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(A) Except as provided in this section, every employer mentioned in
division (B)(2) of section 4123.01 of the Revised Code, and every publicly owned
utility shall pay semiannually in the months of January and July into the state
insurance fund the amount of annual premium the administrator of workers' compensation
fixes for the employment or occupation of the employer, the amount of which premium
to be paid by each employer to be determined by the classifications, rules, and rates
made and published by the administrator. The employer shall pay semiannually a further
sum of money into the state insurance fund as may be ascertained to be due from the
employer by applying the rules of the administrator, and a receipt or certificate
certifying that payment has been made shall be mailed immediately to the employer by
the bureau of workers' compensation. The receipt or certificate is prima-facie
evidence of the payment of the premium. The bureau of workers' compensation shall
verify with the secretary of state the existence of all corporations and organizations
making application for workers' compensation coverage and shall require every such
application to include the employer's federal identification number. An employer as
defined in division (B)(2) of section 4123.01 of the Revised Code who has contracted
with a subcontractor is liable for the unpaid premium due from any subcontractor with
respect to that part of the payroll of the subcontractor that is for work performed
pursuant to the contract with the employer. Division (A) of this section providing for
the payment of premiums semiannually does not apply to any employer who was a
subscriber to the state insurance fund prior to January 1, 1914, or who may first
become a subscriber to the fund in any month other than January or July. Instead, the
semiannual premiums shall be paid by those employers from time to time upon the
expiration of the respective periods for which payments into the fund have been made
by them. The administrator shall adopt rules to permit employers to make periodic
payments of the semiannual premium due under this division. The rules shall include
provisions for the assessment of interest charges, where appropriate, and for the
assessment of penalties when an employer fails to make timely premium payments. An
employer who timely pays the amounts due under this division is entitled to all of
the benefits and protections of this chapter. Upon receipt of payment, the bureau
immediately shall mail a receipt or certificate to the employer certifying that
payment has been made, which receipt is prima-facie evidence of payment. Workers'
compensation coverage under this chapter continues uninterrupted upon timely receipt
of payment under this division. Every employer mentioned in division (B)(1) of
section 4123.01 of the Revised Code, except boards of county hospital trustees
that are self-insuring employers under this section, shall comply with sections
4123.38 to 4123.41, and 4123.48 of the Revised Code in regard to the contribution
of moneys to the public insurance fund.
(B) Provided, that employers mentioned in division (B)(2) of
section 4123.01 of the Revised Code, boards of county hospital trustees, and
publicly owned utilities who will abide by the rules of the administrator and who
may be of sufficient financial ability to render certain the payment of
compensation to injured employees or the dependents of killed employees, and the
furnishing of medical, surgical, nursing, and hospital attention and services and
medicines, and funeral expenses, equal to or greater than is provided for in
sections 4123.52, 4123.55 to 4123.62, and 4123.64 to 4123.67 of the Revised Code,
and who do not desire to insure the payment thereof or indemnify themselves against
loss sustained by the direct payment thereof, upon a finding of such facts by the
administrator, may be granted the privilege to pay individually compensation, and
furnish medical, surgical, nursing, and hospital services and attention and
funeral expenses directly to injured employees or the dependents of killed
employees, thereby being granted status as a self-insuring employer. The
administrator may charge employers, boards of county hospital trustees, or publicly
owned utilities who apply for the status as a self-insuring employer a reasonable
application fee to cover the bureau's costs in connection with processing and making
a determination with respect to an application. All employers granted such status
shall demonstrate sufficient financial and administrative ability to assure that all
obligations under this section are promptly met. The administrator shall deny the
privilege where the employer is unable to demonstrate the employer's ability to
promptly meet all the obligations imposed on the employer by this section. The
administrator shall consider, but is not limited to, the following factors, where
applicable, in determining the employer's ability to meet all of the obligations
imposed on the employer by this section:
(1) The employer employs a minimum of five hundred employees in this state;
(2) The employer has operated in this state for a minimum of two years, provided
that an employer who has purchased, acquired, or otherwise succeeded to the operation
of a business, or any part thereof, situated in this state that has operated for at
least two years in this state, also shall qualify;
(3) Where the employer previously contributed to the state insurance fund or is a
successor employer as defined by bureau rules, the amount of the buy-out, as defined by
bureau rules;
(4) The sufficiency of the employer's assets located in this state to insure the
employer's solvency in paying compensation directly;
(5) The financial records, documents, and data, certified by a certified public
accountant, necessary to provide the employer's full financial disclosure. The records,
documents, and data include, but are not limited to, balance sheets and profit and loss
history for the current year and previous four years.
