LBD00302-01-5
S. 172 2
act, 29 U.S.C.S § 2612(a)(1)(e) and 29 C.F.R. S.825.126[(a)(1)-(8)],
arising out of the fact that the spouse, domestic partner, child, or
parent of the employee is on active duty (or has been notified of an
impending call or order to active duty) in the armed forces of the
United States.
22. "Health care provider" shall mean for the purpose of [family
leave] THIS ARTICLE, a person licensed under article one hundred thir-
ty-one, one hundred thirty-one-B, one hundred thirty-two, one hundred
thirty-three, one hundred thirty-six, one hundred thirty-nine, one
hundred forty-one, one hundred forty-three, one hundred forty-four, one
hundred fifty-three, one hundred fifty-four, one hundred fifty-six or
one hundred fifty-nine of the education law or a person licensed under
the public health law, article one hundred forty of the education law or
article one hundred sixty-three of the education law.
§ 3. Section 203-a of the workers' compensation law, as added by
section 4 of part SS of chapter 54 of the laws of 2016, is amended to
read as follows:
§ 203-a. Retaliatory action prohibited for [family] leave. 1. The
provisions of section one hundred twenty of this chapter and section two
hundred forty-one of this article shall be applicable to family AND
DISABILITY leave.
2. Nothing in this section shall be deemed to diminish the rights,
privileges, or remedies of any employee under any collective bargaining
agreement or employment contract.
§ 4. Section 203-b of the workers' compensation law, as added by
section 4 of part SS of chapter 54 of the laws of 2016, is amended to
read as follows:
§ 203-b. Reinstatement following [family] leave. Any eligible employee
of a covered employer who takes leave under this article shall be enti-
tled, on return from such leave, to be restored by the employer to the
position of employment held by the employee when the leave commenced, or
to be restored to a comparable position with comparable employment bene-
fits, pay and other terms and conditions of employment. The taking of
family OR DISABILITY leave shall not result in the loss of any employ-
ment benefit accrued prior to the date on which the leave commenced.
Nothing in this section shall be construed to entitle any restored
employee to the accrual of any seniority or employment benefits during
any period of leave, or any right, benefit or position to which the
employee would have been entitled had the employee not taken the leave.
§ 5. Section 203-c of the workers' compensation law, as added by
section 4 of part SS of chapter 54 of the laws of 2016, is amended to
read as follows:
§ 203-c. Health insurance during [family] leave. In accordance with
the Family and Medical Leave Act (29 U.S.C. §§ 2601-2654), during any
period of family OR DISABILITY leave the employer shall maintain any
existing health benefits of the employee in force for the duration of
such leave as if the employee had continued to work from the date [he or
she] THE EMPLOYEE commenced family OR DISABILITY leave until the date
[he or she] THE EMPLOYEE returns to employment.
§ 6. Section 204 of the workers' compensation law, as amended by
section 5 of part SS of chapter 54 of the laws of 2016, is amended to
read as follows:
§ 204. Disability and family leave during employment. 1. Disability
benefits shall be payable to an eligible employee for disabilities,
beginning with the eighth day of disability and thereafter during the
continuance of disability, subject to the limitations as to maximum and
S. 172 3
minimum amounts and duration and other conditions and limitations in
this section and in sections two hundred five and two hundred six of
this article. Family leave benefits shall be payable to an eligible
employee for the first full day when family leave is required and there-
after during the continuance of the need for family leave, subject to
the limitations as to maximum and minimum amounts and duration and other
conditions and limitations in this section and in sections two hundred
five and two hundred six of this article. Successive periods of disabil-
ity or family leave caused by the same or related injury or sickness OR
QUALIFYING EVENT shall be deemed a single period of disability or family
leave only if separated by less than three months.
