New York State Releases Waiver and Voluntary Coverage Forms

The New York Workers’ Compensation Board recently released three important forms associated with Paid Family Leave (“PFL”), which will become effective January 1, 2018:

Employee Paid Family Leave Opt-Out and Waiver of Benefits
If an employee does not expect to work long enough to qualify for Paid Family Leave (a seasonal worker, for example), the employee may opt out of Paid Family Leave by completing the Waiver of Benefits Form.
https://www.ny.gov/sites/ny.gov/files/atoms/files/PFLWaiver.pdf

Employer’s Application for Voluntary Coverage (No Employee Contribution)
Employers exempt from providing mandatory Paid Family Leave may provide voluntary Paid Family Leave by completing PFL-135 (if no employee contribution is required).
https://www.ny.gov/sites/ny.gov/files/atoms/files/PFL135.pdf

Employer’s Application for Voluntary Coverage (Employee Contribution Required)
Employers exempt from providing mandatory Paid Family Leave may provide voluntary Paid Family Leave by completing PFL-136 (if they will be requiring an employee contribution).
https://www.ny.gov/sites/ny.gov/files/atoms/files/PFL_136.pdf

Additional Paid Family Leave forms will be released soon. We will provide additional updates as they become available.