(6) The employer's organizational plan for the administration of the workers'
compensation law;
(7) The employer's proposed plan to inform employees of the change from a state
fund insurer to a self-insuring employer, the procedures the employer will follow as
a self-insuring employer, and the employees' rights to compensation and benefits; and
(8) The employer has either an account in a financial institution in this
state, or if the employer maintains an account with a financial institution
outside this state, ensures that workers' compensation checks are drawn from the
same account as payroll checks or the employer clearly indicates that payment will
be honored by a financial institution in this state. The administrator may waive
the requirements of divisions (B)(1) and (2) of this section and the requirement of
division (B)(5) of this section that the financial records, documents, and data be
certified by a certified public accountant. The administrator shall adopt rules
establishing the criteria that an employer shall meet in order for the administrator
to waive the requirement of division (B)(5) of this section. Such rules may require
additional security of that employer pursuant to division (E) of section 4123.351 of
the Revised Code. The administrator shall not grant the status of self-insuring
employer to any public employer, other than publicly owned utilities and boards of
county hospital trustees.
(C) Provided, that a board of county commissioners mentioned in
division (G)(4) of section 4123.01 of the Revised Code, as an employer, that will
abide by the rules of the administrator and that may be of sufficient financial
ability to render certain the payment of compensation to injured employees or the
dependents of killed employees, and the furnishing of medical, surgical, nursing,
and hospital attention and services and medicines, and funeral expenses, equal to
or greater than is provided for in sections 4123.52, 4123.55 to 4123.62, and
4123.64 to 4123.67 of the Revised Code, and that does not desire to insure the
payment thereof or indemnify itself against loss sustained by the direct payment
thereof, upon a finding of such facts by the administrator, may be granted the
privilege to pay individually compensation, and furnish medical, surgical, nursing,
and hospital services and attention and funeral expenses directly to injured
employees or the dependents of killed employees, thereby being granted status as a
self-insuring employer. The administrator may charge a board of county commissioners
mentioned in division (G)(4) of section 4123.01 of the Revised Code that applies for
the status as a self-insuring employer a reasonable application fee to cover the
bureau's costs in connection with processing and making a determination with respect
to an application. All employers granted such status shall demonstrate sufficient
financial and administrative ability to assure that all obligations under this
section are promptly met. The administrator shall deny the privilege where the
employer is unable to demonstrate the employer's ability to promptly meet all the
obligations imposed on the employer by this section. The administrator shall
consider, but is not limited to, the following factors, where applicable, in
determining the employer's ability to meet all of the obligations imposed on the
board as an employer by this section:
(1) The board as an employer employs a minimum of five hundred employees in this
state;
(2) The board has operated in this state for a minimum of two years;
(3) Where the board previously contributed to the state insurance fund or is
a successor employer as defined by bureau rules, the amount of the buy-out, as
defined by bureau rules;
(4) The sufficiency of the board's assets located in this state to insure the
board's solvency in paying compensation directly;
(5) The financial records, documents, and data, certified by a certified public
accountant, necessary to provide the board's full financial disclosure. The records,
documents, and data include, but are not limited to, balance sheets and profit and
loss history for the current year and previous four years.
(6) The board's organizational plan for the administration of the workers'
compensation law;
(7) The board's proposed plan to inform employees of the proposed
self-insurance, the procedures the board will follow as a self-insuring employer,
and the employees' rights to compensation and benefits;
(8) The board has either an account in a financial institution in this state,
or if the board maintains an account with a financial institution outside this
state, ensures that workers' compensation checks are drawn from the same account
as payroll checks or the board clearly indicates that payment will be honored by
a financial institution in this state;
(9) The board shall provide the administrator a surety bond in an amount
equal to one hundred twenty-five per cent of the projected losses as determined
by the administrator.