2. (a) The weekly benefit for family leave that occurs (i) on or after
January first, two thousand eighteen shall not exceed eight weeks during
any fifty-two week calendar period and shall be fifty percent of the
employee's average weekly wage but shall not exceed fifty percent of the
state average weekly wage, (ii) on or after January first, two thousand
nineteen shall not exceed ten weeks during any fifty-two week calendar
period and shall be fifty-five percent of the employee's average weekly
wage but shall not exceed fifty-five percent of the state average weekly
wage, (iii) on or after January first, two thousand twenty shall not
exceed ten weeks during any fifty-two week calendar period and shall be
sixty percent of the employee's average weekly wage but shall not exceed
sixty percent of the state average weekly wage, and (iv) on or after
January first of each succeeding year, shall not exceed twelve weeks
during any fifty-two week calendar period and shall be sixty-seven
percent of the employee's average weekly wage but shall not exceed
sixty-seven percent of the New York state average weekly wage in effect.
The superintendent of financial services shall have discretion to delay
the increases in the family leave benefit level provided in subpara-
graphs (ii), (iii), and (iv) of this paragraph by one or more calendar
years. In determining whether to delay the increase in the family leave
benefit for any year, the superintendent of financial services shall
consider: (1) the current cost to employees of the family leave benefit
and any expected change in the cost after the benefit increase; (2) the
current number of insurers issuing insurance policies with a family
leave benefit and any expected change in the number of insurers issuing
such policies after the benefit increase; (3) the impact of the benefit
increase on employers' business and the overall stability of the program
to the extent that information is readily available; (4) the impact of
the benefit increase on the financial stability of the disability and
family leave insurance market and carriers; and (5) any additional
factors that the superintendent of financial services deems relevant. If
the superintendent of financial services delays the increase in the
family leave benefit level for one or more calendar years, the family
leave benefit level that shall take effect immediately following the
delay shall be the same benefit level that would have taken effect but
for the delay. The weekly benefits for family leave that occurs on or
after January first, two thousand eighteen shall not be less than one
hundred dollars per week except that if the employee's wages at the time
of family leave are less than one hundred dollars per week, the employee
shall receive [his or her] THE EMPLOYEE'S full wages. Benefits may be
payable to employees for paid family leave taken intermittently or for
less than a full work week in increments of one full day or one fifth of
the weekly benefit.
(b) THE WEEKLY BENEFIT WHICH THE DISABLED EMPLOYEE IS ENTITLED TO
RECEIVE FOR THE FIRST TWELVE WEEKS OF DISABILITY COMMENCING: (I) ON OR
S. 172 4
AFTER JANUARY FIRST, TWO THOUSAND TWENTY-SEVEN SHALL BE FIFTY-FIVE
PERCENT OF THE EMPLOYEE'S AVERAGE WEEKLY WAGE BUT SHALL NOT EXCEED FIFTY
PERCENT OF THE STATE AVERAGE WEEKLY WAGE; (II) ON OR AFTER JANUARY
FIRST, TWO THOUSAND TWENTY-EIGHT SHALL BE SIXTY PERCENT OF THE EMPLOY-
EE'S AVERAGE WEEKLY WAGE BUT SHALL NOT EXCEED FIFTY-FIVE PERCENT OF THE
STATE AVERAGE WEEKLY WAGE; (III) ON OR AFTER JANUARY FIRST, TWO THOUSAND
TWENTY-NINE SHALL BE SIXTY-SEVEN PERCENT OF THE EMPLOYEE'S WEEKLY AVER-
AGE WAGE BUT SHALL NOT EXCEED SIXTY PERCENT OF THE STATE AVERAGE WEEKLY
WAGE; AND (IV) ON OR AFTER JANUARY FIRST OF EACH SUCCEEDING YEAR, SHALL
BE SIXTY-SEVEN PERCENT OF THE EMPLOYEE'S AVERAGE WEEKLY WAGE BUT SHALL
