State Fund: Yes there is a competitive state fund - The State Insurance Fund (SIF) is a not-for-profit agency of the State of New York that was established pursuant to the WCL in 1914 to provide a guaranteed source of workers’ compensation insurance coverage at the lowest possible cost to employers within New York State. Despite its State agency status, SIF is a self-supporting insurance carrier that competes with private insurers. Just like any insurance carrier, SIF collects premiums from employers to pay for the claims and related medical expenses of employees who are injured on the job. The premiums are required by law to be fixed at the lowest possible rates. SIF 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 SIF money from a previous bill or account, SIF may deny coverage. SIF is a totally separate and distinct entity from the New York State Workers’ Compensation Board. Contact SIF at:
Assigned Risk: See State Fund. The assigned risk plan is managed by the SIF.
Numerical Exceptions: None
Individual Waivers Allowed: No
Small Deductible Program:
Allowed: Yes - Mandatory that insurance carriers offer
Deductible Range: $100 - $2,500
Type: Medical and Indemnity
Effect on Experience Rating: Unknown
Available In: Voluntary and Assigned Risk
Special Note: Established under WKC 50,3-e (a). Policy holders with an annual premium of $12,000 or more are eligible. An Insurance Carrier, at their option, may also offer the plan to those with less than $12,000 in premium.
Sole Proprietor: Workers’ compensation coverage is not required for a sole proprietor who does not have employees.
A sole proprietor that has employees is automatically excluded from the business’ workers’ compensation insurance coverage. The sole proprietor may elect to have him/herself included ithat coverage by filing Form C-105.32 with the insurance companyr. The proper form may be obtained from the insurance company.
However, if a sole proprietor has no employees but obtains a workers’ compensation policy the sole proprietor is automatically included in coverage. The sole proprietor may elect to be excluded filing the proper form. This situation may occur when the sole proprietor is hiring subcontractors but does not wish to be included in the policy.
When Non-Construction Sole Proprietors are included the rating payroll used is banded between a minimum of $31,200 and a maximum of $97,500 as of 10-1-11. $32,500 / $98,800 as of 1-1-2014 and remains the same for 1-1-2015.
When Construction risk Sole Proprietors are included the rating payroll used is $32,500 / $62,650.12 as of 1-1-2014. $32,500 / $65,854.88 as of 7-1-15.
Partners: Workers’ compensation coverage IS NOT required for partners of a business that is a partnershipunder the laws of New York State that does not have employees. Partners of a business that is a partnership under the laws of New York State and has employees are automatically excluded from the business’ workers’ compensation insurance coverage. The partners may elect to have themselves included in coverage by filing form C105.32 with their insurance company.
However, if a business that is a partnership under the laws of New York State has no employees but obtains a workers’ compensation policy, the partners are automatically included in that policy. These partners may elect to be excluded from coverage by filing the proper form with the insurance carrier.
When Non-Construction risk Partners are included the rating payroll used is banded between a minimum of $31,200 and a maximum of $97,500 as of 10-1-11. $32,900 / $98,800 as of 1-1-2014 and remains the same for 1-1-2015.
When Construction risk Partners are included the rating payroll used is $32,500 / $62,650.12 as of 1-1-2014. $32,500 / $65,854.88 as of 7-1-15.
Corporate Officers: Please read all to determine status - Any executive officer of a corporation who owns all the shares of stock and holds all the offices of the corporation and has employees is automatically included in the corporation’s workers’ compensation insurance policy. This officer may choose to exclude him/herself by filing an exclusion form with his/her insurance carrier at the time the policy is written or renewed. This document, HUForm C-105.51UH, is available on the Board’s website.
For-profit Corporate Officers with No Employees – Coverage Requirements
Any executive officer of a corporation who owns all the shares of stock and holds all the offices of the corporation and has no other persons in his/her employ is automatically excluded from the WCL. This officer may choose to include him/herself by obtaining a workers’ compensation insurance policy.
Any two executive officers of a corporation who each own at least one share of stock and between them own all the shares of stock and hold all the offices of the corporation and have no other persons in their employ are automatically excluded from the WCL. One or both of the officers may choose to be included by obtaining a workers’ compensation insurance policy.
Please note that no corporate officers may be excluded if the corporation has more than two corporate officers or more than two shareholders, or where the one or two corporate officers do not own all the shares of stock (each owning at least one share.)
