reglab/statecodes huggingface dataset:
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-44 - Minimum retrospective premium

Current through all regulations passed and filed through July 1, 2024
(A) The minimum annual premium due shall not
			 be less than the minimum experiencerated premium threshold times the minimum
			 premium percentage for the employer's hazard group, claim limit, and maximum
			 premium percentage for the applicable policy year. The premium will be subject
			 to the premium sized adjustment described in rule 4123-17-03.3 of the
			 Administrative Code.
(B) If
			 estimated experience-rated premium is greater than or equal to the minimum
			 experience-rated premium threshold listed on the employer's retrospective rating minimum
			 premium percentages table, contained in the appendices to rule
			 4123-17-53
			 of the Administrative Code, but actual experience-rated premium is less
			 than the minimum experience-rated premium threshold listed, the minimum premium
			 due is the minimum experience-rated premium threshold times the minimum premium
			 percentage for the employer's hazard group, claim limit, and maximum premium
			 percentage.
(C) The minimum annual
			 premium is due and payable even if the employer has no claims costs during the
			 evaluation period for the applicable policy year.
(D) The minimum premium will be recalculated
			 at the time the employer submits actual payroll pursuant to rule
			 4123-17-14
			 of the Administrative Code.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-45 - Initial computation

Current through all regulations passed and filed through July 1, 2024
(A) The hazard group for an employer shall be
			 determined as follows:
(1)
									The employer's
			 experience-rated premium is totaled for each hazard group for the most recently
			 completed policy year. The employer's hazard group is the group with the
			 highest percentage of premium for the recently completed policy
			 year;
(2)
									For an employer new to Ohio without a reported payroll,
			 the hazard group is based on the employer's application for workers'
			 compensation coverage;
(3)
									Hazard groups are defined as follows:
(a)
										For private
			 employers, appendix C to rule
			 4123-17-72 of the
			 Administrative Code; and
(b)
										For public employer taxing districts, appendix E to
			 rule
			 4123-17-72 of the
			 Administrative Code.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-46 - Premium adjustments

Current through all regulations passed and filed through July 1, 2024
(A) Upon completion of a policy year and
			 annually throughout the evaluation period, the employer's aggregate
			 retrospective-rated premium for the policy year will be determined based on the
			 incurred losses and on the audited payrolls of the employer. The bureau shall
			 annually send the employer an annual evaluation within approximately four
			 months following the end of the policy year.
(B) Incurred losses will be based on
			 compensation payments and medical payments, as defined
			 in rule
			 4123-17-41
			 of the Administrative Code. The cost of permanent total disability claims
			 and death claims will be charged to the employer as the payments are made, and
			 the reserve will be billed in the final settlement.
(C) If the retrospective premium due is less
			 than the retrospective premium paid as of the prior evaluation date, the
			 difference, subject to the minimum premium, less assessments due any fund
			 administered by the bureau will be refunded to the employer.
(D) If the retrospective premium due is
			 greater than the retrospective premium paid as of the prior evaluation date,
			 the difference must be paid to the bureau within forty-five days after the due
			 date of the invoice billing the additional retrospective premium, or the
			 employer will be subject to penalties as provided in rule
			 4123-17-48 of the
			 Administrative Code.
(E) Values
			 used in an annual evaluation will not be revised for any reason other than
			 clerical error. The bureau must be notified of any such errors, in writing,
			 within sixty days after the due date on the invoice billing the retrospective
			 premium.
(F) Premiums are subject
			 to minimum and maximum premium limitations as selected by the
			 employer.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-47 - Final settlement

Current through all regulations passed and filed through July 1, 2024
(A) At the end of the tenth-year
			 determination of retrospective premium, the plan for that retrospective policy
			 year shall terminate.
(B) As part
			 of the final determination of retrospective premium, the
			  bureau  will evaluate the employer's claims and
			 establish reserves. Reserves will be developed for claims, other than allowed
			 permanent total disability claims and allowed death claims, using the balance
			 sheet reserve table in effect as of the ending date of the evaluation
			 period.
(C) The
			  bureau  will notify the employer of the reserve balances
			 which will be reflected on the annual
			 evaluation.
(D) The final
			 settlement calculated, subject to the minimum and maximum premium of the plan
			 selected, shall be paid to the  bureau
			 within
			 
								forty-five days after the due date the the additional retrospective premium.
(E) The final determination of a
			 retrospective premium will not be revised for any reason other than clerical
			 error.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-48 - Penalties