NOT EXCEED SIXTY-SEVEN PERCENT OF THE STATE AVERAGE WEEKLY WAGE. THE
WEEKLY BENEFIT WHICH THE DISABLED EMPLOYEE IS ENTITLED TO RECEIVE FOR
THE PERIODS OF DISABILITY AFTER THE TWELFTH WEEK OF DISABILITY AND
THROUGH THE TWENTY-SIXTH WEEK OF DISABILITY ON OR AFTER JANUARY FIRST,
TWO THOUSAND TWENTY-SEVEN AND EACH SUCCEEDING YEAR SHALL BE THIRTY
PERCENT OF THE EMPLOYEE'S AVERAGE WEEKLY WAGE BUT SHALL NOT EXCEED THIR-
TY PERCENT OF THE STATE AVERAGE WEEKLY WAGE. THE CHAIR OF THE WORKERS'
COMPENSATION BOARD, IN CONSULTATION WITH THE SUPERINTENDENT OF FINANCIAL
SERVICES, SHALL HAVE DISCRETION TO INCREASE THE BENEFIT LEVEL FOR THE
PERIOD OF DISABILITY AFTER THE TWELFTH WEEK OF DISABILITY THROUGH THE
TWENTY-SIXTH WEEK OF DISABILITY, PROVIDED THAT SUCH BENEFIT SHALL NOT
EXCEED SIXTY-SEVEN PERCENT OF THE STATE AVERAGE WEEKLY WAGE. IN DETER-
MINING WHETHER TO INCREASE THE DISABILITY BENEFIT FOR ANY YEAR, THE
CHAIR OF THE WORKERS' COMPENSATION BOARD IN CONSULTATION WITH THE SUPER-
INTENDENT OF FINANCIAL SERVICES SHALL CONSIDER FACTORS INCLUDING BUT NOT
LIMITED TO UTILIZATION OF THE CURRENT BENEFIT, THE EXPECTED UTILIZATION
OF ANY INCREASE, THE NEED FOR A BENEFIT INCREASE, THE CURRENT CONTRIB-
UTION COST TO EMPLOYEES AND EMPLOYERS AND THE EXPECTED COST AFTER ANY
SUCH BENEFIT INCREASE; THE CURRENT NUMBER OF INSURERS ISSUING INSURANCE
POLICIES WITH A DISABILITY BENEFIT AND ANY EXPECTED CHANGE IN THE
NUMBER OF INSURERS ISSUING SUCH POLICIES AFTER THE BENEFIT INCREASE;
AND ANY ADDITIONAL FACTORS THAT THE CHAIR OF THE WORKERS' COMPENSATION
BOARD AND THE SUPERINTENDENT OF FINANCIAL SERVICES DEEMS RELEVANT. THE
WEEKLY BENEFIT WHICH THE DISABLED EMPLOYEE IS ENTITLED TO RECEIVE FOR
DISABILITY LEAVE THAT OCCURS ON OR AFTER JANUARY FIRST, TWO THOUSAND
TWENTY-SEVEN SHALL NOT BE LESS THAN ONE HUNDRED DOLLARS PER WEEK EXCEPT
THAT IF THE EMPLOYEE'S WAGES AT THE TIME OF DISABILITY LEAVE ARE LESS
THAN ONE HUNDRED DOLLARS PER WEEK, THE EMPLOYEE SHALL RECEIVE THE
EMPLOYEE'S FULL WAGES. The weekly benefit which the disabled employee is
entitled to receive for disability commencing on or after May first,
nineteen hundred eighty-nine AND PRIOR TO JANUARY FIRST, TWO THOUSAND
TWENTY-SEVEN shall be one-half of the employee's weekly wage, but in no
case shall such benefit exceed one hundred seventy dollars; except that
if the employee's average weekly wage is less than twenty dollars, the
benefit shall be such average weekly wage. The weekly benefit which the
disabled employee is entitled to receive for disability commencing on or
after July first, nineteen hundred eighty-four shall be one-half of the
employee's weekly wage, but in no case shall such benefit exceed one
hundred forty-five dollars; except that if the employee's average weekly
wage is less than twenty dollars, the benefit shall be such average
weekly wage. The weekly benefit which the disabled employee is entitled
to receive for disability commencing on or after July first, nineteen
hundred eighty-three and prior to July first, nineteen hundred eighty-
four shall be one-half of the employee's average weekly wage, but in no
case shall such benefit exceed one hundred thirty-five dollars nor be
less than twenty dollars; except that if the employee's average weekly
S. 172 5
wage is less than twenty dollars the benefit shall be such average week-
ly wage. The weekly benefit which the disabled employee is entitled to
receive for disability commencing on or after July first, nineteen
hundred seventy-four, and prior to July first, nineteen hundred eighty-
three, shall be one-half of the employee's average weekly wage, but in
no case shall such benefit exceed ninety-five dollars nor be less than
twenty dollars; except that if the employee's average weekly wage is
less than twenty dollars, the benefit shall be such average weekly wage.