For-profit Corporate Officers – Coverage Requirements for Subcontractors -
General contractors routinely require that subcontractors provide proof of their own workers’ compensation coverage in order to co-work on the job. This results in many one or two person owned corporations who are not otherwise legally required to include the corporate officer(s) in a
workers’ compensation policy, being required to purchase and/or include themselves in a workers’ compensation insurance policy in order to work for a particular general contractor.
When for profit non construction risk and included the rating payroll for corporate officers is banded between a minimum of $31,200 and a maximum of $91,000 as of 10-1-11. $32,500 / $98,800 as of 1-1-2014 and remains the same for 1-1-15.
When Construction risk Officers are included the rating payroll used is $32,500 / $62,650.12 as of 1-1-2014. $32,500 / $65,854.88 as of 7-1-15.
When not for profit and included the rating payroll for corporate officers is banded between a minimum of $15,600 and a maximum of $97,500 as of 10-1-11. $16,900 / $98,800 as of 1-1-2014 and remains the same for 1-1-2015.
LLC Members: Under Section 54 of the Workers’ Compensation Law, members of a Limited Liability Company (LLC) or a Limited Liability Partnership (LLP) are treated the same as partners of a business that
is a partnership under the laws of New York State. If the LLC or LLP has employees, the members of the LLC or LLP, themselves, are automatically excluded from that coverage. The members may elect to have themselves include in that coverage by filing a proper form, the HUC-105.32UH with the insurance carrier. That coverage election form may be obtained from the insurance carrier.
Workers’ compensation coverage is not required for members of a LLC or LLP that does not have employees. However, if a LLC or LLP that has no employees obtains a workers’ compensation policy, the members of the LLC or LLP are automatically included in that policy. The members of a LLC or LLP may elect to have themselves excluded in that coverage by filing a proper form with the insurance carrier. The proper form may be obtained from the insurance carrier.
New York Workers Compensation Forms:All New York Workers Compensation Forms - Exclusion and Inclusion forms for the State of New York are available on this webpage from the New York Workers Compensation Board. This site lists all workers compensation forms so you will have to scroll down until you find the Exclusion - Inclusion form you may need. Be sure to contact the New York Board for questions as to how to use these forms. Do not make assumptions as they can be very confusing.
A Note About Forms: Be sure to contact your insurance company for information about additional forms they may use for exclusion or inclusion of coverage.
Contractors: To be considered an independent contractor, and thus not an employee, and not be included in workers compenssation an individual must meet and maintain All ten of the following conditions:
Obtain a Federal Employer Identification Number from the Federal Internal Revenue Service (IRS) or have filed business or self-employment income tax returns with the IRS based on work or service performed the previous calendar year;
Maintain a separate business establishment from the hiring business;
Perform work that is different than the primary work of the hiring business and perform work for other businesses;
Operate under a specific contract, and is responsible for satisfactory performance of work and is subject to profit or loss in performing the UspecificU work under such contract, and be in a position to succeed or fail if the business’s expenses exceed income.
Obtain a liability insurance policy (and if appropriate, workers’ compensation and disability benefits insurance policies) under its own legal business name and federal employer identification number;
Have recurring business liabilities and obligations;
If it has business cards or advertises, the materials must publicize itself, not another entity;
Provide all equipment and materials necessary to fulfill the contract;
Control the time and manner in which the work is to be done; and
The individual works under his/her own operating permit, contract or authority.
Special Notes:Coverage of Agricultural Workers- Requires workers' compensation coverage of farm laborers for 12 months, from April 1, if the farmer's total cash remuneration paid to all farm laborers during the preceding calendar year amounts to $1,200 or more. Farm workers supplied to a farmer by a farm labor contractor would be deemed to be employees of the farmer. Coverage of Domestic Employees- Covers any domestic worker employed (other than those employed on a farm) by the same employer for a minimum of 40 hours per week.
