Get Alicare 1199

The Alicare 1199, also known as the Request for Paid Family Leave form, is essential for workers seeking benefits under New York State law. This guide will provide clear, step-by-step instructions to help users fill out this important online form accurately and efficiently.

Follow the steps to successfully complete the Alicare 1199 online.

1. Click ‘Get Form’ button to obtain the form and open it in the editor.
2. Begin by completing Part A of Form PFL-1, entering your legal name, mailing address, and contact numbers as requested.
3. Provide your Social Security Number or Taxpayer Identification Number, ensuring it is accurate to avoid discrepancies.
4. Indicate whether you are requesting Paid Family Leave to bond with a child, care for a family member, or due to military qualifying events by checking the appropriate box.
5. If applicable, fill out the dates for Continuous or Periodic leave, making sure to provide a reason if you are giving less than 30 days notice.
6. Complete your employment information, including the date of hire, work location, and average gross weekly wage.
7. Once you have filled out all required fields in Part A, review the form for accuracy and ensure that all necessary information is provided.
8. Submit Part A of Form PFL-1 to your employer for completion of Part B.
9. After your employer completes Part B, they will return the document to you. Attach any additional necessary supporting documentation.
10. Send the completed forms and supporting documentation to your Plan Administrator promptly, retaining copies for your records.
11. Finally, check for any updates or additional requirements from the Plan Administrator regarding your claim.

Complete your Alicare 1199 application online today to initiate your Paid Family Leave process.