NYSIF Expedites Electronic Submission for Commonly Used Forms

The New York State Insurance Fund has decided to make its 10 most commonly-used workers’ compensation forms available for electronic signature through DocuSign. This electronic process will expedite form submission. 

Once a NYSIF underwriter initiates the electronic signature process in DocuSign, the policyholder will receive email notification that the online document is available to complete and sign electronically. In cases where more than one authorized signature is required, both signers will receive notification to complete the process.

Once all recipients have successfully signed, both NYSIF and the policyholder will receive an email confirmation that the document has been executed, along with a link to the final form. Previously, policyholders waited for such documents in the mail before signing them manually and mailing them back. 

The following eSignature Forms are available: 

  • U-3 and U-3A Assignment of Interest  
  • U-111 and U-111A Request for Inclusion of Additional Interest (Entity) 
  • U-431 Notice of election coverage of NY workers' compensation 
  • U-445 Experience Ratings Plan Request for Additional Information
  • U-619 Exclusion Form (with U-617 notification) 
  • U-626 and U-627 Election of Coverage for LLP, LLC, Sole Proprietors, etc. 
  • U-629 Notice of non-profit to exclude unsalaried executive officer
  • U-765 Roofing Contractors Supplemental Questionnaire 
  • U-766 Building Demolition Supplemental Questionnaire 

While NYSIF has implemented the electronic signature process for most commonly used forms first, we will soon make more forms available. A future rollout will enable customers to electronically sign supplemental forms needed to obtain coverage.

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