Form PFL-820.1 Supplement to Certificate of Insurance - New York

Form PFL-820.1 Supplement to Certificate of Insurance - New York

What Is Form PFL-820.1?

This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.

FAQ

Q: What is Form PFL-820.1?A: It is a Supplement to Certificate of Insurance in New York.

Q: Who needs to fill out Form PFL-820.1?A: Employers in New York who provide paid family leave benefits to their employees.

Q: Why is Form PFL-820.1 required?A: It provides additional information about an employer's paid family leave insurance policy.

Q: What information is required on Form PFL-820.1?A: It requires details about the employer's policy, coverage, and premiums.

Q: When should Form PFL-820.1 be submitted?A: It should be submitted to the employer's insurance carrier within 30 days of the start of a new policy or at the carrier's request.

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Form Details:

  • Released on March 1, 2018;
  • The latest edition provided by the New York State Workers' Compensation Board;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form PFL-820.1 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.

Download Form PFL-820.1 Supplement to Certificate of Insurance - New York

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