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Statutory Benefits

NY Paid Family Leave Eligibility

NY Paid Family Leave Eligibility Explained

Eligibility can mean a couple of different things, and if you’re not familiar with the different meanings, it can get a bit confusing to understand if/when you can actually start taking paid time off under Paid Family Leave. That’s because coverage eligibility and eligibility to request PFL are not the same. What do we mean by that?

You may be eligible for coverage BUT you may not be eligible to actually request Paid Family Leave or receive benefits yet. So, in order to be able to take PFL, you have to be eligible for coverage and have satisfied all the requirements to use the Paid Family Leave benefit.

 

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First things first: How do you know if you’re eligible for coverage?

Since your employer will be the one to provide Paid Family Leave coverage, your first hurdle is based on whether you’d get Paid Family Leave through your employment. Here are the requirements:

  1. You work in NY State
    • whether on premises at your employer or from home
    • any amount of hours (regardless of part-time or full-time)
    • for an employer in the private sector with at least 1 employee who works at least 30 days per year in NY State
    • as a personal/domestic employee (like a nanny, housekeeper, home health aide, etc.), who works at least 30 days per calendar year at 40+ hours per week for the same employer

    These employers are referred to as a “Covered Employer” because they have to provide this coverage by law. Paid Family Leave is part of statutory short-term disability insurance (commonly referred to as DBL). This means, “Covered Employer” refers to both types of coverages, DBL and PFL, and there are some dependencies between the two with respect to benefit eligibility.

  2. Your type of job doesn’t fall into an excluded occupation or class of employees. Read more about excluded employees here.

 

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PFL Expert Tip:

So, even if you work for an organization that has to provide Paid Family Leave (as part of your DBL coverage), your particular occupation or employee class may be excluded – such as high school students, executive officers at 501(c)3 religious/charitable/educational institutions, etc. See the full list of exclusions here


What if you don’t fall into any of these covered categories (you’re either an excluded class or don’t work for a “Covered Employer”)?

Employers that would normally be exempt (such as organizations in the public sector) or have excluded classes of employees can choose to provide coverage. Since your employer may have opted in to provide coverage on a voluntary basis, we encourage you to confirm with your employer whether you are thereby considered eligible for coverage. Read more about exempt employers and voluntary coverage here.

 

Paid Family Leave
Coverage Eligibility vs. Qualification Period

Once you determine you are eligible for coverage, your employer may already withhold your Paid Family Leave contributions, BUT you may not be eligible to actually use PFL yet. So, let’s look at what it takes to be eligible to actually request paid leave benefits under PFL.


You must make it through what’s called a “qualification period”:

  • If you work 20 or more hours per week, you must have worked at least 26 consecutive weeks at your current employer.
  • If you work less than 20 hours a week, you must have completed at least 175 work days at your current employer. What counts towards the qualification period:
  • Approved vacation
  • Personal time
  • Sick time
  • Other time away from work - you are still considered an employee as long as your Paid Family Leave coverage is paid
What does not count towards the qualification period:
  • Time away from your employer on a DBL claim does not count towards your qualification period.
  • Time away from your employer on furlough from your employer.
  • If you change jobs, your time worked at the previous employer does not count. In other words, you start over with a new qualification period.
PFL Eligibility Period Chart

If you’re eligible to request PFL, does that mean you’re eligible to receive benefits?

Well, whether your claim qualifies for benefit payments depends on several factors. Your specific situation is evaluated when you file your Paid Family Leave claim. Read detailed information and claims guidance here.

For employers:
Not sure if you have to provide PFL?
NY Paid Family Leave Coverage Quiz

Trying to figure out whether your business is required to provide statutory New York Disability and Paid Family Leave? Take this quick and easy 1-minute quiz to find out!

The ABCs of PFL

Our in-depth guide provides everything you need to know about Paid Family Leave in New York. Here’s what you’ll find inside this 33-page guide:

  • PFL basics
  • Eligibility
  • Benefit eligibility and qualification period details
  • Benefits - updated for 2021
  • Claims
  • Premium - updated for 2021
  • Example withholdings - updated for 2021
  • Employer responsibilities
  • How PFL compares to DBL & FMLA
  • Tips from your PFL Experts
  • …And much more!
Download your copy now

 

 

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Learn More About NY Paid Family Leave

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NY Paid Family Leave Eligibility FAQs

Does coverage eligibility for PFL line up with eligibility for statutory short-term disability (DBL)?

Can Employees "Opt-Out" Of NY Paid Family Leave?

Paid Family Leave is a mandatory benefit for employees who do not fall into an excluded class and work at a Covered Employer, just like DBL. You can read more about those excluded classes here.

There are a few limited scenarios under which certain employees may “opt out” by filling out the PFL-Waiver form.

You may file a waiver for paid leave benefits if you:
  • work 20+ hours per week but not 26 weeks in a consecutive 52 week period.
  • work less than 20 hours per week and less than 175 days in a consecutive 52-week period.
Deep-dive for employers:

If an employee’s work schedule ceases to fall below this threshold, their PFL waiver is automatically invalid within 8 weeks of the change in their work schedule. At that time, you must start counting this employee for premium purposes – and if you are collecting employee contributions for Paid Family Leave, any employee coming off a waiver will need to start contributing, including any retroactive amounts back to the date of hire or inception of Paid Family Leave.

You will need to keep the waiver on file for as long as they are working for you – whether the waiver is still in force or not.

One other scenario where an employee may “opt-out” or exempt themselves is if they are receiving, or are eligible to receive Old Age Social Security benefits. However, in this case the employee would need to opt-out of both DBL and PFL by sending written notice to the Chair of the Worker’s Compensation Board.

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PFL Expert Tip:

It’s best practice to educate employees who would qualify for the waiver about their options, especially if you withhold PFL premium from employees, and have them confirm in writing even if they don’t want to waive.

In summary, unless you meet the very specific criteria above and work for a “Covered Employer,” you must participate in Paid Family Leave – even if you’ve already had children, or have no living family members. Not sure if you’re work for a “Covered Employer”? Take this quick quiz to find out.

Can business owners opt out of Paid Family Leave?

As the owner, you may file a request with the Worker’s Compensation Board (WCB) to exclude yourself under the following circumstances:
  • If your business is a corporation with no more than 2 corporate officers (each owning at least 1 share of stock) and you have at least 1 employee, you may elect to exclude yourself from DBL/PFL coverage.
  • As a sole proprietor or co-owner of a partnership, you may elect to exclude your spouse by filing a spousal exclusion.

 

 


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Underwritten by:
ShelterPoint Life Insurance Company (principal office in Garden City, NY) in: NY
ShelterPoint only offers Paid Family Leave in form of a rider to DBL.
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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. Any Paid Family Leave information is based on the applicable statutes and may change if guidance is issued by the State of New York.

 

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