Lance's Corner

OSC Issues Report on New York Social Insurance Programs

Nov 12, 2024

Per the notice below, the Office of the New York State Comptroller (OSC) has issued a report on the social insurance programs offered in New York.

DiNapoli Report Looks at New York's Social Insurance Programs for Unemployed and Injured Workers

Analysis Benchmarks Benefit Levels Against Peer States

The benefits from four major social insurance programs provide crucial financial support during difficult times in the lives of hundreds of thousands New York workers and their families each year, according to a new report by State Comptroller Thomas P. DiNapoli that reviews the benefit amounts, limits, and wage replacement rate of these programs and how they compare with peer states.

“New York’s social insurance programs play a vital role in helping hundreds of thousands of New Yorkers each year cope with the impact of losing a job, or being unable to work due to their own or a family member’s injury or illness, pregnancy or the arrival of a new child,” said DiNapoli.  “We saw the importance of these benefits in helping employees meet household needs during the pandemic, keeping countless families from slipping into poverty.”

New York’s four major social insurance programs are: unemployment insurance (UI), workers’ compensation insurance (WC), temporary disability insurance (TDI), and paid family leave insurance (paid family leave).  More than 138,000 New Yorkers claimed unemployment benefits for the week of Oct. 5, 2024.  In 2023, there were almost 170,000 claims for workers’ compensation.  In 2022, the most recent year for which data are available, more than 163,000 paid family leave claims were paid.

Assessing the adequacy of benefits can be challenging, and is influenced by the benefit rate, the maximum benefit or cap on benefits, and the wages earned by workers claiming benefits.  Adequacy is subjective, and sufficiency may appear differently when assessed against wages lost or cost of living, or in conjunction with household size, other household income and savings, and the duration of benefit provided.  In addition, benefit adequacy must also be balanced with other policy goals, such as affordability of funding the benefits and maintaining an incentive to return to work, among others.  DiNapoli’s report looks at how three types of workers – those earning minimum wage, a living wage, and a six-figure salary – would fare under New York’s programs, and compares these results to those of peer states.  It shows that New York’s benefit rate for these programs are mostly in-line with other participating states, and New York is one of the only states that offers TDI and paid family leave.

Unemployment Insurance

All 50 states provide this benefit, and New York’s benefit rate of 50% is common.  However, in 2024, the state’s maximum benefit of $504 is lower than in 29 other states.  As a result, the UI benefit replaces 42% of the weekly wage of a worker earning a living wage in New York City.  By contrast, a worker earning the same wage would have 60% of income replaced in New Jersey.  Under current law, increases to maximum benefits are being phased in through October 2026, at which point they will equal 50% of the New York State Average Weekly Wage.  Four peer states offer higher replacement of wages for workers earning a wage comparable to a New York minimum wage: Pennsylvania, Texas, Vermont, and New Jersey.  Only Florida and California offer less for workers earning a New York City living wage.  As of Oct. 15, New York continues to owe $6.2 billion to the federal government for UI benefits paid during the pandemic, one of three states that continues to carry a balance.  As DiNapoli has previously reported, federal and state taxes on employers have risen and federal taxes will continue to rise until this balance is repaid.  Employers will also continue to be subject to an interest assessment surcharge.  Since Sept. 30, 2021, $452.3 million has been paid in interest assessment surcharges through Sept. 30, 2024.

Workers’ Compensation

New York’s workers’ compensation benefit rate of 67% for temporary total disability is mostly in line with other peer states, although its maximum benefit in 2024 is lower than 29 states.  For workers receiving the maximum benefit rate under temporary total disability, New York’s two-thirds benefit rate is in the range of most peer states, with only Texas, New Jersey, and Connecticut providing higher rates.  However, New York’s $1,171 maximum benefit is lower than all peer states except New Jersey.  Legislation enacted in 2023 will phase in increases to the minimum benefit through 2026, after which it will be set at 20% of the New York State Average Weekly Wage.

Temporary Disability Insurance

Only five states offer TDI to employees for off-the-job short-term illness or injury, which includes pregnancy.  New York’s $170 maximum weekly benefit ranks last, with the benefit replacing 27% to 28% of the wages of a minimum wage employee in New York.  In comparison, wage replacement rates for minimum wage and living wage workers range from 58% to 85% in the other states that offer this benefit, including California and New Jersey.  No changes have been made to the maximum benefit provided under this program since 1989.

Paid Family Leave

Only nine states and Washington, D.C. provide paid family leave benefits in 2024.  As of Jan. 1, 2024, New York’s benefit rate is 67% of an employee’s average weekly wage, ranking 8th among the few states that offer this benefit.  The amount is capped at a maximum benefit of $1,151, ranking 4th.  DiNapoli’s report found that Connecticut’s policy is most beneficial to minimum wage workers, replacing 94% – 97% of income; however, New York’s higher maximum benefit makes its policy favorable for workers earning $100,000.

Report
New York’s Social Insurance Programs: Benchmarking Benefits

Related Reports
Unemployment Insurance Trust Fund: Challenges Ahead
Update on New York’s Unemployment Insurance Trust Fund: Challenges Continue

USDOL Issues Comprehensive Employer Guidance on Long COVID

The United States Department of Labor (USDOL) has issued a comprehensive set of resources that can be accessed below for employers on dealing with Long COVID.

Supporting Employees with Long COVID: A Guide for Employers

The “Supporting Employees with Long COVID” guide from the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) and Job Accommodation Network (JAN) addresses the basics of Long COVID, including its intersection with mental health, and common workplace supports for different symptoms.  It also explores employers’ responsibilities to provide reasonable accommodations and answers frequently asked questions about Long COVID and employment, including inquiries related to telework and leave.