Current through all regulations passed and filed through July 1, 2024
Any retrospective-rated employer failing to file a report of
				payroll expenditures or failing to pay premium when due, as prescribed in rules
				4123-17-14, 4123-17- 14.2, 4123-17-46, and 
								4123-17-47 of the Administrative Code, will be
				penalized in accordance with paragraph (C) of rule 
								4123-17-16
				of the Administrative Code . All premium due as a result of the selection of
				retrospective rating, including the minimum premium and premium as a result of
				annual evaluations, shall be included as premium as used in this rule.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-49 - Disability relief

Current through all regulations passed and filed through July 1, 2024
Disability relief, as permitted under section
				4123.343 of the Revised Code and
				rule 4123-3-35 of the Administrative
				Code, will be applied to reducible claims costs as limited by the per-claim
				limit selected by the employer.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-52 - Parameters of the retrospective rating plan

Current through all regulations passed and filed through July 1, 2024
(A) An employer participating in
			 retrospective rating will pay the following:
(1) Minimum premium. The minimum premium
			 depends on the assigned hazard group, the per claim limit selected by the
			 employer, the maximum premium limit selected by the employer, and the
			 employer's base-rated premium or experience-rated premium. The employer's
			 base-rated premium or experiencerated premium is assumed to be at least the
			 minimum experience-rated/ base-rated premium threshold listed on the
			 employer's retrospective rating minimum
			 premium percentages table contained in the appendices to rule
			 4123-17-53
			 of the Administrative Code. The minimum premium includes employer
			 contributions to cover safety and hygiene costs, surplus costs, and the cost of
			 losses exceeding the per claim and the maximum premium limitations and those
			 health partnership program costs associated with the losses exceeding the per
			 claim and the maximum premium limitations. The minimum premium is subject to
			 the premium sized adjustment described in rule 4123-17-03.3 of the
			 Administrative Code.
(2) Premium
			 based on paid losses. The employer will pay for any compensation payments,
			 including death and permanent total disability, and medical payments made in
			 covered claims. Billings to the employer will be sent annually for ten years to
			 collect for these medical and compensation payments.
(3) Premium based on claim reserves. The
			 employer will pay the value of reserves on claims evaluated as of the end of
			 the tenth year.
(4) Premium for
			 health partnership program costs on retained losses. In each evaluation period
			 associated with a policy year, the employer will pay an additional premium
			 based on a percentage,
			 known as the
									loss conversion
			 factor applied to the paid losses and
			 
									claims reserves to cover the associated health
			 partnership program costs of those paid losses or claims reserves. Each policy year will have a specific
			 loss conversion factor, determined before the start of the policy year, which
			 will apply for the ten year retrospective period.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-53 - Private employer retrospective rating plan minimum premium percentages

Current through all regulations passed and filed through July 1, 2024
The administrator of workers' compensation, with the advice and
				consent of the bureau of workers' compensation board of directors, has
				authority to approve contributions made to the state insurance fund by
				employers pursuant to sections
				4121.121,
				4121.13,
				4121.30,
				4123.29, and
				4123.34 of the Revised
				Code.
The administrator hereby sets the private employer
				retrospective rating plan minimum premium percentages to be effective July 1,
				2024, as
				indicated in the appendixes A, (Tier I, tables A, B, C, D, E, F, and G) and B
				(Tier II, tables A, B, C, D, E, F, and G) to this rule.
The administrator hereby sets the private employer loss
				conversion factors to be applied to losses associated with policy years
				beginning on or after July 1, 2015, as indicated in appendix C to this
				rule.
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Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-54 - Public employer retrospective rating plan minimum premium percentages

Current through all regulations passed and filed through July 1, 2024
The administrator of workers' compensation, with the advice and
				consent of the bureau of workers' compensation board of directors, has
				authority to approve contributions made to the state insurance fund by
				employers pursuant to sections
				4121.121,
				4123.29,
				and
				4123.34
				of the Revised Code.
The administrator hereby sets the public employer taxing
				districts retrospective rating plan minimum premium percentages to be effective
				January 1, 2016, as indicated in appendixes A (Tier I) and B (Tier II) to this
				rule.
The administrator hereby sets the public employer loss
				conversion factors to be applied to losses associated with policy years
				beginning on or after January 1, 2016, as indicated in appendix C to this
				rule.
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Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-54 - Public employer retrospective rating plan minimum premium percentages