The weekly benefit which the disabled employee is entitled to receive
for disability commencing on or after July first, nineteen hundred
seventy and prior to July first, nineteen hundred seventy-four shall be
one-half of the employee's average weekly wage, but in no case shall
such benefit exceed seventy-five dollars nor be less than twenty
dollars; except that if the employee's average weekly wage is less than
twenty dollars the benefit shall be such average weekly wage. [For any
period of disability less than a full week, the benefits payable shall
be calculated by dividing the weekly benefit by the number of the
employee's normal work days per week and multiplying the quotient by the
number of normal work days in such period of disability.] BENEFITS MAY
BE PAYABLE TO EMPLOYEES FOR DISABILITY LEAVE TAKEN INTERMITTENTLY OR FOR
LESS THAN A FULL WORK WEEK IN INCREMENTS OF ONE FULL DAY OR ONE-FIFTH OF
THE WEEKLY BENEFIT. The weekly benefit for a disabled employee who is
concurrently eligible for benefits in the employment of more than one
covered employer shall, within the maximum and minimum herein provided,
be one-half of the total of the employee's average weekly wages received
from all such covered employers, and shall be allocated in the propor-
tion of [their] THE EMPLOYEE'S respective average weekly wage payments.
(C) PROVIDED THAT THE PROVISIONS OF PARAGRAPH (B) OF THIS SUBDIVISION
CONCERNING BENEFITS ON OR AFTER JANUARY FIRST, TWO THOUSAND TWENTY-SEVEN
AND SUBPARAGRAPHS (I) AND (II) OF PARAGRAPH (A) OF SUBDIVISION THREE OF
SECTION TWO HUNDRED NINE OF THIS ARTICLE MAY BE WAIVED BY A COVERED
EMPLOYER SUBJECT TO A COLLECTIVE BARGAINING AGREEMENT WITH A BONA FIDE
LABOR ORGANIZATION IN EFFECT ON JANUARY FIRST, TWO THOUSAND TWENTY-SEVEN
FOR EMPLOYEES SUBJECT TO SUCH COLLECTIVE BARGAINING AGREEMENT FOR A
DISABILITY COMMENCING BETWEEN JANUARY FIRST, TWO THOUSAND TWENTY-SEVEN
AND UNTIL JANUARY FIRST, TWO THOUSAND THIRTY; AND PROVIDED THAT FOR SUCH
WAIVER TO BE VALID, IT SHALL EXPLICITLY REFERENCE THIS SECTION AND BE
AGREED TO BY THE BONA FIDE LABOR ORGANIZATION. NOTHING HEREIN SHALL
PREVENT A COLLECTIVE BARGAINING AGREEMENT FROM PROVIDING TEMPORARY DISA-
BILITY BENEFITS GREATER THAN THE BENEFITS REQUIRED HEREIN.
§ 7. Subdivision 2 of section 206 of the workers' compensation law, as
amended by section 7 of part SS of chapter 54 of the laws of 2016, is
amended to read as follows:
2. If an employee who is eligible for disability benefits under
section two hundred three or two hundred seven of this article is disa-
bled and has claimed or subsequently claims workers' compensation bene-
fits under this chapter or benefits under the volunteer firefighters'
benefit law or the volunteer ambulance workers' benefit law, and such
claim is controverted on the ground that the employee's disability was
not caused by an accident that arose out of and in the course of [his]
THE EMPLOYEE'S employment or by an occupational disease, or by an injury
in line of duty as a volunteer firefighter or volunteer ambulance work-
er, the employee shall be entitled in the first instance to receive
benefits under this article for [his or her] THE EMPLOYEE'S disability.
