Form

PFL-135 - Employer’s Application for Voluntary Coverage (No Employee Contribution)

Who Files: Employers exempt from providing mandatory Paid Family Leave may provide voluntary Paid Family Leave by completing PFL-135 (if no employee contribution is required).
Where to File:

Bureau of Compliance

Plans Acceptance Unit

328 State Street

Schenectady, NY 12305

or email to PAU@wcb.ny.gov

When to File: To voluntarily cover employees for whom Paid Family Leave is not required under the Law with no employee contributions to the cost of the coverage.