Ohio Administrative Code
Title 4123 - Bureau of Workers' Compensation
Chapter 4123-17 - General Rating for the State Insurance Fund
Section 4123-17-55 - Transitional work development grant and transitional work bonus program
Universal Citation: OH Admin Code 4123-17-55
Current through all regulations passed and filed through September 16, 2024
(A) Definitions.
As used in this rule:
(1) "AEO" and "PEO" have the same meaning as
defined in rule
4123-17-15 of the Administrative
Code.
(2) "Application deadline"
means the applicable application deadline set forth in appendix A or in
appendix B to rule
4123-17-74 of the Administrative
Code.
(3) "Client employer" has the
same meaning as defined in rule
4123-17-15 of the Administrative
Code.
(4) "Program period" means
the policy year for which the employer elects to participate in the
transitional work program.
(5)
"Transitional work" has the same meaning as defined in rule
4123-6-01 of the Administrative
Code.
(6) "Transitional work
developer" means the provider who develops the employer's transitional work
program. A transitional work developer shall:
(a) Meet the minimum credentials designated
in rule 4123-6-02.2 of the
Administrative Code for one of the following provider types:
(i) A vocational rehabilitation case
manager,
(ii) An occupational
therapist, or
(iii) A physical
therapist; and
(b)
Complete bureau of workers' compensation
sponsored transitional work development training prior to delivering
transitional work programs and at two-year intervals.
(B) Eligibility requirements.
(1) To receive benefits under this rule, the
employer must meet the following criteria as of the application date for the
grant or the application deadline for the transitional work bonus:
(a) The employer must be current with respect
to all payments due the bureau, as defined in rule
4123-17-14 of the Administrative
Code.
(b) The employer must not
have cumulative lapses in workers' compensation coverage in excess of forty
days within the preceding twelve months.
(c) The employer must be in an active policy
status. For purposes of this rule, "active policy status" does not include a
policy that is a no coverage policy or a policy that is lapsed.
(d) The employer must report actual payroll
for the preceding policy year and pay any premium due upon reconciliation of
estimated premium and actual premium for that policy year no later than the
application deadline.
(2) The following employers shall not be
eligible for either a transitional work program development grant or a
transitional work bonus under this rule:
(a)
Employers paying the minimum administrative charge for the applicable payroll
reporting period as set forth in rule
4123-17-26 of the Administrative
Code;
(b)
State agencies; and
(c)
Self-insuring employers providing compensation and benefits pursuant to section
4123.35 of the Revised
Code.
(3) The following
employers shall not be eligible to receive a transitional work program
development grant under paragraph (C) of this rule:
(a) Employers who have elective coverage
only; and
(b) Sole proprietors with
zero payroll.
(4) An
employer that is found to be ineligible for participation in the program may
reapply for a subsequent program period.
(C) Transitional work program development grant.
(1) An employer interested in obtaining
a transitional work program development grant shall apply to the bureau on a
form provided by the bureau. In signing the application form, the chief
executive officer or designated management representative of the employer is
certifying to the bureau that the employer will comply with all program
requirements.
(2) The bureau shall
evaluate each application to determine the employer's eligibility to receive a
transitional work program development grant and shall have the final authority
to approve a grant for an eligible employer and to determine the amount of the
grant. If, upon review of an application, the bureau determines that it can
assist the employer in developing a transitional work program, the bureau may
deny the grant and provide assistance to the employer directly.
(3) Transitional work program development
grant awards expire five years from the date of the mailing of the notice of
approval of the grant. Upon expiration of the grant, the employer loses any
remaining grant funds that were awarded but unspent. However, the employer may
apply for a new transitional work program development grant.
(4) An employer is eligible for no more than
one transitional work program development grant per policy number every five
years, calculated from the date of the mailing of the notice of approval of the
previous transitional work program development grant. The bureau shall provide
assistance to employers as needed to update transitional work programs
developed with previous grants.
(5)
Grant amounts will be determined by the bureau based on employer size and the
complexity of services needed for transitional work services. Factors which may
determine appropriate grant amounts may include the employer's:
(a) Payroll;
(b) Job classifications;
(c) Job analyses needed; and
(d) Collective bargaining
agreements.
