reglab/statecodes huggingface dataset:
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-18 - Rehabilitation of Injured and Disabled Workers › Section 4123-18-14 - Injured workers suffering compensable injuries, occupational diseases or death while in an approved vocational rehabilitation plan

Current through all regulations passed and filed through July 1, 2024
(A)
			 Claims for injury, occupational disease or death incurred in the course of and
			 arising out of participation in an approved vocational rehabilitation plan may
			 be filed for compensation and benefits.
(B) The full or average weekly wage for the
			 rehabilitation injury, occupational disease, or death claim
			 
								will be
			 calculated using the full or average weekly wage information in the original
			 claim pursuant to which the injured worker undertook participation in the
			 prescribed rehabilitation program; provided, that if the statewide average
			 weekly wage in the year of the rehabilitation injury, occupational disease or
			 death is different from that applicable to the original claim, the injured
			 worker's full or average weekly wage 
								will be calculated using the original wage
			 information but subject to the maximum compensation rate in such subsequent
			 year.
(C) All compensation and
			 benefit awards arising out of such a claim 
								are charged to the surplus fund
			 account established by section
			 4123.34 of the Revised Code, and
			 not charged through the state insurance fund to the employer against which the
			 claim was allowed so long as the employer pays assessments into the surplus
			 fund account for the payment of such compensation and benefits. If an employer
			 is a self-insuring employer,  these compensation and benefits
			 are paid by the self-insuring employer directly
			 as a part of a claim.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-18 - Rehabilitation of Injured and Disabled Workers › Section 4123-18-16 - Self-insuring employer's obligation to provide vocational rehabilitation services

Current through all regulations passed and filed through July 1, 2024
(A)
			 Employers who provide compensation and benefits pursuant to section
			 4123.35 of the Revised Code
			 shall furnish all eligible and feasible injured workers with vocational
			 rehabilitation services equal to or greater in quality and content than the
			 services administered by the bureau and managed by the managed care
			 organizations (MCOs).
(B) Upon
			 referral, a self-insuring employer 
								will determine whether the injured worker is
			 eligible and feasible for vocational rehabilitation services using the criteria
			 set forth in rule
			 4123-18-03 of the Administrative
			 Code. If it is determined that the injured worker is eligible and feasible for
			 vocational rehabilitation services, the self-insuring employer shall provide
			 vocational rehabilitation case management services equal to or greater in
			 quality and content than the services administered by the bureau and managed by
			 the MCOs, utilizing the services of a provider who meets the minimum
			 credentialing criteria set forth in rule
			 4123-6-02.2 of the Administrative Code.
			 The self-insuring employer 
								will submit a copy of the approved vocational
			 rehabilitation plan to the injured worker and the injured worker's
			 representative.
(C) The bureau
			 
								will
			 inspect and review the quality and content of all authorized self-insuring
			 employers' vocational rehabilitation services in order to determine whether or
			 not such services are equal to or greater in quality and content than the
			 services administered by the bureau and managed by the MCOs. Such inspections
			 and reviews 
								will be conducted upon receipt of evidence indicating
			 that a self-insuring employer's vocational rehabilitation services are of a
			 lesser quality than the services administered by the bureau and managed by the
			 MCOs.
(D) The bureau may direct
			 complaints of sub-standard vocational rehabilitation programs to the bureau's
			 self-insured department for review.
(E) The self-insuring employer
			 
								will
			 promptly pay living maintenance, wages in lieu of compensation, or salary
			 continuation directly to the injured worker
								, in accordance
			 with  rule
			 4123-18-04 of the Administrative
			 Code.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-18 - Rehabilitation of Injured and Disabled Workers › Section 4123-18-21 - Wage loss payments to injured workers who complete rehabilitation plans

Current through all regulations passed and filed through July 1, 2024
(A)
			 For purposes of this rule:
(1) "Successful
			 return to work" as a result of an approved vocational rehabilitation plan means
			 that the injured worker has obtained employment no later than sixty days from
			 the date of closure of the injured worker's approved comprehensive vocational
			 rehabilitation plan or has retained employment following the closure of the
			 injured worker's job retention plan, and the employment:
(a) Is within the physical and/or psychiatric
			 limitations caused by the impairments resulting from the allowed conditions in
			 the claim in which the injured worker completed the comprehensive vocational
			 rehabilitation plan or job retention plan; and
(b) Is reasonable in comparison with the
			 return to work goals of the comprehensive vocational rehabilitation plan or job
			 retention plan completed by the injured worker.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-19 - General Procedures for State Insurance Fund; Self-Insuring Employers › Section 4123-19-01 - Definitions

