Workers’ Compensation Insurance FAQ

What is workers’ compensation insurance?

Workers’ compensation insurance protects employers from liability for on-the-job injuries resulting in employee disability or death, providing injured workers with monetary relief and medical benefits, or in the case of death, survivor benefits to their dependents. The cost of the insurance must be covered completely by the employer. The Workers’ Compensation Law, which became effective in New York on July 1, 1914, benefits both the employer and employee because it usually removes the issue of negligence or who is at fault. Workers’ comp insurance protects the employer from being sued by the employee and it provides benefits for the employee in exchange for the employer accepting liability.

Who needs to be covered by workers’ comp? Who doesn’t need to be covered?

In general, all employees in all for-profit and non-profit businesses need to be covered by workers’ compensation insurance. Employee can include day labor, leased and borrowed staff, volunteers, part-timers, family members, as well as most subcontractors. Visit the Workers’ Compensation Board website for more detail on “Who is an employee under the Workers’ Compensation Law?” There are few exceptions for who does not need to be covered under the Workers’ Compensation Law in New York State. Some exemptions may include licensed real estate, insurance agents and media salespeople in certain contractual relationships. See a complete list of who is not covered by the law on the Workers’ Compensation Board website.

Are there penalties for not having workers’ comp insurance if you’re required to? What are they?

Yes. Failure by an employer to provide workers’ compensation coverage is a crime punishable by fines and/or criminal prosecution. There is a $2,000 penalty for every 10 days without insurance, and penalties for misrepresenting payroll, employees and record-keeping failures. In addition, a stop work order may be issued for the company that is not providing workers’ comp coverage.

What is a safety group?

A safety group is a fully insured, insurance program that enables employers in the same industry to pool their insurance premiums with the goal of reducing the cost of workers’ compensation insurance. It gives small and medium sized employers the opportunity to participate in the type of program that is usually reserved for much larger employers. The Retail Council of New York State Safety Group 493 is fully insured by the New York State Insurance Fund (NYSIF); it is not a self-insured trust and there is no joint and several liability for members of Safety Group 493.

What is the Council’s role in Safety Group 493?

The Retail Council of New York State is the safety group manager of Safety Group 493. The safety group manager oversees the group and serves as the liaison between NYSIF and the safety group members. The group manager is responsible for submitting all applications on behalf of prospective members to NYSIF and represents the group as a whole and on behalf of individual members in dealing with NYSIF. As the safety group manager, the Council also provides excellent customer service. Our team of licensed insurance professionals will assist you with questions regarding billing, claims, renewal, audits, certificate processing, loss run and Rating Board data reports. Personalized customer service and attention to detail remains our number one priority.

Who is eligible for the Retail Council of New York State Safety Group 493?

In general, traditional retailers with a store front and a safe workplace environment are the best fit for the Council’s Safety Group 493. See our list of eligible classification codes. The only way to know for sure if your business is eligible for our Safety Group is to call our insurance services department at (800) 442-3589 or email Virginia Hitchcock (vhitchcock@retailcouncilnys.com) or Ken Rutsky (krutsky@retailcouncilnys.com).

How do I get a quote for your Safety Group 493 program?

Call the Council at (800) 442-3589 and ask to speak with an insurance services representative or email Virginia Hitchcock at vhitchcock@retailcouncilnys.com. To prepare a quote, we will need the following information or documents:

  • Current policy declaration or last audit indicating payroll
  • Acord application or a completed New York State Insurance Fund application
  • Three to five years of loss history (policy periods must be clearly indicated)

What is a dividend?

A dividend is a portion of the premium paid for workers’ comp insurance coverage that is returned to the insured after the end of the group policy period. Safety groups are often able to pay out dividends because they spread the risk from the individual policyholder to the entire group. In addition, they have a lower risk of workplace incidences so they don’t pay claims for as many accidents. This allows the group to have more from participants’ premiums leftover at the end of the policy year to return to group members. The Retail Council of New York State Safety Group 493 has returned more than $100 million in dividends to participants since 1978. See the Retail Council Safety Group 493 Dividend History.

How do I file a workers’ comp claim?

If you are a Safety Group 493 participant,the easiest way to ensure your claims are filed properly is to complete your C-2 form on the New York State Insurance Fund (NYSIF) website (via NYSIF eFROI®). Once on the website, click on the link to NYSIF eFROI to start your report of injury. Claims can also be filed verbally by calling (877) 469-7432, or mailed to the address on the C-2 form. See also, How to File a Workers’ Compensation Claim: A guide for Retail Council members.

If you choose to mail your claim, please request a C-2 form from the Council then send one copy of the completed form to NYSIF as indicated on the front of the C-2. The original, completed C-2 should be directed to the Workers’ Compensation Board as noted on the back of the form.

How can I make a workers’ compensation insurance physical audit go smoothly?

For tips on workers’ compensation insurance physical audits, view NYSIF’s website page on Preparing for an Audit. See also our article, Why are Workers’ Comp Payroll Audits Necessary?

What is NYSIF PAYGO?

NYSIF PAYGO is a simple and convenient way for eligible policyholders to pay their workers’ compensation insurance through approved payroll processors. NYSIF PAYGO eliminates down payment requirements, calculates premium based upon actual payroll, calculates more accurate premium payments, resulting in smaller audit adjustments and allows policyholders to match payments to cash flow. Visit NYSIF’s PAYGO page for more information.

 

Visit the Retail Council’s Workers’ Comp Insurance page to see how we can help lower your comp insurance expenses!

 

(Additional sources: www.NYSIF.com, www.WCB.NY.gov)