two
members shall be appointed
for terms ending two years after September 10, 2007, and two
members shall be appointed
for terms ending three years after
September 10, 2007. Thereafter, terms shall be for three
years,
except for the term of the member appointed under division (A)(7)
of this section who shall serve a term of two years, with each
term ending on the same day of the same month as
did
the term
that
it succeeds. Each member appointed under
division divisions
(A)(3), (4), (5), (6), and (7) of this
section shall hold office
from the date
of
appointment until the
end of the term for
which the
appointment
was made. Members may be
reappointed. Any
member
appointed
pursuant to division divisions (A)(3), (4),
(5), (6), and (7) of
this section to fill a
vacancy
occurring
prior to the expiration
of the term for which
the
member's
predecessor was appointed shall
hold office for the
remainder of
that term. Each member appointed
pursuant to
division divisions
(A)(3), (4), (5), (6), and (7) of this section shall continue in
office
subsequent to the expiration date of the member's term
until the
member's successor takes office or until a period of
sixty days
has elapsed, whichever occurs first.
(E) Vacancies shall be filled in the manner prescribed for
original appointments.
Sec. 4123.29. (A) The administrator of workers'
compensation, subject to the approval of the bureau of workers'
compensation board of directors, shall do all of the
following:
(1) Classify occupations or industries with respect to
their
degree of hazard and determine the risks of the different
classes
according to the categories the national council on
compensation
insurance establishes that are applicable to
employers in this
state;
(2)(a) Fix the rates of premium of the risks of the classes
based upon the total payroll in each of the classes of occupation
or industry sufficiently large to provide a fund for the
compensation provided for in this chapter and to maintain a state
insurance fund from year to year. The administrator shall set
the
rates at a level that assures the solvency of the fund.
Where the
payroll cannot be obtained or, in the opinion of the
administrator, is not an adequate measure for determining the
premium to be paid for the degree of hazard, the administrator
may determine the rates of premium upon such other basis,
consistent with insurance principles, as is equitable in view of
the degree of hazard, and whenever in this chapter reference is
made to payroll or expenditure of wages with reference to fixing
premiums, the reference shall be construed to have been made also
to such other basis for fixing the rates of premium as the
administrator may determine under this section.
(b) If an employer elects to obtain other-states' coverage
pursuant to section 4123.292 of the Revised Code
through either
the administrator, if the administrator elects to
offer such
coverage, or an other-states' insurer, calculate the employer's
premium for the state insurance fund in the same manner as
otherwise required under division (A) of this section and section
4123.34 of the Revised Code, except that when the administrator
determines the expenditure of wages, payroll, or both upon which
to base the employer's premium, the administrator shall use only
the expenditure of wages, payroll, or both attributable to the
labor performed and services provided by that employer's employees
when those employees performed labor and provided services in this
state only and to which the other-states' coverage does not
apply.
(c) The administrator in setting or revising rates shall
furnish
to employers an adequate explanation of the basis for the
rates
set.
(3) Develop and make available to employers who are paying
premiums to the state insurance fund alternative premium plans.
Alternative premium plans shall include retrospective rating
plans. The administrator may make available plans under which an
advanced deposit may be applied against a specified deductible
amount per claim.
(4)(a) Offer to insure the obligations of employers under
this chapter under a plan that groups, for rating purposes,
employers, and pools the risk of the employers within the group
provided that the employers meet all of the following conditions:
(i) All of the employers within the group are members of
an
organization that has been in existence for at least two years
prior to the date of application for group coverage;
(ii) The organization was formed for purposes other than
that
of obtaining group workers' compensation under this
division;
(iii) The employers' business in the organization is
substantially similar such that the risks which are grouped are
substantially homogeneous;
(iv) The group of employers consists of at least one
hundred
members or the aggregate workers' compensation premiums
of the
members, as determined by the administrator,
are expected
to
exceed one hundred fifty thousand dollars during the coverage
period;
(v) The formation and operation of the group program in
the
organization will substantially improve accident prevention
and
claims handling for the employers in the group;
(vi) Each employer seeking to enroll in a group for
workers'
compensation coverage has an industrial insurance
account in good
standing with the bureau of workers' compensation
such that at the
time the agreement is processed no outstanding
premiums,
penalties, or assessments are due from any of the
employers.
(b) If an organization sponsors more than one employer group
to participate in group plans established under this section, that
organization may submit a single application that supplies all of
the information necessary for each group of employers that the
organization wishes to sponsor.
(c) In providing employer group plans under division (A)(4)
of
this section, the administrator shall consider an employer
group
as a single employing entity for purposes of
group
rating.
No employer may be a member of more than one
group
for
the
purpose of obtaining workers' compensation coverage
under
this
division.
(d) At the time the administrator revises premium rates
pursuant to this section and section 4123.34 of the Revised Code,
if the premium rate of an employer who participates in a group
plan established under this section changes from the rate
established for the previous year, the administrator, in addition
to sending the invoice with the rate revision to that employer,
shall send a copy of that invoice to the third-party administrator
that administers the group plan for that employer's group.
(e) In providing employer group plans under division (A)(4)
of this section, the administrator shall establish a program
designed to mitigate the impact of a significant claim that would
come into the experience of a private, state fund group-rated
employer for the first time and be a contributing factor in that
employer being excluded from a group-rated plan. The administrator
shall establish eligibility criteria and requirements that such
employers must satisfy in order to participate in this program.
For purposes of this program, the administrator shall establish a
discount on premium rates applicable to employers who qualify for
the program.
(f) In no event shall division (A)(4) of this section be
construed as granting to an employer status as a self-insuring
employer.
(g)(i) An employer that is merging operations with another
employer shall notify the administrator of workers' compensation
of the merger not more than thirty days after the merger takes
effect.
(ii) If the administrator receives a notice from one or
more
employers of a merger of operations between those
employers as
described in division (A)(4)(f)(i) of this section,
and if any
employer involved in the merger
participates
in a group plan
established under this section, the
administrator
shall provide
a written notice to the organization
that sponsors
and the third
party administrator that administers
the group plan
in which an
employer who is involved in the
merger
participates informing
that organization and the third
party
administrator about the
merger.
(iii) The administrator shall comply with the notice
requirements of division (A)(4)(f)(i) of this section relative to
every employer that participates in a group plan that is involved
in a merger about which the administrator receives a
notice
described in that division.
(g)(h) The administrator shall develop classifications of
occupations or industries that are sufficiently distinct so as
not
to group employers in classifications that unfairly represent
the
risks of employment with the employer.
(5) Generally promote employer participation in the state
insurance fund through the regular dissemination of information
to
all classes of employers describing the advantages and
benefits of
opting to make premium payments to the fund. To that
end, the
administrator shall regularly make employers aware of
the various
workers' compensation premium packages developed and
offered
pursuant to this section.
(6) Make available to every employer who is paying
premiums
to the state insurance fund a program whereby the
employer or the
employer's agent pays to the claimant or on
behalf of the
claimant
the first fifteen thousand dollars of a compensable workers'
compensation medical-only claim filed by that claimant that is
related to the same injury or occupational disease. No formal
application is required; however, an employer must elect to
participate by telephoning the bureau after July 1, 1995. Once an
employer has elected to participate in the program, the employer
will be responsible for all bills in all medical-only claims with
a date of injury the same or later than the election date, unless
the employer notifies the bureau within fourteen days of receipt
of the notification of a claim being filed that it does not wish
to pay the bills in that claim, or the employer notifies the
bureau that the fifteen thousand dollar maximum has been paid, or
the employer notifies the bureau of the last day of service on
which it will be responsible for the bills in a particular
medical-only claim. If an
employer elects to enter the program,
the administrator shall not
reimburse the employer for such
amounts paid and shall not charge
the first fifteen thousand
dollars of any medical-only claim paid by
an employer to the
employer's experience or otherwise use it in
merit rating or
determining the risks of any employer for the
purpose of payment
of premiums under this chapter. A certified health care provider
shall extend to an employer who participates in this program the
same rates for services rendered to an employee of that employer
as the provider bills the administrator for the same type of
medical claim processed by the bureau and shall not charge,
assess, or otherwise attempt to collect from an employee any
amount for covered services or supplies that is in excess of that
rate. If an employer elects to enter the
program and the employer
fails to pay a bill for a medical-only
claim included in the
program, the employer shall be liable for
that bill and the
employee for whom the employer failed to pay the
bill shall not
be liable for that bill. The
administrator shall
adopt rules to
implement and administer
division (A)(6) of this
section. Upon
written request from the bureau, the employer shall
provide
documentation to the bureau of all medical-only bills that
they
are paying directly. Such requests from the bureau may not be
made more frequently than on a semiannual basis. Failure to
provide such documentation to the bureau within thirty days of
receipt of the request may result in the employer's forfeiture of
participation in the program for such injury. The provisions of
this section shall not apply to claims in which an employer with
knowledge of a claimed compensable injury or occupational disease,
has paid wages in lieu of compensation or total disability.