Current through all regulations passed and filed through July 1, 2024
(A)
			 "Benefits" means medical, surgical, nursing, and hospital attention and
			 services and medicines, and funeral expenses as provided in sections
			 4123.52,
			 4123.55 to
			 4123.62, and
			 4123.64 to
			 4123.67 of the Revised
			 Code.
(B) "State
			 
								insurance
			 fund employer" are hereby defined as those employers who pay their full
			 premium into the state insurance fund.
(C) "Self-insuring 
								employers" are
			 hereby defined as those employers who 
								demonstrate sufficient financial
			 ability to carry their own insurance; who do not desire to insure the payment
			 thereof, except as provided in division (B) of section
			 4123.82 of the Revised Code; who
			 secure authority from the administrator  to pay compensation and benefits directly; who pay into
			 the state insurance fund an assessment as established by a rule of the bureau
			  adopted in
			 accordance with section
			 111.15 of the Revised Code; who
			 pay to the bureau a contribution to the self-insuring employers' guaranty fund
			 pursuant to section 4123.351 of the Revised Code;
			 and who provide an additional security, where required by the bureau, in the
			 amount or form that may be specified by the bureau.
(D) "Self-insurance" is a privilege granted
			 or denied by the administrator. Once granted the privilege of self-insurance,
			 the employer determines the first level of a claim and must have employees with
			 a working knowledge of current Ohio workers' compensation law and all rules and
			 regulations of the bureau and the industrial commission. A self-insuring
			 employer may, without any prior order from the industrial commission or the bureau, grant or refuse to grant any claim made
			 under the Ohio Workers' Compensation Act. In granting a claim or awarding
			 payment of compensation or benefits, the employer may provide to its employees
			 compensation or benefits that are greater than those required by law. The
			 employer may not pay compensation or benefits less than that which is required
			 by law.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-19 - General Procedures for State Insurance Fund; Self-Insuring Employers › Section 4123-19-03 - Where an employer desires to secure the privilege to pay compensation and benefits directly

Current through all regulations passed and filed through July 1, 2024
(A)
			 All employers granted the privilege to pay compensation and benefits directly
			 shall demonstrate sufficient financial strength and administrative ability to
			 assure that all obligations under section
			 4123.35 of the Revised Code will
			 be met promptly. The administrator of workers' compensation shall deny the
			 privilege to pay compensation and benefits directly, where the employer is
			 unable to demonstrate its ability to promptly meet all the obligations under
			 the rules of the industrial commission and the bureau and section
			 4123.35 of the Revised Code. The
			 administrator of workers' compensation shall consider, but shall not be limited
			 to the factors in divisions (B)(1) and (B)(2) of section
			 4123.35 of the Revised Code
			 where they are applicable in determining the employer's ability to meet all
			 obligations under section
			 4123.35 of the Revised Code.
The administrator of workers' compensation shall review all
				financial records, documents, and data necessary to provide a full financial
				disclosure of the employer, including but not limited to, the balance sheets
				and a profit and loss history for the current year and the previous four years.
				The administrator of workers' compensation shall consider whether the employer
				has demonstrated the financial ability to pay any and all claims obligations.
				Unless an applicant obtains waiver under paragraph (D) of rule
				4123-19-03.1 of the
				Administrative Code, financial records submitted to the bureau must be audited
				by a certified public accountant, in accordance with generally accepted
				accounting principles, and shall include the certified public accountant's
				audit opinion.
(1) The administrator
			 of workers' compensation may waive certain requirements of divisions (B)(1) and
			 (B)(2) of section 4123.35 of the Revised Code
			 pursuant to rule
			 4123-19-03.1 of the
			 Administrative Code.
(2) The
			 administrator of workers' compensation 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, including its hospitals.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-19 - General Procedures for State Insurance Fund; Self-Insuring Employers › Section 4123-19-03.1 - Waiver of certain requirements

Current through all regulations passed and filed through July 1, 2024
(A) Definitions.
As used in this rule:
(1) "Applicant" means an employer who is
			 applying for the privilege to pay compensation directly pursuant to section
			 4123.35 of the Revised
			 Code.
(2) "Certified financial
			 statements" means financial statements that have been audited by a certified
			 public accountant, in accordance with generally accepted accounting principles,
			 and include the certified public accountant's audit opinion.
(3) "Reviewed financial statements" means
			 financial statements that have been subject to procedures performed by a
			 certified public accountant in accordance with the statements on standards for
			 accounting and review services as contained in the professional standards
			 promulgated by the American institute of certified public accountants and in
			 effect on the date of the applicant's application for the privilege to pay
			 compensation directly. Such statements must include full footnote disclosure,
			 prepared and submitted in accordance with generally accepted accounting
			 principles.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-19 - General Procedures for State Insurance Fund; Self-Insuring Employers › Section 4123-19-09 - In regard to complaints filed against self-insuring employers under the provisions of section 4123.35 of the Revised Code

