New York Paid Family Leave: What You Need to Know for 2019

In 2016, New York’s Governor Cuomo signed into law the New York Paid Family Leave Act to provide job protection and wage reimbursement for all New York workers who need to take a temporary leave to bond with a child, care for a loved one with a serious illness, or assist at home when a family member is called into active duty.

As of January 1st, 2019, eligible employees can file under this coverage for up to 10 weeks of benefits.

PAID FAMILY LEAVE RATES AND WEEKLY CONTRIBUTIONS:

The weekly contribution, determined by the state, is by employee and is 0.153% of an employee’s weekly wage. An employee’s wages are capped at $1,357.11 per week, with an annual maximum contribution of $107.97. Employees will see this deduction from their checks starting 1/1/2019. These rates and contributions are subject to change in future years.

Paid Family Leave Act rates are set by New York state and are state mandatory, but certain employees may opt out of Paid Family Leave (PFL) under the limited scenarios shown below.

For individuals who prefer to opt out of the coverage and forgo the withholding, the PFL Waiver Form, available here, will need to be submitted to your accounting department and must be forwarded to your paymaster prior to the processing of your first 2019 payroll.

Unless this form is received, withholding will commence and coverage will be enacted, so it is imperative that the form is provided if coverage is not desired.

Please note: If an employee opts out because they are working less than a certain amount of time as indicated in the chart above (working less than 20 hours per week and less than 175 days in a consecutive 52-week period OR working 20+ hours per week but less than 26 consecutive weeks), they will automatically be opted in once they work the amount of time and hours to be eligible.

HOW IS PAID FAMILY LEAVE ELIGIBILITY DETERMINED?

Eligibility is based on an employee’s 12-month employment status prior to the date of the claim.

• Employees with a regular schedule of 20 or more hours per week are eligible after they are employed for 26 consecutive weeks for the employer under which leave will be taken.
• Employees with a regular schedule of less than 20 hours per week are eligible after they work 175 days for the employer under which leave will be taken.

Once employees meet the eligibility requirements, they remain eligible for that employer until employment is terminated. If employees start a new job, they must work long enough with their new employer to meet the eligibility requirement.

Executive officers are only covered if they are included on NY State Disability; coverage is not automatic, and they must opt in to be included.

WHEN CAN PAID FAMILY LEAVE BENEFITS BE USED?

Maternity or paternity leave: In 2019, if you are a parent expecting, fostering, or adopting a child, with proper documentation you may be eligible for up to 10 weeks of employee-funded Paid Family Leave to take time to care for your child.

A parent may take Paid Family Leave during the first 12 months following the birth, adoption, or fostering of a child. Paid Family Leave only begins after birth and is not available for prenatal conditions.

Caring for a close relative with a serious health condition: A serious health condition is an illness, injury, impairment, or physical or mental condition that involves inpatient care in a hospital, hospice, or residential health care facility, or continuing treatment or continuing supervision by a health care provider.

A close relative includes:

• Spouse
• Domestic partner
• Child
• Parent
• Parent-in-law
• Grandparent
• Grandchild

Paid Family Leave could be used for situations like the following: if you need one or more full days to care for your mom when she undergoes chemotherapy, your dad is having surgery followed by extensive recuperation, or your child is undergoing intense psychotherapy and is unable to attend school for a period of time.

Active duty deployment: Paid Family Leave is available for families who are eligible for time off under the military provisions in the federal Family Medical Leave Act when a spouse, child, domestic partner, or parent of the employee is on active duty or has been notified of an impending call or order of active duty.

Paid Family Leave cannot be used for one’s own disability or qualifying military event. It may only be used to take care of your:

• Spouse
• Domestic partner
• Child
• Parent

WHAT ARE THE PAID FAMILY LEAVE BENEFITS?

For example, in 2019, an employee who makes $1,000 a week would receive a benefit of $550 a week (55% of $1,000). Another employee who makes $2,000 a week would receive a benefit of $746.41, because this employee is capped at one-half of New York State's Average Weekly Wage (NYSAWW) —currently $1,357.11. Half of that amount is the $746.41 benefit.

HOW DO I FILE A CLAIM FOR PAID FAMILY LEAVE?

Download the full list of instructions here. You must complete the applicable claim form based on the type of claim you are filing (bonding, medical care provider, military deployment).

For all types of claims, you must provide the completed form to your employer and an employer must complete and return Part B of the PFL-1 form to the employee within 3 days.

• For bonding: You must complete the PFL-2 Form included in the bonding claim packet of forms and provide required supporting documentation to confirm the birth of the child and your relationship to the child.
• For providing care: You must complete the PFL-3 and PFL-4 forms in the providing care claim packet of forms. The PFL-3 form is completed by the care recipient and given to the health care provider. After you enter your information in the PFL-4 form, provide the form to the recipient’s health care provider to complete in full. They will then return the form to you to submit with all supporting documentation.
• For military active duty: You must complete the PFL-5 form included in the military claim packet of forms and provide all required supporting documentation.

Once all forms are completed and supporting documentation is collected, all of the forms and documents are submitted to the Insurance Carrier (Arch Insurance Company - claims@archinsurance.com) with a copy to our insurance management division (wcir@gslate.com).

The insurance company will respond within 18 days confirming or denying the claim including instructions on how the benefit payments will be disbursed.

WHEN CAN I USE DISABILITY COVERAGE VS. PAID FAMILY LEAVE?

In New York, you may use both disability coverage and Paid Family Leave for assistance. NY Disability is for an ‘off the job injury’ of an employee, which includes maternity leave, for up to 13 weeks of coverage (one week is unpaid). Benefits are limited to $170/week in compensation, so the pay is less, but this provides a block of consecutive time needed for recuperation (or bonding).

Paid Family Leave (PFL) is for an employee’s personal time off for only 3 qualifying events: bonding with a child, medical care for a family member, or a family member’s military service activation.

The only potential overlap would be maternity leave/child bonding. You cannot go from Paid Family Leave to Disability, but you could start on Disability and then transfer to Paid Family Leave once benefits are exhausted under State Disability.

HAVE QUESTIONS OR WANT TO LEARN MORE?

If you have any questions, please feel free to contact us at wcir@gslate.com or 212.206.1099.

For the latest updates and additional information, visit the New York Paid Family Leave site.

This information is distributed with the understanding that the publisher is not rendering legal, accounting, tax or other professional services. If legal advice or other assistance is required, an attorney, CPA or tax advisor should be consulted.