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OBTAINING AN ORDER

The law provides guaranteed job protection and paid leave for New York employees who are unable to work while subject to a COVID-19 precautionary or mandatory ORDER of quarantine. Benefits are only available for the duration of the ORDER of quarantine or Employees Need to DoIf you receive a positive COVID-19 test result, regardless of vaccination status:1. Isolate for at least 5 complete days, with day 0 being the date your symptoms started or you were tested positive for COVID-192. Obtain an AFFIRMATION OF ISOLATIONIf you were exposed to COVID-19 and are NOT up to date on COVID-19 vaccinations:1. Stay home and quarantine for at least 5 full days2. Obtain an AFFIRMATION OF QUARANTINEFor more information on isolation and quarantine please visit: GUIDANCEAFFIRMATION OF ISOLATIONC omplete this affirmation if you or your minor dependent child has tested positive for COVID-19 and have been in get an affirmation of isolation, please visit: OF QUARANTINEC omplete this form if you or your minor dependent child:1.

Mar 30, 2020 · quarantine, provided they follow the process noted above. For additional information about COVID-19, please visit the New York State Department of Health’s coronavirus website at coronavirus.health.ny.gov/home . OBTAINING AN ORDER For Mandatory or Precautionary Quarantine Under Governor Cuomo’s New COVID-19 Paid Sick Leave Law

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Instructions for taking Disability and/or Paid Family ...

docs.paidfamilyleave.ny.gov

Attach mandatory or precautionary order of quarantine or isolation. 4. ... If you disagree with the insurance carrier’s decision, or if payment is untimely, you may request arbitration with NAM (National Arbitration and . Mediation) at nyspfla.com. PART A - EMPLOYEE INFORMATION (to be completed by the employee)

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Instructions for taking Paid Family Leave for a Minor ...

docs.paidfamilyleave.ny.gov

SECTION 1 - PAID FAMILY LEAVE (PFL) REQUEST (to be completed by the employee) Reason for PFL request: Care for minor dependent child subject to COVID-19 Quarantine/Isolation. 1. Minor dependent child’s name (first name, middle initial, last name) 2. Minor child’s date of birth (MM/DD/YYYY) 3. Minor child’s mailing address. Street address

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Information for Employers

docs.paidfamilyleave.ny.gov

“Employers” section of PaidFamilyLeave.ny.gov. · Collect employee payroll contributions to pay for the insurance. You may withhold employee contributions at the rate set by DFS each year to pay for the cost of the insurance until employees reach their annual maximum contributions.

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How to Request Paid Family Leave - Government of New York

docs.paidfamilyleave.ny.gov

Complaints about employer discrimination or retaliation are resolved by a Workers’ Compensation Board Law Judge after a hearing. If you believe that your employer has discriminated or retaliated against you for taking or requesting Paid Family Leave, visit PaidFamilyLeave.ny.gov or contact (844) 337-6303.

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Paid Family Leave: Model Language for Employee Materials

docs.paidfamilyleave.ny.gov

Leave should continue to collect employee contribution during periods of paid time off. Model language: Time spent on paid vacation, sick or personal days can be counted toward an . employee’s eligibility determination. Time out on short-term disability does not count towards an employee's eligibility determination. 3.

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Employee Notice of Paid Family Leave Payroll Deduction for ...

docs.paidfamilyleave.ny.gov

Based on your average pay period earnings of $ _____. _____, your estimated pay period deduction will be: $ _____. _____. Note: This deduction may fluctuate pay period to pay period, depending on your hours worked. For more information, visit PaidFamilyLeave.ny.gov or call the Paid Family Leave Helpline for assistance at (844) 337-6303.

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Employee Notice of Paid Family Leave Payroll Deduction for ...

docs.paidfamilyleave.ny.gov

Based on your average pay period earnings of $ _____. _____, your estimated pay period deduction will be: $ _____. _____. Note: This deduction may fluctuate pay period to pay period, depending on your hours worked. For more information, visit . PaidFamilyLeave.ny.gov. or call the Paid Family Leave Helpline for assistance at(844) 337-6303.

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New York Paid Family Leave at-a-glance fact sheet

docs.paidfamilyleave.ny.gov

New York State, or a public employer who has opted in. Meet the time-worked requirements: • Full-time (regularly work 20 or more hours/week), after 26 consecutive weeks of employment. • Part-time (regularly work fewer than 20 hours/week), after 175 working days. How to Request PFL Give 30 days’ notice to your employer, if foreseeable.

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How to Request Paid Family Leave

docs.paidfamilyleave.ny.gov

Mail or fax your Form PFL-1 and Form PFL-4 to your employer’s insurance carrier. To find out who your employer’s insurance carrier is, you can: Look for the Paid Family Leave poster in your workplace. Ask your employer. Use the employer coverage search application on wcb.ny.gov to …

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New York State Paid Family Leave Statement of Rights

docs.paidfamilyleave.ny.gov

STATEMENT OF RIGHTS If you need to take time off from work to care for a family member, you may be entitled to paid family leave benefits ... Employees with a regular work schedule of less than 20 hours per week are eligible after 175 days worked. Citizenship or immigration status is not a factor in your eligibility.

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