Current through all regulations passed and filed through July 1, 2024
(A)
			 The bureau  shall
			 receive all complaints, regardless of the source,
			 concerning any employer engaged in paying compensation and benefits directly to
			 its employees. The bureau shall transfer to the self-insuring employers
			 evaluation board only those complaints which are not resolved. An employer
			 shall respond in writing to a complaint within fourteen days of receipt
			 thereof, and the employer's response shall be made a part of the complaint
			 file. Failure of an employer to timely respond in
			 writing to the complaint within fourteen days may result in a valid complaint
			 determination.
(B) The
			 administrator 
			 shall investigate and process all complaints against a self-insuring employer
			 through the bureau's self-insured department. The
			 self-insured department may address any violations by a self-insuring employer
			 that are discovered during the course of the investigation of a complaint,
			 regardless if the violation is initially reported. However, the bureau
			 may dismiss a complaint based upon the employer's action or lack of action with
			 respect to events that occurred more than two years prior to the filing of the
			 complaint, unless the facts could not have been reasonably known to the
			 claimant.
(C) The bureau shall
			 maintain a file  of all
			 complaints that relate to the employer, together with any information filed by
			 the employer as to such complaints. A copy of all complaints shall become a
			 part of the self-insuring employer's 
			 file and shall be available at the time of renewal consideration. The bureau
			 shall evaluate each complaint and take appropriate action as follows:
(1) If the bureau records for such employee
			 does not contain full information as to the matter which is the subject of the
			 complaint, the bureau may attempt to obtain such information by correspondence
			 with the self-insuring employer, the claimant, and their authorized
			 representatives, if any.
(2) The
			 bureau may also audit the program of the employer in the manner provided in
			 section 4123.35 of the Revised
			 Code.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-19 - General Procedures for State Insurance Fund; Self-Insuring Employers › Section 4123-19-10 - In regard to audits by the bureau

Current through all regulations passed and filed through July 1, 2024
(A)
			 The bureau  shall
			 audit the programs of employers who elect to pay compensation directly in the
			 following situations:
(1)
									
									On a random basis;
(2)
									
									Whenever the bureau has grounds for believing that an
			 employer is not in full compliance with the rules of the
			 industrial commission 
									or the bureau or
			 the provisions of Chapter 4123. of the Revised Code;
(3) Upon request from the self-insured review
			 panel or the self-insuring employers evaluation board.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-19 - General Procedures for State Insurance Fund; Self-Insuring Employers › Section 4123-19-11 - Fixing time limits beyond which the failure of a self-insuring employer to provide for the necessary medical examinations and evaluations may not delay a decision on a claim

Current through all regulations passed and filed through July 1, 2024
(A)
			 When a self-insuring employer has provided or arranged for a necessary medical
			 examination or evaluation, in accordance with paragraph (A) of rule
			 4121-03-09 of the Administrative
			 Code,
								
								the self-insuring employer shall promptly notify
			 the industrial commission
			 
								of such action.
(B) Failure of a self-insuring employer to
			 provide for or arrange for the scheduling of such necessary medical
			 examinations and evaluations within the period of fifteen days from the
			 notification shall not delay a decision in the
			 claim.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-19 - General Procedures for State Insurance Fund; Self-Insuring Employers › Section 4123-19-12 - Grounds for holding public hearings to evaluate the program for self-insuring employers

Current through all regulations passed and filed through July 1, 2024
The administrator  shall hold a public hearing to evaluate the program for
				self-insuring employers in the following situations:
(A) If there has been a substantial amendment
			 of the statutes relating to self-insuring employers;
(B) If decisions are rendered by the supreme
			 court of Ohio which materially change the interpretation of such statutes or
			 invalidate material portions of the rules of the industrial commission or the
			 bureau ;
			 or
(C) If there is substantial evidence that the
			 self-insuring employers are not complying with the laws of the state of
			 Ohio
								or the
			 rules and procedures of the bureau 
								or the industrial
			 commission.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-19 - General Procedures for State Insurance Fund; Self-Insuring Employers › Section 4123-19-13 - Self-insuring employers evaluation board

Current through all regulations passed and filed through July 1, 2024
(A)
			 Section 4123.352 of the Revised Code
			 establishes a self-insuring employers evaluation board. The board shall consist
			 of three members:
(1) The member of the
			 industrial commission representing the public , serving ex officio, as
			 chairman.
(2) A member of the
			 
									Ohio self-insurers association appointed by the
			 governor with the advice and consent of the senate.
(3) A member of labor
			  appointed by the governor with the
			 advice and consent of the senate.
(4) Not more than two of the members shall be
			 of the same political party.
(5)
			 For purposes of administration, the board shall be part of the bureau
			 . The bureau shall
			 furnish the necessary office space, staff, and supplies. The board shall meet
			 as the board determines or as requested by the bureau.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-19 - General Procedures for State Insurance Fund; Self-Insuring Employers › Section 4123-19-16 - Self-insured construction projects

