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This website publishes administrative rules on their effective dates, as designated by the adopting state agencies, colleges, and universities.

Chapter 4123-21 | Coal-Workers' Pneumoconiosis Fund

 
 
 
Rule
Rule 4123-21-01 | Procedures for subscription to the coal-workers' pneumoconiosis fund.
 

(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

Supplemental Information

Authorized By: 4121.12, 4121.121
Amplifies: 4131.01, 4131.02, 4131.03
Five Year Review Date: 8/1/2028
Rule 4123-21-02 | Determination of coverage.
 

(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

Supplemental Information

Authorized By: 4121.121, 4121.12
Amplifies: 4131.04
Five Year Review Date: 8/1/2028
Prior Effective Dates: 2/22/1990
Rule 4123-21-03 | Premium payment.
 

(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

Supplemental Information

Authorized By: 4121.12, 4121.121, 4121.30, 4123.05
Amplifies: 4131.01, 4131.04
Five Year Review Date: 8/1/2028
Prior Effective Dates: 2/22/1990, 10/14/2002
Rule 4123-21-04 | Notice of estimated premium, payroll reporting and reconciliation of premium due.
 

(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

Supplemental Information

Authorized By: 4121.12, 4121.121
Amplifies: 4131.04
Five Year Review Date: 8/1/2028
Prior Effective Dates: 4/1/2019
Rule 4123-21-05 | Audit and inspections.
 

(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

Supplemental Information

Authorized By: 4121.12, 4121.121
Amplifies: 4131.02, 4131.04
Five Year Review Date: 8/1/2028
Rule 4123-21-06 | Default, retroactive coverage.
 

(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

Supplemental Information

Authorized By: 4121.12, 4121.121
Amplifies: 4134.04
Five Year Review Date: 8/1/2028
Prior Effective Dates: 5/28/2008
Rule 4123-21-07 | Effect of cancelled subscription.
 

(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

Supplemental Information

Authorized By: 4121.12, 4121.121
Amplifies: 4131.04
Five Year Review Date: 8/1/2028
Prior Effective Dates: 4/1/2019
Rule 4123-21-08 | Controversion of claims.
 

(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

Supplemental Information

Authorized By: 4121.12, 4121.121
Amplifies: 4131.02, 4131.04
Five Year Review Date: 8/1/2028
Prior Effective Dates: 6/3/1982
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

Supplemental Information

Authorized By: 4121.12, 4121.121, 4131.03, 1513.30
Amplifies: 4121.12, 4121.121
Five Year Review Date: 8/1/2028