(B) The administrator shall supply an employer, at the time
the employer institutes coverage under this chapter and first
selects a managed care organization under the health partnership
program, with a list of all groups participating in the group
rating program created pursuant to this section and a list of all
premium discount programs offered by the administrator pursuant to
this chapter.
(C) The administrator, with the
advice and consent of the
board, by
rule, may do both of the following:
(1) Grant an employer who makes the employer's semiannual
premium
payment at least one month prior to the last day on which
the
payment may be made without penalty, a discount as the
administrator fixes from time to time;
(2) Levy a minimum annual administrative charge upon risks
where semiannual premium reports develop a charge less than the
administrator
considers adequate to offset administrative costs of
processing.
(D) The administrator shall adopt a rule that sets an
estimated discount for programs or alternative premium plans
not
later than the first day of September prior to the policy year
in
which the premium rate is to be in
effect and shall adopt a rule
that sets the actual discount for programs or alternative premium
plans not later than the first day of January of the year in which
the discount for programs or alternative premium plans is to be in
effect, except for the premium year starting July 1, 2010, in
which case the rule that sets the estimate shall not be adopted.
Sec. 4123.34. It shall be the duty of the bureau of
workers'
compensation board of directors and the administrator of
workers'
compensation to safeguard and maintain the solvency of
the state
insurance fund and all other funds specified in this
chapter and
Chapters 4121., 4127., and 4131. of the Revised Code.
The
administrator,
in the exercise of the powers and discretion
conferred upon the
administrator in section 4123.29 of the Revised
Code, shall fix and
maintain, with the advice and consent of the
board, for each class of occupation or industry, the lowest
possible
rates of premium consistent with the maintenance of a
solvent state
insurance fund and the creation and maintenance of a
reasonable
surplus, after the payment of legitimate claims for
injury,
occupational disease, and death that the administrator
authorizes to be paid from the state insurance fund for the
benefit of
injured, diseased, and the dependents of killed
employees. In
establishing rates, the administrator shall take
into account the
necessity of ensuring sufficient money is set
aside in the
premium payment security fund to cover any defaults
in premium
obligations. The administrator shall observe all of the
following requirements in fixing the rates of premium for the
risks of occupations or industries:
(A) The administrator shall keep an accurate account of the
money paid in
premiums by each of the several classes of
occupations or
industries, and the losses on account of injuries,
occupational
disease, and death of employees thereof, and also
keep an account
of the money received from each individual
employer and the
amount of losses incurred against the state
insurance fund on
account of injuries, occupational disease, and
death of the
employees of the employer.
(B) Ten per cent A portion of the money paid into the state
insurance
fund shall be set aside for the creation of a surplus
until the
surplus amounts to the sum of one hundred thousand
dollars, after
which time, whenever necessary in the judgment of
the
administrator to guarantee a solvent fund account within the
state insurance fund, a
sum
not exceeding five per cent of all
the money paid into the
state
insurance fund shall be credited to
the surplus fund. Any references in this chapter or in Chapter
4121., 4125., 4127., or 4131. of the Revised Code to the surplus
fund, the surplus created in this division, the statutory surplus
fund, or the statutory surplus of the state insurance fund are
hereby deemed to be references to the surplus fund account. The
administrator may transfer the portion of the state insurance fund
to the surplus fund account as the administrator determines is
necessary to satisfy the needs of the surplus fund account and to
guarantee the
solvency of the state insurance fund and the
surplus fund account.
In addition
to all statutory authority
under this chapter and
Chapter 4121. of
the Revised Code, the
administrator has
discretionary and
contingency authority to
make charges to the
surplus fund account. The
administrator
shall account for all
charges, whether statutory,
discretionary,
or contingency, that
the administrator may make to the
surplus
fund account. A
revision
of basic
rates shall be made annually
on the
first day
of July.
Notwithstanding any provision of the law to the contrary,
one
hundred eighty days after the effective date on which
self-insuring employers first may elect under division (D) of
section 4121.66 of the Revised Code to directly pay for
rehabilitation expenses, the administrator shall calculate the
deficit, if any, in the portion of the surplus fund account that
is used for
reimbursement to self-insuring employers for all
expenses other
than handicapped reimbursement under section
4123.343 of the
Revised Code. The administrator, from time to
time, may
determine
whether the
surplus fund account has such a
deficit and may assess all
self-insuring
employers who
participated in the portion of the
surplus fund account
during
the accrual of the deficit and who during that
time period
have
not made the election under division (D) of
section 4121.66
of
the Revised Code the amount the administrator
determines
necessary to reduce the deficit.
Revisions of basic rates shall be in accordance with the
oldest four of the last five calendar years of the combined
accident and occupational disease experience of the administrator
in the administration of this chapter, as shown by the accounts
kept as provided in this section, excluding the experience of
employers that are no longer active if the administrator
determines that the
inclusion of those employers would have a
significant negative impact on the
remainder of the employers in a
particular manual classification; and the
administrator shall
adopt rules, with the advice and
consent of the board, governing
rate
revisions, the object of which shall be to make an equitable
distribution of losses among the several classes of occupation or
industry, which rules shall be general in their application.
(C) The administrator may apply that form of rating system
that the administrator finds is best calculated to merit
rate or
individually rate the risk more equitably, predicated upon the
basis
of its individual industrial accident and occupational
disease
experience, and may encourage and stimulate accident
prevention. The
administrator shall develop fixed and equitable
rules
controlling the rating system, which rules shall conserve to
each
risk the basic principles of workers' compensation insurance.
(D) The administrator, from the money paid into the state
insurance fund, shall set aside into an account of the state
insurance fund titled a premium payment security fund sufficient
money to pay for any premiums due from an employer and
uncollected
that are in excess of the employer's premium security deposit.
The fund shall be in the custody of the treasurer of state.
All investment earnings of the fund shall be deposited in the
fund. Disbursements from the fund shall be made by the bureau of
workers' compensation upon order of the administrator to the
state
insurance fund. The use of the moneys held by the premium
payment
security fund is restricted to reimbursement to the state
insurance fund of premiums due and uncollected in excess of an
employer's premium security deposit. The moneys constituting the
premium payment security fund shall be maintained without regard
to or reliance upon any other fund. This section does not
prevent
the deposit or investment of the premium payment security
fund
with any other fund created by this chapter, but the premium
payment security fund is separate and distinct for every other
purpose and a strict accounting thereof shall be maintained.
(E) The administrator may grant discounts on premium rates
for employers who meet either of the following requirements:
(1) Have not incurred a compensable injury for one year or
more and who maintain an employee safety committee or similar
organization or make periodic safety inspections of the
workplace.
(2) Successfully complete a loss prevention program
prescribed by the superintendent of the division of safety and
hygiene and conducted by the division or by any other person
approved by the superintendent.
(F)(1) In determining the premium rates for the
construction
industry the administrator shall calculate the employers' premiums
based upon the actual remuneration
construction industry employees
receive from construction
industry employers, provided that the
amount of remuneration the
administrator uses in calculating the
premiums shall not exceed
an average weekly wage equal to one
hundred fifty per cent of the statewide
average weekly wage
as
defined in division (C) of section 4123.62 of the Revised
Code.
(2) Division (F)(1) of this section shall not be construed
as
affecting the manner in which benefits to a claimant are
awarded
under this chapter.
(3) As used in division (F) of this section, "construction
industry" includes any activity performed in connection with the
erection, alteration, repair, replacement, renovation,
installation, or demolition of any building, structure, highway,
or bridge.
(G) Commencing with the bureau of workers' compensation
policy year beginning on July 1, 2010, the administrator shall
offer a workplace safety program to all
employers, whether or not
the employers participate in a group as
described in division
(A)(4) of section 4123.29 of the Revised
Code. The administrator
shall provide any employer who
participates in the workplace
safety program a discount on the
employer's premiums of not less
than two per cent.
