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New york exclude officer 2026

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The document outlines the process for revoking the election of a not-for-profit corporation or unincorporated association to exclude an unsalaried executive officer from coverage under New York's Workers' Compensation Law. It details the necessary steps, including certification by the Board of Directors, and specifies that the revocation becomes effective 30 days after filing with the Workers' Compensation Board and insurance carrier.

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Click ‘Get Form’ to open it in the editor.
Begin by entering the name and address of your insurance carrier in the designated fields at the top of the form.
Next, provide the name of your corporation or association along with its address. If applicable, indicate under which state laws it is incorporated.
Fill in the details of the executive officer you wish to include in the policy, including their name and title.
Certify that this revocation was made during a board meeting by signing and typing your name and title in the appropriate sections.
If your corporation has a seal, affix it; if not, check the provided box. Finally, include a contact telephone number for any follow-up.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

Can corporate officers be excluded from workers compensation in NY?

Officers of a corporation that does not employ any person who is required to be covered under the law is statutorily excluded from coverage. However, coverage may be elected for such executive officer(s) by obtaining a standard workers compensation policy.

Why are officers excluded from workers comp?

The main reason to exclude owners and officers is to save the company premium dollars. It is also often assumed that owners and officers would not need to file a workers comp claim anyway.

Can officers be excluded from workers compensation in NY?

Executive officers of a corporation are usually included for coverage under each states workers compensation laws. They will usually be covered unless they intentionally file for an exclusion from the insurance policy.

What is an excluded officer?

An officer or director who individually owns at least 10 percent of the corporations issued and outstanding stock (or at least 1 percent of outstanding stock if a specified family member owns at least 10 percent of outstanding stock) and is covered by a health insurance policy or health care service plan may elect to

What is NY action over exclusion?

If someone gets hurt on a job site and multiple companies are involved, a clause known as action over exclusion could remove insurance coverage when you need it most. Learn more about the action over exclusion and how to protect your business from costly third-party claims.

determining whether an employee is essential nys

ny workers' comp officer exclusion form State OF New York Workers' Compensation Board notice OF COMPLIANCE NYSIF New York State Division of Corporations NY WCB RFA-2 Workers' compensation officer exclusion NY c240 Workers' comp waiver form

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Who is exempt from workers compensation in NY?

Sole Proprietors and Business Partners Sole proprietors and partners in a business are typically exempt from mandatory workers compensation coverage. Since they are not considered employees of their own business, they are not required to be covered unless they voluntarily choose to purchase a policy.