Political Subdivisions are exempt from the requirement to provide disability and Paid Family Leave benefits to their employees but may voluntarily provide either benefit. If they elect to provide one of these benefits, one of the ways in which they may do so is to self-insure those benefits.
Political subdivisions may elect to self-insure for disability only, Paid Family Leave only, or disability and Paid Family Leave together. Political subdivisions that elect to self-insure their disability and/or Paid Family Leave benefits must file:
- Application for Self-Insurance Disability and Paid Family Leave Benefits Law (Form DB-26 DB); along with
- A certified copy of a resolution from its governing body, which states that they have elected to provide disability and/or Paid Family Leave benefits through self-insurance
- One or more of the following:
- Employer's Application for Voluntary Coverage – No Employee Contribution (Form DB-135)
- Employer's Application for Voluntary Coverage – Employee Contribution Required (Form DB-136)
- Employer's Application for Voluntary Coverage – No Employee Contribution (Form PFL-135)
- Employer's Application for Voluntary Coverage – Employee Contribution Required (Form PFL-136)
- Other documentation as necessary.
Political subdivisions that elect to self-insure their disability, Paid Family Leave, or both benefits, are exempt from posting a security deposit.
The Office of Self-Insurance will notify an applicant of final approval if all conditions are met.
For more information about the self-insurance application process please contact the Office of Self-Insurance at SelfInsurance@wcb.ny.gov
Annual Reporting Requirements
While actively self-insured, each employer must submit the following annually:
A Political Subdivisions may terminate their self-insurance at any time by notifying the Office of Self-Insurance.