(H) Commencing with the bureau of workers' compensation
policy year beginning on July 1, 2010, the administrator shall
offer a drug free workplace program to all
employers, whether or
not the employers participate in a group as
described in division
(A)(4) of section 4123.29 of the Revised
Code. The administrator
shall provide any employer who
participates in the drug free
workplace program a discount of not less than three per cent per
year on the
employer's premiums for each year the employer
participates in the program.
(I) The administrator of workers' compensation shall not
place a limit on the length of time that an employer may
participate in the bureau of workers' compensation drug free
workplace and workplace safety programs.
Sec. 4123.35. (A) Except as provided in this section,
every
employer mentioned in division (B)(2) of section 4123.01 of
the
Revised Code, and every publicly owned utility shall pay
semiannually in the months of January and July into the state
insurance fund the amount of annual premium the administrator of
workers' compensation fixes for the employment or occupation of
the employer, the amount of which premium to be paid by each
employer to be determined by the classifications, rules, and rates
made and published by the administrator. The employer shall pay
semiannually a further sum of money into the state insurance fund
as may be ascertained to be due from the employer by applying the
rules of the administrator, and a receipt or certificate
certifying that payment has been made, along with a written notice
as is required in section 4123.54 of the Revised Code, shall be
mailed immediately
to the employer by the bureau of workers'
compensation. The
receipt or certificate is prima-facie evidence
of the payment of
the premium, and the proper posting of the
notice constitutes the employer's compliance with the notice
requirement mandated in section 4123.54 of the Revised Code.
The bureau of workers' compensation shall verify with the
secretary of state the existence of all corporations and
organizations making application for workers' compensation
coverage and shall require every such application to include the
employer's federal identification number.
An employer as defined in division (B)(2) of section 4123.01
of the Revised Code who has contracted with a subcontractor is
liable for the unpaid premium due from any subcontractor with
respect to that part of the payroll of the subcontractor that is
for work performed pursuant to the contract with the employer.
Division (A) of this section providing for the payment of
premiums semiannually does not apply to any employer who was a
subscriber to the state insurance fund prior to January 1, 1914,
or who may first become a subscriber to the fund in any month
other than January or July. Instead, the semiannual premiums
shall
be paid by those employers from time to time upon the
expiration
of the respective periods for which payments into the
fund have
been made by them.
The administrator shall adopt rules to permit employers to
make periodic payments of the semiannual premium due under this
division. The rules shall include provisions for the assessment
of
interest charges, where appropriate, and for the assessment of
penalties when an employer fails to make timely premium payments.
An employer who timely pays the amounts due under this division is
entitled to all of the benefits and protections of this chapter.
Upon receipt of payment, the bureau immediately shall mail a
receipt or certificate to the employer certifying that payment has
been made, which receipt is prima-facie evidence of payment.
Workers' compensation coverage under this chapter continues
uninterrupted upon timely receipt of payment under this division.
Every public employer, except public employers that are
self-insuring employers under this section, shall comply with
sections 4123.38 to 4123.41, and 4123.48 of the Revised Code in
regard to the contribution of moneys to the public insurance fund.
(B) Employers who will abide by the rules of the
administrator and who may be of sufficient financial ability to
render certain the payment of compensation to injured employees or
the dependents of killed employees, and the furnishing of medical,
surgical, nursing, and hospital attention and services and
medicines, and funeral expenses, equal to or greater than is
provided for in sections 4123.52, 4123.55 to 4123.62, and 4123.64
to 4123.67 of the Revised Code, and who do not desire to insure
the payment thereof or indemnify themselves against loss sustained
by the direct payment thereof, upon a finding of such facts by the
administrator, may be granted the privilege to pay individually
compensation, and furnish medical, surgical, nursing, and hospital
services and attention and funeral expenses directly to injured
employees or the dependents of killed employees, thereby being
granted status as a self-insuring employer. The administrator may
charge employers who apply for the status as a self-insuring
employer a reasonable application fee to cover the bureau's costs
in connection with processing and making a determination with
respect to an application.
All employers granted
status
as self-insuring employers
shall
demonstrate
sufficient financial and administrative ability
to
assure that all
obligations under this section are promptly
met.
The
administrator shall deny the privilege where the
employer is
unable to demonstrate the employer's ability to
promptly meet all
the obligations imposed on the employer by this
section.
(1) The administrator shall consider, but is not limited to,
the following factors, where applicable, in determining the
employer's ability to meet all of the obligations imposed on the
employer by this section:
(a) The employer employs a minimum of five hundred employees
in this state;
(b) The employer has operated in this state for a minimum of
two years, provided that an employer who has purchased, acquired,
or otherwise succeeded to the operation of a business, or any part
thereof, situated in this state that has operated for at least two
years in this state, also shall qualify;
(c) Where the employer previously contributed to the state
insurance fund or is a successor employer as defined by bureau
rules, the amount of the buyout, as defined by bureau rules;
(d) The sufficiency of the employer's assets located in this
state to insure the employer's solvency in paying compensation
directly;
(e) The financial records, documents, and data, certified by
a certified public accountant, necessary to provide the employer's
full financial disclosure. The records, documents, and data
include, but are not limited to, balance sheets and profit and
loss history for the current year and previous four years.
(f) The employer's organizational plan for the
administration
of the workers' compensation law;
(g) The employer's proposed plan to inform employees of the
change from a state fund insurer to a self-insuring employer, the
procedures the employer will follow as a self-insuring employer,
and the employees' rights to compensation and benefits; and
(h) The employer has either an account in a financial
institution in this state, or if the employer maintains an account
with a financial institution outside this state, ensures that
workers' compensation checks are drawn from the same account as
payroll checks or the employer clearly indicates that payment will
be honored by a financial institution in this state.
The administrator may waive the requirements of divisions
(B)(1)(a) and (b) of this section and the requirement of division
(B)(1)(e) of this section that the financial records, documents,
and data be certified by a certified public accountant. The
administrator shall adopt rules establishing the criteria that an
employer shall meet in order for the administrator to waive the
requirement of division (B)(1)(e) of this section. Such rules may
require additional security of that employer pursuant to division
(E) of section 4123.351 of the Revised Code.
The administrator shall not grant the status of self-insuring
employer to the state, except that the administrator may grant the
status of self-insuring employer to a state institution of higher
education, excluding its hospitals, that meets the requirements of
division (B)(2) of this section.
(2) When considering the application of a public employer,
except for a board of county commissioners described in division
(G) of section 4123.01 of the Revised Code, a board of a county
hospital, or a publicly owned utility, the administrator shall
verify that the public employer satisfies all of the following
requirements as the requirements apply to that public employer:
(a) For the two-year period preceding application under this
section, the public employer has maintained an unvoted debt
capacity equal to at least two times the amount of the current
annual premium established by the administrator under this chapter
for that public employer for the year immediately preceding the
year in which the public employer makes application under this
section.
(b) For each of the two fiscal years preceding application
under this section, the unreserved and undesignated year-end fund
balance in the public employer's general fund is equal to at least
five per cent of the public employer's general fund revenues for
the fiscal year computed in accordance with generally accepted
accounting principles.
(c) For the five-year period preceding application under
this
section, the public employer, to the extent applicable, has
complied fully with the continuing disclosure requirements
established in rules adopted by the United States securities and
exchange commission under 17 C.F.R. 240.15c 2-12.
(d) For the five-year period preceding application under
this
section, the public employer has not had its local government
fund
distribution withheld on account of the public employer being
indebted or otherwise obligated to the state.
(e) For the five-year period preceding application under
this
section, the public employer has not been under a fiscal
watch or
fiscal emergency pursuant to section 118.023, 118.04, or
3316.03
of the Revised Code.
(f) For the public employer's fiscal year preceding
application under this section, the public employer has obtained
an annual financial audit as required under section 117.10 of the
Revised Code, which has been released by the auditor of state
within seven months after the end of the public employer's fiscal
year.
(g) On the date of application, the public employer holds a
debt rating of Aa3 or higher according to Moody's investors
service, inc., or a comparable rating by an independent rating
agency similar to Moody's investors service, inc.
(h) The public employer agrees to generate an annual
accumulating book reserve in its financial statements reflecting
an actuarially generated reserve adequate to pay projected claims
under this chapter for the applicable period of time, as
determined by the administrator.
(i) For a public employer that is a hospital, the public
employer shall submit audited financial statements showing the
hospital's overall liquidity characteristics, and the
administrator shall determine, on an individual basis, whether the
public employer satisfies liquidity standards equivalent to the
liquidity standards of other public employers.