If benefits have been paid under this article in respect to a disability
alleged to have arisen out of and in the course of the employment or by
S. 172 6
reason of an occupational disease, or in line of duty as a volunteer
firefighter or a volunteer ambulance worker, the employer or carrier or
the chair making such payment may, at any time before award of workers'
compensation benefits, or volunteer firefighters' benefits or volunteer
ambulance workers' benefits, is made, file with the board a claim for
reimbursement out of the proceeds of such award to the employee for the
period for which disability benefits were paid to the employee under
this article, and shall have a lien against the FULL award for
reimbursement, notwithstanding the provisions of section thirty-three of
this chapter or section twenty-three of the volunteer firefighters'
benefit law or section twenty-three of the volunteer ambulance workers'
benefit law provided the insurance carrier liable for payment of the
award receives, before such award is made, a copy of the claim for
reimbursement from the employer, carrier or chair who paid disability
benefits, or provided the board's decision and award directs such
reimbursement therefrom.
§ 8. Paragraph (a) of subdivision 3 of section 209 of the workers'
compensation law, as amended by section 10 of part SS of chapter 54 of
the laws of 2016, is amended to read as follows:
(a) Disability benefits. (I) The contribution of each such employee to
the cost of disability benefits provided by this article shall be one-
half of one per centum of the employee's wages paid to [him or her] THE
EMPLOYEE on and after July first, nineteen hundred fifty, but not in
excess of sixty cents per week.
(II) BEGINNING JANUARY FIRST, TWO THOUSAND TWENTY-SEVEN, THE MAXIMUM
EMPLOYEE CONTRIBUTION THAT A COVERED EMPLOYER IS AUTHORIZED TO COLLECT
FROM EACH EMPLOYEE FOR THE COST OF DISABILITY BENEFITS PROVIDED BY THIS
ARTICLE SHALL BE ONE-HALF OF ONE PER CENTUM OF THE EMPLOYEE'S WAGES BUT
SHALL NOT EXCEED TWO DOLLARS AND TWENTY CENTS PER WEEK PROVIDED, HOWEV-
ER, THAT THE EMPLOYEE CONTRIBUTION SHALL BE PURSUANT TO SUBPARAGRAPH (I)
OF THIS PARAGRAPH WHERE SUCH EMPLOYEE IS COVERED UNDER PARAGRAPH (C) OF
SUBDIVISION TWO OF SECTION TWO HUNDRED FOUR OF THIS ARTICLE.
(III) BEGINNING JANUARY FIRST, TWO THOUSAND THIRTY, THE MAXIMUM
EMPLOYEE CONTRIBUTION THAT A COVERED EMPLOYER IS AUTHORIZED TO COLLECT
FROM EACH EMPLOYEE FOR THE COST OF DISABILITY BENEFITS PROVIDED BY THIS
ARTICLE SHALL BE ONE-HALF OF ONE PER CENTUM OF THE EMPLOYEE'S WAGES, BUT
SHALL NOT EXCEED FORTY PERCENT OF THE AVERAGE OF THE COMBINATION OF ALL
EMPLOYEE AND EMPLOYER CONTRIBUTIONS TO DISABILITY BENEFITS PROVIDED
PURSUANT TO PARAGRAPH (B) OF SUBDIVISION TWO OF SECTION TWO HUNDRED FOUR
OF THIS ARTICLE DURING THE PRIOR CALENDAR YEAR, AS DETERMINED ANNUALLY
BY THE SUPERINTENDENT OF FINANCIAL SERVICES PURSUANT TO SUBSECTION (N)
OF SECTION FOUR THOUSAND TWO HUNDRED THIRTY-FIVE OF THE INSURANCE LAW.
A SELF-INSURER SHALL SUBMIT REPORTS TO THE SUPERINTENDENT OF FINANCIAL
SERVICES FOR THE PURPOSE OF DETERMINING FORTY PERCENT OF THE AVERAGE OF
THE COMBINATION OF ALL EMPLOYEE AND EMPLOYER CONTRIBUTIONS TO DISABILITY
BENEFITS PROVIDED PURSUANT TO PARAGRAPH (B) OF SUBDIVISION TWO OF
SECTION TWO HUNDRED FOUR OF THIS ARTICLE DURING THE PRIOR CALENDAR YEAR,
PURSUANT TO SUBSECTION (N) OF SECTION FOUR THOUSAND TWO HUNDRED THIRTY-
FIVE OF THE INSURANCE LAW.
