New York State Dbl and Paid Family Leave

Paid Family Leave

New York State Dbl is another state-mandated program for employers. It covers employees for OFF the job injuries and sickness. Benefits are payable for 26 weeks of disability. There is a 7 day wait in which no benefits are paid. The mandated and standard NYS dbl maximum payable is 50% of salary to a max of $170 per week. Some insurance companies have enhanced programs available if the employer chooses a higher benefit.

Employers may choose to withhold from employees a maximum of .60 per week toward this benefit. There are other circumstances that may affect NYS dbl such as multiple employment, excluded employees, and other factors. We have posted a very good handbook put out by New York State that offers a great guidebook in understanding mandated employer programs. Look under our News and Insights tab for the pdf.

In 2018 NYS introduced  Paid Family Leave (PFL)Shelterpoint Life Insurance Company has kindly given me permission to post two articles showing a great comparison and explanation of NYS Dbl and PFL.

Top 3 Must See — Q&A on DBL vs. PFL

Since New York Paid Family Leave (PFL) was added to New York’s statutory Disability policy (DBL, short for Disability Benefits Law) as a rider, there are a lot of questions about how they relate, compare, and interact. While there is some overlap between the two, they are, at their cores, distinctly different in that PFL is for time off from work spent for a family member, and DBL is specifically for an employee’s own serious illness or injury.

Some of the biggest differences between DBL and PFL include:

  • job protection (PFL has it, DBL doesn’t),
  • pay rate (in 2018, DBL maxes out at $170/week, PFL at $652.96/week), and
  • leave time (in 2018, DBL provides up to 26 weeks in a 52-week period, PFL offers up 8 weeks in a 52-week period – however, the combined time out on DBL and PFL cannot exceed 26 weeks in a 52-week period).

With this general understanding in mind, let’s look at the top 3 questions we’ve received about DBL vs. PFL from real people like you.

1. If I’m Eligible To Take DBL, I’m Already Eligible For PFL, Right?

Not necessarily. While DBL and PFL are related, their eligibility requirements are not identical. We’ve summarized those differences in the chart below.

 

DBL

PFL

Full-time definition

Persons working the amount of hours that constitute the specific employer’s normal work week

Persons working 20+ hours/week

Full-time employees

Worked at least 4 consecutive weeks for any Covered Employer(s)

Employed at least 26 consecutive weeks at their current Covered Employer

Part-time employees

Completed at least 25 working days at any Covered Employer(s)

Completed at least 175 days at their current Covered Employer

Personal or domestic employees

Work at least 40 hours/week (if they work 30 or more days in a calendar year for you)

Transferability of qualification period

Yes, if an employee changes jobs from one Covered Employer to another, their time worked at the previous employer counts.

 

However, if their previous job was at an exempt employer without voluntary coverage, they have to satisfy the qualification period at their new Covered Employer.

No. If an employee changes jobs from one Covered Employer to another, their time worked at the previous employer does not count.

What counts towards qualification period

Approved vacation, personal, and sick time.

 

Other time away from work but still considered an employee as long as their PFL coverage is paid for.

What does not count towards the qualification period

N/A

Time out on DBL

2. Can I Take DBL And PFL At The Same Time?

No, you can’t take DBL and PFL at the same time, but it is possible to take them consecutively.

For example, if you give birth to a baby, you can take DBL for the first part of your leave to recover from birth (typically 6 weeks for normal delivery and 8 weeks for a C-section), followed by Paid Family Leave to bond with your new child. For more details on how maternity/paternity leave works with both DBL and PFL, check out our Top 3 Questions from February.  

3. Why Does My PFL Claim Take Longer To Process Than My DBL Claim?

Because DBL deals exclusively with an employee’s personal injury or illness, there are fewer forms and information to provide and verify. Paid Family Leave gives eligible employees time off for things related to a qualifying family member (bonding with a new child, caring for a seriously ill loved one, handling things related to a family member’s military service), which involves more information, forms, and documentation to provide and verify. Due to those additional verification steps for PFL, NY State gives carriers 18 days (from receipt of fully completed forms including all required documentation) to process a claim. Below is a quick chart showing how DBL and PFL claim turn-around times compare:

 

DBL

PFL

Claim determination turn-around time allowed by law

 4 business days after the latter of:

  • The 14th day of being out on DBL, or
  • Receipt of the claim (fully completed form with all required documentation and statements)

18 days after a fully completed claim is received.

 

We have a handy roadmap here that illustrates what’s required for each type of leave to help make sure employees have all the necessary information before submitting.

PFL Versus DBL

June 8, 2017 – updated June 26, 2018


Today we’re taking a closer look at another benefit extended to most employees in New York State: Statutory short-term disability (commonly referred to as DBL, short for Disability Benefits Law).  This benefit is important to understand and look at in conjunction with the Paid Family Leave benefit since NY PFL is typically provided in form of a rider (i.e., add-on coverage) to DBL. We’ll highlight some of the essential features, commonalities, and differences between these two required NY benefits.

But first, what is DBL?

DBL provides benefits for employees who are unable to work due to a non-job-related illness/disability or injury that happened off the job. For a maximum of 26 weeks, eligible employees can receive cash benefits of 50% of their average weekly wage, capped at the current maximum benefit of $170/week.  When using this benefit the employee has to be certified “disabled” by a physician, and unable to perform any normal job duties. For DBL purposes, recovering from the birth of a child would count as such.