(j) Any additional criteria that the administrator adopts by
rule pursuant to division (E) of this section.
The administrator shall not approve the application of a
public employer, except for a board of county commissioners
described in division (G) of section 4123.01 of the Revised Code,
a board of a county hospital, or publicly owned utility, who does
not satisfy all of the requirements listed in division (B)(2) of
this section.
(C) A board of county commissioners described in division
(G)
of section 4123.01 of the Revised Code, as an employer, that
will
abide by the rules of the administrator and that may be of
sufficient financial ability to render certain the payment of
compensation to injured employees or the dependents of killed
employees, and the furnishing of medical, surgical, nursing, and
hospital attention and services and medicines, and funeral
expenses, equal to or greater than is provided for in sections
4123.52, 4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised
Code, and that does not desire to insure the payment thereof or
indemnify itself against loss sustained by the direct payment
thereof, upon a finding of such facts by the administrator, may be
granted the privilege to pay individually compensation, and
furnish medical, surgical, nursing, and hospital services and
attention and funeral expenses directly to injured employees or
the dependents of killed employees, thereby being granted status
as a self-insuring employer. The administrator may charge a board
of county commissioners described in division (G) of section
4123.01 of the Revised Code that applies for the status as a
self-insuring employer a reasonable application fee to cover the
bureau's costs in connection with processing and making a
determination with respect to an application. All employers
granted such status shall demonstrate sufficient financial and
administrative ability to assure that all obligations under this
section are promptly met. The administrator shall deny the
privilege where the employer is unable to demonstrate the
employer's ability to promptly meet all the obligations imposed on
the employer by this section. The administrator shall consider,
but is not limited to, the following factors, where applicable, in
determining the employer's ability to meet all of the obligations
imposed on the board as an employer by this section:
(1) The board as an employer employs a minimum of five
hundred employees in this state;
(2) The board has operated in this state for a minimum of
two
years;
(3) Where the board previously contributed to the state
insurance fund or is a successor employer as defined by bureau
rules, the amount of the buyout, as defined by bureau rules;
(4) The sufficiency of the board's assets located in this
state to insure the board's solvency in paying compensation
directly;
(5) The financial records, documents, and data, certified by
a certified public accountant, necessary to provide the board's
full financial disclosure. The records, documents, and data
include, but are not limited to, balance sheets and profit and
loss history for the current year and previous four years.
(6) The board's organizational plan for the administration
of
the workers' compensation law;
(7) The board's proposed plan to inform employees of the
proposed self-insurance, the procedures the board will follow as a
self-insuring employer, and the employees' rights to compensation
and benefits;
(8) The board has either an account in a financial
institution in this state, or if the board maintains an account
with a financial institution outside this state, ensures that
workers' compensation checks are drawn from the same account as
payroll checks or the board clearly indicates that payment will be
honored by a financial institution in this state;
(9) The board shall provide the administrator a surety bond
in an amount equal to one hundred twenty-five per cent of the
projected losses as determined by the administrator.
(D) The administrator shall require a surety bond from all
self-insuring employers, issued pursuant to section 4123.351 of
the Revised Code, that is sufficient to compel, or secure to
injured employees, or to the dependents of employees killed, the
payment of compensation and expenses, which shall in no event be
less than that paid or furnished out of the state insurance fund
in similar cases to injured employees or to dependents of killed
employees whose employers contribute to the fund, except when an
employee of the employer, who has suffered the loss of a hand,
arm, foot, leg, or eye prior to the injury for which compensation
is to be paid, and thereafter suffers the loss of any other of the
members as the result of any injury sustained in the course of and
arising out of the employee's employment, the compensation to be
paid by the self-insuring employer is limited to the disability
suffered in the subsequent injury, additional compensation, if
any, to be paid by the bureau out of the surplus created by
section 4123.34 of the Revised Code.
(E) In addition to the requirements of this section, the
administrator shall make and publish rules governing the manner of
making application and the nature and extent of the proof required
to justify a finding of fact by the administrator as to granting
the status of a self-insuring employer, which rules shall be
general in their application, one of which rules shall provide
that all self-insuring employers shall pay into the state
insurance fund such amounts as are required to be credited to the
surplus fund in division (B) of section 4123.34 of the Revised
Code. The administrator may adopt rules establishing requirements
in addition to the requirements described in division (B)(2) of
this section that a public employer shall meet in order to qualify
for self-insuring status.
Employers shall secure directly from the bureau central
offices application forms upon which the bureau shall stamp a
designating number. Prior to submission of an application, an
employer shall make available to the bureau, and the bureau shall
review, the information described in division (B)(1) of this
section, and public employers shall make available, and the bureau
shall review, the information necessary to verify whether the
public employer meets the requirements listed in division (B)(2)
of this section. An employer shall file the completed application
forms with an application fee, which shall cover the costs of
processing the application, as established by the administrator,
by rule, with the bureau at least ninety days prior to the
effective date of the employer's new status as a self-insuring
employer. The application form is not deemed complete until all
the required information is attached thereto. The bureau shall
only accept applications that contain the required information.
(F) The bureau shall review completed applications within a
reasonable time. If the bureau determines to grant an employer
the
status as a self-insuring employer, the bureau shall issue a
statement, containing its findings of fact, that is prepared by
the bureau and signed by the administrator. If the bureau
determines not to grant the status as a self-insuring employer,
the bureau shall notify the employer of the determination and
require the employer to continue to pay its full premium into the
state insurance fund. The administrator also shall adopt rules
establishing a minimum level of performance as a criterion for
granting and maintaining the status as a self-insuring employer
and fixing time limits beyond which failure of the self-insuring
employer to provide for the necessary medical examinations and
evaluations may not delay a decision on a claim.
(G) The administrator shall adopt rules setting forth
procedures for auditing the program of self-insuring employers.
The bureau shall conduct the audit upon a random basis or whenever
the bureau has grounds for believing that a self-insuring employer
is not in full compliance with bureau rules or this chapter.
The administrator shall monitor the programs conducted by
self-insuring employers, to ensure compliance with bureau
requirements and for that purpose, shall develop and issue to
self-insuring employers standardized forms for use by the
self-insuring employer in all aspects of the self-insuring
employers' direct compensation program and for reporting of
information to the bureau.
The bureau shall receive and transmit to the self-insuring
employer all complaints concerning any self-insuring employer. In
the case of a complaint against a self-insuring employer, the
administrator shall handle the complaint through the
self-insurance division of the bureau. The bureau shall maintain
a
file by employer of all complaints received that relate to the
employer. The bureau shall evaluate each complaint and take
appropriate action.
The administrator shall adopt as a rule a prohibition against
any self-insuring employer from harassing, dismissing, or
otherwise disciplining any employee making a complaint, which rule
shall provide for a financial penalty to be levied by the
administrator payable by the offending self-insuring employer.
(H) For the purpose of making determinations as to whether
to
grant status as a self-insuring employer, the administrator may
subscribe to and pay for a credit reporting service that offers
financial and other business information about individual
employers. The costs in connection with the bureau's subscription
or individual reports from the service about an applicant may be
included in the application fee charged employers under this
section.
(I) The administrator, notwithstanding other provisions of
this chapter, may permit a self-insuring employer to resume
payment of premiums to the state insurance fund with appropriate
credit modifications to the employer's basic premium rate as such
rate is determined pursuant to section 4123.29 of the Revised
Code.
(J) On the first day of July of each year, the administrator
shall calculate separately each self-insuring employer's
assessments for the safety and hygiene fund, administrative costs
pursuant to section 4123.342 of the Revised Code, and for the
portion of the surplus fund under division (B) of section 4123.34
of the Revised Code that is not used for handicapped
reimbursement, on the basis of the paid compensation attributable
to the individual self-insuring employer according to the
following calculation:
(1) The total assessment against all self-insuring employers
as a class for each fund and for the administrative costs for the
year that the assessment is being made, as determined by the
administrator, divided by the total amount of paid compensation
for the previous calendar year attributable to all amenable
self-insuring employers;
(2) Multiply the quotient in division (J)(1) of this section
by the total amount of paid compensation for the previous calendar
year that is attributable to the individual self-insuring employer
for whom the assessment is being determined. Each self-insuring
employer shall pay the assessment that results from this
calculation, unless the assessment resulting from this calculation
falls below a minimum assessment, which minimum assessment the
administrator shall determine on the first day of July of each
year with the advice and consent of the bureau of workers'
compensation
board of directors, in which event, the self-insuring
employer
shall pay the minimum assessment.