§ 9. The opening paragraph of section 211 of the workers' compensation
law, as amended by section 12 of part SS of chapter 54 of the laws of
2016, is amended to read as follows:
A covered employer, UNLESS PROVIDED WITH A WAIVER PURSUANT TO SECTION
204(2)(C), shall, with [his or her] SUCH EMPLOYER'S own contributions
and the contributions of [his] SUCH EMPLOYER'S employees, provide disa-
bility and after January first, two thousand eighteen, family leave
S. 172 7
benefits to [his or her] SUCH EMPLOYER'S employees in one or more of the
following ways:
§ 10. The opening paragraph and subdivision 1 of section 214 of the
workers' compensation law, as amended by section 26 of part GG of chap-
ter 57 of the laws of 2013, are amended to read as follows:
There is hereby created a fund which shall be known as the special
fund for disability benefits to provide for the payment of [disability]
benefits under sections two hundred seven, two hundred thirteen and
attendance fees under section two hundred thirty-two of this article.
1. As promptly as practicable after April first, in each year, the
[chairman] CHAIR shall ascertain the condition of the fund, and if as of
any such date the net assets of the fund shall be one million dollars or
more below the sum of twelve million dollars, the [chairman] CHAIR shall
assess and collect an amount sufficient to restore the fund to an amount
equal to twelve million dollars.[.] Such assessment shall be included in
the assessment rate established pursuant to subdivision two of section
one hundred fifty-one of this chapter. Such assessments shall be depos-
ited with the commissioner of taxation and finance and transferred to
the benefit of such fund upon payment of debt service, if any, pursuant
to section one hundred fifty-one of this chapter.
§ 11. Subdivision 1 of section 217 of the workers' compensation law,
as amended by section 16 of part SS of chapter 54 of the laws of 2016,
is amended to read as follows:
1. Written notice and proof of disability or proof of need for family
leave shall be furnished to the employer by or on behalf of the employee
claiming benefits or, in the case of a claimant under section two
hundred seven of this article, to the chair, within thirty days after
commencement of the period of disability. Additional proof shall be
furnished thereafter from time to time as the employer or carrier or
chair may require but not more often than once each week. Such proof
shall include a statement of disability by the employee's [attending
physician or attending podiatrist or attending chiropractor or attending
dentist or attending psychologist or attending certified nurse midwife
or family leave care recipient's health care provider, or in the case of
an employee who adheres to the faith or teachings of any church or
denomination, and who in accordance with its creed, tenets or principles
depends for healing upon prayer through spiritual means alone in the
practice of religion, by an accredited practitioner,] HEALTH CARE
PROVIDER containing facts and opinions as to such disability in compli-
ance with regulations of the chair. Failure to furnish notice or proof
within the time and in the manner above provided shall not invalidate
the claim but no benefits shall be required to be paid for any period
more than two weeks prior to the date on which the required proof is
furnished unless it shall be shown to the satisfaction of the chair not
to have been reasonably possible to furnish such notice or proof and
that such notice or proof was furnished as soon as possible; provided,
however, that no benefits shall be paid unless the required proof [of
disability] is furnished within the period of actual disability or fami-
ly leave that does not exceed the statutory maximum period permitted
under section two hundred four of this article. No limitation of time
provided in this section shall run as against any disabled employee who
is mentally incompetent, or physically incapable of providing such
notice as a result of a serious medical condition, or a minor so long as
such person has no guardian of the person and/or property.
S. 172 8
§ 12. Section 218 of the workers' compensation law, as added by chap-
ter 600 of the laws of 1949, subdivision 2 as amended by chapter 809 of
the laws of 1985, is amended to read as follows:
§ 218. [Disability benefit] BENEFIT rights inalienable. 1. Any agree-
ment by an employee to waive [his] THE EMPLOYEE'S rights under this
article shall be void.