Current through all regulations passed and filed through July 1, 2024
(A)
			 As used in this rule:
(1) "Responsible
			 self-insuring employer" or "responsible employer" means the selfinsuring
			 employer or the public school employer that enters into a construction contract
			 and applies for permission to self-insure the construction contract. The
			 responsible employer is the entity responsible for the cost of the construction
			 project and generally will be the owner of the project. The responsible
			 employer is the payor under the contract. "Responsible self-insuring employer"
			 or "responsible employer" may include a self-insuring general contractor or
			 construction manager whose principal source of business is the execution of
			 construction projects.
(2) "Public
			 school employer" means an employer defined in division (R) of section
			 4123.35 of the Revised Code that
			 enters into a construction contract exceeding twenty five million dollars and
			 applies for permission to self-insure the construction contract, whether or not
			 the employer is a self-insuring employer.
(3) "General contractor" means a
			 self-insuring employer that has entered into a contract with an owner to
			 perform more than fifty per cent, by value, of the work on a construction
			 project.
(4) "Construction manager"
			 means a self-insuring employer that has entered into a contract with an owner
			 to provide substantially the same services described in division (A) of section
			 9.33 of the Revised Code in
			 connection with a construction project. Regardless of any contrary terms of
			 section 9.33 of the Revised Code, for
			 purposes of this rule, the term "construction manager" is not limited to public
			 projects and may apply even if the construction manager also performs
			 construction work on the project.
(5) "Contracting employer" or "subcontracting
			 employer" means any employer, whether state fund or self-insured, that has
			 contracted either directly with a responsible self-insuring employer or with a
			 contracting or subcontracting employer to perform construction services on the
			 construction project. The contracting employer is the payee under the contract,
			 except for where the contracting employer has subcontracted with another
			 contracting employer.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-20 - Marine Industry Fund › Section 4123-20-01 - Application for subscription to the marine industry fund

Current through all regulations passed and filed through July 1, 2024
(A) Any employer
			 doing business in the state of Ohio and having, by reason of operations within
			 the territorial boundaries of this state, exposure to liability under the
			 "United States Longshoremen's and Harbor Workers' Compensation Act,"
			 33
			 U.S.C. section 901 et seq., may make
			 application to the marine industry fund created by section
			 4131.13 of the Revised Code.
(B) An employer wishing to
			 subscribe to the marine industry fund shall complete an application for
			 subscription, which shall be provided by the bureau of workers' compensation.
			 No disposition shall be made of any such application until the same is
			 complete, and no such application shall be deemed complete until all
			 information requested by the bureau in connection therewith is supplied. The
			 bureau shall have the right to make reasonable inspections of an applicant's
			 place of business, and of any records which may be pertinent to such
			 applicant's application for subscription at any time prior to reaching a
			 decision regarding an application for subscription.
(C) In determining whether to accept or
			 reject an application for subscription to the marine industry fund, the
			 administrator of workers' compensation shall consider the following criteria,
			 which are set out by way of illustration and not by way of limitation:
(1) The applicant's history with respect to
			 Ohio workers' compensation, including compliance with applicable laws and
			 rules, payment of premiums and assessments, safety record, and experience
			 ratings; and
(2) The applicant's
			 history with respect to Longshoremen's Act insurance, including the names of
			 prior carriers, record of payment of premiums, record of cooperation with
			 carriers in the processing of claims, safety record, and experience rating.
The administrator has the authority, in the administrator's
				discretion, to accept or reject an application for subscription to the marine
				industry fund. The decision of the administrator shall be final.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-20 - Marine Industry Fund › Section 4123-20-02 - Subscription to the marine industry fund

Current through all regulations passed and filed through July 1, 2024
(A) An employer whose application for
			 subscription to the marine industry fund has been approved by the administrator
			 of workers' compensation as provided in rule
			 4123-20-01
			 of the Administrative Code shall be issued a marine industry fund insurance
			 policy upon payment of the initial premium required for such policy.
(B) Coverage under a marine industry fund
			 insurance policy shall not be effective until the initial
			 prepaid premium is received by the bureau of
			 workers' compensation.
(C) Any policy
			 of insurance issued by the marine industry fund shall expire at midnight on the
			 expiration date stated on the face of such policy. Beginning July 1, 2012, that date shall be either the last
			 day of February or August thirty-first. Any such policy may be renewed by
			 payment of the renewal premium. Payment of a renewal premium
			 
								prior to the stated expiration date shall be
			 effective to continue the coverage of the insured without lapse.
(D) Payment of a renewal premium
			  after the
			 expiration date shall be ineffective to continue the coverage of the insured
			 employer without lapse. If an insured employer tenders payment of a renewal
			 premium  after the
			 stated expiration date, the administrator may, in the administrator's
			 discretion, reinstate the coverage of such employer as of the date of receipt
			 of payment or require the employer to submit a new application for subscription
			 to the marine industry fund. In no event shall retroactive coverage be granted
			 with respect to any period when the coverage of an insured employer has lapsed.
Five Year Review (FYR) Dates:
				03/27/2017 and
				03/01/2022
Promulgated
				Under: 119.03
Statutory
				Authority: 4121.12,
				4121.121
Rule
				Amplifies: 4131.13,
				4131.14
Prior
				Effective Dates: 3/23/81, 12/18/89 (Emer.), 2/22/90,
				7/5/12
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-20 - Marine Industry Fund › Section 4123-20-03 - Premium payment

