25 February 2020

How to Switch to a Private Plan for NJ Temporary Disability Insurance

How to Switch to a Private Plan for NJ Temporary Disability Insurance

Now that we’ve gone over the advantages of switching your clients to a private New Jersey  Temporary Disability (TDI) plan in our Valentine’s Day post, we want to walk you through how to migrate to an approved private plan – and also what you need to quote a ShelterPoint TDI plan specifically.  Missed that article? Stay up-to-date here with all our NJ Temporary Disability posts.



NJ Temporary Disability Insurance: how to switch to an approved private plan

  1. Request a quote on behalf of your client.

  2. Complete the State of NJ’s application for Temporary Disability Insurance (form DP-1) together with your client.

  3. Submit it to your private carrier of choice.

  4. The carrier reviews the application.

  5. If approved, the carrier sends the DP-1 and policy documents to the State of NJ for acceptance.

  6. The State of NJ issues a Certificate of Approval.

  7. The private plan carrier then issues the policy and posting notice. 

  8. The carrier forwards the coverage documents to you for forwarding to your client.


ShelterPoint's process to apply for a TDI private plan


What is the DP-1 Form?

The DP-1 Form is the application for approval or modification of an insured private plan in New Jersey.

Some other important notes about the DP-1 Form:

  • All applicable fields must be completed.
  • Must be signed by a Person of Authority (Owner, Partner, President, Vice President,  Secretary or Treasurer )
  • An electronic application/signature is acceptable - no wet signature is required.


  • NJ State Fund to Private Carrier
    • Effective date of the policy MUST be the FIRST DAY OF ANY FUTURE QUARTER (Jan. 1, Apr 1, Jul 1, Oct 1).  The completed DP-1 Form must be received by the State prior to the effective date.


  • Private Carrier to Private Carrier
    • The effective date of coverage may be on any day of the year.
    • 60 Day Waiver Letter is required if application is received within 60 days of the effective date.

Image of NJ's TDI DP-1 form to apply for a ShelterPoint plan


How to quote a private NJ TDI plan with ShelterPoint

To quote a NJ TDI plan with ShelterPoint, you’ll need the following:

  • Client’s full legal business name and address
  • Broker name, address and contact person/email address
  • Requested effective date
  • Census, including gender and salary
  • List of any special services
  • Due date


If Current coverage is with NJ State: If Current coverage is with a private carrier:
  1. Form AC-174.1 for the past 4 years.
    To obtain the form for the most recent year and/or if prior years are needed, the insured may register and download this information through the Employer Access app on the NJ Department of Labor site.
  2. Male/female employee count
  3. Salary census
  1. Your client’s reporting forms for the past 3 years from the current carrier showing your client’s premium and claims experience.
  2. Male/female employee count
  3. Rate history, including current/renewal rates
  4. Salary census


Your Statutory Insurance Experts are here to help your clients make the switch

We are here to guide you through this process.  If you have any questions along the way our TDI experts will be happy to help – contact us anytime at: TDIQuestions@shelterpoint.com 

Learn more about New Jersey Temporary Disability Benefits here, and sign up now to never miss a post!


The information in this post is not intended as an offer of coverage (“Invitation to Contract”). It is for illustrative purposes only, providing a general overview of the services descred. It is not a contract. Available in NJ only. The Temporary Disability Benefits (TDB) Law (Temporary Disability Benefits law (P.L.1948, c.110 (C:43-21-25 et seq.) governs this private plan and its interpretation and administration. All coverage extends up to TDB Law limits reflected in this policy. Please refer to the policy and TDB law for coverage details, a complete listing of covered services, provisions, conditions, exclusions, and terms under which the policy may be continued or cancelled. In the event of conflicting information with the policy and applicable TDB Law, the policy and TDB Law will take precedence over what is shown in this material. Claim payment is not guaranteed; benefit amount depends on wages. Policies have a statutory 7-day waiting period.

Underwritten by:

ShelterPoint Life Insurance Company (principal office in Garden City, NY) in: NJ (form# TDB-P-NJ)

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