Current through all regulations passed and filed through July 1, 2024
The administrator of workers' compensation, with the advice and
				consent of the bureau of workers' compensation board of directors, has
				authority to approve contributions made to the state insurance fund by
				employers pursuant to sections
				4121.121,
				4123.29, and
				4123.34 of the Revised
				Code.
The administrator hereby sets the public employer taxing
				districts retrospective rating plan minimum premium percentages to be effective
				January 1, 2025, as indicated in appendixes A (Tier I) and B
				(Tier II) to this rule.
The administrator hereby sets the public employer loss
				conversion factors to be applied to losses associated with policy years
				beginning on or after January 1, 2016, as indicated in appendix C to this
				rule.
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Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-55 - Transitional work development grant and transitional work bonus program

Current through all regulations passed and filed through July 1, 2024
(A)
			 Definitions.
As used in this rule:
(1) "AEO" and "PEO" have the same meaning as
			 defined in rule
			 4123-17-15 of the Administrative
			 Code.
(2) "Application deadline"
			 means the applicable application deadline set forth in appendix A or in
			 appendix B to rule
			 4123-17-74 of the Administrative
			 Code.
(3) "Client employer" has the
			 same meaning as defined in rule
			 4123-17-15 of the Administrative
			 Code.
(4) "Program period" means
			 the policy year for which the employer elects to participate in the
			 transitional work program.
(5)
			 "Transitional work" has the same meaning as defined in rule
			 4123-6-01 of the Administrative
			 Code.
(6) "Transitional work
			 developer" means the provider who develops the employer's transitional work
			 program. A transitional work developer shall:
(a) Meet the minimum credentials designated
			 in rule 4123-6-02.2 of the
			 Administrative Code for one of the following provider types:
(i) A vocational rehabilitation case
			 manager,
(ii) An occupational
			 therapist, or
(iii) A physical
			 therapist; and
(b)
			 Complete bureau of workers' compensation
			 sponsored transitional work development training prior to delivering
			 transitional work programs and at two-year intervals.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-56 - Safety grant programs

Current through all regulations passed and filed through July 1, 2024
(A) Pursuant to section
			 4121.37 of the Revised Code, the
			 administrator of workers' compensation may
			 establish a program of safety grants for safety interventions or research for
			 eligible employers. The safety grant program may provide grant funds to an
			 eligible employer for safety interventions including education, training,
			 research, or purchase of equipment to prevent occupational injuries, illnesses,
			 or fatalities.
(1) The purpose of the safety
			 intervention grant program is for the  division of safety and hygiene
			 of the bureau of wokers' compensation to fund
			 employer interventions that reduce the risk of injuries, illnesses, and
			 fatalities in the workplace, investigate the effectiveness of safety
			 interventions in preventing occupational injuries, illnesses, and fatalities
			 and establish safety and health best practices. For this purpose, the bureau
			 may make safety grants to employers as provided in this rule.
(2) If the  division of safety and hygiene concludes
			 there are interventions outside the scope of the program, the division of
			 safety and hygiene may establish an unapproved items list to notify employers
			 of specific safety education, training, research, or purchase of equipment that
			 the bureau shall not fund.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-56.1 - Workplace wellness grant program rule

Current through all regulations passed and filed through July 1, 2024
(A) For purposes of this rule:
(1) "Health risk factors" means physical and
			 mental characteristics that can be modified, nearly always with much less cost
			 compared to waiting for sickness and then attempting to treat the
			 disease.
(2) "Employer" or "employer" means a private state fund
			 employer, a public employer taxing district, a marine industry fund employer,
			 or a coal-workers' pneumoconiosis fund employer.
(3)
									"Workplace
			 wellness program" means a health and wellness program in the workplace which
			 consists of a biometric screening and health risk appraisal, and activities
			 based on the results of the screening, program measurements and
			 policies.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-56.2 - Safety council rebate program

Current through all regulations passed and filed through July 1, 2024
(A) Definitions.
For the purposes of this rule,
(1) "Local safety council" means an entity
			 contracted with the bureau of workers'
			 compensation to provide a safety campaign in accordance with standards
			 set forth by the superintendent of the division of safety and
			 hygiene.
(2) "Program year" means
			 July first to June thirtieth, inclusive.
(3) "Superintendent" means the superintendent
			 of the division of safety and hygiene or the superintendent's
			 designee.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-57 - Premium for construction industry