Current through all regulations passed and filed through July 1, 2024
(A) Except as otherwise provided in this
			 rule, premiums for marine industry fund insurance coverage shall be payable in
			 advance, in semiannual installments, at a rate determined by the administrator
			 of workers' compensation, subject to the approval of the bureau of workers'
			 compensation board of directors. The amount of prepaid premium for any
			 six-month period shall be determined by applying the rates and manuals in use
			 by the marine industry fund for such period to the estimated payroll of the
			 insured for a period of eight months.
(B) The initial premium required for the
			 issuance of a new marine industry fund insurance policy shall be a sum equal to
			 the estimated premium obligation for a period of eight months. Payment of the
			 initial premium shall secure to the insured coverage for
			 
								the remainder of
			 the six month period 
			 from the date of issuance of the policy plus a two
			 month adjustment period.
(C)
								
								Beginning
			 July 1, 2012, renewal premiums shall be due and payable
			 
								no later than August thirty-first (for the January first to
			 June thirtieth period) and the last day of February (for the July first to
			 December thirty-first period) . The premium required to renew a marine
			 industry fund insurance policy shall be the prepaid premium for the next
			 renewal period, determined in accordance with the provisions of paragraph (A)
			 of this rule.
(D) All prepaid
			 premiums shall be subject to adjustment at or after the close of the period
			 with respect to which such prepaid premium was submitted. Adjustments shall be
			 based on the employer's report of his actual payroll for the period, or upon
			 audit findings reported by the authorized agents of the marine industry fund.
			 In the event that adjustment of the prepaid premium reveals that the insured
			 has overpaid his premium for the period being adjusted, the insured shall be
			 entitled to reduce his renewal premium by the amount of such overpayment, or the insured shall be entitled to a refund. Should
			 the adjustment reveal that the prepaid premium was less than the premium
			 obligation based on actual payroll for the period being adjusted, the
			 additional premium found to be owing shall be added to the renewal premium, or
			 shall be billed to the employer.
Five Year Review (FYR) Dates:
				03/27/2017 and
				03/01/2022
Promulgated
				Under: 119.03
Statutory
				Authority: 4121.12,
				4121.121
Rule
				Amplifies: 4131.13,
				4131.14
Prior
				Effective Dates: 3/23/81, 12/18/89 (Emer.), 2/22/90,
				7/5/12
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-20 - Marine Industry Fund › Section 4123-20-04 - Payroll reporting

Current through all regulations passed and filed through July 1, 2024
(A) All employers insured by the marine
			 industry fund shall, at such intervals as may be required by the fund, submit
			 payroll reports showing the number of persons employed in occupations covered
			 by the marine industry fund insurance policy and the total payroll allocable to
			 each manual classification in use by the marine industry fund and applicable to
			 the insured.
(B)
								
								In July and January of
			 each year, the marine industry fund shall mail the insured a report form.
			 The insured shall return such form, together with any adjustment premiums and
			 renewal premiums then due, to the fund 
								no later than August thirty-first and not later than the
			 last day of February, for the respective payroll periods. Such report
			 shall include a statement of the insured's actual payroll allocable to each
			 appropriate manual classification for the prior six months, and an estimate of
			 the insured's anticipated payroll for the ensuing eight months, and such other
			 information as shall be required by the fund.
(C) The payroll reports provided for in
			 paragraph (B) of this rule shall be used as the basis for adjustment of
			 premiums paid for the prior period, and for determination of the prepaid
			 premium for the ensuing period. No provision of this rule shall be construed to
			 limit in any way the right of the fund to audit the payroll records of the
			 insured or to make adjustments based on the findings of such audits.
(D) In the event that the actual payroll for
			 any six-month reporting period is greater than ninety per cent of the
			 eight-month estimated payroll, the insured employer shall be subject to a
			 penalty in the sum of ten per cent of the total premium due for such six-month
			 period. The penalty provided for herein shall not apply, if the insured
			 employer shall promptly notify the marine industry fund of any increase in
			 payroll expenditures beyond the level of previously reported estimated payroll,
			 and submit payment of additional premium to cover such increased payroll, prior
			 to the end of the six-month reporting period.
(E)
								 Pursuant to
			 section 4131.14 of the Revised Code, for
			 all payroll periods beginning July 1, 2012, if the employer estimates no
			 payroll or calculates estimated premium of less than the minimum administrative
			 charge for the reporting period, the employer shall pay a minimum annual
			 non-refundable administrative charge at a rate of fifty dollars each six months
			 or one hundred dollars annually.
Five Year Review (FYR) Dates:
				03/27/2017 and
				03/01/2022
Promulgated
				Under: 119.03
Statutory
				Authority: 4121.12,
				4121.121
Rule
				Amplifies: 4131.13,
				4131.14
Prior
				Effective Dates: 3/23/81, 12/18/89 (Emer.), 2/22/90,
				7/5/12
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-20 - Marine Industry Fund › Section 4123-20-05 - Payroll to be reported

