Five states require employees to be covered under a short-term disability plan either through state-run programs, private insurance, or self-insured arrangements. States mandating coverage include California, Hawaii, New Jersey, New York, and Rhode Island. The rules on plan eligibility and how they operate vary significantly between states. If you have an employee working in any of these states and is not currently covered, please review the regulations and contact your Horton representative.
Disability insurance provides wage replacement benefits for employees who are unable to perform their jobs due to non-job-related illnesses or injuries. While most states do not require employers to provide disability insurance coverage for their employees, there are currently five states that require employees to be covered by disability insurance through state-run programs, private insurance or self-insured arrangements. These states are California, Hawaii, New Jersey, New York, and Rhode Island. Key components of these state programs are as follows:
- In each of these states, employers are required to provide coverage for temporary wage replacement benefits for disabled workers.
- The duration of benefits, eligibility requirements and methods for determining the amount of weekly benefits vary from state-to-state.
- Both California’s and Rhode Island’s disability insurance programs include wage replacement benefits for employees who need time off from work to care for family members.
State Resources:
California Employment Development Dept.
Hawaii Dept. of Labor and Ind. Relations
New Jersey Dept. of Labor and Workforce Dev.
New York Worker’s Compensation Board
Rhode Island Dept. of Labor and Training
California
Programs |
Funding |
Benefits |
State Disability Insurance (SDI) program includes the following benefits: |
Benefits are funded through mandatory employee payroll deductions. |
DI Benefits: An individual may receive up to 52 weeks of DI benefits. The weekly benefit amount is approximately 60 to 70 percent (depending on income) of wages earned 5 to 18 months prior to an individual’s claim start date, up to the maximum weekly benefit amount. |
Voluntary Plan (VP): California law allows employers or a majority of employees to apply to the Employment Development Department (EDD) for approval of a VP for the payment of DI and PFL insurance benefits in place of the mandatory SDI coverage. To be approved for a VP, the employer must post a security deposit with the EDD to guarantee that it meets all obligations of the VP. |
Once a VP is approved, the employer is no longer required to send SDI withholdings to the EDD. When an employer requires contributions from employees under the VP, the employer must place those contributions in a separate account to pay claims and approved expenses. A VP cannot cost employees more than the current SDI plan rate. |
A VP must provide all the benefits of SDI coverage and at least one benefit that is better than SDI. |
Disability Insurance Elective Coverage (DIEC): California’s DIEC program serves as a safety net for self-employed individuals who are not required to pay into the SDI, but want to be covered by DI and PFL. |
DIEC premiums are based on net profit reported on IRS Form 1040 Schedule SE or Schedule C. Each quarter, one-fourth of this amount is reported as “wages.” Premiums are calculated at a percentage of these “quarterly wages.” |
Individuals who are covered by the DIEC program may be eligible for DI and PFL benefits. Eligible individuals may receive up to 39 weeks of DI benefits. Under the PFL program, eligible individuals may receive up to six weeks of benefits in a 12-month period to care for a seriously ill family member or to bond with a new child. |
MORE INFORMATION: More information on California’s disability insurance law is available through the state’s Employment Development Department. |
HAWAII
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Funding |
Benefits |
Hawaii requires most employers to provide partial wage replacement insurance coverage to their eligible employees for non-work related illness or injury (including pregnancy). If an employee is unable to work because of an off-the-job sickness or injury and that employee meets the qualifying conditions of the law, the disabled employee will be paid disability or sick leave benefits to partially replace the wages lost. |
An employer may adopt one or more of the following methods of providing disability benefits:
An employer may pay for the entire cost of disability benefits, or the employer may share the cost with employees. However, the employee’s contribution cannot exceed 0.5 percent of the employee’s weekly wages, with the maximum deduction not to exceed $5.44. |
If the employer has a statutory plan (that is, a plan that provides benefits according to the minimum benefit standards as required by law), the employee is entitled to disability benefits from the eighth day of disability for a maximum of 26 weeks at 58 percent of the employee’s average weekly wages. For claims beginning on or after Jan. 1, 2019, the maximum weekly benefit is $632. |
MORE INFORMATION: More information on Hawaii’s disability insurance law is available through Hawaii’s Department of Labor and Industrial Relations. |
NEW JERSEY
Programs |
Funding |
Benefits |
Temporary Disability Insurance (TDI) State Plan: All New Jersey employers covered by the state’s unemployment compensation law (except for certain governmental entities) are required to provide temporary disability benefits for non-work-related illnesses or injuries, including pregnancy, that prevent employees from working. Covered employers must provide disability benefits under a state plan, unless benefits are provided through an approved private plan. |
Both New Jersey workers and employers contribute to the cost of temporary disability coverage. |
Weekly Benefit Rate: The weekly benefit rate is calculated on the basis of the claimant’s average weekly wage (AWW). |
TDI Private Plan Coverage: New Jersey permits employers to provide coverage for temporary disability benefits through an approved private plan instead of the state plan. The plan may be insured by the employer, by an insurance company or by a union welfare fund. All private plans must be approved by the Division of Temporary Disability Insurance before they become effective. |
Employees may be required to contribute to the cost of an employer’s private plan. However, employees cannot be charged more than they would have contributed for state plan coverage. If employees must contribute to the cost of the plan, a written election must be held and a majority of employees must agree to the plan prior to the effective date of the plan. |
Private plans must be at least as generous in benefit amounts, eligibility requirements and duration of payments as the state plan. |
Disability During Unemployment Program: If a worker becomes totally disabled and has been out of New Jersey covered employment for more than 14 days, he or she may be eligible for benefits under the state’s Disability During Unemployment program. |
Benefits are covered under the state temporary disability plan or an approved private plan. |
Weekly Benefit Rate: A claimant’s weekly benefit amount is 60 percent of his or her AWW. For a disability that begins on or after Jan. 1, 2019, the maximum weekly benefit rate is $696. If the claimant’s weekly benefit rate is less than the weekly benefit rate, the benefits might be increased if the claimant has unemployed dependents. |
MORE INFORMATION: More information on New Jersey’s disability insurance programs is available through the Department of Labor and Workforce Development. |
NEW YORK
Programs |
Funding |
Benefits |
Employers must provide disability benefits coverage to employees for an off-the-job injury or illness. |
Coverage for disability benefits can be obtained through a disability benefits insurance carrier who is authorized by the New York’s Workers’ Compensation Board (Board) to write those policies. Another option for large employers is to become authorized by the Board to self-insure. |
Disability benefits are temporary cash benefits paid to an eligible wage earner when he or she is disabled by an off-the-job injury or illness. New York’s disability benefits law provides weekly cash benefits to replace, in part, wages lost due to injuries or illnesses that do not arise out of or in the course of employment. Disability benefits are also paid to an unemployed worker to replace unemployment insurance benefits lost because of illness or injury. |
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RHODE ISLAND
Programs |
Funding |
Benefits |
Temporary Disability Insurance (TDI): TDI provides benefit payments to insured Rhode Island workers for weeks of unemployment caused by disability or injury. It protects workers against wage loss resulting from a non-work-related illness or injury. |
The TDI/TCI program is funded exclusively by employee payroll deductions. |
An insured’s weekly benefit rate is equal to 4.62 percent of the worker’s wages in the highest quarter of his or her base period. |
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