Current through all regulations passed and filed through July 1, 2024
(A)
			 As used in this rule:
(1) As defined in
			 division (F)(3) of section
			 4123.34 of the Revised Code,
			 "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. The
			 
									classification codes satisfying this definition
			 are listed in paragraph (E) of this rule.
(2) "Construction industry employer" is an
			 employer that reports payroll of a construction industry employee for work
			 performed in a construction industry 
			 classification code as defined in paragraph (E)
			 of this rule.
(3) "Construction
			 industry employee" is any employee as defined in division (A) of section
			 4123.01 of the Revised Code who
			 performs work and whose payroll is properly reported in a construction industry
			  classification
			 code as defined in paragraph (E) of this
			 rule.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-58 - Drug-free safety program (DFSP) and comparable program

Current through all regulations passed and filed through July 1, 2024
(A) Definitions.
For purposes of this rule:
(1)
									"AEO" and "PEO"
			 have the same meaning as defined in rule
			 4123-17-15
			 of the Administrative Code.
(2) "Application
			 deadline" means the applicable deadline set forth in appendix A or
			 in appendix B to rule
			 4123-17-74
			 of the Administrative Code.
(3) "Client employer"
			 has the same meaning as defined in  rule
			 4123-17-15
			 of the Administrative Code.
(4) "Comparable
			 program" means a program referred to in section
			 153.03
			 of the Revised Code.
(5) "Drug-free safety program" or "DFSP" means the
			 bureau's loss prevention and safety program to prevent and reduce the risk of
			 workplace accidents and injuries attributed to the use and abuse of alcohol and
			 other drugs, including prescription, over-the-counter, and illegal drugs.
(6) "Program period" means the policy year
			 for which the employer elects to participate in DFSP.
(7) "Safety-sensitive position or function"
			 means any job position or work-related function or job task designated as such
			 by the employer, which through the nature of the activity could be dangerous to
			 the physical well-being of or jeopardize the security of the employee,
			 co-workers, customers or the general public through a lapse in attention or
			 judgment.
(8) "Supervisor" means an
			 employee who supervises others in the performance of their jobs, has the
			 authority and responsibility to initiate reasonable suspicion testing and
			 recommend or perform hiring or firing procedures.
(9) "Superintendent" means the superintendent
			 of the division of safety and hygiene or the superintendent's
			 designee.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-60 - Annuity factors

Current through all regulations passed and filed through July 1, 2024
The administrator of workers' compensation, with the advice and
				consent of the bureau of workers' compensation board of directors, has
				authority to approve contributions made to the state insurance fund by
				employers pursuant to sections
				4121.121,
				4123.29, and
				4123.34 of the Revised Code. The
				administrator hereby establishes annuity factors for use in establishing claims
				reserves and premium rates as indicated in appendixes A, B, C, D, and E to this
				rule. The basis and interest factor of each annuity factor table is indicated
				on the appendix.
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Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-62 - Application for group experience rating

Current through all regulations passed and filed through July 1, 2024
(A)
			 Sponsoring organization requirements.
(1) A
			 sponsoring organization shall make annual application for group experience
			 rating by submitting an employer roster for group rating plan (AC-25) for each
			 group it sponsors. Each AC-25 shall:
(a) Be
			 signed each year by an officer of the sponsoring organization to which the
			 members of the group belong;
(b)
			 Identify each individual employer to be included in the group policy year for
			 which the group application is made; and
(c) Identify whether, in the previous policy
			 year, each employer was:
(i) Enrolled in the
			 same group,
(ii) Not enrolled in
			 the same group, but enrolled in a different group sponsored by the sponsoring
			 organization, or
(iii) Not enrolled
			 in the same group, and not enrolled in a different group sponsored by the
			 sponsoring organization.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-63 - Eligibility for group experience rating-size criteria