In determining the total amount due for the total assessment
against all self-insuring employers as a class for each fund and
the administrative assessment, the administrator shall reduce
proportionately the total for each fund and assessment by the
amount of money in the self-insurance assessment fund as of the
date of the computation of the assessment.
The administrator shall calculate the assessment for the
portion of the surplus fund under division (B) of section 4123.34
of the Revised Code that is used for handicapped reimbursement in
the same manner as set forth in divisions (J)(1) and (2) of this
section except that the administrator shall calculate the total
assessment for this portion of the surplus fund only on the basis
of those self-insuring employers that retain participation in the
handicapped reimbursement program and the individual self-insuring
employer's proportion of paid compensation shall be calculated
only for those self-insuring employers who retain participation in
the handicapped reimbursement program. The administrator, as the
administrator determines appropriate, may determine the total
assessment for the handicapped portion of the surplus fund in
accordance with sound actuarial principles.
The administrator shall calculate the assessment for the
portion of the surplus fund under division (B) of section 4123.34
of the Revised Code that under division (D) of section 4121.66 of
the Revised Code is used for rehabilitation costs in the same
manner as set forth in divisions (J)(1) and (2) of this section,
except that the administrator shall calculate the total assessment
for this portion of the surplus fund only on the basis of those
self-insuring employers who have not made the election to make
payments directly under division (D) of section 4121.66 of the
Revised Code and an individual self-insuring employer's proportion
of paid compensation only for those self-insuring employers who
have not made that election.
The administrator shall calculate the assessment for the
portion of the surplus fund under division (B) of section 4123.34
of the Revised Code that is used for reimbursement to a
self-insuring employer under division (H) of section 4123.512 of
the Revised Code in the same manner as set forth in divisions
(J)(1) and (2) of this section except that the administrator shall
calculate the total assessment for this portion of the surplus
fund only on the basis of those self-insuring employers that
retain participation in reimbursement to the self-insuring
employer under division (H) of section 4123.512 of the Revised
Code and the individual self-insuring employer's proportion of
paid compensation shall be calculated only for those self-insuring
employers who retain participation in reimbursement to the
self-insuring employer under division (H) of section 4123.512 of
the Revised Code.
An employer who no longer is a self-insuring employer in this
state or who no longer is operating in this state, shall continue
to pay assessments for administrative costs and for the portion of
the surplus fund under division (B) of section 4123.34 of the
Revised Code that is not used for handicapped reimbursement, based
upon paid compensation attributable to claims that occurred while
the employer was a self-insuring employer within this state.
(K) The administrator shall deposit any moneys received from
a self-insuring employer for the self-insuring employer's
assessment to pay the costs solely attributable to the workers'
compensation council
into the administrative assessment account
described in division (B) of section 4123.342 of the Revised Code
for the administrative cost assessment collected by the
administrator for the council. There is hereby
created in the
state treasury the
self-insurance assessment fund.
All investment
earnings of the
fund shall be deposited in the
fund. The
administrator shall use
the money in the self-insurance
assessment fund only for
administrative costs as specified in
section 4123.341 of the
Revised Code.
(L) Every self-insuring employer shall certify, in affidavit
form subject to the penalty for perjury, to the bureau the amount
of the self-insuring employer's paid compensation for the previous
calendar year. In reporting paid compensation paid for the
previous year, a self-insuring employer shall exclude from the
total amount of paid compensation any reimbursement the
self-insuring employer receives in the previous calendar year from
the surplus fund pursuant to section 4123.512 of the Revised Code
for any paid compensation. The self-insuring employer also shall
exclude from the paid compensation reported any amount recovered
under section 4123.931 of the Revised Code and any amount that is
determined not to have been payable to or on behalf of a claimant
in any final administrative or judicial proceeding. The
self-insuring employer shall exclude such amounts from the paid
compensation reported in the reporting period subsequent to the
date the determination is made. The administrator shall adopt
rules, in accordance with Chapter 119. of the Revised Code,
that
provide for all of the following:
(1) Establishing the date by which self-insuring employers
must submit
such information and the amount of the assessments
provided for in
division (J) of this section for employers who
have been granted
self-insuring status within the last calendar
year;
(2) If an employer fails to pay the assessment when due, the
administrator may add a late fee penalty of not more than five
hundred dollars to the assessment plus an additional penalty
amount as follows:
(a) For an assessment from sixty-one to ninety days past due,
the prime interest rate, multiplied by the assessment due;
(b) For an assessment from ninety-one to one hundred twenty
days past due, the prime interest rate plus two per cent,
multiplied by the assessment due;
(c) For an assessment from one hundred twenty-one to one
hundred fifty days past due, the prime interest rate plus four per
cent, multiplied by the assessment due;
(d) For an assessment from one hundred fifty-one to one
hundred eighty days past due, the prime interest rate plus six per
cent, multiplied by the assessment due;
(e) For an assessment from one hundred eighty-one to two
hundred ten days past due, the prime interest rate plus eight per
cent, multiplied by the assessment due;
(f) For each additional thirty-day period or portion thereof
that an assessment remains past due after it has remained past due
for more than two hundred ten days, the prime interest rate plus
eight per cent, multiplied by the assessment due.
(3) An employer may appeal a late fee penalty and penalty
assessment to the administrator.
For purposes of division (L)(2) of this section, "prime
interest rate" means the average bank prime rate, and the
administrator shall determine the prime interest rate in the same
manner as a county auditor determines the average bank prime rate
under section 929.02 of the Revised Code.
The administrator shall include any assessment and penalties
that
remain unpaid for previous assessment periods in the
calculation and
collection of any assessments due under this
division or division
(J) of this section.
(M) As used in this section, "paid compensation" means all
amounts paid by a self-insuring employer for living maintenance
benefits, all amounts for compensation paid pursuant to sections
4121.63, 4121.67, 4123.56, 4123.57, 4123.58, 4123.59, 4123.60, and
4123.64 of the Revised Code, all amounts paid as wages in lieu of
such compensation, all amounts paid in lieu of such compensation
under a nonoccupational accident and sickness program fully funded
by the self-insuring employer, and all amounts paid by a
self-insuring employer for a violation of a specific safety
standard pursuant to Section 35 of Article II, Ohio Constitution
and section 4121.47 of the Revised Code.
(N) Should any section of this chapter or Chapter 4121. of
the Revised Code providing for self-insuring employers'
assessments based upon compensation paid be declared
unconstitutional by a final decision of any court, then that
section of the Revised Code declared unconstitutional shall revert
back to the section in existence prior to November 3, 1989,
providing for assessments based upon payroll.
(O) The administrator may grant a self-insuring employer the
privilege to self-insure a construction project entered into by
the self-insuring employer that is scheduled for completion within
six years after the date the project begins, and the total cost of
which is estimated to exceed one hundred million dollars
or, for
employers described in division (R) of this section, if the
construction project is estimated to exceed twenty-five million
dollars. The
administrator may waive such cost and time criteria
and grant a
self-insuring employer the privilege to self-insure a
construction
project regardless of the time needed to complete the
construction
project and provided that the cost of the
construction project is
estimated to exceed fifty million dollars.
A self-insuring
employer who desires to self-insure a construction
project shall
submit to the administrator an application listing
the dates the
construction project is scheduled to begin and end,
the estimated
cost of the construction project, the contractors
and
subcontractors whose employees are to be self-insured by the
self-insuring employer, the provisions of a safety program that is
specifically designed for the construction project, and a
statement as to whether a collective bargaining agreement
governing the rights, duties, and obligations of each of the
parties to the agreement with respect to the construction project
exists between the self-insuring employer and a labor
organization.
A self-insuring employer may apply to self-insure the
employees of either of the following:
(1) All contractors and subcontractors who perform labor or
work or provide materials for the construction project;
(2) All contractors and, at the administrator's discretion,
a
substantial number of all the subcontractors who perform labor
or
work or provide materials for the construction project.
Upon approval of the application, the administrator shall
mail a certificate granting the privilege to self-insure the
construction project to the self-insuring employer. The
certificate shall contain the name of the self-insuring employer
and the name, address, and telephone number of the self-insuring
employer's representatives who are responsible for administering
workers' compensation claims for the construction project. The
self-insuring employer shall post the certificate in a conspicuous
place at the site of the construction project.
The administrator shall maintain a record of the contractors
and subcontractors whose employees are covered under the
certificate issued to the self-insured employer. A self-insuring
employer immediately shall notify the administrator when any
contractor or subcontractor is added or eliminated from inclusion
under the certificate.
