Chapter 123:1-72 Disability Leave Benefits
For purposes of Chapter 123:1-72 of the Administrative Code:
(A) "Benefits" means the payment of disability leave benefits covered under a program established by the director of administrative services.
(B) "Contributions" means amounts contributed by the state or from federal funds, amounts contributed by any state appointing authority, and income derived from dividends, interest earned, rate adjustments, interim and final settlement amounts, and other refunds.
(C) "Administrator" means a company, authorized to do the business of sickness and accident insurance under Title XXXIX of the Revised Code, or professional claim administrator with which the director has contracted to administer the disability leave benefits program pursuant to section 124.83 of the Revised Code.
(D) "State employee disability leave benefit fund" means a fund established by the director of administrative services pursuant to sections 124.83 and 124.87 of the Revised Code to provide state employees with benefits equivalent to those that may be paid under a policy or contract of insurance as specified in section 124.385 of the Revised Code.
(E) "Professional claim administrator" means any person with experience in the handling of disability insurance claims and determined by the director to be fully qualified, financially sound, and capable of meeting all of the service requirements of the contract or administration under such criteria as may be established by the director.
(F) "Director" means the director of administrative services.
(A) Approved claims for disability leave benefits for a particular appointing authority may be deducted by the director from the payroll contributions made by the appointing authority. The director shall establish an administrative special account into which net payroll contributions and all other income shall be credited and from which administrative costs, fees, premiums, subscription charges, amounts available for investment or claims for benefits may be paid. An investment trust account shall be maintained by the treasurer of state in the manner provided in paragraph (E) of this rule.
(B) The state employee disability leave benefit fund shall be available without fiscal year limitation for the payment of benefits, premiums, subscription charges, and administrative costs as specified in sections 124.83 and 124.87 of the Revised Code. The fund shall be under the custody and supervision of the director, which shall be responsible, under approved bonds, for all monies coming into and paid out of the fund in accordance with sections 124.83 and 124.87 of the Revised Code, and which shall ensure that the fund is actuarially sound.
(C) The director shall transfer monies among the various accounts and shall instruct the treasurer of state to make investments in the manner provided for in paragraph (E) of this rule.
(D) Contributions shall be credited to and constitute the state employee disability leave benefit fund. Any amounts remaining in the state employee disability leave benefit fund after all premiums, subscription charges, and other expenses have been paid shall be retained in the fund as a special reserve for adverse claim fluctuation.
(E) Any amounts held by the state employee disability leave benefit fund that are available for investment shall be invested by the treasurer of the state. The amount in the investment trust account shall be invested for a period not to exceed one year, for credit only to the state employee disability leave benefit fund. Investments shall be subject to the terms, conditions, limitations, and restrictions imposed under Chapter 3907. of the Revised Code upon domestic life insurance companies in the investment of their capital, surplus, and accumulations.
(F) All income derived from investments shall accrue to the fund. When monies are paid to the treasurer of state, the director shall submit an estimate of the date such monies are no longer available for investment. When the director wishes to withdraw monies from the trust account, the director shall submit a request for the withdrawal in writing to the treasurer of state, and such funds shall be available to the director within thirty days after the treasurer's receipt of the director's request.
(G) Any necessary and reasonable costs incurred by the treasurer of state or the department of administrative services in administering these rules shall be charged against the administrative special account established under paragraph (A) of this rule.
(H) The director, in consultation with the superintendent of insurance, may, in accordance with the competitive bidding procedures under sections 125.07 to 125.11 of the Revised Code, periodically contract with an insurance company for the issuance of a policy of short term disability and income protection, covering all state employees who are eligible pursuant to section 124.385 of the Revised Code.
(I) The director may enter into a contract with an administrator to administer the portion of the fund set aside to provide benefits specified in section 124.385 of the Revised Code. Determination as to the qualifications of the administrator shall be made by the director in consultation with the superintendent of insurance, and in consideration of the following factors:
(1) Cost of providing required administrative service;
(2) Claim service capability, including location of claim office, nature of claim processing system, claim payment turn-around time, and productivity of claim processors;
(3) Evidence of the effective exercise of claim control and cost containment capability;
(4) Experience with other large groups;
(5) Financial strength;
(6) Non-claim service provided; and
(7) The availability and cost of stop-loss coverage for the state.
(A) All eligible permanent employees in active pay status whose salary or wage is paid directly by warrant of the director of budget and management shall be eligible for disability leave benefits as established in Chapter 123:1-33 of the Administrative Code.
(B) All or any portion of the cost, premium or charges for the benefits provided by the state employee disability leave benefit fund shall be paid by the state. The director may establish a premium contribution rate based on a per cent of each appointing authority's payroll of eligible employees. The director may also consider previous withdrawals from the fund by appointing authorities in determining each appointing authority's premium contribution rate.
(C) The director shall determine eligibility of all employees for disability leave benefits and the termination of disability leave benefits.
Five Year Review (FYR) Dates: 05/15/2017 and 05/15/2022
Promulgated Under: 119.03
Statutory Authority: 124.09
Rule Amplifies: 124.83
Prior Effective Dates: 3/18/82, 2/4/96, 12/1/06, 8/26/12
Every year, the director shall have prepared, by an accredited actuary familiar with disability insurance, a report showing a complete actuarial evaluation of the fund and the adequacy of the rates of contribution and reserves. The report shall contain such recommendations as the actuary considers advisable. The director may at any time request the actuary to conduct studies or evaluations to determine the adequacy of the rates of contribution. Such rates may be adjusted by the director, as recommended by the actuary, to be effective as of the first of any fiscal year thereafter.