Current through all regulations passed and filed through July 1, 2024
(A)
			 To be eligible for group experience rating, the group taken as a whole must
			 include at least one hundred employers, each employer being identified as a
			 separate employer for state fund identification purposes, or
			 the group taken as a whole must be of sufficient size that the premiums of the
			 members, as determined by the administrator of workers'
			 compensation, are expected to exceed one hundred fifty thousand dollars
			 during the coverage period, except as provided by paragraph (C) of this rule.
			 The administrator may determine the aggregate premium of the members based upon
			 the historical premium experience of the members, projected payroll, and
			 anticipated premium rates. The evaluation period for determining aggregate
			 premium shall be the rating year beginning two years prior to the coverage
			 period.
(B) For a group of less
			 than one hundred members, the premium requirement shall be deemed to have been
			 satisfied if the aggregate premium to the state insurance fund for the members
			 of the group for the rating year beginning two years prior to the coverage
			 period exceeded one hundred fifty thousand dollars, except as provided by
			 paragraph (C) of this rule. Failure to reach one hundred fifty thousand dollars
			 in premium during the coverage period shall not negate the group
			 coverage.
(C) The bureau
			 of workers' compensation shall calculate the
			 premium based upon the actual experience modified premium of the member
			 employers during the evaluation period, including any modification due to group
			 rating. The administrator may waive the requirement that premiums exceed one
			 hundred fifty thousand dollars during the coverage period for a continuing
			 group of substantially similar membership if the sole reason that the premium
			 fails to exceed one hundred and fifty thousand dollars is due to the premium
			 modification discounts earned by the group as a direct result of safety
			 operations of the group rating program, and not due to other factors, such as a
			 departure of members from the group or a reduction in payroll for members of
			 the group.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-64 - Group experience rate calculations

Current through all regulations passed and filed through July 1, 2024
(A)
			 A group meeting all the requirements for group rating shall be considered as a
			 single employing entity for purposes of group experience rating. The
			 eligibility of data for use in the group shall be the same as the eligibility
			 of data for use in the individual employer's rate calculation. Credibility
			 limits and all factors based upon credibility will apply at the group level.
			 For catastrophe claims, the definition of a catastrophe under paragraph (A) of
			 rule 4123-17-12 of the Administrative
			 Code must be satisfied by an individual employer in the group to be eligible
			 for catastrophe claim cost relief, although more than one individual employer
			 in the group may qualify for catastrophe relief from the same catastrophe
			 occurrence. Disability relief charges to surplus shall be applied
			 at the group level.
(B) All
			 operations or classification codes of an employer electing group rating
			 are subject to group experience rating.
(C)
								Except with respect to
			 mergers or transfers of the operations of a business, an employer's experience
			 may be combined once during a policy year to create an experience modification
			 for multiple employers grouped together for experience rating
			 purposes.
(D) Employers
			 participating in a group rating plan may implement the drug- free safety
			 program.
(E) An employer that is in
			 a cancelled coverage status, for at least one
			 full rating year as of the date that the experience modification of a group of
			 which it had been a member is recalculated, will not be liable for any
			 obligation, nor will such employer receive the
			 benefit of any credit, associated
			 with the recalculation.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-64.2 - Public employer taxing district group rating break even factor

Current through all regulations passed and filed through July 1, 2024
The administrator will apply an adjustment factor to all
				public empoyer taxing district group rated
				employer experience modifiers (EM) as indicated in appendix A to this
				rule.
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Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-65 - Experience retention for group experience rate calculation purposes

Current through all regulations passed and filed through July 1, 2024
If an individual employer is a member of a group
				for group experience rating and leaves the group, the experience of that
				individual employer shall be used in experience-rating calculations for the
				group to impact only the rating years that the employer was a member of the
				group. The individual employer leaving the group retains its own experience
				rating incurred while a member of the group for the balance of the standard
				experience period. The group shall not be liable for claims experience incurred
				by an individual employer for claims occurring after the employer has left the
				group.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-67 - Representation for group experience rating

Current through all regulations passed and filed through July 1, 2024
(A)
			 A group that has been established and has been accepted by the bureau of
			 workers' compensation for the purpose of group experience rate calculation
			 shall have no more than one permanent authorized representative for
			 representation of the group and the individual employers of the group before
			 the bureau and the industrial commission in any and all
			 
								employer-related matters pertaining to participation
			 in the 
								state insurance fund.
(B) The selection of an authorized group
			 representative must be made by submission of a completed form AC-24, and any
			 change or termination of the authorized group representative can be made only
			 by a subsequent submission of form AC-24. Only an officer of the group may sign
			 an AC-24.
(C) Notwithstanding the
			 provisions of paragraph (A) of this rule, an individual
			 
								employer
			 in a group may retain the services of an attorney or other authorized
			 representative for claims-related matters, such as representation at claims
			 hearings before the bureau and the industrial commission, through submission of
			 the appropriate authorization for representation in such individual claim
			 files. The bureau will recognize only one authorized representative for notice
			 and appeal purposes.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-71 - Claim impact reduction program

