This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and
universities.
| Rule |
Rule 4123-21-01 | Procedures for subscription to the coal-workers' pneumoconiosis fund.
Effective:
August 1, 2023
(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.
Last updated August 1, 2023 at 8:38 AM
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Rule 4123-21-02 | Determination of coverage.
Effective:
August 1, 2023
(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.
Last updated August 1, 2023 at 8:38 AM
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Rule 4123-21-03 | Premium payment.
Effective:
August 1, 2023
(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.
Last updated August 1, 2023 at 8:39 AM
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Rule 4123-21-04 | Notice of estimated premium, payroll reporting and reconciliation of premium due.
Effective:
August 1, 2023
(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. (B) At the conclusion of each policy
year, the bureau or its designee will mail the insured a payroll report. The
insured shall return the payroll report, and include a statement of the
insured's actual payroll and the number of employees employed within each
of the insured's assigned manual classifications for the prior policy
period. (1) The report shall
contain the premium payment total based on the estimated gross
payroll; (2) The payroll report
shall reconcile the premium difference between the estimated payroll and the
actual payroll; (3) The payroll report
must be filed by and any balance due the coal workers' pneumoconiosis fund
paid by August fifteenth, and effective the policy year beginning July 1, 2024,
by the thirty-first day of August, following the conclusion of the policy year.
Any balance due the employer shall be credited to the insured. (4) If the employer fails
to submit the final payroll report, the bureau will not lapse the
employer's coverage. The bureau will increase by ten percent the estimated
premium and bill the employer. The bureau will certify the premium balance to
the attorney general seventy-five days after the due date if not paid. The
bureau may cancel coverage for the subsequent renewal period for failure to
submit the final payroll report. (C) Officers of a corporation, partners,
or sole proprietors who engage in work activity directly related to the
extraction, processing or transportation of coal shall report their
remuneration to the coal-workers' pneumoconiosis fund. Reporting of
officers', partners' or proprietors' remuneration is a condition
precedent to the extension of coal-workers' pneumoconiosis fund coverage
to such individuals as claimants. (D) No provision of this rule may be
construed to limit in any way the right of the bureau or its designee to audit
the payroll records of the insured or to make adjustments based upon the
findings of such audits.
Last updated August 1, 2023 at 8:39 AM
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Rule 4123-21-05 | Audit and inspections.
Effective:
August 1, 2023
(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.
Last updated August 1, 2023 at 8:39 AM
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Rule 4123-21-06 | Default, retroactive coverage.
Effective:
August 1, 2023
(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. (C) Such request shall be submitted to
the bureau by the employer concerned or by its duly authorized representative.
The reason for the relief sought shall be fully explained. The bureau may hold
a request in abeyance until the request is properly completed, and the
applicant will be notified accordingly. (D) The administrator may refer all such
requests to the adjudicating committee, appointed by the administrator of
workers' compensation, for a determination pursuant to rule 4123-14-06 of
the Administrative Code.
Last updated August 1, 2023 at 8:39 AM
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Rule 4123-21-07 | Effect of cancelled subscription.
Effective:
August 1, 2023
(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. (B) Thirty days prior to cancellation of
an operator's subscription, the bureau will notify the defaulting operator
and the United States department of labor of the impending
cancellation. (C) An operator whose subscription has
been cancelled may apply for reinstatement at any time, provided that such
application shall be governed by rules 4123-21-01 and 4123-21-02 of the
Administrative Code.
Last updated August 1, 2023 at 8:39 AM
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Rule 4123-21-08 | Controversion of claims.
Effective:
August 1, 2023
(A) The bureau of workers'
compensation is authorized under regulations promulgated by the United States
department of labor to act as an insurance carrier with respect to liabilities
created by Title IV of the "Federal Coal Mine Health and Safety Act of
1969," as amended. In this capacity, it is recognized under applicable
provisions of federal law and regulations as a party in interest to all
proceedings regarding claims filed against employers insured by said
fund. (B) All notices of claims received
from employers insured by the coal-workers' pneumoconiosis fund, and all
notices of claims received from the department of labor will be promptly
reviewed by the bureau. The administrator or the administrator's designee
is authorized to file notices of controversion in the name of the
coal-workers' pneumoconiosis fund, in all cases wherein such action is
warranted by the facts of the case or the law applicable to such
facts. (C) In any controverted claim the
administrator or designee is authorized to represent the interest of the
coal-workers' pneumoconiosis fund in all proceedings pertinent to the
controverted claim. This rule will not be construed to limit or preclude a
subscriber from obtaining private counsel to represent it in such claims and
expenses thereby incurred are the responsibility of the
subscriber. (D) Expenses in connection with the
controversion of claims by the coal-workers' pneumoconiosis fund are
charged to the coal-workers' pneumoconiosis fund.
Last updated August 1, 2023 at 8:40 AM
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Rule 4123-21-09 | Rule to transfer funds from coal-workers pneumoconiosis fund to mining regulation and safety fund.
(A) Pursuant to division (B) of section
4131.03 of the Revised Code, the director of natural resources annually may
request the administrator of workers' compensation to transfer a portion
of the funds from the net position of the coal-workers pneumoconiosis fund to
the mining regulation and safety fund created in section 1513.30 of the Revised
Code for the purposes specified in that section. (B) If the administrator receives a
request, the administrator may transfer an amount not to exceed one million
dollars on the first day of July or as soon as possible
thereafter. (C) The administrator may transfer a
portion of the funds from the net position of the coal-workers'
pneumoconiosis fund to the mining regulation and safety fund only if the ratio
of assets to liabilities of the coal-workers' pneumoconiosis fund at the
time of the request is greater than or equal to 1.5. If such ratio is below 1.5
at the time of the request, the administrator may only the transfer funds to
the mining regulation and safety fund after the ratio of assets to liabilities
rises above 1.5 and a qualified actuary has determined that this ratio is not
likely to fall below 1.5 over an acceptable defined period.
Last updated January 4, 2024 at 9:12 AM
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