2. Disability OR FAMILY LEAVE benefits payable under this article
shall not be assigned or released, except as provided in this article,
and shall be exempt from all claims of creditors and from levy,
execution and attachment or other remedy for recovery or collection of a
debt, which exemption may not be waived provided, however, that such
benefits shall be subject to an income execution or order for support
enforcement pursuant to section fifty-two hundred forty-one or fifty-two
hundred forty-two of the civil practice law and rules.
§ 13. Section 221 of the workers' compensation law, as amended by
section 19 of part SS of chapter 54 of the laws of 2016, is amended to
read as follows:
§ 221. Determination of contested claims for disability and family
leave benefits. In accordance with regulations adopted by the chair,
within twenty-six weeks of written notice of rejection of claim, the
employee may file with the chair a notice that [his or her] THE EMPLOY-
EE'S claim for disability or family leave benefits has not been paid,
and the employee shall submit proof of disability or entitlement to
family leave and of [his or her] THE EMPLOYEE'S employment, wages and
other facts reasonably necessary for determination of the employee's
right to such benefits. Failure to file such notice within the time
provided, may be excused if it can be shown not to have been reasonably
possible to furnish such notice and that such notice was furnished as
soon as possible. On demand the employer or carrier shall forthwith
deliver to the board the original or a true copy of the health care
provider's report, wage and employment data and all other documentation
in the possession of the employer or carrier with respect to such claim.
The chair or designee, shall have full power and authority to deter-
mine all issues in relation to every such claim for disability benefits
required or provided under this article, and shall file its decision in
the office of the [chairman] CHAIR. Upon such filing, the [chairman]
CHAIR shall send to the parties a copy of the decision. Either party may
present evidence and be represented by counsel at any hearing on such
claim. The decision of the board shall be final as to all questions of
fact and, except as provided in section twenty-three of this chapter, as
to all questions of law. Every decision shall be complied with in
accordance with its terms within ten days thereafter except as permitted
by law upon the filing of a request for review, and any payments due
under such decision shall draw simple interest from thirty days after
the making thereof at the rate provided in section five thousand four of
the civil practice law and rules. The chair shall adopt rules and regu-
lations to carry out the provisions of this article including but not
limited to resolution of contested claims and requests for review there-
of, and payment of costs for resolution of disputed claims by carriers.
Any designated process shall afford the parties the opportunity to pres-
ent evidence and to be represented by counsel in any such proceeding.
The chair shall have the authority to provide for alternative dispute
resolution procedures for claims arising under DISABILITY AND family
leave, including but not limited to referral and submission of disputed
claims to a neutral arbitrator under the auspices of an alternative
dispute resolution association pursuant to article seventy-five of the
S. 172 9
civil practice law and rules. Neutral arbitrator shall mean an arbitra-
tor who does not have a material interest in the outcome of the arbi-
tration proceeding or an existing and substantial relationship, includ-
ing but not limited to pecuniary interests, with a party, counsel or
representative of a party. Any determination made by alternative dispute
resolution shall not be reviewable by the board and the venue for any
appeal shall be to a court of competent jurisdiction.
§ 14. Section 228 of the workers' compensation law, as added by
section 27 of part GG of chapter 57 of the laws of 2013, is amended to
read as follows:
§ 228. Administrative expenses. 1. The estimated annual expenses
necessary for the workers' compensation board to administer the
provisions of the disability AND PAID FAMILY LEAVE benefits law shall be
borne by all affected employers and included as part of the assessment
rate generated pursuant to subdivision two of section one hundred
fifty-one of this chapter.
2. Annually, as soon as practicable after the first day of April, the
chair and department of audit and control shall ascertain the total
amount of actual expenses.
