Ohio Revised Code Search

...tion, and any legal entity that is self-insured and provides health care benefits to its employees or members. (B) No person shall knowingly solicit, offer, pay, or receive any kickback, bribe, or rebate, directly or indirectly, overtly or covertly, in cash or in kind, in return for referring an individual for the furnishing of health care services or goods for which whole or partial reimbursement is or may be made ...

...insurance support organization, or self-insured entity, or by an agent, employee, or contractor of that type of entity, in connection with any claims investigation activity, anti-fraud activity, rating, or underwriting; (h) For use in providing notice to the owner of a towed, impounded, immobilized, or forfeited vehicle; (i) For use by any licensed private investigative agency or licensed security service for any...

...ection with insurance contractors, self-insured programs, or other similar insurance programs. "Independent adjuster" does not include either of the following: (a) An attorney who adjusts insurance losses incidental to the practice of law and who does not advertise or represent that the attorney is an independent insurance adjuster; (b) A licensed agent or general agent of an insurer licensed in this state who ...

...rkers' compensation shall require every self-insuring employer, including any self-insuring employer that is indemnified by a captive insurance company granted a certificate of authority under Chapter 3964. of the Revised Code, to pay a contribution, calculated under this section, to the self-insuring employers' guaranty fund established pursuant to this section. The fund shall provide for payment of compensation and...

...of a state other than this state and is insured under the workers' compensation law or similar laws of a state other than this state, the employee and the employee's dependents are not entitled to receive compensation or benefits under this chapter, on account of injury, disease, or death arising out of or in the course of employment while temporarily within this state, and the rights of the employee and the employee...

...(A) There is hereby created the self-insuring employers evaluation board consisting of three members. The member of the industrial commission representing the public shall be a member of the self-insuring employers evaluation board and shall serve, ex officio, as chairman. The governor shall appoint the remaining two members with the advice and consent of the senate. One member shall be a member of the Ohio self-insu...

...rdingly. In the event the employer is a self-insuring employer, the self-insuring employer shall deduct the amount from the paid compensation the self-insuring employer reports to the administrator under division (L) of section 4123.35 of the Revised Code. If an employer is a state risk and has paid an assessment for a violation of a specific safety requirement, and, in a final administrative or judicial action, it i...

...s involving state fund employers, or a self-insuring employer, for that employer's claims, shall notify the obligor and the obligor's attorney in writing that the obligor is subject to a support order and that the administrator or self-insuring employer, as appropriate, shall hold the lump sum payment for a period of thirty days after the administrator or self-insuring employer sends this written notice, pendin...

... application under this division. Every self-insuring employer that enters into a final settlement agreement with an employee shall mail, within seven days of executing the agreement, a copy of the agreement to the administrator and the employee's representative. The administrator shall place the agreement into the claimant's file. (B) Except as provided in divisions (C) and (D) of this section, a settlement agreed...

... repayment is made to the bureau or the self-insuring employer. (2) Payment of an amount equal to three times the amount of any excess payments; (3) Payment of a sum of not less than five thousand dollars and not more than ten thousand dollars for each act of deception; (4) All reasonable and necessary expenses that the court determines have been incurred by the bureau or the self-insuring employer in the enforcem...

...(A) As used in this section, "self-insuring employer" has the same meaning as in section 4123.01 of the Revised Code. (B) Not later than thirty calendar days after the date on which a professional employer organization agreement is terminated, the professional employer organization is adjudged bankrupt, the professional employer organization ceases operations within the state of Ohio, or the registration of the prof...

...ministrator of workers' compensation, a self-insuring public employer for the peace officers, firefighters, and emergency medical workers employed by or volunteering for that self-insuring public employer, or a detention facility that is a self-insuring employer for the facility's employees, including corrections officers, shall pay the costs of conducting post-exposure medical diagnostic services, consistent with th...

...(A) As used in this section, "self-insuring employer" has the same meaning as in section 4123.01 of the Revised Code. (B) Not later than thirty calendar days after the date on which an alternate employer organization agreement is terminated, the alternate employer organization is adjudged bankrupt, the alternate employer organization ceases operations within the state of Ohio, or the registration of the alternate e...