Current through all regulations passed and filed through July 1, 2024
(A)
			 Definitions.
As used in this rule:
(1)
									"Claim impact reduction program"
			 or 
									"CIRP" means the 
									bureau of workers'
			 compensation's voluntary rate program which offers a private employer or
			 a public employer taxing district employer the opportunity to mitigate the
			 impact of a significant claim that will enter the employer's experience for the
			 first time.
(2) "Program
			 eligibility period" means the four policy years in which an employer has a
			 significant claim in its experience period.
(3) "Significant claim" means a claim whose
			 total value or maximum claim value, whichever is lower, will be greater than
			 the employer's total limited losses ("TLL") as defined in rule
			 4123-17-03 of the Administrative
			 Code. Effective July 1, 2020, for private employers whose expected losses fall
			 below the minimum expected loss provided in appendix A to rule
			 4123-17-05.1 of the
			 Administrative Code, a TLL of three hundred dollars shall be used; for public
			 employer taxing districts whose expected losses fall below the minimum expected
			 loss provided in appendix A to rule
			 4123-17-33.1 of the
			 Administrative Code, a TLL of five hundred fifty dollars shall be
			 used.
(4) "Minor claim" means a
			 medical-only or lost-time claim whose total value or maximum claim value,
			 whichever is lower, will be less than the employer's TLL as defined in rule
			 4123-17-03 of the Administrative
			 Code, subject to the TLL provisions of a significant claim that became
			 effective July 1, 2020.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-72 - Deductible rule

Current through all regulations passed and filed through July 1, 2024
(A)
			 Definitions.
As used in this rule:
(1) "Coverage period" means the twelve month
			 period beginning July first through June thirtieth for private employers, and
			 January first through December thirty-first for public employers. The
			 deductible selected by the employer will apply only to claims with a date of
			 injury within the coverage period defined in the deductible
			 agreement.
(2) "Deductible" means
			 the maximum amount an employer participating in the deductible program must
			 reimburse the bureau for each claim that occurs during the policy year.
(a) "Small deductible" means a deductible
			 less than or equal to ten thousand dollars.
(b) "Large deductible" means a deductible
			 greater than ten thousand dollars.
(3) "Experience rated premium" means the
			 premium obligations of an employer for the policy year excluding
			 the disabled workers' relief fund ("DWRF")
			 assessment. Experience rated premium may include any
			 experience rated premium related to policy combinations. The premium is subject
			 to the premium sized adjustment described in rule
			 4123-17-03.3 of the
			 Administrative Code.
(4) "Modified
			 rate" means the rate that employers who are experience rated pay as a
			 percentage of their payroll. This rate is calculated by taking the base rate
			 and multiplying it by the employer's experience modification ("EM")
			 factor.
(5) "Base rate" means the
			 rate that employers who are not experience rated pay as a percentage of their
			 payroll.
(6) "Policy in good
			 standing" means the employer is current on all payments due to the bureau and
			 is in compliance with bureau laws, rules, and regulations at the time of
			 enrollment or reenrollment.
(7)
			 "Premium" means money paid and due from an employer for workers' compensation
			 insurance. Premium does not include money paid as fees, fines, penalties or
			 deposits.
(8) "Qualified employer"
			 means an employer that has a state insurance fund policy that is in good
			 standing at the time of enrollment or reenrollment. Although the employer may
			 be a qualified employer, the bureau may not accept the employer into the
			 deductible program for other reasons set forth in this rule.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-74 - Deadline dates and compatibility information for employer programs

Current through all regulations passed and filed through July 1, 2024
This rule defines employer program deadlines, miscellaneous
				dates, and compatibility between programs. Specifics may be found in the
				following appendices:
Appendix A: Private employer program deadlines and
				miscellaneous dates.
Appendix B: Public employer taxing district program deadlines
				and miscellaneous dates.
Appendix C: Employer program compatibility.
This rule supersedes other rules referencing program deadlines
				and compatibility.
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Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-75 - Bonus and rebate incentive programs