Current through all regulations passed and filed through July 1, 2024
(A) When completing the payroll reports
			 required pursuant to rule
			 4123-20-04 of
			 the Administrative Code, an insured shall report to the marine industry fund
			 all remuneration earned by such employees of the insured as engaged in
			 activities constituting "maritime employment" within the meaning of the
			 "Longshoremen's and Harbor Workers' Compensation Act,"
			 but limited to employees whose maritime employment is
			 within the territorial boundaries of the state of Ohio, and employees employed
			 to work in Ohio who, in the course of and incidental to their employment within
			 the state of Ohio, temporarily leave the state. As used in this rule the
			 term "remuneration" means all compensation for personal services paid under a
			 contract of hire, oral or written, express or implied. "Remuneration" shall
			 include, but shall not be limited to salaries or hourly wages paid by cash or
			 check.
(B) In the case of an
			 employee who spends some time performing duties in "maritime employment" and
			 some time performing duties of a non-maritime nature, only the remuneration of
			 such employee's maritime employment shall be reported to the marine industry
			 fund for premium purposes.
(C) The
			 entire remuneration of officers of a corporation shall be reported to the
			 marine industry fund. In the case of a corporate officer who is a shareholder
			 of the insured, the payment of a bona fide dividend on the shares owned by such
			 officer shall not be deemed to constitute remuneration for purposes of this
			 rule, nor shall any other payment made to such officer solely on account of his
			 ownership of shares of the insured.
(D) A sole proprietor shall not be considered
			 to be an employee of the enterprise, and the remuneration of a sole proprietor
			 shall not be reported to the marine industry fund. This provision shall not be
			 construed so as to relieve a sole proprietor from the obligation to report the
			 remuneration earned by his employees.
(E) The remuneration of partners shall be
			 reported to the marine industry fund. This provision shall not be construed so
			 as to relieve a partnership from the obligation to report the remuneration
			 earned by employees of the partnership.
(F) The remuneration of employees whose
			 duties are exclusively of a non-maritime character or
			 whose maritime activities occur entirely on waterways outside the territorial
			 boundaries of Ohio, shall not be reported to the marine industry
			 fund.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-20 - Marine Industry Fund › Section 4123-20-06 - Audits and inspections

Current through all regulations passed and filed through July 1, 2024
(A) At any time during the term of any marine
			 industry fund insurance policy, and for a period of two years after the
			 termination of any such policy, the marine industry fund or its authorized
			 agents shall have the right to make reasonable inspections of the insured's
			 place of business, and any records, payrolls, books of account, ledgers, or
			 contracts which reflect upon the payroll expenditures of the insured, or the
			 allocation of such payroll expenditures to the appropriate manual
			 classifications.
(B) Refusal on
			 the part of the insured to permit reasonable audits and inspections, or willful
			 interference by the insured with the authorized agents of the marine industry
			 fund carrying out any audit or inspection, shall be sufficient reason for
			 cancellation of the marine industry fund coverage of the insured.
(C) If the findings of any audit or
			 inspection reveal a discrepancy in the amount of premium paid by the insured
			 for any period, the fund shall have the right to adjust the account of the
			 insured in accordance with the audit findings.
Five Year Review (FYR) Dates:
				03/27/2017 and
				03/01/2022
Promulgated
				Under: 119.03
Statutory
				Authority: 4121.12,
				4121.121
Rule
				Amplifies: 4131.13,
				4131.14
Prior
				Effective Dates: 3/23/81, 12/18/89 (Emer.),
				2/22/90
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-20 - Marine Industry Fund › Section 4123-20-07 - Controversion of claims