Download the guide

Accommodation and Compliance: Long COVID

The Long COVID Accommodation and Compliance webpage from the USDOL-funded Job Accommodation Network (JAN) helps employers and employees understand strategies for supporting workers with Long COVID.  Topics include Long COVID in the context of disability under the Americans with Disabilities Act (ADA), specific accommodation ideas based on limitations or work-related functions, common situations and solutions, and questions to consider when identifying effective accommodations for employees with Long COVID.  Find this and other Long COVID resources from JAN, below:

Long COVID, Disability and Underserved Communities: Recommendations for Employers

The research-to-practice brief “Long COVID, Disability and Underserved Communities” synthesizes an extensive review of documents, literature and data sources, conducted by the USDOL-funded Employer Assistance and Resource Network on Disability Inclusion (EARN) on the impact of Long COVID on employment, with a focus on demographic differences.  It also outlines recommended actions organizations can take to create a supportive and inclusive workplace culture for people with Long COVID, especially those with disabilities who belong to other historically underserved groups.

Read the brief

Long COVID and Disability Accommodations in the Workplace

The policy brief “Long COVID and Disability Accommodations in the Workplace” explores Long COVID’s impact on the workforce and provides examples of policy actions different states are taking to help affected people remain at work or return when ready.  It was developed by the National Conference of State Legislatures (NCSL) as part of its involvement in USDOL’s State Exchange on Employment and Disability (SEED) initiative.

Download the policy brief

Understanding and Addressing the Workplace Challenges Related to Long COVID

The report “Understanding and Addressing the Workplace Challenges Related to Long COVID” summarizes key themes and takeaways from an ePolicyWorks national online dialogue through which members of the public were invited to share their experiences and insights regarding workplace challenges posed by Long COVID.  The dialogue took place during summer 2022 and was hosted by USDOL and its agencies in collaboration with the Centers for Disease Control and Prevention and the U.S. Surgeon General.

Download the report

Working with Long COVID

The USDOL-published “Working with Long COVID” fact sheet shares strategies for supporting workers with Long COVID, including accommodations for common symptoms and resources for further guidance and assistance with specific situations.

Download the fact sheet

COVID-19: Long-Term Symptoms

This USDOL motion graphic informs workers with Long COVID that they may be entitled to temporary or long-term supports to help them stay on the job or return to work when ready, and shares where they can find related assistance.

Watch the motion graphic

A Personal Story of Long COVID and Disability Disclosure

In the podcast “A Personal Story of Long COVID and Disability Disclosure,” Pam Bingham, senior program manager for Intuit’s Diversity, Equity and Inclusion in Tech team, shares her personal experience of navigating Long COVID symptoms at work.  The segment was produced by the USDOL-funded Partnership on Employment and Accessible Technology (PEAT) as part of its ongoing “Future of Work” podcast series.

Listen to the podcast

HHS OIG Issues Annual Report on State MFCUs

Per the notice below, the Office of the Inspector General (OIG) of the United States Department of Health and Human Services (HHS) has issued its annual report on the performance of state Medicaid Fraud Control Units (MFCUs).

Medicaid Fraud Control Units Fiscal Year 2023 Annual Report (OEI-09-24-00200) 

Medicaid Fraud Control Units (MFCUs) investigate and prosecute Medicaid provider fraud and patient abuse or neglect. OIG is the Federal agency that oversees and annually approves federal funding for MFCUs through a recertification process. This new report analyzed the statistical data on annual case outcomes—such as convictions, civil settlements and judgments, and recoveries—that the 53 MFCUs submitted for Fiscal Year 2023.  New York data is as follows:

Outcomes

  • Investigations1 - 556
  • Indicted/Charged - 9
  • Convictions - 8
  • Civil Settlements/Judgments - 28
  • Recoveries2 - $73,204,518

Resources

  • MFCU Expenditures3 - $55,964,293
  • Staff on Board4 - 257

1Investigations are defined as the total number of open investigations at the end of the fiscal year.

2Recoveries are defined as the amount of money that defendants are required to pay as a result of a settlement, judgment, or prefiling settlement in criminal and civil cases and may not reflect actual collections.  Recoveries may involve cases that include participation by other Federal and State agencies.

3MFCU and Medicaid Expenditures include both State and Federal expenditures.

4Staff on Board is defined as the total number of staff employed by the Unit at the end of the fiscal year.

Read the Full Report

View the Statistical Chart

Engage with the Interactive Map

GAO Issues Report on Medicaid Managed Care Service Denials and Appeal Outcomes

The United States Government Accountability Office (GAO) has issued a report on federal use of state data on Medicaid managed care service denials and appeal outcomes.  GAO found that federal oversight is limited because it doesn't require states to report on Medicaid managed care service denials or appeal outcomes and there has not been much progress on plans to analyze and make the data publicly available.  To read the GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the first link below.  To read GAO highlights of the report on federal use of state data on Medicaid managed care service denials and appeal outcomes, use the second link below.
https://www.gao.gov/assets/d24106627.pdf  (GAO report on federal use of state data on Medicaid managed care service denials and appeal outcomes)
https://www.gao.gov/assets/d24106627_high.pdf  (GAO highlights on federal use of state data on Medicaid managed care service denials and appeal outcomes)

CMS Issues Latest Medicare Regulatory Activities Update

The Centers for Medicare and Medicaid Services (CMS) has issued its latest update on its regulatory activities in the Medicare program.  While dentistry is only minimally connected to the Medicare program, Medicare drives the majority of health care policies and insurance reimbursement policies throughout the country.  Therefore, it always pays to keep a close eye on what CMS is doing in Medicare.  To read the latest CMS update on its regulatory activities in Medicare, use the link below.
https://www.cms.gov/training-education/medicare-learning-network/newsletter/2024-03-14-mlnc