Upon approval of the application, the self-insuring employer
is responsible for the administration and payment of all claims
under this chapter and Chapter 4121. of the Revised Code for the
employees of the contractor and subcontractors covered under the
certificate who receive injuries or are killed in the course of
and arising out of employment on the construction project, or who
contract an occupational disease in the course of employment on
the construction project. For purposes of this chapter and
Chapter
4121. of the Revised Code, a claim that is administered
and paid
in accordance with this division is considered a claim
against the
self-insuring employer listed in the certificate. A
contractor or
subcontractor included under the certificate shall
report to the
self-insuring employer listed in the certificate,
all claims that
arise under this chapter and Chapter 4121. of the
Revised Code in
connection with the construction project for which
the certificate
is issued.
A self-insuring employer who complies with this division is
entitled to the protections provided under this chapter and
Chapter 4121. of the Revised Code with respect to the employees of
the contractors and subcontractors covered under a certificate
issued under this division for death or injuries that arise out
of, or death, injuries, or occupational diseases that arise in the
course of, those employees' employment on that construction
project, as if the employees were employees of the self-insuring
employer, provided that the self-insuring employer also complies
with this section. No employee of the contractors and
subcontractors covered under a certificate issued under this
division shall be considered the employee of the self-insuring
employer listed in that certificate for any purposes other than
this chapter and Chapter 4121. of the Revised Code. Nothing in
this division gives a self-insuring employer authority to control
the means, manner, or method of employment of the employees of the
contractors and subcontractors covered under a certificate issued
under this division.
The contractors and subcontractors included under a
certificate issued under this division are entitled to the
protections provided under this chapter and Chapter 4121. of the
Revised Code with respect to the contractor's or subcontractor's
employees who are employed on the construction project which is
the subject of the certificate, for death or injuries that arise
out of, or death, injuries, or occupational diseases that arise in
the course of, those employees' employment on that construction
project.
The contractors and subcontractors included under a
certificate issued under this division shall identify in their
payroll records the employees who are considered the employees of
the self-insuring employer listed in that certificate for purposes
of this chapter and Chapter 4121. of the Revised Code, and the
amount that those employees earned for employment on the
construction project that is the subject of that certificate.
Notwithstanding any provision to the contrary under this chapter
and Chapter 4121. of the Revised Code, the administrator shall
exclude the payroll that is reported for employees who are
considered the employees of the self-insuring employer listed in
that certificate, and that the employees earned for employment on
the construction project that is the subject of that certificate,
when determining those contractors' or subcontractors' premiums or
assessments required under this chapter and Chapter 4121. of the
Revised Code. A self-insuring employer issued a certificate under
this division shall include in the amount of paid compensation it
reports pursuant to division (L) of this section, the amount of
paid compensation the self-insuring employer paid pursuant to this
division for the previous calendar year.
Nothing in this division shall be construed as altering the
rights of employees under this chapter and Chapter 4121. of the
Revised Code as those rights existed prior to September 17, 1996.
Nothing in this division shall be construed as altering the rights
devolved under sections 2305.31 and 4123.82 of the Revised Code as
those rights existed prior to September 17, 1996.
As used in this division, "privilege to self-insure a
construction project" means privilege to pay individually
compensation, and to furnish medical, surgical, nursing, and
hospital services and attention and funeral expenses directly to
injured employees or the dependents of killed employees.
(P) A self-insuring employer whose application is granted
under division (O) of this section shall designate a safety
professional to be responsible for the administration and
enforcement of the safety program that is specifically designed
for the construction project that is the subject of the
application.
A self-insuring employer whose application is granted under
division (O) of this section shall employ an ombudsperson for the
construction project that is the subject of the application. The
ombudsperson shall have experience in workers' compensation or the
construction industry, or both. The ombudsperson shall perform
all
of the following duties:
(1) Communicate with and provide information to employees
who
are injured in the course of, or whose injury arises out of
employment on the construction project, or who contract an
occupational disease in the course of employment on the
construction project;
(2) Investigate the status of a claim upon the request of an
employee to do so;
(3) Provide information to claimants, third party
administrators, employers, and other persons to assist those
persons in protecting their rights under this chapter and Chapter
4121. of the Revised Code.
A self-insuring employer whose application is granted under
division (O) of this section shall post the name of the safety
professional and the ombudsperson and instructions for contacting
the safety professional and the ombudsperson in a conspicuous
place at the site of the construction project.
(Q) The administrator may consider all of the following when
deciding whether to grant a self-insuring employer the privilege
to self-insure a construction project as provided under division
(O) of this section:
(1) Whether the self-insuring employer has an organizational
plan for the administration of the workers' compensation law;
(2) Whether the safety program that is specifically designed
for the construction project provides for the safety of employees
employed on the construction project, is applicable to all
contractors and subcontractors who perform labor or work or
provide materials for the construction project, and has
as a
component, a safety training program that complies with standards
adopted pursuant to the "Occupational Safety and Health Act of
1970," 84 Stat. 1590, 29 U.S.C.A. 651, and provides for continuing
management and employee involvement;
(3) Whether granting the privilege to self-insure the
construction project will reduce the costs of the construction
project;
(4) Whether the self-insuring employer has employed an
ombudsperson as required under division (P) of this section;
(5) Whether the self-insuring employer has sufficient surety
to secure the payment of claims for which the
self-insuring
employer would be responsible pursuant to the
granting of the
privilege to self-insure a construction project
under division
(O)
of this section.
(R)
As used in divisions (O), (P), and (Q), "self-insuring
employer" includes the following employers, whether or not they
have been granted the status of being a self-insuring employer
under division (B) of this section:
(1) A state institution of higher education;
(2) A school district;
(3) A county school financing district;
(4) An educational service center;
(5) A community school established under Chapter 3314. of
the
Revised Code;
(6) A municipal power agency as defined in section 3734.058
of the Revised Code.
(S) As used in this section:
(1) "Unvoted debt capacity" means the amount of money that a
public employer may borrow without voter approval of a tax levy;
(2) "State institution of higher education" means the state
universities listed in section 3345.011 of the Revised Code,
community colleges created pursuant to Chapter 3354. of the
Revised Code, university branches created pursuant to Chapter
3355. of the Revised Code, technical colleges created pursuant to
Chapter 3357. of the Revised Code, and state community colleges
created pursuant to Chapter 3358. of the Revised Code.
Sec. 4123.82. (A) All contracts and agreements are void
which undertake to indemnify or insure an employer against loss
or
liability for the payment of compensation to workers or their
dependents for death, injury, or occupational disease occasioned
in the course of the workers' employment, or which provide that
the insurer shall pay the compensation, or which indemnify the
employer against damages when the injury, disease, or death
arises
from the failure to comply with any lawful requirement for
the
protection of the lives, health, and safety of employees, or
when
the same is occasioned by the willful act of the employer or
any
of the employer's officers or agents, or by which it is
agreed
that the
insurer shall pay any such damages. No license or
authority to
enter into any such agreements or issue any such
policies of
insurance shall be granted or issued by any public
authority in
this state. Any corporation organized or admitted
under the laws
of this state to transact liability insurance as
defined in
section 3929.01 of the Revised Code may by amendment of
its
articles of incorporation or by original articles of
incorporation, provide therein for the authority and purpose to
make insurance in states, territories, districts, and counties,
other than the state of Ohio, and in the state of Ohio in respect
of contracts permitted by division (B) of this section,
indemnifying employers against loss or liability for payment of
compensation to workers and employees and their dependents for
death, injury, or occupational disease occasioned in the course
of
the employment and to insure and indemnify employers against
loss,
expense, and liability by risk of bodily injury or death by
accident, disability, sickness, or disease suffered by workers
and
employees for which the employer may be liable or has assumed
liability.
(B) Notwithstanding division (A) of this section:
(1) No contract because of that division is void which
undertakes to indemnify a self-insuring employer against all or
part of such employer's loss in excess of at least fifty thousand
dollars from any one disaster or event arising out of the
employer's liability under this chapter, but no insurance
corporation shall, directly or indirectly, represent an employer
in the settlement, adjudication, determination, allowance, or
payment of claims. The superintendent of insurance shall enforce
this prohibition by such disciplinary orders directed against the
offending insurance corporation as the superintendent of
insurance
deems appropriate in the circumstances and the
administrator of
workers' compensation shall enforce this
prohibition by such
disciplinary orders directed against the
offending employer as the
administrator deems appropriate in the
circumstances, which orders
may include revocation of the
insurance corporation's right to
enter into indemnity contracts
and revocation of the employer's
status as a self-insuring
employer.