Current through all regulations passed and filed through July 1, 2024
(A) The marine industry fund is authorized
			 under regulations promulgated by the United States department of labor to act
			 as an insurance carrier with respect to liabilities created by the provisions
			 of the "Longshoremen's and Harbor Workers' Compensation Act." The marine
			 industry fund, in such capacity, is recognized under applicable provisions of
			 the governing federal law and regulations, as a party in interest to all
			 proceedings regarding claims filed against employers insured by the fund.
(B) All notices of injury received
			 from employers insured by the marine industry fund, and all notices of claims
			 received from the department of labor shall be promptly reviewed by the marine
			 industry fund. The administrator of workers' compensation or the
			 administrator's designee shall be authorized to file notices of controversion
			 in the name of the marine industry fund, in all cases wherein such action is
			 warranted by the facts of the case or the law applicable to such facts. In the
			 event that a notice of controversion is filed, the administrator or designee is
			 authorized to represent, or cause to be represented, the interest of the marine
			 industry fund in all proceedings pertinent to a controverted claim.
Five Year Review (FYR) Dates:
				03/27/2017 and
				03/01/2022
Promulgated
				Under: 119.03
Statutory
				Authority: 4121.12,
				4121.121
Rule
				Amplifies: 4131.13,
				4131.14
Prior
				Effective Dates: 3/23/81, 12/18/89 (Emer.),
				2/22/90
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-21 - Coal-Workers' Pneumoconiosis Fund › Section 4123-21-01 - Procedures for subscription to the coal-workers' pneumoconiosis fund

Current through all regulations passed and filed through July 1, 2024
(A) As used in
			 sections 4131.01 to
			 4131.06 of the Revised Code,
			 "operator" and "operator of a coal mine" have the same meaning as "operator" as
			 defined in the "Federal Coal Mine Health and Safety Act of 1969," 83 Stat. 742,
			 30 U.S.C.
			 801 et seq., as now or hereafter amended, and
			 as implemented by the regulations of the secretary of labor under Title IV of
			 the act, who, by reason of operations within the territorial boundaries of Ohio
			 is amenable to Title IV of the act, including claims reviewed and allowed under
			 30 U.S.C.
			 945. Any operator as herein defined may elect
			 to become a subscriber as defined in division (D) of section
			 4131.01 of the Revised Code by
			 applying for coverage and paying the premiums 
								specified in
			 this chapter.
(B) An employer
			 wishing to subscribe to the coal-workers' pneumoconiosis fund shall complete an
			 application for subscription, which shall be provided by the bureau of workers'
			 compensation. No disposition 
								will be made of any such application until the
			 same is complete, and no such application 
								will be deemed
			 complete until all information requested by the bureau in connection therewith
			 is supplied. On reasonable advance notice, the applicant shall provide the
			 bureau with access to all records pertinent to the application for
			 subscription. The administrator of workers' compensation has the authority to
			 accept or reject an application for subscription to the coal-workers'
			 pneumoconiosis fund.
(C) Employers
			 who are active subscribers to the coal-workers' pneumoconiosis fund on the date
			 of adoption of these rules 
								will not have to reapply for
			 coverage. However, renewal of the subscription to the fund thereafter shall be
			 deemed acceptance of the terms, conditions and duties contained in Chapter
			 4123-21 of the Administrative Code.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-21 - Coal-Workers' Pneumoconiosis Fund › Section 4123-21-02 - Determination of coverage

Current through all regulations passed and filed through July 1, 2024
(A) An employer whose application for
			 subscription to the coal-workers' pneumoconiosis fund has been approved by the
			 administrator of workers' compensation 
								will be issued
			 a coal-workers' pneumoconiosis fund insurance policy upon payment of the
			 initial premium required for such policy.
(B) Coverage under a coal-workers'
			 pneumoconiosis fund insurance policy 
								is not 
			 effective until the initial premium is received by the bureau of workers'
			 compensation or its designee.
(C)
			 Any policy of insurance issued by the coal-workers' pneumoconiosis fund
			 
								expires at midnight on the expiration date stated on
			 the face of the policy. Any such policy may be renewed by payment of the
			 renewal premium. Payment of renewal premium in accordance with rule
			 4123-21-03 of the Administrative
			 Code 
								will be effective to continue the coverage of the
			 insured.
(D) Coverage with respect
			 to claims filed on or after the effective date of this rule will be afforded in
			 claims where the claimant's last exposure to the conditions causing the disease
			 occurs both while in the employment of the subscriber and during a period of
			 active subscription to the coal-workers' pneumoconiosis fund.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-21 - Coal-Workers' Pneumoconiosis Fund › Section 4123-21-03 - Premium payment

