Ohio Admin. Code 4123-19-14 - Self-insured review panel

(A) The administrator of the bureau of workers' compensation may delegate the authority granted to the administrator under Chapters 4121. and 4123. of the Revised Code for determining self-insuring employer matters as may be authorized. For this purpose, the administrator may appoint a self-insured review panel to provide advice to the administrator and the bureau's self-insured department of the bureau of workers' compensation and provide employers with hearings on matters referred to the panel, or as requested by the employer. The bureau shall refer all unresolved issues involving the financial strength or the administrative ability of the employer to operate a self-insured workers' compensation program to the panel for a hearing.

(B) The self-insured review panel shall consist of three members appointed by the administrator. The members shall consist of persons who shall have expertise or experience in matters relating to self-insuring employers.

(C) The self-insured review panel shall hold meetings and hearings to determine matters referred to it by the administrator or the bureau's self-insured department for a review. The panel may issue decisions without formal hearing, and may advise the administrator or the self-insured department on issues referred to it. The panel shall afford an employer the opportunity for a formal hearing before the panel upon request.

(D) If an employer requests a hearing before the review panel, or the panel determines that a hearing is in the best interests of the employer or the state insurance fund, the panel shall mail a notice of hearing to the employer and its representatives, setting forth the date, time, and place of the hearing. The notice shall be mailed not less than twenty one twenty-one days before the date of such hearing. In justifiable cases, an emergency hearing may be arranged with the review panel.

(E) The panel shall keep a record of its dockets and proceedings. The panel's decisions shall be reduced to writing and mailed to all interested parties and shall state the evidence upon which the decision was based and the reasons for the panel's actions. The decision of the panel shall be the decision of the administrator. If the employer files a written appeal within fourteen days of the employer's receipt of the panel's decision, at the administrator's discretion, the administrator may reconsider the decision of the panel, and may conduct a formal hearing for such purpose.

(F) The administrator may authorize the review panel to consider the following matters:

(1) Granting or denying an application for the privilege to pay compensation, etc., and benefits directly;

(2) Non-renewals of self-insured status;

(3) Revocation of self-insuring employer status;

(4) Issues of a self-insuring employer's adequacy of contribution to the self-insuring employers' guaranty fund or need for additional security under section 4123.351 of the Revised Code;

(5) Any other self-insuring employer matter as authorized and delegated by the administrator under Chapters 4121. and 4123. of the Revised Code.

Notes

Ohio Admin. Code 4123-19-14

Effective: 8/1/2019
Five Year Review (FYR) Dates: 6/1/2022
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.121, 4121.30, 4123.05
Rule Amplifies: 4123.35, 4123.351, 4123.352
Prior Effective Dates: 05/09/1990, 11/19/1993, 12/17/2001, 09/10/2012, 08/18/2017