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How to file PFL Claims in New York

From Shelterpoint:

New Year, New Regulations: How to Apply for Paid Family Leave Now that it’s Here

Paid Family Leave is officially here, and we want to make sure that everything goes smoothly when you need to take time off with PFL. Here are the 4 easy steps you need to take to apply for PFL paid time off.

Step 1: Employer Notification
Paid Family Leave requires that you notify your employer in writing at least 30 days in advance of taking PFL when possible. It isn’t always possible to give such advanced notice for some qualifying events, but it is important that you notify your employer as soon as you know you will need to take paid time off.

If you plan on taking recurring paid time off — for example, if you have a family member who needs assistance getting to and from regular medical appointment, like physical therapy or dialysis treatment — make sure you remind your employer regularly to avoid any complications.   This also helps give your employer time to prepare for your time away.

Step 2: Download and Fill-Out PFL Claim Forms
To receive your Paid Family Leave benefits, you need to fully complete the required PFL claims forms.  You can download claim forms here.

The forms, and documentation (more on that in a bit), you need depends on the type of leave taken.  Read more about that, and get visual guides to the process at here.

Step 3: Obtain Supporting Documentation
Depending on your qualifying leave event, the kind of documentation you need to provide will vary. Some of the common types of supporting documentation are listed below.

Bonding with a new child:

  • Birth certificate
  • Adoption forms
  • Foster care placement forms

Active military family members:

  • Deployment certifications
  • Ceremony dates

Family member with a serious medical condition:

  • Medical forms
  • Doctors notes
  • Therapy schedules

Visit this article for more details on claim forms and supporting documentation. Each leave-specific claim form packet, by the way, includes a checklist with all applicable documentation.

It is recommended that you make copies of your forms and supporting documentation for your own records before submitting.

Step 4: Submit Claims Forms and Supporting Documentation to Your Insurance Carrier
As the person requesting Paid Family Leave, it is your responsibility to file the necessary paperwork with your employer’s NY Statutory Disability (DBL) Carrier.  Send your fully completed PFL claim forms and documentation to your insurance carrier.   If you are a ShelterPoint client check out this blog post with visual PFL claim guideswith all the information you need on where to send your claim.  Once your fully completed claim form and documentations are received, your DBL insurance carrier will review the claim and either let you know if information is missing, and what you still need to provide, or review the claim and determine if you are eligible for payments or not.  Eligible PFL claims that are submitted within 30 days of the first day of leave taken and properly completed are paid within 18 days of receipt, otherwise, within 18 days of submission of the missing information.


Things to Consider if You Plan to Retire Before 60


Financially speaking, what moves might you want to make?


Provided by Reeve Conover


By choice or by chance, some people wrap up their careers before turning 60. If you sense this will prove true for you, what could you do to potentially make your retirement transition easier? As a start, you may need to withdraw your retirement funds strategically.


The I.R.S. wants you to leave your retirement accounts alone until your sixties. To encourage this, it assesses a 10% early withdrawal penalty for most savers who take money out of traditional retirement accounts prior to certain ages. For a traditional IRA, the penalty applies if you withdraw funds prior to age 59½; for a workplace retirement plan, the penalty may apply as early as age 55.1


You may be able to avoid that 10% penalty by planning 72(t) distributions. Under a provision in the Internal Revenue Code, you can withdraw funds from a traditional IRA prior to age 59½ in the form of substantially equal periodic payments (SEPPs) over the course of your lifetime. The schedule of payments must last for at least five years or until you reach age 59½, whichever period is longer. Once the schedule of periodic payments is established, it cannot be revised – if the payments are not taken according to schedule, you will be hit with the 10% early withdrawal penalty. All 72(t) distributions represent taxable income.1,2

You can also take 72(t) distributions, in the form of SEPPs, from many employee retirement plans. To do this, you must “separate from service” with your employer, i.e., leave or lose your job. Should that happen in the year you turn 55 (or in subsequent years), you can take a lump sum out of the plan without any early withdrawal penalty. If you quit or leave before age 55, you may arrange SEPPs over your lifetime or prior to age 59½, as per the above paragraph.3


If you have a Roth IRA or Roth employer-sponsored retirement account, things get easier. You can withdraw your contributions to these accounts at any time without incurring taxes or tax penalties. At age 59½ or older, both account contributions and account earnings can be distributed tax free and penalty free if you have held the account for at least five years.3


In addition to your retirement funds, you will need health coverage. A decade may pass before you are eligible for Medicare, so what are your options past 18 months of COBRA?