(D) The administrator shall require a surety bond from all
self-insuring employers, issued pursuant to section 4123.351 of the Revised Code,
that is sufficient to compel, or secure to injured employees, or to the dependents
of employees killed, the payment of compensation and expenses, which shall in no
event be less than that paid or furnished out of the state insurance fund in
similar cases to injured employees or to dependents of killed employees whose
employers contribute to the fund, except when an employee of the employer, who
has suffered the loss of a hand, arm, foot, leg, or eye prior to the injury for
which compensation is to be paid, and thereafter suffers the loss of any other of
the members as the result of any injury sustained in the course of and arising out
of the employee's employment, the compensation to be paid by the self-insuring
employer is limited to the disability suffered in the subsequent injury, additional
compensation, if any, to be paid by the bureau out of the surplus created by section
4123.34 of the Revised Code.
(E) In addition to the requirements of this section, the
administrator shall make and publish rules governing the manner of making
application and the nature and extent of the proof required to justify a finding
of fact by the administrator as to granting the status of a self-insuring employer,
which rules shall be general in their application, one of which rules shall provide
that all self-insuring employers shall pay into the state insurance fund such
amounts as are required to be credited to the surplus fund in division (B) of
section 4123.34 of the Revised Code. Employers shall secure directly from the bureau
central offices application forms upon which the bureau shall stamp a designating
number. Prior to submission of an application, an employer shall make available to
the bureau, and the bureau shall review, the information described in divisions
(B)(1) to (8) of this section. An employer shall file the completed application
forms with an application fee, which shall cover the costs of processing the
application, as established by the administrator, by rule, with the bureau at least
ninety days prior to the effective date of the employer's new status as a
self-insuring employer. The application form is not deemed complete until all the
required information is attached thereto. The bureau shall only accept applications
that contain the required information.
(F) The bureau shall review completed applications within a
reasonable time. If the bureau determines to grant an employer the status as a
self-insuring employer, the bureau shall issue a statement, containing its
findings of fact, that is prepared by the bureau and signed by the administrator.
If the bureau determines not to grant the status as a self-insuring employer, the
bureau shall notify the employer of the determination and require the employer to
continue to pay its full premium into the state insurance fund. The administrator
also shall adopt rules establishing a minimum level of performance as a criterion
for granting and maintaining the status as a self-insuring employer and fixing time
limits beyond which failure of the self-insuring employer to provide for the
necessary medical examinations and evaluations may not delay a decision on a claim.
(G) The administrator shall adopt rules setting forth procedures
for auditing the program of self-insuring employers. The bureau shall conduct the
audit upon a random basis or whenever the bureau has grounds for believing that an
employer is not in full compliance with bureau rules or this chapter. The administrator
shall monitor the programs conducted by self-insuring employers, to ensure compliance
with bureau requirements and for that purpose, shall develop and issue to self-insuring
employers standardized forms for use by the employer in all aspects of the employers'
direct compensation program and for reporting of information to the bureau. The bureau
shall receive and transmit to the employer all complaints concerning any self-insuring
employer. In the case of a complaint against a self-insuring employer, the administrator
shall handle the complaint through the self-insurance division of the bureau. The bureau
shall maintain a file by employer of all complaints received that relate to the employer.
The bureau shall evaluate each complaint and take appropriate action. The
administrator shall adopt as a rule a prohibition against any self-insuring employer
from harassing, dismissing, or otherwise disciplining any employee making a complaint,
which rule shall provide for a financial penalty to be levied by the administrator
payable by the offending employer.
(H) For the purpose of making determinations as to whether to grant
status as a self-insuring employer, the administrator may subscribe to and pay for a
credit reporting service that offers financial and other business information about
individual employers. The costs in connection with the bureau's subscription or
individual reports from the service about an applicant may be included in the
application fee charged employers under this section.
(I) The administrator, notwithstanding other provisions of this
chapter, may permit a self-insuring employer to resume payment of premiums to the
state insurance fund with appropriate credit modifications to the employer's basic
premium rate as such rate is determined pursuant to section 4123.29 of the Revised
Code.