(2) The administrator may enter into a contract of
indemnity
with any such employer upon such terms, payment of such
premium,
and for such amount and form of indemnity as the
administrator
determines and the bureau of workers' compensation board of
directors may procure
reinsurance of the liability of the public
and private funds
under this chapter, or any part of the liability
in respect of
either or both of the funds, upon such terms and
premiums or
other payments from the fund or funds as the
administrator deems
prudent in the maintenance of a solvent fund
or funds from year
to year. When making the finding of fact which
the administrator
is required by section 4123.35 of the Revised
Code to make with
respect to the financial ability of an employer,
no contract of
indemnity, or the ability of the employer to
procure such a
contract, shall be considered as increasing the
financial ability
of the employer.
(C) Nothing in this section shall be construed to prohibit
the administrator or an other-states' insurer from providing to
employers in this state other-states' coverage in accordance with
section 4123.292 of the Revised Code.
(D) Notwithstanding any other section of the Revised Code,
but subject to division (A) of this section,
the superintendent
of insurance shall have the sole authority to
regulate any
insurance products, except for the bureau of workers' compensation
and those products offered by
the bureau, that indemnify or
insure
employers
against workers' compensation losses in this
state or
that are
sold to employers in this state.
SECTION 102. That existing sections 121.52, 4121.12,
4121.125, 4121.62, 4121.70, 4121.75, 4123.29, 4123.34, 4123.35,
and 4123.82 of the Revised Code are
hereby repealed.
SECTION 201. All items in Sections 201 and 203 of this act
are hereby
appropriated
out
of
any moneys
in the state treasury
to the credit
of the
designated
fund. For all
appropriations
made in this act,
those
in the
first
column are for fiscal year
2010, and those in
the
second
column
are for fiscal year 2011.
FND |
AI |
|
AI TITLE |
|
|
|
Appropriations |
BWC BUREAU OF WORKERS' COMPENSATION
Workers' Compensation Fund Group
7023 |
855401 |
|
William Green Lease Payments to OBA |
|
$ |
19,871,795 |
|
$ |
19,049,395 |
7023 |
855407 |
|
Claims, Risk and Medical Management |
|
$ |
138,129,873 |
|
$ |
142,659,528 |
7023 |
855408 |
|
Fraud Prevention |
|
$ |
12,546,239 |
|
$ |
13,101,761 |
7023 |
855409 |
|
Administrative Services |
|
$ |
124,674,772 |
|
$ |
120,192,995 |
7023 |
855410 |
|
Attorney General Payments |
|
$ |
4,621,850 |
|
$ |
4,621,850 |
8220 |
855606 |
|
Coal Workers' Fund |
|
$ |
91,894 |
|
$ |
91,894 |
8230 |
855608 |
|
Marine Industry |
|
$ |
53,952 |
|
$ |
53,952 |
8250 |
855605 |
|
Disabled Workers Relief Fund |
|
$ |
492,500 |
|
$ |
492,500 |
8260 |
855609 |
|
Safety and Hygiene Operating |
|
$ |
20,734,750 |
|
$ |
20,734,750 |
8260 |
855610 |
|
Gear Program |
|
$ |
4,000,000 |
|
$ |
4,000,000 |
8290 |
855604 |
|
Long Term Care Loan Program |
|
$ |
2,000,000 |
|
$ |
2,000,000 |
TOTAL WCF Workers' Compensation |
|
|
|
|
|
|
Fund Group |
|
$ |
327,217,625 |
|
$ |
326,998,625 |
Federal Special Revenue Fund Group
3490 |
855601 |
|
OSHA Enforcement |
|
$ |
1,604,140 |
|
$ |
1,604,140 |
TOTAL FED Federal Special Revenue Fund Group |
|
$ |
1,604,140 |
|
$ |
1,604,140 |
TOTAL ALL BUDGET FUND GROUPS |
|
$ |
328,821,765 |
|
$ |
328,602,765 |
WILLIAM GREEN LEASE PAYMENTS
The foregoing appropriation item 855401, William Green Lease
Payments to OBA,
shall be used for lease payments to the Ohio
Building Authority, and these
appropriations shall be used to meet
all payments at the times they are
required to be made during the
period from July 1, 2009, to June 30, 2011, by
the Bureau of
Workers' Compensation to the Ohio Building Authority pursuant to
leases and agreements made under Chapter 152. of the Revised Code
and Section
6 of Am. Sub. H.B. 743 of the 118th General Assembly.
Of the amounts received
in Fund 7023, appropriation item 855401,
William Green Lease Payments to OBA,
up to $38,921,190 shall be
restricted for lease rental payments to
the Ohio Building
Authority. If it is
determined that additional
appropriations are
necessary for such purpose, such
amounts are
hereby appropriated.
Notwithstanding any provision of law to the contrary,
all
tenants of the
William Green Building not funded by the
Workers'
Compensation Fund (Fund 7023)
shall pay their fair share
of the
costs of lease payments to the Workers'
Compensation Fund
(Fund
7023) by intrastate transfer voucher.
WORKERS' COMPENSATION FRAUD UNIT
The Workers' Compensation Section Fund (Fund 1950) that is
used by the Attorney General shall
receive payments from
the
Bureau of Workers' Compensation at the
beginning of each quarter
of each
fiscal year to fund expenses of
the Workers' Compensation
Fraud Unit of the
Attorney General's
Office. Of the foregoing
appropriation item 855410,
Attorney
General Payments, $828,200 in
fiscal year 2010 and $828,200 in
fiscal
year 2011 shall be used
to provide these payments.
SAFETY AND HYGIENE
Notwithstanding section 4121.37 of the Revised Code, the
Administrator of Workers' Compensation shall
transfer moneys from
the State Insurance
Fund so that
appropriation item 855609,
Safety
and Hygiene Operating, is
provided
$20,734,750 in fiscal
year 2010
and $20,734,750 in fiscal
year 2011.
OSHA ON-SITE CONSULTATION PROGRAM
The Bureau of Workers' Compensation may designate a portion
of appropriation item 855609, Safety and Hygiene Operating, to be
used to match federal funding for the federal Occupational Safety
and Health Administration's (OSHA) on-site consultation program.
VOCATIONAL REHABILITATION
The Bureau of Workers' Compensation and the Rehabilitation
Services Commission
shall enter into an interagency agreement for
the provision of vocational
rehabilitation services and staff to
mutually eligible clients. The bureau
shall provide $605,407 in
fiscal year 2010 and $605,407 in fiscal year 2011
from the State
Insurance Fund to
fund vocational rehabilitation services and
staff in accordance with the
interagency agreement.
FUND BALANCE
Any unencumbered cash balance in excess of $45,000,000 in the
Workers'
Compensation Fund (Fund 7023) on the thirtieth day of
June
of each fiscal year
shall be used to reduce the
administrative
cost rate charged to employers to
cover
appropriations for Bureau
of Workers' Compensation
operations.
SECTION 203. WCC WORKERS' COMPENSATION COUNCIL
5FV0 |
321600 |
|
Remuneration Expenses |
|
$ |
471,200 |
|
$ |
471,200 |
TOTAL 5FV0 Workers' Compensation Council Remuneration Fund
|
|
$ |
471,200 |
|
$ |
471,200 |
TOTAL ALL BUDGET FUND GROUPS |
|
$ |
471,200 |
|
$ |
471,200 |
WORKERS' COMPENSATION COUNCIL
The foregoing appropriation item 321600, Remuneration
Expenses, shall be used to pay the payroll and fringe benefit
costs for employees of the Workers' Compensation Council.
Between July 1, 2009, and December 31, 2009, the
Administrator of Workers' Compensation shall direct the Treasurer
of State to transfer $325,000 in cash from the Workers'
Compensation Fund (Fund 7023) to the Workers' Compensation Council
Fund, created in division (C) of section 4121.79 of the Revised
Code, in three installments. These transfers shall be made
according to a schedule agreed to by the Director of the Workers'
Compensation Council and the Administrator of Workers'
Compensation.
If the Workers' Compensation Council contracts with an
independent actuary to have that actuary perform an actuarial
valuation as described in division (A)(1) of Section 512.45 of Am.