The health insurance exchanges may be your best resource to find coverage at a decent cost. In fact, you may qualify for health insurance subsidies because your income will drop when you leave work. Retirement (and the loss of employer health coverage) counts as a “qualifying life event,” giving you a special 60-day enrollment window outside the usual November-December enrollment period.4


In the best-case scenario, your employer keeps you on its group plan for a few years after your retirement. (If you have paid for your own health insurance for years, you can keep doing so.)


You may appreciate having a health savings account. Contributions to HSAs are tax deductible, and the assets within them grow tax-free. HSAs are sometimes called “backdoor IRAs” because you can use the money within them for any reason without penalty once you turn 65, not just for qualified health care expenses. (All HSA withdrawals are taxable.)5


Think about a conservative retirement income withdrawal rate. The standard 4% baseline may be too optimistic; 3% or 3.5% may be more realistic if you feel you will be retired for 30 years or longer.


Should you claim Social Security at 62? You can, as long as you are prepared for the trade-off: the probability of proportionately smaller monthly benefits over the rest of your life compared with larger monthly benefits you could receive by claiming later.


Any early retirement decision should prompt a consultation with a qualified financial or tax professional. This is a critical financial juncture in your life, and whether you find yourself at it by choice or by chance, your decisions could have lifelong impact.


Reeve Conover can be reached at 843-800-8190 or at


This material was prepared by MarketingPro, Inc., and does not necessarily represent the views of the presenting party, nor their affiliates. This information has been derived from sources believed to be accurate. Please note – investing involves risk, and past performance is no guarantee of future results. The publisher is not engaged in rendering legal, accounting or other professional services. If assistance is needed, the reader is advised to engage the services of a competent professional. This information should not be construed as investment, tax or legal advice and may not be relied on for the purpose of avoiding any Federal tax penalty. This is neither a solicitation nor recommendation to purchase or sell any investment or insurance product or service, and should not be relied upon as such. All indices are unmanaged and are not illustrative of any particular investment.




1 – [7/5/17]

2 – [8/28/17]

3 – [8/2/17]

4 – [9/9/17]

5 – [8/23/17]


“Million-Dollar Questions”- interviewing

A great short is in this months Entrepreneurs Magazine, along with a number of other great articles.  They got  CEO’s to divulge their new interview questions and approaches…

“Tell me about your best and worst days at work”-

“What do you do when you are not at work?”-

Ask an unusual question to see how they apply logic.

Pull the candidate back in after they leave the room, ask them to tell you everyones name they met.  Ask them if they got the job.

“IF I called your current boss, what would they say about you.”



Maine COOP sues Government over cost sharing subsidies

From HEalth Affairs Online:


“On December 28, 2017, Maine Community Health Options (MCHO)—a nonprofit insurer in Maine—filed what is believed to be the first lawsuitagainst the U.S. Department of Health and Human Services (HHS) for failing to reimburse marketplace insurers for cost-sharing reductions (CSRs) for 2017. MCHO seeks an estimated $5.6 million in CSR payments for the 2017 plan year.

“Although much of the damage of CSR nonpayment has been mitigated for 2018 through higher rates, it remains to be seen whether MCHO will be successful and whether other insurers will sue HHS for outstanding CSR payments. ”


For the full Article, click here.

Military Retirement Benefits Changing

To Address the fact that most military personnel never stay the 20 years they need to earn their maximum retirement benefits, the Military is changing the rules.  The new plan, called “Blended Retirement System” or BRS, “combines a traditional pension with a defined contribution plan, similar to a private sector 401(k) plan. As of Jan. 1, service members entering the military will automatically be enrolled in the new BRS program.  Those who have served 12 years or more as of Dec. 31, 2017 will remain in the old legacy retirement plan, earning that guaranteed pension.”


For the full article, click here.

March 2018
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Reeve Conover is a Registered Representative. Securities offered through Cambridge Investment Research, Inc., a Broker/dealer member FINRA/SPIC. Cambridge and Conover Consulting are not affiliated. Licensed in SC, NC, NY, CT, NJ, and CA. - SIPC - Brokercheck