(J) On the first day of July of each year, the administrator shall
calculate separately each self-insuring employer's assessments for the safety and
hygiene fund, administrative costs pursuant to section 4123.342 of the Revised
Code, and for the portion of the surplus fund under division (B) of section
4123.34 of the Revised Code that is not used for handicapped reimbursement, on
the basis of the paid compensation attributable to the individual self-insuring
employer according to the following calculation:
(1) The total assessment against all self-insuring employers as a class for each
fund and for the administrative costs for the year that the assessment is being made,
as determined by the administrator, divided by the total amount of paid compensation
for the previous calendar year attributable to all amenable self-insuring employers;
(2) Multiply the quotient in division (J)(1) of this section by the total
amount of paid compensation for the previous calendar year that is attributable
to the individual self-insuring employer for whom the assessment is being
determined. Each self-insuring employer shall pay the assessment that results from
this calculation, unless the assessment resulting from this calculation falls below
a minimum assessment, which minimum assessment the administrator shall determine on
the first day of July of each year with the advice and consent of the workers'
compensation oversight commission, in which event, the self-insuring employer shall
pay the minimum assessment. In determining the total amount due for the total
assessment against all self-insuring employers as a class for each fund and the
administrative assessment, the administrator shall reduce proportionately the
total for each fund and assessment by the amount of money in the self-insurance
assessment fund as of the date of the computation of the assessment. The
administrator shall calculate the assessment for the portion of the surplus fund
under division (B) of section 4123.34 of the Revised Code that is used for
handicapped reimbursement in the same manner as set forth in divisions (J)(1)
and (2) of this section except that the administrator shall calculate the total
assessment for this portion of the surplus fund only on the basis of those
self-insuring employers that retain participation in the handicapped reimbursement
program and the individual self-insuring employer's proportion of paid compensation
shall be calculated only for those self-insuring employers who retain participation
in the handicapped reimbursement program. The administrator, as the administrator
determines appropriate, may determine the total assessment for the handicapped
portion of the surplus fund in accordance with sound actuarial principles. The
administrator shall calculate the assessment for the portion of the surplus fund
under division (B) of section 4123.34 of the Revised Code that under division (D)
of section 4121.66 of the Revised Code is used for rehabilitation costs in the
same manner as set forth in divisions (J)(1) and (2) of this section, except that
the administrator shall calculate the total assessment for this portion of the
surplus fund only on the basis of those self-insuring employers who have not made
the election to make payments directly under division (D) of section 4121.66 of
the Revised Code and an individual self-insuring employer's proportion of paid
compensation only for those self-insuring employers who have not made that
election. An employer who no longer is a self-insuring employer in this state or
who no longer is operating in this state, shall continue to pay assessments for
administrative costs and for the portion of the surplus fund under division (B)
of section 4123.34 of the Revised Code that is not used for handicapped
reimbursement, based upon paid compensation attributable to claims that occurred
while the employer was a self-insuring employer within this state.
(K) There is hereby created in the state treasury the
self-insurance assessment fund. All investment earnings of the fund shall be
deposited in the fund. The administrator shall use the money in the self-insurance
assessment fund only for administrative costs as specified in section 4123.341 of
the Revised Code.
(L) Every self-insuring employer shall certify, in affidavit form
subject to the penalty for perjury, to the bureau the amount of the self-insuring
employer's paid compensation for the previous calendar year. In reporting paid
compensation paid for the previous year, a self-insuring employer shall exclude
from the total amount of paid compensation any reimbursement the employer receives
in the previous calendar year from the surplus fund pursuant to section 4123.512
of the Revised Code for any paid compensation. The self-insuring employer also
shall exclude from the paid compensation reported any amount recovered under section
4123.93 of the Revised Code and any amount that is determined not to have been
payable to or on behalf of a claimant in any final administrative or judicial
proceeding. The self-insuring employer shall exclude such amounts from the paid
compensation reported in the reporting period subsequent to the date the
determination is made. The administrator shall adopt rules, in accordance with
Chapter 119. of the Revised Code, establishing the date by which self-insuring
employers must submit such information and the amount of the assessments provided
for in division (J) of this section for employers who have been granted self-insuring
status within the last calendar year. The administrator shall include any assessment
that remains unpaid for previous assessment periods in the calculation and collection
of any assessments due under this division or division (J) of this section.
