If you haven’t already heard, New York State is tightening enforcement around Disability Benefits Law (DBL) and Paid Family Leave (PFL) compliance—and the penalties for non-compliance are about to get a lot more serious.
What’s Changing?
The New York State Workers’ Compensation Board (WCB) is implementing stricter rules and penalties for late or missing Proof of Coverage (POC) filings. This includes both Add Policy (new coverage) and Cancellation transactions. The goal? To ensure timely and accurate reporting from private insurance carriers and employers alike.
Key Takeaways
The WCB is removing flexibility from the private market to create more opportunities for penalty enforcement.
- Backdating DBL/PFL coverage will no longer be allowed in most cases.
- Private carriers will be required to enforce stricter termination policies for late premium payments.
Penalty Structure
The WCB will begin measuring carrier performance quarterly. If a carrier fails to meet an 85% timeliness threshold, they will be penalized for any late Add or Cancel transactions. Here’s how “late” is defined:
| Transaction Type | Timely Filing | Late (Penalized) |
| Cancel – Non-payment | ≥10 days before cancellation date | After cancellation date |
| Cancel – Other reasons | ≥30 days before cancellation date | <20 days before cancellation date |
| Add (New Policy) | ≤30 days after policy effective date | >40 days after policy effective date |
Immediate Action Required
- Review Active Policies: Carriers must cancel any inactive policies by May 30, 2025, to avoid future penalties.
- Audit Internal Processes: Ensure your systems and workflows support timely and accurate POC submissions.
What’s Next?
In October 2025, the WCB will release Q3 performance data (June 1–September 30) to help carriers assess their compliance. This will be the final checkpoint before penalties begin.
The Board also plans to host a webinar to walk through the new process, answer questions, and explain how to appeal penalties. Keep an eye out for the invite.
Contact Us
For more information or any questions our employee benefits team is here to help you.
This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem. Please refer to your policy contract for any specific information or questions on applicability of coverage.
Please note coverage can not be bound or a claim reported without written acknowledgment from a OneGroup Representative.
This content is for informational purposes only and not for the purpose of providing professional, financial, medical or legal advice. You should contact your licensed professional to obtain advice with respect to any particular issue or problem.
[1] Disability and Paid Family Leave Benefits Penalties for Not Having …