Current through all regulations passed and filed through July 1, 2024
(A) When the initial application for coverage
			 is received and accepted, the applicant 
								will be billed
			 initial premium based upon its estimated gross annual payroll
			 
								provided by the employer on its application for
			 subscription. Premiums for coal workers' pneumoconiosis insurance
			 coverage 
								are payable in annual installments. An employer whose
			 premiums are above the minimum administrative charge may change to semi-annual
			 installments upon request. An employer must make the request no later than
			 April first preceding the policy year.
(B) The initial premium required for issuance
			 of a new coal-workers' pneumoconiosis fund insurance policy
			 
								will be
			 an advance deposit sufficient to cover premiums for a twelve-month period, unless semi-annual installments
			 were selected. If an employer elects semi-annual installments, the premium
			 required for issuance 
								will be an advance deposit equal to one-half of
			 the premium for a twelve-month period.
(C) Annual renewal premiums
			 
								are
			 due and payable no later than April thirtieth of each year. Semi-annual
			 installment renewal premiums 
								are due and payable by April thirtieth and
			 October thirty-first of each year. Where applicable, the coal workers'
			 pneumoconiosis fund 
								will provide the notice of impending cancellation
			 required by paragraph (B) of rule
			 4123-21-07 of the Administrative
			 Code on or before May twenty-sixth of each year, for annual installments and on
			 or before November twenty-sixth where an employer fails to make its semi-annual
			 installment payment. The premium required for renewal for the next annual
			 period 
								will be determined in accordance with the provisions
			 of paragraphs (A) and (B) of this rule. However, the administrator of workers'
			 compensation, subject to the approval of the bureau of workers' compensation
			 board of directors, may by rule establish a minimum annual premium, payment of
			 which 
								is a condition to continuation of coverage.
(D)
			 Upon cancellation of coverage other than by default, any premiums due through
			 the date of cancellation 
								will be deducted from the advance premium deposit
			 and the balance 
								will be refunded to the former
			 subscriber.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-21 - Coal-Workers' Pneumoconiosis Fund › Section 4123-21-04 - Notice of estimated premium, payroll reporting and reconciliation of premium due

Current through all regulations passed and filed through July 1, 2024
(A)
			 The bureau 
								will provide employers a notice of estimated premium
			 due no later than March first preceding the policy year
			 . BWC will estimate annual premium based on payroll from the most
			 recently completed policy year.
The notice 
									includes all the following:
(1) The estimated payroll used by the coal
			 workers' pneumoconiosis fund to calculate the employer's estimated premium
			 due;
(2) The manual
			 classification(s) in use by the coal workers' pneumoconiosis fund in which the
			 employer's payroll is segregated and the base rates for each of the manual
			 classifications identified;
(3) The
			 employer's estimated premium due for the applicable policy year.
The employer may revise the estimated payroll amount used to
				calculate estimated premium due for the policy year for good cause shown, as
				determined by bureau policy specific to the coal workers pneumoconiosis fund.
				Requests will not be accepted to revise payroll after April first preceding the
				policy year.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-21 - Coal-Workers' Pneumoconiosis Fund › Section 4123-21-05 - Audit and inspections

Current through all regulations passed and filed through July 1, 2024
(A) At any time during the term of any
			 coal-workers' pneumoconiosis fund insurance policy, and for a period of two
			 years after the termination of any such policy, the bureau of workers'
			 compensation 
								has the right to make reasonable inspections of
			 any records, payrolls, books of account, ledgers or contracts which reflect
			 upon the payroll expenditures of the insured, or the allocation of such payroll
			 expenditures to the appropriate manual classifications.
(B) Refusal on the part of the insured to
			 permit reasonable audits, or willful interference by the insured with the
			 bureau carrying out any audit or inspection, 
								is sufficient reason for cancellation
			 of the coal-workers' pneumoconiosis fund coverage of the insured.
(C) If any audit or inspection reveals a
			 discrepancy in the amount of premium paid by the insured for any period, the
			 bureau 
								will adjust the account of the insured in accordance
			 with the audit findings.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-21 - Coal-Workers' Pneumoconiosis Fund › Section 4123-21-06 - Default, retroactive coverage

Current through all regulations passed and filed through July 1, 2024
(A) Payment of a renewal premium received
			 after the expiration date 
								is ineffective to continue the coverage of the
			 insured employer.
(B) The
			 administrator of workers' compensation may, upon request, and for good cause
			 shown:
(1) Approve the original black lung
			 coverage to take effect retroactively, upon payment of past due premiums,
			 interest thereon, and such other terms, conditions or exclusions as the
			 administrator may find appropriate; or
(2) Approve retroactive coverage for
			 cancelled periods, upon payment of past due premiums, interest thereon, and
			 with such other terms, conditions, or exclusions as the administrator may find
			 appropriate.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-21 - Coal-Workers' Pneumoconiosis Fund › Section 4123-21-07 - Effect of cancelled subscription

Current through all regulations passed and filed through July 1, 2024
(A) No coverage will be extended to an
			 operator whose subscription has been cancelled, except:
(1) In the case of a successor operator who
			 immediately applies for coverage effective the day following cancellation of
			 the prior operator's coverage pursuant to rule
			 4123-21-01 of the Administrative
			 Code, and
(2) In the case described
			 in paragraph (D) of rule
			 4123-21-02 of the Administrative
			 Code.