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CMS-1500 electronic submission is mandatory

Employers Workers’ Compensation Insurance

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Overview

Workers’ compensation insurance is mandatory for most employers of one or more employees. It protects employers from liability for on-the-job injury or illness and provides the following:

  • Legal representation for the employer by the insurance carrier
  • Protection for the employer against most lawsuits for on-the-job injuries/illnesses
  • Payment of medical services needed to treat the job injury or illness
  • Temporary payments to the employee to help replace lost wages
  • Payments to the employee to compensate for permanent effects of the injury
  • A death benefit for the employee’s survivors in the event of a fatal injury

Ways to obtain

Insurance policies can be obtained through a private insurance carrier, State Insurance Fund, or becoming self-insured. See below for more information on each option.

Insurance carrier

Policies can be purchased through an insurance carrier, broker, or agent. There are more than 200 private insurance carriers authorized by the New York State Department of Financial Services. These insurance carriers may specialize in certain markets and offer various incentives to policyholders.

NY State Insurance Fund (NYSIF)

Policies may also be purchased through NYSIF, a public insurance carrier. NYSIF is a not-for-profit agency of the State of New York that offers workers’ compensation, New York State disability benefits and Paid Family Leave insurance. It is a separate and distinct entity from the New York State Workers’ Compensation Board.

NYSIF must provide insurance to any employer seeking coverage, regardless of the employer’s type of business, safety record or size. However, if an employer owes NYSIF money from a previous bill or account, coverage can be denied.

Qualified participants receive an advance discount. Based upon the safety performance of the members of the group, each group member receives a proportionate share of any dividend earned.

Self-insurance

Employers may apply to provide workers’ compensation, disability, and Paid Family Leave benefit coverage to their employees through self-insurance. If qualified to self-insure, employers agree to make benefit payments, meet all obligations under WCB laws, rules and regulations, and must maintain an adequate security deposit in the event of a default.

Deduction and waiver

It is important to note that WCL Section 31 specifically states that it is a misdemeanor for employers to make deductions from the salary or wages of an employee to offset the costs of workers’ compensation insurance coverage.

Further, Section 32 of the WCL specifically states that NO agreement by an employee to waive their right to workers’ compensation benefits shall be valid if it does not relate to a specific claim and has not been approved by the Board.

Your FEIN is important

Each business that is a legal entity (e.g. sole proprietorship, partnership, corporation, etc.) has its own, unique Federal Employer Identification Number (FEIN) assigned to it. A firm’s FEIN is the Board’s primary identification for that business.

Employers must notify their insurance carrier of FEIN(s) when

  • Obtaining or modifying workers’ compensation coverage.
  • Changing their legal entity type.
  • Adding new legal entities to their business operations.

When an employer obtains an insurance policy, it is the insurer's responsibility to electronically notify the Board of that coverage using the employer's FEIN.

If the FEIN on your notice is the correct legal FEIN (and the FEIN on your policy is incorrect), contact your insurance carrier (or advise your agent/broker) and request they submit the correct FEIN to the Board.

If the FEIN on the policy is the correct legal FEIN (and the FEIN on this notice is incorrect), send a copy of your CP575 issued by the Internal Revenue Service (IRS) to the New York State Department of Labor, Registration Section, State Office Campus, Building 12, Albany, NY 12240 or fax it to (518) 485-8010.

Tips to decrease cost

Workers' Compensation insurance can be an expensive cost of doing business. However, employers can take responsibility for those costs by following some of the tips below:

  • Start getting quotes from a variety of insurance carriers through your agent. Do this several months before you need the policy.
  • Make sure that the underwriter is using the proper classification of employees. If you misclassify your employees to get an initial lower rate, an audit will catch this and you will be charged retroactively. You may also be subject to penalties and/or felony prosecution for misclassification of employees.
  • Research the insurer's claims handling practices. An insurer that either automatically pays every claim or controverts many claims can directly affect your premium in the future.
  • Collect certificates of New York State workers' compensation insurance from all subcontractors that are providing services to your business. Insurance carriers routinely charge general contractors workers' compensation insurance premiums for all subcontractors not covered by their own New York State workers' compensation insurance policies.
  • Discuss what types of alternative plans are available (deductibles, premium credits, safety programs).

New York State offers premium credit programs to eligible employers. Check if any of these programs are available to you:

New York State Safe Patient Handling Act Program (NYSPHAP)

  • The New York State Safe Patient Handling Act (Article 29-D, Title 1-A of the New York State Public Health Law) provides eligible health care facilities that comply with program requirements a credit of up to 2.5% on their workers' compensation premium.
  • Health care facilities as defined in Section 2997-h(1) of the New York State Public Health Law, such as hospitals, nursing homes, assisted living facilities and alcohol and drug rehabilitation facilities are eligible to participate.
  • Additional information can be found on NYCIRB's website on their New York Workers' Compensation and Employers Liability Manual.

Construction Classification Premium Adjustment Program (CPAP)

Code Rule 60 Workplace Safety and Loss Incentive Program

  • Code Rule 60 is a voluntary program that provides a premium credit to insured employers who are not in a recognized safety group with the New York State Insurance Fund, have an experience rating under 1.30, and pay annual NYS workers' compensation premiums of at least $5,000.
  • Eligible insured employers can apply for a credit if they implement one or more of the following programs: 1) safety incentive, 2) drug and alcohol prevention, or 3) return-to work program.
  • For more information, see the NYS Department of Labor's Workplace Safety and Loss Prevention Incentive Program poster and the webpage on How to Apply for an Incentive Credit under Code Rule 60.