Top Agent PFL FAQs

This benefit became effective January 1^st, 2018.

Yes, employers are required to provide this coverage for all eligible employees. They cannot opt out.

The premium rate used to calculate employee premium will be increased effective January 1, 2025. It will be 0.388% (0.00388) of an employee's weekly wage up to and not to exceed the statewide average weekly wage. The statewide average weekly wage for use with Paid Family Leave, as of January 1, 2025 is $1,757.19, making the annual maximum contribution, per employee, $354.53 ($1,757.19 x 52 weeks x .00388 = $354.53).

PFL and DBL will be billed separately on the same billing notice. The employer will need to input the number of male and female employees, along with the total annual wages paid to these employees. An employer should only total each employee’s total gross wage, up to the maximum covered wage for each individual employee. In 2025 the maximum covered wage for each individual employee will be $91,373.88.

The DBL application will have minor changes to incorporate the PFL coverage. There will be no changes to how you will apply for a policy. If you have any policy related questions not answered here, please contact policyholder services at 646-509-2100 or email us at policyservices@sslicny.com.

Bonding
An employee may file for PFL to bond with their child during the first year after birth, or during the first year after placement of an adopted or foster child. An employee may apply for family leave before the actual placement for adoption or foster care. Examples of valid reasons for leave in this scenario: to attend counseling sessions, court appearances, attorney consultations or travel to another country to complete an adoption.

Caring for a Family Member with a Serious Health Condition
An employee may file for PFL to care for a close family member with a serious health condition. A close family member of the employee includes the employee's spouse, domestic partner, child, parent, grandparent, grandchild, and sibling. A "serious health condition" is an illness, injury impairment, or physical or mental condition that involves either (a) inpatient care or (b) continuing treatment or continuing supervision by a health care provider.

Qualifying Military Event
An employee may file for PFL for a qualifying military event when a spouse, child, domestic partner, or parent of the employee is on active duty or has been notified of an impending call or order of active duty.

Employees who regularly work 20 or more hours per week may be eligible after they have worked for at least 26 consecutive weeks. Employees who work less than 20 hours per week may be eligible after they have worked at least 175 days.

The NYS PFL program reached the final phase of the 4-year benefit implementation in 2021. For the year 2025, eligible employees will receive a portion of their weekly earnings during a qualifying leave period, subject to a New York State average weekly wage (NYSAWW) maximum, as follows:

Year	Weeks Available	% of Employee Salary	Up to a Maximum % of State Average Weekly Wage	Maximum Weekly Benefit Payout Amount
1/1/2025	12	67%	67%	$1,177.32
1/1/2024	12	67%	67%	$1,151.16
1/1/2023	12	67%	67%	$1,131.09
1/1/2022	12	67%	67%	$1,068.36

Examples:

In 2025, an employee who makes $1,125 a week would receive a benefit of $753.75 a week (67% of $1,125). An employee who makes $1,900 a week would receive a benefit of $1,177.32, because this employee is capped at 67% of New York State's Average Weekly Wage (NYSAWW) — currently $1,757.19. 67% of the NYSAWW for use in 2025 brings you to the $1,177.32 maximum weekly benefit.

Employees are guaranteed to be able to return to their job and the employer must continue their health insurance coverage. It is important to note, employees must continue to pay their portion of the premium cost while on PFL. The employer must work out those details with the employees; this will not be handled through the PFL benefit.

If they have an employee handbook or any written guidance for employees regarding benefits or leave rights, they must include information concerning leave under PFL; which should include the employee rights and obligations under PFL and how to file a claim for this benefit. If they do NOT have written policies, manuals, or handbooks they still must provide written guidance to each of their employees regarding all the employee's rights and obligations under PFL, including information on how to file a claim.

PFL is entirely employee-funded. As of July 1, 2017, employers were authorized by NYS to be able to institute a payroll deduction to cover the PFL benefit premium.

Yes. Citizenship and immigration status has no impact on PFL eligibility.

An employee of a covered employer whose regular work schedule is less than 20 hours per week will become eligible to take family leave after working at least 175 days in that employment prior to the first full day leave begins.

No, if the employee is not working and is collecting workers' compensation, PFL may not be used.

Yes, your client can choose to allow employees to use their sick and vacation time so they may receive full salary. If they allow them to do this, they may request reimbursement of any approved PFL benefits. An employer cannot require them to use their PTO.

Once we receive a completed request for PFL with the necessary certification, we have 18 days to pay or deny a PFL claim.

You can download/print claim forms here. Also provided are detailed instructions and a claim filing requirements chart. You can also download/print the claim filing requirement charts separately.

They can mail it to:	Standard Security Life Insurance Company of New York P. O. Box 25339 Farmington, New York 14425
They can email it to:	claims@sslicny.com
Or
They can fax it to:	585-398-2854

If you have any claim related questions not answered here, please contact us at 1-800-477-0087 or email us at claims@sslicny.com.