(6) The bureau shall not reimburse an
employer for costs associated with a transitional work developer's preparing
and submitting a proposal to an employer and shall not reimburse for costs
determined by the bureau to be ineligible or unnecessary. The bureau may
monitor the content and implementation of transitional work services.
(7) The employer shall have and maintain
continuous active state fund coverage for a period of one year from the date
the bureau disburses the grant funds to the employer. The bureau may recover
the entire grant if the bureau determines the employer has failed to maintain
coverage as required by this rule.
(D) Transitional work bonus program.
An employer who has developed and implemented a transitional work program may be eligible to receive a transitional work bonus as provided in this rule.
(1) The employer must report actual payroll
due upon reconciliation of estimated premium and actual premium for the program
period no later than the date set forth in rule
4123-17-14 of the Administrative
Code. An employer will be deemed to have met this requirement if the bureau
receives the payroll report, and the employer
pays premium associated with such report, before
the expiration of any grace period established by the
administrator of workers' compensation pursuant to
rule 4123-17-16 of the Administrative
Code.
(a) Failure to comply with paragraph
(D)(1) of this rule shall immediately remove the employer from the transitional
work bonus program for the current program period, and the employer shall not
be eligible for a transitional work bonus for the current program
period.
(b) Should an employer fail
to comply with paragraph (D)(1) of this rule, the employer may reapply to the
transitional work bonus program subject to the eligibility requirements of
paragraph (B) of this rule for the next program period.
(2) An employer interested in participating
in the transitional work bonus program shall apply to the bureau on a form
provided by the bureau. In signing the application form, the chief executive
officer or designated management representative of the employer is certifying
to the bureau that the employer will comply with all program
requirements.
(3) The bureau shall
evaluate each application to determine the employer's eligibility to
participate in the transitional work bonus program at the time of the
application. The bureau shall have the final authority to approve an eligible
employer for participation in the transitional work bonus program.
(4) The transitional work program bonus
calculation shall occur at six months following the end of the applicable
program period. The bureau will evaluate all claims of the employer with injury
dates that fall within the applicable program period to determine:
(a) How many of those claims had the
potential for transitional work services, and
(b) How many of the claims identified in
paragraph (D)(4)(a) of this rule utilized transitional work services.
(5) The bureau will calculate the
employer's percentage of claims with potential for transitional work services
in which transitional work services were utilized.
(6) The employer will receive a transitional
work bonus equal to the percentage calculated pursuant to paragraph (D)(5) of
this rule multiplied by a percentage of the employer's pure premium for the
applicable program period as set forth in the appendix to rule
4123-17-75 of the Administrative
Code. The transitional work bonus will be posted to the employer's account with
the bureau.
(7) An AEO or a PEO
shall be eligible to receive a transitional work bonus under this rule for
claims in which the AEO or the PEO was the employer of record on the date of
injury and transitional work services were available under a transitional work
program of either the AEO, the PEO or its client employer.
(8) An employer may appeal the bureau's
transitional work bonus program application rejection or the bureau's
transitional work bonus determination to the bureau's adjudicating committee
pursuant to section 4123.291 of the Revised Code and
rule 4123-14-06 of the Administrative
Code.
(9) Unless an employer
notifies the bureau otherwise as outlined below, continued participation in
this program for each subsequent program period shall be automatic provided
that the employer continues to meet the eligibility requirements set forth in
paragraph (B) of this rule.
An employer that elects to opt out of continued participation in this program shall provide written notice to the bureau by the application deadline set forth in this rule.
(10)
The transitional
work bonus program will gradually be phased out with reductions in the
percentage of the employer's pure premium for the applicable program period
used in the transitional work bonus calculation pursuant to paragraph (D)(6) of
this rule and the maximum transitional work bonus per employer, as set forth in
the appendix to rule
4123-17-75 of the Administrative
Code. The last policy year for the transitional work bonus program will be the
policy year beginning July 1, 2025, for private employers, and beginning
January 1, 2026, for public employers.
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