Cuyahoga Metropolitan Housing Authority v. Industrial Commission

463 N.E.2d 1286, 11 Ohio App. 3d 192, 11 Ohio B. 286, 1983 Ohio App. LEXIS 11274
CourtOhio Court of Appeals
DecidedSeptember 27, 1983
Docket83AP-206
StatusPublished

This text of 463 N.E.2d 1286 (Cuyahoga Metropolitan Housing Authority v. Industrial Commission) is published on Counsel Stack Legal Research, covering Ohio Court of Appeals primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Cuyahoga Metropolitan Housing Authority v. Industrial Commission, 463 N.E.2d 1286, 11 Ohio App. 3d 192, 11 Ohio B. 286, 1983 Ohio App. LEXIS 11274 (Ohio Ct. App. 1983).

Opinion

Norris, J.

Defendants, the Industrial Commission of Ohio and its members, and the Bureau of Workers’ Compensation and its administrator, appeal from a judgment of the trial court granting to plaintiff a declaratory judgment that a portion of a rule of the commission is invalid and ordering a refund to plaintiff of $476,384 in premiums it paid into the State Insurance Fund.

Plaintiff, a private employer, became a participant in the State Insurance Fund in 1933, and paid premiums into the fund thereafter. In 1980, its application to become a self-insuring employer was approved by the commission, pursuant to the provisions of R.C. 4123.35.

Prior to granting plaintiff self-insurance status, the commission made calculations required by its “buy-out rule,” which reads as follows:

“(N) If at the time of applying for the self-insurance status the employer is a state risk, which means that it has industrial insurance coverage by paying premiums to the state insurance fund, the following additional provisions shall be applicable:
“(1) When an employer requests approval of the industrial commission to transfer from state fund to self-insurance, the actuary of the commission and bureau shall determine, on the basis of the full past experience of the industrial commission and the bureau of workers’ compensation, the amount of the liability of such employer to the commission and bureau for losses incurred and losses which may be incurred for injuries or occupational diseases occurring during the oldest four of the latest five-calendar-year period used in the most recent merit rating *193 calculations as of the date of filing of the application for self-insurance. If the ultimate liability of risk lossés exceeds pure premium paid on payroll for those same four calendar years, the difference shall be paid by the risk to the state insurance fund. If pure premium paid exceeds the ultimate liability of' risk losses, then no refund of excess premium shall be made. * * *” (Ohio Adm. Code 4121-9-03[N][l].)

According to the calculations, defendants determined that plaintiff’s premiums paid exceeded its ultimate liability of risk losses. Plaintiff sought a refund of the excess, which was denied.

Plaintiff then brought an action seeking a declaration that it was entitled to the refund.

Defendants raise six assignments of error:

“I. The lower court erred in finding that the buy-out rule was without proper statutory basis.
“II. The lower court erred by finding the buy-out rule to be in violation of the Equal Protection Clause of the U.S. and Ohio Constitutions.
“III. The lower court erred in finding the buy-out rule is in derogation of the industrial commission fiduciary duties to employers and employees.
“IV. The referee erred by including findings of fact in his report which are clearly irrelevant to the issues raised in this case.
“V. The lower court erred in ruling that CMHA is entitled to a refund of premium is contrary to the basic principles of Workers’ Compensation Insurance and is therefore contrary to law.
“VI. To affirm the relief granted to CMHA would have the effect of making or revising an administrative rule and therefore is prohibited by law.”

The first assignment of error is directed at several of the trial court’s conclusions of law, among them that the portion of the rule which prohibits a refund to plaintiff “is not reasonably related to R.C. 4123.35 (which authorizes the Commission to promulgate rules for self-insurance) * * We assume from the quoted language that the trial court also concluded that that portion of the rule was invalid as being beyond the General Assembly’s grant of rule-making authority. In support of its conclusion, the trial court cited our opinion in State, ex rel. Wenco, Inc., v. Indus. Comm. (1979), 65 Ohio App. 2d 233 [19 O.O.3d 197]. If the trial court is correct in its application of that opinion, then the entire rule (including the portion requiring employers in a deficit position to pay into the insurance fund) was beyond the capacity of the commission to promulgate, not just a portion. And, if the entire rule is invalid, then the trial court was left without a basis upon which to ground its equal protection conclusions.

However, the reasoning applied in our opinion in State, ex rel. Wenco, supra, does not prevent the promulgation of the rule. In that case, we were concerned with a rule promulgated by the commission with a purported purpose of creating a standard to determine whether an employer would have the capacity to assume self-insurance status and at the same time afford to its employees the protection they would receive if their employer were paying into the State Insurance Fund, and we noted that the challenged rule in that case bore no reasonable relationship to the standards promulgated in R.C. 4123.35 for making that determination. Here, the purported purpose of the challenged rule is related to the integrity of the fund and the effect the exiting of an employer will have on the fund. Accordingly, the question that should have been addressed by the trial court was whether the rule bears a reasonable relationship to the authority granted the commission by the General Assembly, in R.C. 4123.32, to adopt rules relating to the maintenance of the State Insurance Fund. We are unable to say that the rule is not within the General *194 Assembly’s grant of rule-making authority for that purpose.

Defendants further contend that the trial court erred in concluding that “[t]he refund of premium paid by a self-insurance applicant in excess of its ultimate liability of risk losses (‘excess premiums’) is required by the merit-rating principle of R.C. 4123.34(C).” That provision of the Revised Code reads as follows:

‘ ‘(C) The commission may apply that form of rating system which it finds is best calculated to merit rate or individually rate the risk more equitably, predicated upon the basis of its individual industrial accident and occupational disease experience, and may encourage and stimulate accident prevention. The commission shall develop fixed and equitable rules controlling the rating system, which rules shall conserve to each risk the basic principles of workers’ compensation insurance.”

It is conceded by the parties, and the trial court found, that the commission has adopted a merit-rating system which gives an employer with claims experience better than the norm a percentage credit off its basic premium rate, and charges an employer with experience worse than the norm a percentage surcharge on top of its basic premium rate. There is no requirement found in R.C. 4123.34(C) that any merit-rating system adopted by the commission provide for the refund of any premiums to employers who seek to leave the fund and assume the status of self-insuring employers.

Also well-taken is defendants’ contention that the trial court erred in concluding that “[t]he refund of excess premium paid by a self-insurance applicant is mandated by the R.C.

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Related

State Ex Rel. Wenco, Inc. v. Industrial Commission
417 N.E.2d 1280 (Ohio Court of Appeals, 1979)

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Bluebook (online)
463 N.E.2d 1286, 11 Ohio App. 3d 192, 11 Ohio B. 286, 1983 Ohio App. LEXIS 11274, Counsel Stack Legal Research, https://law.counselstack.com/opinion/cuyahoga-metropolitan-housing-authority-v-industrial-commission-ohioctapp-1983.