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  • New York PFL vs. New York State Sick Leave Act: What Insurance Brokers Need to Know
March 30, 2023
Dawn Allcot
Monday, 19 October 2020 / Published in Ancillary Benefits, Coronavirus Pandemic, Disability Coverage, Enriched DBL, NYS DBL, Paid Family Leave

New York PFL vs. New York State Sick Leave Act: What Insurance Brokers Need to Know

 

New York insurance brokers may be getting questions from customers about the New York State Sick Leave (NYSSL) act, which went into effect September 30, 2020. However, employees cannot take paid sick leave through the state law until January 1, 2021, or at a time after that date if their employer requires them to accrue paid time off.

A direct result of the coronavirus pandemic to help contain the spread of the virus by encouraging employees to stay home, with pay, if they are not feeling well, the Paid Sick Leave Law mandates that employers of any size now provide paid sick leave to employees.

Unlike New York State DBL benefits or Paid Family Leave (PFL), New York State Sick Leave  (NYSSL) is funded entirely by employers through payroll. It is not an insurance benefit.

However, employers may have questions about when employees can use their paid sick leave and when they need to file a claim for DBL or PFL. It helps brokers to be aware of the new legislation to reduce unnecessary or unqualified DBL and PFL claims in New York.

New York PFL v. DBL v. NYSSL

The duration of NYSSL is much shorter than New York State’s short-term disability coverage or PFL coverage.

Here are a few other differences between the three types of leave:

DBL / Enriched DBL

DBL or enriched DBL insurance provides partial pay to employees who are seriously ill or injured and cannot perform their normal job functions for up to 26 weeks. The DBL Center can help you bind DBL & Enriched coverage under 50 lives easily online here.

New York State Paid Family Leave (NYS PFL)

Written as a mandatory rider  to statutory DBL coverage, PFL in New York provides partial pay to employees taking time off to care for an ill family member, a newborn (or newly adopted or newly fostered) child within the first year, or to manage family matters while a military spouse is deployed. The maximum duration for Paid Family Leave is 12 weeks. Learn more about New York State PFL coverage, first introduced in 2017, here.

NYSSL

Introduced in September 2020 and going into effect on January 1, 2021, Paid Sick Leave provides full pay for up to 56 hours (in some cases) for employees who are:

  • Sick or injured
  • Caring for family members who are sick or injured
  • Under quarantine due to possible exposure to COVID-19
  • Caring for minor family members under quarantine

The New York State Sick Leave law (NYSSL) also covers a host of other circumstances for which employees may need time off, including:

  • Preventative care
  • Mental health
  • Medical or mental health treatments
  • Domestic violence incidents

Other Differences You Need to Know About DBL/PFL and NYSSL

The reason for Paid Family Leave or DBL must be documented on the appropriate claims form. On the other hand, the reasons for taking NYSSL can remain confidential. Employers may not require employees to disclose any confidential information regarding their need for sick time.

In addition, the definition of a family member as it relates to paid sick leave extends beyond the PFL definition to include siblings, grandchildren, grandparents, and the children or parents of an employee’s spouse or domestic partner.

How Employers Can Issue New York State Sick Leave

Business owners in New York have a choice to “frontload” employees’ sick time at the beginning of the calendar year, offering paid sick leave from day one that the benefit goes into effect (January 1, 2021). Or, employers may permit employees to accrue sick time at a rate of 1 hour for every 30 hours worked, up to 40 or 56 hours in total – depending on the company size.

Employers with at least 100 employees must provide 56 hours paid sick leave. Employers with fewer than 100 employees or fewer than five employees but a net income of $1 million for the prior tax year must provide 40 hours paid sick leave.

Businesses with fewer than five employees but less than $1 million in net income must allow 40 hours of unpaid sick leave with no disciplinary action permitted for employees who take that time off without pay.

Should Your Customers’ Employees File a DBL or PFL Claim?

The decision for an employee to take paid sick time or to file a DBL or PFL claim largely comes down to the duration of the time off required and, of course, the reason. See below:

  • DBL insurance claims provide partial pay for severe illnesses or injuries that require more than a few days or a week out of work.
  • PFL, on the other hand, covers employees when they need to care for someone else for an extended time period of up to 12 weeks.
  • NYSSL offers full pay up to the amount of accrued sick time. It permits parents to stay home for a short duration with a sick or feverish child without losing a day’s pay. It also makes it financially easier for employees who are feeling under the weather to call out sick and avoid spreading germs.

Help Your Customers Understand the New Laws

Until now, Paid Time Off remained the choice of New York State business owners. Many companies provided generous PTO while others didn’t. Some small business didn’t even have a written policy but trusted their workers not to take unnecessary time off.

By standardizing PTO under the NYSSL, and outlining specific permissible reasons for sick time, New York State has eliminated confusion, miscommunication, or gray areas surrounding PTO.

By understanding the new law, you can help your customers reduce unnecessary DBL or PFL claims and continue to act as a resource for them when it comes to managing employee benefits.

Tagged under: DBL, enriched DBL, New York State Sick Leave Act, NYS PFL, Paid Family Leave

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