Virtually all employers in New York State must provide workers’ compensation coverage for their employees (WCL §2 and 3). Employers must post notice of coverage in their place(s) of business (WCL §51). Employers must cover the following workers for workers’ compensation insurance:
Workers in all employments conducted for-profit. Part-time employees, borrowed employees, leased employees, family members and volunteers working for a for-profit business must also be covered under the Workers’ Compensation Law (WCL §3 Groups 1-14-a);
Employees of counties and municipalities engaged in work defined by the law as “hazardous” (WCL §3 Groups 15, 15-a and 17);
Public school teachers, excluding those employed by New York City, and public school aides, including New York City (WCL §3 Groups 20, 20-a and 22);
Employees of the State of New York, including some volunteer workers (WCL §3 Group 16);
Domestic workers employed forty or more hours per week by the same employer, including full-time sitters or companions, and live-in maids (WCL §3 Group 12) (see HUDomestic WorkersUH)
Farm workers whose employer paid $1,200 or more for farm labor in the preceding calendar year (WCL §3 Group 14-b) (see HUFarmsUH)
Any other worker determined by the Board to be an employee and not specifically excluded from coverage under the WCL (WCL §3 Groups 1-14-a and 18);
All corporate officers if the corporation has more than two officers and/or two stockholders (WCL §54 ) (see HUCorporate Officer Coverage RequirementsUH);
Officers of one-or-two person corporations if there are other individuals in employment. These officers may choose to exclude themselves from coverage (WCL §54 ) (see HUCorporate Officer Coverage RequirementsUH); and
Most workers compensated by a nonprofit organization (WCL §3 Group 18) (see HUNonprofit OrganizationsUH).
Volunteer Firefighters and Volunteer Ambulance Workers are provided benefits for death or injuries suffered in the line of duty under the Volunteer Firefighters’ Benefit Law and Volunteer Ambulance Workers’ Benefit Law.
A black car operator, as defined in Article 6-F of the executive law (“The Black Car Law”), is an "employee" of the New York Black Car Operators' Injury Compensation Fund, Inc. (NYBCOICF). NYBCOICF began providing coverage on January 20, 2000, and currently provides workers’ compensation insurance coverage through the State Insurance Fund for the drivers affiliated with its members.
Limousine companies must become members of the NYBCOICF if they meet the criteria outlined in the statute. The members of NYBCOICF are large limousine companies (central dispatch facilities) that own less than 50% of their vehicles and receive 90% of their fares as non-cash. Once a limousine company meets these requirements it MUST become a member of the Fund.
Black Car and limousine companies operating outside of New York State are also required to become members of the NYBCOICF if they do work in New York State and meet the criteria outlined in the statute.
The Fund derives its income to provide workers’ compensation insurance, from a 2% surcharge, which is billed and collected by member companies from their clients and then remitted to the fund. The statute permits the fund to either increase or decrease the percentage by notifying and filing a request with the Department of State.
NYBCOICF does not cover Medallion Taxicabs or Community Car Service vehicles. Generally, the NYBCOICF only covers Black Car and Limousine drivers of NYBCOICF members. If a driver’s dispatch facility is not a member of NYBCOICF, the driver cannot be covered by NYBCOICF no matter what vehicle he/she drives.
New York Workers Compensation Subrogation: Rules governing New York subrogation for workers compensation can be found in Work Comp section 29. Work Comp 29 is called Remedies of Employees;Subrogation and provides you with specifics about subrogation in New York. This code can be viewed online so we have provided you with the link below that will take you directly to this code.
New York Workers Working In Other States; Other States Workers Working In New York, Extraterritorial, Reciprocity and Non-Compliance: When New York workers are working temporarily in another state, workers compensation coverage for that worker is then governed by the extraterritorial provisions found in New York statutes. When or if allowed it's extraterritorial provisions that allow benefits for an injured worker to apply as if the worker was in their primary state. Not all states provide Extraterritorial Provisions so it's important that an employer or insurance professional be aware of how their state responds to out of state employment. It's reciprocity that governs how New York workers compensation coverage responds for a worker from another state who is working temporarily in New York. Compliance of workers compensation laws varies from state to state and it is important for an employer with workers performing duties in other states to be aware of the specific state rules that govern their coverage. We've provided this general information about extraterritorial and reciprocity as a basic guide. Please contact your New York state authority with your specific questions or applications concerning this topic!
Duration: In general a New York employee who is working outside the state of New York while under the control of a New York employer will be eligible for benefits under New York statute with no time limit. Be aware however that the New York employee may choose to file a claim for benefits under the state in which they are performing work.
Allowed: No. New York must be shown in item 3A on the workers compensation insurance information page.
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Information on this page is provided only as a reference. While we strive to mantain accurate information on this site please realize workers compensation laws are complicated and subject to change at any time. No warranty as to the accuracy or completeness of this information is provided or to be implied. You must verify this data before use with the individual governing authority for this state. If you need help with a workers compensation problem or have a specific situation or question please contact our office. Otherwise please consult your states governing authority or an attorney in your state of residency for assistance.