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Why Choose A Fully-Insured Private Plan?

Temporary Disability Insurance (TDI) is a state-mandated benefit in New Jersey. Employers automatically default to the State Fund for their coverage unless they have chosen to provide their employees the coverage through an approved private plan.

So, what are the advantages of choosing a private plan? Insurance carriers have built expertise and scalability around administering and paying claims. This focus may bring other advantages such as faster claims turnaround and dedicated claims service – potentially resulting in a better insurance experience for employees.


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NJ Temporary Disability Insurance: How To Apply For An Approved Private Plan



Step 1 – You and your broker

Provide your broker with the information they need to request a quote.

Complete the State of NJ’s application for Temporary Disability Insurance (form DP-1) together with your broker. Your broker will submit it to your private insurance carrier of choice.

Step 2 – Carrier

The carrier reviews the application.

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

Step 3 – The State of New Jersey

The State of NJ issues a Certificate of Approval.

Step 4 – Carrier

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

Step 5 – You and your broker

The carrier forwards the coverage documents to your broker to forward to you.

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.


TDI - Application form

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

  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

If Current coverage is with a private carrier

  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


Learn More About NJ Temporary Disability Insurance

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*The ShelterPoint family of companies operates under the “ShelterPoint” name strictly as a marketing name, and no legal significance is expressed or implied. The ShelterPoint family of companies consists of ShelterPoint Life Insurance Company, a NY-domiciled carrier, and its wholly-owned subsidiary ShelterPoint Insurance Company, a FL-domiciled carrier, depending on the state. ShelterPoint is a registered service mark.

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

This page is for informational purposes only and is not intended to provide legal counsel. Please consult with an appropriate professional for legal and compliance advice.

The information on this page is not intended as an offer of coverage (“Invitation to Contract”). It is for illustrative purposes only, providing a general overview of the services described. 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.


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