Current through all regulations passed and filed through July 1, 2024
(A)
			 The following bonus and rebate incentives are offered:
(1)
			 The transitional work bonus established in rule
			 4123-17-55 of the Administrative
			 Code;
(2) The safety council
			 rebate established in rule
			 4123-17-56.2 of the
			 Administrative Code; and
(3) The drug-free
			 safety program bonus established in rule
			 4123-17-58 of the Administrative
			 Code.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-17 - General Rating for the State Insurance Fund › Section 4123-17-76 - Cancellation of workers' compensation coverage

Current through all regulations passed and filed through July 1, 2024
(A) The administrator of the bureau of
			 workers' compensation may cancel an employer's workers' compensation coverage
			 if any of the following apply:
(1) The
			 employer fails to pay the required premium by the annual renewal date in
			 accordance with rule
			 4123-17-14
			 of the Administrative Code, and the employer's estimated annual premium is
			 equal to the minimum administrative charge as set forth in rule
			 4123-17-26
			 of the Administrative Code;
(2) The
			 employer's policy is in lapsed status, and the employer's policy has
			  no allowed claims filed against it within two years; or
(3) The employer is a new employer who failed
			 to pay estimated premium and assessments when due.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-18 - Rehabilitation of Injured and Disabled Workers › Section 4123-18-01 - Provision of vocational rehabilitation services

Current through all regulations passed and filed through July 1, 2024
Managed care organizations (MCOs)  provide vocational rehabilitation management
				to injured workers under the health partnership program (HPP).
(A) The rules of this chapter
			 
								are
			 applicable to the vocational rehabilitation of injured workers, whether the
			 vocational rehabilitation services are administered by the bureau and managed
			 by an MCO, or administered by a self-insuring employer. Self-insuring employers
			 shall adhere to these rules to ensure that vocational rehabilitation services
			 provided to their injured workers are equal to or greater than the services
			 defined in this chapter.
(B) The
			 bureau 
								will:
(1) Develop
			 policy to implement vocational rehabilitation services.
(2) Assure that injured workers receive
			 appropriate remain at work and/or return to work vocational rehabilitation
			 services.
(3) Audit the MCOs'
			 vocational rehabilitation management practices and provision of
			 services.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-18 - Rehabilitation of Injured and Disabled Workers › Section 4123-18-02 - Goals of vocational rehabilitation

All regulations passed and
  filed through January 1, 2024
(A)
			 The bureau 
								will take measures and make expenditures as it deems
			 necessary to aid injured workers who have sustained compensable injuries or
			 contracted compensable occupational diseases to remain at work or to return to
			 work.
(B) The objectives of the
			 surplus funded vocational rehabilitation program are to be addressed and
			 considered in the following order:
(1) To
			 return the injured worker to the former employer in the original job, or, if
			 this is not possible;
(2) To
			 encourage the employer to modify the original job or to provide employment in a
			 different job, or, if this is not possible;
(3) To assist the injured worker in finding
			 employment in a related industry, and if this is not possible;
(4) To assist the injured worker in finding
			 employment in any industry.
The hierarchy of return to work objectives outlined in this
				paragraph may 
										necessitate the provision of appropriate skill
				enhancement and/or remedial or short term training to aid an injured worker in
				successfully returning to work at any of the steps.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-18 - Rehabilitation of Injured and Disabled Workers › Section 4123-18-03 - Guidelines for referral to and acceptance into vocational rehabilitation

Current through all regulations passed and filed through July 1, 2024
(A)
			 Scope of vocational rehabilitation.
(1)
			 Vocational rehabilitation is the process of restoring the vocational
			 functioning of a worker who experiences a work related injury and who
			 voluntarily agrees to participate in vocational rehabilitation. Vocational
			 rehabilitation services are focused on return to work and are not reimbursable
			 from the surplus fund if solely directed toward the medical management of a
			 claim.
(2) The vocational
			 rehabilitation rules of Chapter 4123-18 of the Administrative Code
			  aid in the development of procedures
			 for providing reimbursable vocational rehabilitation
			 services.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-18 - Rehabilitation of Injured and Disabled Workers › Section 4123-18-05 - Individualized written vocational rehabilitation plan

