Qualifications and Assumptions:
This proposal is for illustrative purposes only, not a contract or policy, and is an estimate based on underwriting and payroll information provided. Actual premium owed may be different than the proposal estimate. Coverage is statutory NY Paid Family Leave benefits with an assumed effective date of 1/1/23 or the policy effective date, whichever is later. PFL coverage is provided by either an amendment rider to the NY DBL policy, or if employer is self-insured for DBL or a Public employer, coverage can be a stand-alone PFL policy. PFL stand-alone policy acceptance is subject to Home Office underwriting approval. The PFL benefit is employee paid, with contributions of 0.455% of the employee's weekly wage capped when their annual wage exceeds $.87,785.88 - which equals a maximum annual premium contribution of $399.43.