New York Insurance brokers are all too familiar with the state-mandated insurance coverages that NY employers must provide. But, if you’re a broker who is based outside New York, you may not know all the ins and outs of keeping your clients with NY locations or employees compliant. Yes, even if your client is not located in the state of New York, they still need to comply with NY law if they have employees working there. In today’s post, we’re here to help walk you through the Disability Benefits Law and mandatory Paid Family Leave Rider, and what it may mean for your clients.
What is Disability Benefits Law?
The Disability Benefits Law is NY’s version of Temporary Disability Insurance (TDI) and is commonly referred to as DBL. It’s governed by Article 9 of the NY Workers’ Compensation Law, which requires private businesses in NY State to provide statutory Short-Term Disability – providing insurance benefits to eligible employees who can’t work due to a pregnancy/birth of a baby, or a non-occupational illness or injury.
Additionally, the Paid Family Leave (PFL) Rider is required since 2018 and provides benefits to take job-protected, partially paid time off to bond with a new baby, care for a seriously ill family member, or attend to military exigencies.
Which states require DBL?
There are a handful of states/territories in the US that have mandatory Short-Term Disability Insurance aside from NY: Rhode Island, California, New Jersey, Puerto Rico, and Hawaii. They go by different names and different benefit levels from state to state. NY is the only state where this coverage is called Disability Benefits Law (DBL).
When do businesses have to provide DBL coverage?
If your client’s business qualifies as a "Covered Employer" under the Disability Benefits Law, they must provide DBL for all their eligible employees. A business is considered a “Covered Employer” after it has employed at least one person for any 30-day period (or longer) in New York in a calendar year.
This means, even though your client’s main location is not in New York, if they have employees working in the state of NY, they must cover those employees!
How it works for employers with employees working in multiple locations?
Scenario 1- Employer main location is outside NY but has a satellite office/branch in New York State:
If you are an employer located outside of NY, you need a DBL policy for your New York employees if you employ one or more individuals each for at least 30 days in a calendar year in New York State.
Scenario 2 - Employer has no office location in New York but employees working in NY (such as telecommuters):
The above requirements include anyone working remotely from their home, as long as their home is located in NY.
Scenario 3 - New York employer with employees working in other states:
Coverage for DBL can be extended to other employees working outside of NY. However, it’s important to point out that Paid Family Leave coverage cannot be extended to out-of-state workers.
We’ll have more details on eligibility in a deep-dive coming soon. Sign-up for updates to never miss a post!
What happens if NY businesses don’t comply with DBL?
If your clients don’t provide DBL coverage as required by law, the Workers’ Compensation Board may investigate and take action.
Possible Penalties if your clients don’t comply with the DBL coverage requirements:
- The Workers’ Compensation Board has the right to impose a penalty based on the amount of the employer’s payroll during the time the employer does not have required DBL coverage (0.5% of payroll during that period). An additional fine for each period of noncompliance may also be imposed.
- If your client does not have the required DBL coverage, they may be subject to a monetary fine and/or imprisonment for up to 1 year. Subsequent violations may result in increased fines.
- Additionally, your client may be liable for either the total value of any disability benefits claims paid by the Special Fund for Disability Benefits during the period of noncompliance or one percent of the payroll during the period of noncompliance (whichever is greater).
Please visit the Workers’ Compensation Board’s website for more details about possible fines.
Do all businesses in NY have to provide DBL? Are there any exclusions?
Typically, all private sector organizations with at least 1 employee who works in NY for at least 30 days in a year must provide DBL coverage. There are however a few DBL-exempt employers who do not meet the definition of “Covered Employers” and thus are not required to have a DBL/PFL policy in place.
- Public Employers, meaning any political subdivision of New York State, a public authority or any other governmental agency or instrumentality thereof.
- Examples of public employers:
- State of New York
- City of XYZ
- Village of XYZ
- Town of XYZ
- Public Libraries without a federal 501(c)3 status*
- Public Authority
- Fire District
- Water District
- School District
- Owners/shareholders of Partnerships, LLCs, LLPs, Sole Proprietorships (“business owners”) without employees
- If an employee is hired, the employer becomes a "Covered Employer” 4 weeks after the 30th day of such employment, and a policy must be in place by this deadline to ensure compliance.
- Owners/shareholders of a Corporation with 1 or 2 officers who own all the stock of the corporation and have no employees
- Domestic Employer whose only employees are domestic workers that work less than 40 hours per week for the household and do not live on premise
- Native American Enterprises
Other Excluded Groups:
Some Covered Employers may have workers who are excluded classes/occupations. You can read more about excluded employees here.
More information for your clients
We advise you to notify your clients with employees working in NY to ensure they are compliant with DBL. If their main location is not in NY or they don’t have an actual satellite location, they may not realize they need to be providing this mandatory insurance coverage to their employees working in New York, even if those employees work from their NY home.
It’s full of FAQs broken out into two sections – one for employers and one for employees.
And, keep checking back here for updates. As your DBL and PFL Experts, we will have more posts coming on specific topics related to New York Disability Benefits Law and Paid Family Leave over the coming weeks. Sign-up now, and never miss a post!
Selling Disability Benefits Law
Never sold DBL before? That’s ok, as we like to say, “If you can spell it, you can sell it” because any licensed insurance professional with a New York insurance (whether P&C or Life/Health) license can sell DBL – and it’s commissionable!
We’ll have more on this in a future post, but if you want more information in the meantime, or want to speak to someone directly, please fill out this quick form, and we’ll have your ShelterPoint Sales Rep reach out to you with how you can get started selling DBL with us today!
*Public libraries organized as an Association Library with a federal 501(c)3 status are required to have a DBL/PFL policy in place for their employees. Municipal, School District, and Special District Public Libraries are not required to have a DBL/PFL policy in place for their employees.
Information in this article is for broker/agent use only and is not intended for the general public. This information is not intended as an offer of coverage. It is for illustrative purposes only, providing a general overview of featured benefit highlights provided under the respective policies. It is not a contract.
ShelterPoint Life only provides statutory coverages in the states of NY and NJ, and DOES NOT provide statutory coverages in CA, HI, RI, and Puerto Rico.
NY DBL is underwritten by: ShelterPoint Life Insurance Company (principal office in Garden City, NY). Policy Form# SPL DBL1114
NY DBL policies are governed by Article 9 of Workers Compensation Board (WCB) Law (New York State Disability and Paid Family Leave Benefits Law). In the event of conflicting information with the policy, the policy will take precedence over what is shown in this material. Please refer to the policy for terms under which it may be continued or cancelled. Conditions, covered services, exclusions, limitations, and terms of coverage apply as pursuant to Article 9 of WCB Law.