Current through all regulations passed and filed through July 1, 2024
(A)
			 When surplus funds are used, the managed care organization (MCO)
			 
								will
			 ensure that a vocational rehabilitation case management provider contacts the
			 injured worker and prepares a written vocational rehabilitation assessment
			 plan, comprehensive vocational rehabilitation plan, or job retention plan for
			 the injured worker's acknowledgment and approval. The vocational rehabilitation
			 case management provider 
								will, where practical, consult with the injured
			 worker's employer, the physician of record, and others considered appropriate.
			 A vocational rehabilitation assessment plan may be prepared prior to the
			 individualized written comprehensive vocational rehabilitation plan. The
			 assessment plan may be up to four weeks in length, during which time the
			 injured worker will be actively engaged in career exploration and assessment
			 activities.
(B) Each written
			 vocational rehabilitation assessment plan 
								will include,
			 at a minimum, the following information:
(1)
			 The evaluation questions to be answered by the assessment;
(2) The types of services
			 
									needed to complete the assessment, including:
(a) The estimated costs for the
			 services;
(b) The estimated length
			 of time 
										needed to complete the services;
(c) The provider for the services;
(3) The estimated length of time
			 
									needed to complete the assessment.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-18 - Rehabilitation of Injured and Disabled Workers › Section 4123-18-08 - Payment for rehabilitation services and related expenses from the surplus fund

Current through all regulations passed and filed through July 1, 2024
(A)
			 General principles.
(1) Vocational
			 rehabilitation services and related expenses, as set forth in this rule,
			 
									are
			 paid from the surplus fund established by section
			 4123.34 of the Revised Code, so
			 long as such costs are incurred in a lost time claim pursuant to an approved
			 vocational rehabilitation assessment plan, comprehensive vocational
			 rehabilitation plan, or job retention plan.
(2) Vocational rehabilitation services can
			 include but 
									cannot be solely directed toward medical
			 management and allied medical treatment of the injured worker in an approved
			 vocational rehabilitation assessment plan, comprehensive vocational
			 rehabilitation plan, or job retention plan.
(3) Any period of treatment relating to the
			 allowed condition(s) of the claim which has been prescribed and provided prior
			 to the approval of the vocational rehabilitation plan by the physician of
			 record in the claim, by a specialist to whom the injured worker has been
			 referred by the physician of record, the injured worker's employer, the managed
			 care organization (MCO), or the bureau of workers' compensation, and which
			 extends into the calendar period of the injured worker's approved vocational
			 rehabilitation assessment plan, comprehensive vocational rehabilitation plan,
			 or job retention plan 
									will be charged to the risk of the
			 employer.
(4) Vocational
			 rehabilitation case management costs incurred in the development and
			 preparation of an approved vocational rehabilitation assessment plan,
			 comprehensive vocational rehabilitation plan, or job retention plan, including
			 costs for necessary medical, psychological, and vocational evaluations, are
			 vocational rehabilitation services and are paid from the surplus fund. On-going
			 vocational rehabilitation case management professional services and travel are
			 also paid from the surplus fund as part of the approved vocational
			 rehabilitation assessment plan, comprehensive vocational rehabilitation plan,
			 or job retention plan.
Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-18 - Rehabilitation of Injured and Disabled Workers › Section 4123-18-09 - Vocational rehabilitation provider fee schedule

Current through all regulations passed and filed through
  July 1, 2024
(A)
  Pursuant to sections 4121.441 and
  4121.61 of the Revised Code, the
  
  administrator hereby adopts the vocational rehabilitation provider fee schedule
  indicated in appendix A to this rule, developed with stakeholder
  input.
(B) Notwithstanding the
  provisions of paragraph (A) of this rule, consistent with the provisions of
  division (F)(1) of section
  4121.44 of the Revised Code,
  managed care organizations may enter into other arrangements and reimbursement
  agreements with medical, professional and pharmacy providers.
Click to
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Ohio Administrative Code › Title 4123 - Bureau of Workers' Compensation › Chapter 4123-18 - Rehabilitation of Injured and Disabled Workers › Section 4123-18-11 - Incentive payments to employers who hire or retain injured workers who have completed a rehabilitation program

Current through all regulations passed and filed through July 1, 2024
The bureau, as a means of encouraging employers to retain,
				rehire, or hire injured workers who have successfully completed a prescribed
				rehabilitation program, may make payments to employers from the surplus fund
				established by section
				4123.34 of the Revised
				Code.
(A) The payments
			 
								will be
			 negotiated with the employer and based upon a written agreement signed by the
			 employer and the injured worker and approved by the bureau. The basis for
			 such negotiation 
								will be:
(1) The nature of the disability of the
			 injured worker as determined by the bureau;
(2) The relationship of the disability to the
			 job 
									duties; and
(3) The individual merits of the
			 case.