(M) As used in this section, "paid compensation" means
all amounts paid by a self-insuring employer for living maintenance benefits, all
amounts for compensation paid pursuant to sections 4121.63, 4121.67, 4123.56,
4123.57, 4123.58, 4123.59, 4123.60, and 4123.64 of the Revised Code, all amounts
paid as wages in lieu of such compensation, all amounts paid in lieu of such
compensation under a nonoccupational accident and sickness program fully funded by
the self-insuring employer, and all amounts paid by a self-insuring employer for a
violation of a specific safety standard pursuant to Section 35 of Article II, Ohio
Constitution and section 4121.47 of the Revised Code.
(N) Should any section of this chapter or Chapter 4121. of the
Revised Code providing for self-insuring employers' assessments based upon
compensation paid be declared unconstitutional by a final decision of any court,
then that section of the Revised Code declared unconstitutional shall revert back
to the section in existence prior to November 3, 1989, providing for assessments
based upon payroll.
(O) The administrator may grant a self-insuring employer the
privilege to self-insure a construction project entered into by the self-insuring
employer that is scheduled for completion within six years after the date the
project begins, and the total cost of which is estimated to exceed one hundred
million dollars. The administrator may waive such cost and time criteria and grant
a self-insuring employer the privilege to self-insure a construction project
regardless of the time needed to complete the construction project and provided that
the cost of the construction project is estimated to exceed fifty million dollars. A
self-insuring employer who desires to self-insure a construction project shall submit
to the administrator an application listing the dates the construction project is
scheduled to begin and end, the estimated cost of the construction project, the
contractors and subcontractors whose employees are to be self-insured by the
self-insuring employer, the provisions of a safety program that is specifically
designed for the construction project, and a statement as to whether a collective
bargaining agreement governing the rights, duties, and obligations of each of the
parties to the agreement with respect to the construction project exists between the
self-insuring employer and a labor organization. A self-insuring employer may apply to
self-insure the employees of either of the following:
(1) All contractors and subcontractors who perform labor or work or provide
materials for the construction project;
(2) All contractors and, at the administrator's discretion, a substantial
number of all the subcontractors who perform labor or work or provide materials
for the construction project. Upon approval of the application, the administrator
shall mail a certificate granting the privilege to self-insure the construction
project to the self-insuring employer. The certificate shall contain the name of
the self-insuring employer and the name, address, and telephone number of the
self-insuring employer's representatives who are responsible for administering
workers' compensation claims for the construction project. The self-insuring
employer shall post the certificate in a conspicuous place at the site of the
construction project. The administrator shall maintain a record of the contractors
and subcontractors whose employees are covered under the certificate issued to the
self-insured employer. A self-insuring employer immediately shall notify the
administrator when any contractor or subcontractor is added or eliminated from
inclusion under the certificate. Upon approval of the application, the
self-insuring employer is responsible for the administration and payment of all
claims under this chapter and Chapter 4121. of the Revised Code for the employees
of the contractor and subcontractors covered under the certificate who receive
injuries or are killed in the course of and arising out of employment on the
construction project, or who contract an occupational disease in the course
of employment on the construction project. For purposes of this chapter and
Chapter 4121. of the Revised Code, a claim that is administered and paid in
accordance with this division is considered a claim against the self-insuring
employer listed in the certificate. A contractor or subcontractor included under
the certificate shall report to the self-insuring employer listed in the
certificate, all claims that arise under this chapter and Chapter 4121. of the
Revised Code in connection with the construction project for which the certificate
is issued. A self-insuring employer who complies with this division is entitled
to the protections provided under this chapter and Chapter 4121. of the Revised
Code with respect to the employees of the contractors and subcontractors covered under
a certificate issued under this division for death or injuries that arise out of, or
death, injuries, or occupational diseases that arise in the course of, those employees'
employment on that construction project, as if the employees were employees of the
self-insuring employer, provided that the self-insuring employer also complies with
this section. No employee of the contractors and subcontractors covered under a
certificate issued under this division shall be considered the employee of the
self-insuring employer listed in that certificate for any purposes other than this
chapter and Chapter 4121. of the Revised Code. Nothing in this division gives a
self-insuring employer authority to control the means, manner, or method of employment
of the employees of the contractors and subcontractors covered under a certificate
issued under this division. The contractors and subcontractors included under a
certificate issued under this division are entitled to the protections provided
under this chapter and Chapter 4121. of the Revised Code with respect to the
contractor's or subcontractor's employees who are employed on the construction
project which is the subject of the certificate, for death or injuries that arise
out of, or death, injuries, or occupational diseases that arise in the course of,
those employees' employment on that construction project. The contractors and
subcontractors included under a certificate issued under this division shall
identify in their payroll records the employees who are considered the employees of
the self-insuring employer listed in that certificate for purposes of this chapter
and Chapter 4121. of the Revised Code, and the amount that those employees earned
for employment on the construction project that is the subject of that certificate.
