The administrator may reorganize the work of the bureau to the extent necessary to achieve the most efficient performance of its functions. The duties of the operational units of the bureau include, but are not limited to the following:
(A) A division responsible for the fiscal and planning function will assist the administrator in maintaining the solvency of the insurance fund, establishing policies and procedures for fiscal management, receiving and disbursing funds from the state insurance fund, and preparing the bureau's budget.
(B) A division responsible for the medical services function will assist the administrator in establishing and maintaining a quality pool of medical and vocational service providers, developing and maintaining quality medical , vocational rehabilitation, and pharmaceutical benefits plans, overseeing managed care services, and ensuring the proper and timely payment of medical bills.
(C) A department responsible for the special investigations function will conduct investigations of alleged workers' compensation fraud and alleged violations of specific safety requirements pursuant to workers' compensation claims.
(D) A division or divisions responsible for the customer service function will assist the administrator in:
(1) Identifying employers subject to the Ohio Workers' Compensation Act;
(2) Conducting periodic reviews of the manual classifications and payroll reports of state fund employers to ensure that employer premium payments have been properly computed and paid
(3) Developing and making available alternative premium plans to state fund employers;
(4) Managing the claims of injured workers in accordance with applicable statutes, rules and policies;
(E) A division responsible for the actuarial function will assist the administrator in ensuring that rates for all employers are calculated based on actuarial principles and standards of practice, ensuring that financial liabilities for compensation and compensation adjustment are calculated based on actuarial principles and standards of practice, and developing and supporting alternative rating options for employers.
(F) A division responsible for the investment function will assist the administrator in the investment and monitoring of assets of the state insurance fund and other funds administrated by the bureau, and in the implementation and monitoring of the bureau investment policy approved by the board of directors.
(G) A division responsible for the internal audit function will conduct reviews of divisions and control systems within the bureau, at appropriate intervals, to determine whether they are effectively carrying out their functions of administration, accounting, safeguarding of bureau assets, and control in accordance with management's instructions, policies, and procedures, and in a manner that is in agreement with both agency objectives and high standards of administrative practice; conduct special examinations at the request of management or the bureau of workers' compensation board of directors audit committee; submit an annual audit plan to the administrator and the audit committee for their review and approval.
Cite as Ohio Admin. Code 4123-5-01
R.C. 119.032 review dates: 06/10/2014 and 08/01/2019
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.121, 4121.13, 4121.30
Rule Amplifies: 4123.05
Prior Effective Dates: 1/1/78, 9/1/96, 12/1/09