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This version of the form is not currently in use and is provided for reference only. Download this version of
Form DB-150
for the current year.
Form DB-150 Application for Self-insurance - Disability and Paid Family Leave Benefits Law - New York
What Is Form DB-150?
This is a legal form that was released by the New York State Workers' Compensation Board - a government authority operating within New York. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is DB-150?
A: DB-150 is an application for self-insurance for Disability and Paid Family Leave Benefits Law in New York.
Q: What does DB-150 cover?
A: DB-150 covers Disability and Paid Family Leave benefits in New York.
Q: Who uses DB-150?
A: Employers in New York who wish to self-insure for Disability and Paid Family Leave benefits use DB-150.
Q: What is the purpose of DB-150?
A: The purpose of DB-150 is to allow employers in New York to self-insure for Disability and Paid Family Leave benefits.
Form Details:
- Released on April 1, 2023;
- The latest edition provided by the New York State Workers' Compensation Board;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form DB-150 by clicking the link below or browse more documents and templates provided by the New York State Workers' Compensation Board.
Download Form DB-150 Application for Self-insurance - Disability and Paid Family Leave Benefits Law - New York
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