Sub. H.B. 100 of the 127th General Assembly as amended by this
act, or a review as described in division (A)(2), (3), or (4) of
Section 512.45 of Am. Sub. H.B. 100 of the 127th General Assembly
as amended by this act, on or before January 31, 2011, the
Director of the Workers' Compensation Council shall request the
funds necessary to cover the expenses of the valuation or review,
which amount shall not exceed $650,000, from the Administrator of
Workers' Compensation. The Administrator shall direct the
Treasurer of State to transfer the amount requested by the
Director from the Workers' Compensation Fund (Fund 7023) to the
Workers' Compensation Council Fund created in division (C) of
section 4121.79 of the Revised Code. The Director and
Administrator shall agree to a schedule for the transfer of these
funds.
SECTION 211. DEPUTY INSPECTOR GENERAL FOR BWC AND OIC FUNDING
On July 1, 2009, January 1, 2010, July 1, 2010, and January
1, 2011 or as soon after each date as possible, the
Director of
Budget and Management shall transfer $212,500 in cash
from the
Workers' Compensation Fund (Fund 7023) to the Deputy
Inspector
General for the Bureau of Workers' Compensation and
Industrial
Commission Fund (Fund 5FT0). The amounts transferred
are
appropriated.
Should
additional amounts be necessary, the Inspector
General may
seek Controlling
Board approval for additional
transfers of cash and to increase the amount appropriated from
appropriation item 965604, Deputy Inspector General for the Bureau
of Workers' compensation and Industrial Commission, in the amount
of the additional transfers.
SECTION 215.01. That Section 512.45 of Am. Sub. H.B. 100 of
the 127th General Assembly be amended to read as follows:
Sec. 512.45. (A) The Workers' Compensation Council shall may
contract with an independent actuary to have that actuary perform
an any of the following work as the Council determines is
necessary:
(1) An actuarial valuation of the assets, liabilities, and
funding
requirements of the funds specified in Chapters 4121.,
4123.,
4127., and 4131. of the Revised Code. The;
(2) A review of a recent actuarial valuation performed
pursuant to division (C)(1) of section 4121.125 of the Revised
Code;
(3) A review of the study required by Section 512.50 of Am.
Sub. H.B. 100 of the 127th General Assembly;
(4) A review of any actuarial analysis of any of the funds
specified in Chapters 4121., 4123., 4127., and 4131. of the
Revised Code that is completed as required by the Auditor of
State.
(B) If the Council contracts with an actuary with whom the
Council contracts under pursuant to division (A)(1) of this
section, that actuary shall prepare a report of the
valuation
described in that division in accordance with the standards of
practice promulgated
by the Actuarial Standards Board of the
American Academy of
Actuaries and shall submit that report to the
Council. The actuary
shall include all of the following
information in the report:
(A)(1) A summary of the compensation and benefit provisions
evaluated;
(B)(2) A summary of the census data and financial information
used in the valuation;
(C)(3) A description of the actuarial assumptions, actuarial
cost method, and asset valuation method used in the valuation;
(D)(4) A summary of the findings that includes a statement of
the actuarial accrued compensation and benefit liabilities and
unfounded actuarial accrued compensation and benefit liabilities.
The (C) If the Council contracts with an actuary pursuant to
division (A)(2), (3), or (4) of this section, that actuary shall
prepare a report of the review in accordance with the standards of
practice promulgated by the Actuarial Standards Board of the
American Academy of Actuaries and shall submit that report to the
Council. The actuary shall include all of the following
information in the report:
(1) A summary of the valuation, study, or analysis the
actuary reviewed;
(2) The actuarial assumptions and methods and the data
underlying the valuation, study, or analysis, as appropriate;
(3) An assessment of the adequacy of each of the funds
specified in Chapters 4121., 4123., 4127., and 4131. of the
Revised Code that were evaluated to pay the claims authorized
under those chapters;
(4) A discussion of the reasonableness of the findings of
valuation, study, or analysis, and whether the valuation, study,
or analysis was performed in accordance with the actuarial
standards of practice promulgated by the Actuarial Standards Board
of the American Academy of Actuaries;
(5) A description of any additional studies the actuary
recommends to assist the Council in the performance of its duties.
(D) If the Council contracts with an actuary under this
section, the Council shall submit to the governor Governor and the
general
assembly General Assembly a report summarizing the
valuation required any report completed under this
section not
later than two years after the effective date of
section 4121.75
of the Revised Code, as enacted by this act September 10,2011.
SECTION 215.02. That existing Section 512.45 of Am. Sub. H.B.
100 of the 127th General Assembly is hereby repealed.
SECTION 217. All members serving on the Workers'
Compensation Council on the effective date of section 4121.75 of
the Revised Code as amended by this act shall serve the duration
of their terms as appointed. Upon the expiration of the terms of
the members serving on the Council on the effective date of
section 4121.75 of the Revised Code as amended by this act, new
appointments shall be made to the Council in accordance with
section 4121.75 of the Revised Code as amended by this act. The
President of the Senate shall make the initial appointment of the
member described in division (A)(7) of section 4121.75 of the
Revised Code as amended by this act, and thereafter the President
and the Speaker of the House shall alternate appointments as
described in division (A)(7) of section 4121.75 of the Revised
Code as amended by this act.
SECTION 219. The Speaker of the House of Representatives,
the President of the Senate, and the Governor shall make the
initial appointments of
the members of the Labor-Management
Government Advisory Council
described in divisions (A)(5), (6),
and (7) of section 4121.70 of the
Revised Code, as amended by
this act, within sixty days after the
effective date of section
4121.70 of the Revised Code, as amended
by this act. The members
appointed pursuant to this section shall
serve terms of six
years, as described in division (B) of section
4121.70 of the
Revised Code. Subsequent appointments of the
members described in
divisions (A)(5), (6), and (7) of section 4121.70
of the Revised
Code, as amended by this act, shall be made in
accordance with
section 4121.70 of the Revised Code, as amended by
this act.
SECTION 220. (A) For the policy year beginning July 1, 2009
and ending June 30, 2010, and thereafter until the Bureau of
Workers' Compensation completes the Bureau's transition to the
adoption of a split-experienced rating plan in conformity with the
current methodology of the National Council of Compensation
Insurance, the Bureau shall offer to an eligible construction
industry employer a construction industry cap on the employer's
experience modification as provided in this section.
(B) The Bureau shall establish the employer's experience
modifier at .99 for the policy year beginning July 1, 2009, and
ending June 30, 2010, unless the employer opts to not participate.
The Bureau shall adjust the premium rate calculation of a
participating employer by including an adjustment factor in the
calculation of the blended rate of the employer to establish a
blended rate that the employer would have paid as established by
using the initially calculated experience modifier.
(C) The construction industry cap is available to a
construction industry employer that satisfies all of the following
requirements:
(1) The employer's predominant premium for the policy year
beginning July 1, 2007, is in Industry Group 4, Construction, as
identified in Appendix A to section 4123-17-05 of the Ohio
Administrative Code.
(2) The employer had an experience modifier of less than or
equal to 1.0 in the preceding policy year.
(3) The experience modifier initially calculated for the
employer for the current policy year is greater than 1.0 and not
more than 1.5.
(4) The employer participates in a safety program approved by
the Bureau or by the Occupational Safety and Health Administration
during the policy year to improve accident prevention.
SECTION 221. Law contained in the Main Operating
Appropriations Act of the 128th General Assembly that applies
generally to the appropriations made in that act also applies
generally to the appropriations made in this act.
SECTION 301. The provisions of law contained in this act, and
their applications, are severable. If any provision of law
contained in this act, or if any application of any provision of
law contained in this act, is held invalid, the invalidity does
not affect other provisions of law contained in this act and their
applications that can be given effect without the invalid
provision or application.
SECTION 311. Except as otherwise provided in this act, the
amendment, enactment, or repeal by this act of a section of law is
exempt from the referendum because it is or relates to an
appropriation for current expenses within the meaning of Ohio
Constitution, Article II, Section 1d and section 1.471 of the
Revised Code and therefore takes effect immediately when this act
becomes law.
SECTION 313. The amendment, enactment, or repeal by this act
of the divisions and sections of law listed below are subject to
the referendum
under Ohio Constitution, Article II, Section 1c
and therefore
take effect on the ninety-first day after this act
is filed with
the Secretary of State.
The amendment by this act of divisions (A)(4)(g)
and (B) of
section 4123.29, division (B) of section 4123.34 and
sections
4121.12, 4121.125,
4121.62, 4121.70, and 4123.35 of the
Revised
Code.
|