 

How PFL and DBL Relate

When Paid Family Leave went into effect on January 1, 2018, it was added as a mandatory rider to existing DBL policies, so any Covered Employer under DBL is also required to provide PFL to their eligible employees. Since PFL is a rider to DBL, this also means that both DBL and PFL must be from the same insurance carrier.

Employers who are exempt from DBL, such as municipalities, can choose to provide stand-alone Paid Family Leave.

Sole proprietors and partners in LLCs/LLPs can get voluntary Paid Family Leave coverage similar to how they obtained their voluntary DBL coverage.

So, how do these benefits compare?

 

PFL Expert Tip:
The key differentiator between PFL and DBL is that DBL is taken for YOUR OWN injury or illness, whereas Paid Family Leave is taken to care for or bond with someone else, for example, a member of your immediate family like a child or parent, or bonding with a newborn after delivery.

 

Eligibility requirements are quite different between DBL and PFL:

 

DBL

PFL

Full-time definition

Persons working the amount of hours that constitute the specific employer’s normal work week

Persons working 20+ hours/week

Full-time employees

Worked at least 4 consecutive weeks for any Covered Employer(s)

Employed at least 26 consecutive weeks at their current Covered Employer

Part-time employees

Completed at least 25 work days at any Covered Employer(s)

Completed at least 175 work days at their current Covered Employer

Personal or domestic employees

Work at least 40 hours a week (if they work 30 or more days in a calendar year for the same domestic employer)

Transferability of qualification period

Yes, if an employee changes jobs from one Covered Employer to another, their time worked at the previous employer counts.

However, if their previous job was at an exempt employer without voluntary coverage, they have to satisfy the qualification period at their new Covered Employer.

 

No

(If an employee changes jobs from one Covered Employer to another, their time worked at the previous employer does not count.)

What counts towards the qualification period

Approved vacation, personal, sick time

Other time away from work but still considered an employee as long as their PFL coverage is paid for

What does not count towards the qualification period

n/a

Time out on DBL

 

Here’s how DBL and PFL benefits compare:      
                                                                                    

 

DBL

PFL

Benefit payouts

50% of your average weekly wage (AWW) to a maximum of $170/week

PFL provides 50% of your AWW capped at 50% of NYSAWW in 2018 and gradually increased to up to 67% of the AWW capped at 67% of NY’s AWW once fully implemented in 2021.

Estimate what you can expect while out on PFL with our easy Benefit Estimator tool!

Waiting period

7 days (no benefit is paid for the first 7 days of your illness or disability)

None (your benefits kick in on the first day of the qualified leave event)

 

Maximum leave duration

26 weeks in a consecutive 52-week period

8 weeks beginning in 2018 and increasing to a maximum of 12 weeks in 2021 in a consecutive 52-week period

You can’t take DBL and PFL at the same time, i.e., receive benefits for both concurrently. They have to be taken in sequence. And if you qualify for both, the combined duration cannot exceed 26 weeks in a consecutive 52-week period.

Job protection while on leave

None

Yes, even for employers with less than 50 employees.

Employers must provide the same position, or one comparable in wages and benefits, to employees returning from PFL.

Benefit offsets

Benefits are not reduced by PTO such as vacation time, i.e. you can collect DBL benefits while using paid vacation days.

You can’t receive PFL benefits while out on PTO (Paid Time Off) or using full days of sick/vacation time.

 


Here are some other noteworthy items to compare:

 

DBL

PFL

How it’s funded

Employer pays the premium to the carrier (unless self-insured) and has option to recoup cost through employee contributions (capped at state-set maximum contribution levels).

 

Use our handy PFL Premium Estimator tool.

Maximum employee contributions

$0.60/week

The 2018 maximum contribution: 0.126% of the employee’s annualized wages capped at the annualized New York State Average Weekly Wage (NYSAWW) of $67,907.84 per year;*  which means the maximum annual premium to be charged to an employee for Paid Family Leave is $85.56 per year. 
Read more about PFL withholdings here.

*The PFL rate is determined each year by September 1 by the NYS Department of Financial Services – starting 2018  

**NY Department of Labor releases the annually updated statewide AWW by March 31.

Employer reimbursement

Yes, if the employee receives salary continuation while out.

Claim determination turn-around time allowed by law

 4 business days after the latter of:

  • The 14th day of being out on DBL, or
  • Receipt of the claim (fully completed form with all required documentation and statements)

18 days after a fully completed claim is received.

We have handy roadmaps here that illustrate what’s required for each type of leave to help make sure employees have all the necessary information before submitting.

    

  

DBL and PFL Bonding Leave

The most common reason employees have used Paid Family Leave is to welcome a new addition to their family with bonding leave. And since the qualifying events surrounding motherhood often overlap situations covered by both DBL and Paid Family Leave, it’s important to outline where PFL Bonding Leave will start and where DBL would end. 

For example, a condition like bed rest for an expecting mother would be covered under DBL, since it’s the mother’s own “disability.” She would be able to file a DBL claim for the time she was on bedrest prior to birth and recovery after birth (typically 6 weeks for normal delivery and 8 weeks for C-section). When her child is born, Mom can choose whether to use DBL for her recovery first or use Paid Family Leave for bonding with her newborn.  Learn more about all the options available to a new mom here.


PFL Expert Tip:
Postpartum Depression is considered a pregnancy-related complication and is covered under DBL.

 

Both DBL and PFL play important roles in providing for the health and well-being of New York’s workers, and both will continue to work in tandem to support employee needs outside the workplace. 

  • Download Guidebook
    Windows: Right Click / Save As
    Mac: Right Click (option + click) / Save Link As

INSURANCE & FINANCIAL SOLUTIONS THAT WORK