... bureau of workers' compensation, or a self-insuring employer under Chapter 4121., 4123., 4127., or 4131. of the Revised Code; (4) Enter into an agreement or conspiracy to defraud the bureau or a self-insuring employer by making or presenting or causing to be made or presented a false claim for workers' compensation benefits; (5) Make or present or cause to be made or presented a false statement concerning ma...

... (1) For private fund employers, except self-insuring employers: (a) For policy years commencing prior to July 1, 2015, in January and July of each year upon gross payrolls of the preceding six months; (b) For policy years commencing on or after July 1, 2015, in the month of June immediately preceding each policy year upon gross payrolls estimated for that policy year. (2) For counties and taxing district employer...

...r than those in which the employer is a self-insuring employer, if the administrator determines under division (A) of this section that a claimant is or is not entitled to an award of compensation or benefits, the administrator shall issue an order no later than twenty-eight days after the sending of the notice under division (A) of this section, granting or denying the payment of the compensation or benefits, or bot...

...ed the injuries have not been purposely self-inflicted, or to the dependents of the employees in case death has ensued. (2) As long as injuries have not been purposely self-inflicted, the bureau shall disburse the surplus fund created under section 4123.34 of the Revised Code to off-duty peace officers, firefighters, emergency medical technicians, and first responders, or to their dependents if death ensues, who are...

... do business in this state. (D) "Group self-insurance program" means a program by which benefits are provided to members, employees of members, or the dependents of such members or employees, other than through sickness and accident insurance purchased from an insurance company licensed to do business in this state or health care services purchased from a health insuring corporation authorized to do business in this...

... (a) The employee has been continuously insured under a group policy or under the policy and any prior similar group coverage replaced by the policy, during the entire three-month period preceding the termination of the employee's employment. (b) The employee did not voluntarily terminate the employee's employment and the termination of employment is not a result of any gross misconduct on the part of the emplo...

...ith respect to, or if the employer is a self-insuring employer, from payment of direct compensation and benefits to and assessments required by this chapter and Chapter 4121. of the Revised Code on account of, an individual employee who meets the requirements of this section. The employer shall make an application on forms provided by the bureau of workers' compensation which forms may be those used by or similar to ...

...take-home weekly wage. In the case of a self-insuring employer, payments shall be for a duration based upon the medical reports of the attending physician, certified nurse-midwife, clinical nurse specialist, or certified nurse practitioner. If the employer disputes the attending physician's or attending nurse's report, payments may be terminated only upon application and hearing by a district hearing officer pursuant...

...y; (3) In the event the employer is a self-insuring employer, one of the following has occurred: (a) Written or facsimile notice of the specific part or parts of the body claimed to have been injured has been given to the commission or bureau or the employer has furnished treatment by a licensed physician, certified nurse-midwife, clinical nurse specialist, or certified nurse practitioner in the employ of an empl...

..., a member or its employees are deemed "insureds" or "policyholders" as used in Title XXXIX of the Revised Code. (B) Notwithstanding division (A) of this section, no multiple employer welfare arrangement operating a group self-insurance program shall be considered an insurer for the purposes of Chapters 3955. and 3956. of the Revised Code, or the laws of this state that relate solely to insurers or insurance compani...

...employees of the county may provide for self-insurance of all risk in the provision of fringe benefits, and may provide through the self-insurance method specific fringe benefits as authorized by the rules of the board of trustees of the jointly administered trust fund. The fringe benefits may include, but are not limited to, hospitalization, surgical care, major medical care, disability, dental care, vision ca...

...into the state insurance fund. (B) No self-insuring employer shall knowingly misrepresent the amount of paid compensation paid by such employer for purposes of the assessments provided under this chapter and Chapter 4121. of the Revised Code as required by section 4123.35 of the Revised Code. Whoever violates this division is liable to the state in an amount determined by the self-insuring employers evaluation boa...