Notwithstanding any provision to the contrary under this chapter and Chapter 4121.
of the Revised Code, the administrator shall exclude the payroll that is reported
for employees who are considered the employees of the self-insuring employer listed
in that certificate, and that the employees earned for employment on the construction
project that is the subject of that certificate, when determining those contractors'
or subcontractors' premiums or assessments required under this chapter and Chapter
4121. of the Revised Code. A self-insuring employer issued a certificate under this
division shall include in the amount of paid compensation it reports pursuant to
division (L) of this section, the amount of paid compensation the self-insuring
employer paid pursuant to this division for the previous calendar year. Nothing in
this division shall be construed as altering the rights of employees under this
chapter and Chapter 4121. of the Revised Code as those rights existed prior to
September 17, 1996. Nothing in this division shall be construed as altering the
rights devolved under sections 2305.31 and 4123.82 of the Revised Code as those
rights existed prior to September 17, 1996. As used in this division, "privilege
to self-insure a construction project" means privilege to pay individually
compensation, and to furnish medical, surgical, nursing, and hospital services
and attention and funeral expenses directly to injured employees or the
dependents of killed employees.
(P) A self-insuring employer whose application is granted under
division (O) of this section shall designate a safety professional to be
responsible for the administration and enforcement of the safety program that is
specifically designed for the construction project that is the subject of the
application. A self-insuring employer whose application is granted under division
(O) of this section shall employ an ombudsperson for the construction project that
is the subject of the application. The ombudsperson shall have experience in
workers' compensation or the construction industry, or both. The ombudsperson shall
perform all of the following duties:
(1) Communicate with and provide information to employees who are injured in the
course of, or whose injury arises out of employment on the construction project, or
who contract an occupational disease in the course of employment on the construction
project;
(2) Investigate the status of a claim upon the request of an employee to do so;
(3) Provide information to claimants, third party administrators, employers, and
other persons to assist those persons in protecting their rights under this chapter
and Chapter 4121. of the Revised Code. A self-insuring employer whose application is
granted under division (O) of this section shall post the name of the safety
professional and the ombudsperson and instructions for contacting the safety
professional and the ombudsperson in a conspicuous place at the site of the construction
project.
(Q) The administrator may consider all of the following when
deciding whether to grant a self-insuring employer the privilege to self-insure a
construction project as provided under division (O) of this section:
(1) Whether the self-insuring employer has an organizational plan for the
administration of the workers' compensation law;
(2) Whether the safety program that is specifically designed for the
construction project provides for the safety of employees employed on the
construction project, is applicable to all contractors and subcontractors who
perform labor or work or provide materials for the construction project, and has
a component, a safety training program that complies with standards adopted
pursuant to the "Occupational Safety and Health Act of 1970," 84 Stat.
1590, 29 U.S.C.A. 651, and provides for continuing management and employee
involvement;
(3) Whether granting the privilege to self-insure the construction project will
reduce the costs of the construction project;
(4) Whether the self-insuring employer has employed an ombudsperson as required
under division (P) of this section;
(5) Whether the self-insuring employer has sufficient surety to secure the
payment of claims for which the self-insuring employer would be responsible pursuant
to the granting of the privilege to self-insure a construction project under
division (O) of this section.
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