§ 15. Subsection (n) of section 4235 of the insurance law is amended
by adding a new paragraph 4 to read as follows:
(4)(A) THE SUPERINTENDENT SHALL ESTABLISH BY SEPTEMBER FIRST OF EACH
YEAR THE MAXIMUM EMPLOYEE CONTRIBUTION THAT A COVERED EMPLOYER, AS
DEFINED IN SECTION TWO HUNDRED TWO OF THE WORKERS' COMPENSATION LAW, IS
AUTHORIZED TO COLLECT FROM EACH EMPLOYEE FOR THE COST OF DISABILITY
BENEFITS PROVIDED PURSUANT TO ARTICLE NINE OF THE WORKERS' COMPENSATION
LAW THROUGH A GROUP ACCIDENT AND HEALTH INSURANCE POLICY OR THROUGH A
SELF-FUNDED EMPLOYER FOR ITS EMPLOYEES. BEGINNING JANUARY FIRST, TWO
THOUSAND TWENTY-SEVEN, THE MAXIMUM EMPLOYEE CONTRIBUTION AMOUNT SHALL BE
TWO DOLLARS AND TWENTY CENTS PER WEEK, AND BEGINNING JANUARY FIRST, TWO
THOUSAND THIRTY, THE MAXIMUM EMPLOYEE CONTRIBUTION SHALL BE ONE-HALF OF
ONE PERCENT OF THE EMPLOYEE'S WAGES BUT SHALL NOT EXCEED FORTY PERCENT
OF THE AVERAGE OF THE COMBINATION OF ALL EMPLOYEE AND EMPLOYER CONTRIB-
UTIONS TO DISABILITY BENEFITS PROVIDED PURSUANT TO PARAGRAPH (B) OF
SUBDIVISION TWO OF SECTION TWO HUNDRED FOUR OF THE WORKERS' COMPENSATION
LAW DURING THE PRIOR CALENDAR YEAR, WHICH THE SUPERINTENDENT SHALL
DETERMINE AND PUBLISH ON THE DEPARTMENT'S WEBSITE.
(B) A SELF-FUNDED EMPLOYER SHALL SUBMIT REPORTS TO THE SUPERINTENDENT
FOR THE PURPOSE OF DETERMINING FORTY PERCENT OF THE AVERAGE OF THE
COMBINATION OF ALL EMPLOYEE AND EMPLOYER CONTRIBUTIONS TO DISABILITY
BENEFITS PROVIDED PURSUANT TO PARAGRAPH (B) OF SUBDIVISION TWO OF
SECTION TWO HUNDRED FOUR OF THE WORKERS' COMPENSATION LAW. A SELF-FUND-
ED EMPLOYER SHALL SUBMIT A REPORT TO THE SUPERINTENDENT BY JULY FIRST,
TWO THOUSAND TWENTY-SIX THAT SETS FORTH EMPLOYEE AND EMPLOYER CONTRIB-
UTIONS TO DISABILITY BENEFITS PROVIDED PURSUANT TO PARAGRAPH (B) OF
SUBDIVISION TWO OF SECTION TWO HUNDRED FOUR OF THE WORKERS' COMPENSATION
LAW FOR THE YEAR ENDING TWO THOUSAND TWENTY-FIVE, IN A FORMAT DETERMINED
BY THE SUPERINTENDENT. BEGINNING APRIL FIRST, TWO THOUSAND TWENTY-SEV-
EN, AND ANNUALLY THEREAFTER, A SELF-FUNDED EMPLOYER SHALL SUBMIT A
REPORT TO THE SUPERINTENDENT THAT SETS FORTH EMPLOYEE AND EMPLOYER
CONTRIBUTIONS TO DISABILITY BENEFITS PROVIDED PURSUANT TO PARAGRAPH (B)
OF SUBDIVISION TWO OF SECTION TWO HUNDRED FOUR OF THE WORKERS' COMPEN-
SATION LAW FOR THE PRIOR CALENDAR YEAR, IN A FORMAT DETERMINED BY THE
SUPERINTENDENT.
§ 16. Section 2605 of the insurance law is amended to read as follows:
S. 172 10
§ 2605. Penalty for violating workers' compensation law. The super-
intendent may impose a penalty not to exceed twenty-five hundred dollars
PER VIOLATION upon any insurer required to be licensed under the
provisions of this chapter, if, after notice to and a hearing of such
insurer, [he] THE SUPERINTENDENT finds it has unreasonably failed to
comply with the workers' compensation law.
§ 17. This act shall take effect immediately and shall apply to all
policies issued, renewed, modified, altered, or amended on or after
January 1, 2027.
