Free Ga 4 New York Form in PDF

1. What is the GA-4 New York form?

   The GA-4 form, officially known as the Quarterly Unified Employer Assessment Municipal Self-Insurers Remittance Form, is a mandatory document for every active municipal self-insured employer in the State of New York. It is used for submitting quarterly assessments to the Workers' Compensation Board.

2. Who needs to file the GA-4 form?

   Any municipal employer in New York State that is actively self-insured for workers' compensation needs to complete and submit this form every quarter. This includes municipalities covered under a county plan or part of a municipal group.

3. When is the GA-4 form due?

   This form must be completed and submitted, with payment, within thirty days after the end of each quarter.

4. What information is required on the GA-4 form?

   The form requires the municipal self-insurer's WCB Identification Number, Federal Employer Identification Number (FEIN), and mailing address. It also asks for detailed payroll information, including total loss cost, assessment rates, and the total assessment due.

5. How is the total assessment due calculated?

   The total assessment is calculated by first determining the total loss cost, which involves multiplying the payroll by the loss cost per hundred dollars of payroll and dividing by 100. Then, this amount is multiplied by the assessment rate set by the Chair pursuant to WCL Section 151.

6. What if there are additional municipal employers covered under the same W number?

   If there are additional municipal employers covered under the same W number, such as those in a county plan or municipal group, their payroll information must be reported separately on the GA-4.1, Payroll by FEIN Addendum.

7. What happens if the information reported is inaccurate?

   If inaccurate reporting leads to an underpayment of the assessment, the self-insurer must pay the full amount due plus interest at an annual rate of 9%. Additionally, if it's found that the incorrect information was knowingly provided, an additional penalty of up to 20% of the underpaid amount may be imposed.

8. How can questions regarding the form or process be addressed?

   Any questions related to the GA-4 form or the submission process should be directed to the Workers' Compensation Board Finance Office at WCBFinanceOffice@wcb.ny.gov.

Filling out the GA-4 New York form, a Quarterly Unified Employer Assessment for Municipal Self-Insurers, requires attention to detail and a good understanding of the form's requirements. Common mistakes can lead to inaccuracies in reporting, potential fines, or issues with the Workers' Compensation Board. Here are five common errors:

1. Omitting or incorrectly reporting the WCB Identification Number ("W Number"). This number is vital because it uniquely identifies the municipal self-insured employer. Without it, the form cannot be correlated with the correct entity.
2. Failing to correctly list the Name of the Municipal Self-Insured Employer. This name must match the legal name of the employer approved to self-insure as any discrepancy could cause delays or misapplication of the filed report.
3. Incorrectly filling out the FEIN (Federal Employer Identification Number). This mistake is particularly crucial because the FEIN is a federal identifier. Wrong information here can lead to issues not just with the Workers' Compensation Board but potentially with other federal reports.
4. Inaccuracies in reporting Total Payroll and/or Excluded Payroll. Accurate payroll figures are essential for correct assessment calculation. Overestimating or underestimating these figures can directly affect the total assessment due.
5. Not providing a proper reconciliation when the total quarterly payroll does not agree with NYS-45 figures. Without this reconciliation, it's challenging for the board to verify the accuracy of the reported payroll, potentially leading to audits or penalties.

Aside from these specific errors, individuals often overlook the certification section, leading to unsigned or improperly certified submissions. Each part of the form, including all applicable addendums, must be completed in good faith and certified as true and correct. Remember that aside from filling the form correctly, timely submission is also critical, with forms and payments due within thirty days of the quarter's end. Ensuring accuracy and attention to detail can save considerable time and prevent unnecessary complications with the Workers' Compensation Board.

When managing municipal self-insurers in New York, particularly for workers' compensation, the Quarterly Unified Employer Assessment Municipal Self-Insurers Remittance Form (GA-4) plays a crucial role. Besides the GA-4 form itself and its Payroll by FEIN Addendum (GA-4.1), various other documents and forms are also integral to the process, ensuring compliance and accurate assessment. These additional forms help provide a comprehensive view of an employer's responsibilities and financial obligations regarding workers' compensation insurance.

• NYS-45, Quarterly Combined Withholding, Wage Reporting, and Unemployment Insurance Return: This form is crucial for reporting an employer's quarterly wages paid, taxes withheld, and unemployment insurance contributions. It helps in verifying the payroll information provided on the GA-4 form.
• C-2F, Employer's Report of Work-Related Injury/Illness: Employers must use this form to report any work-related injuries or illnesses. It's vital for adjusting assessments based on claims and costs associated with workplace incidents.
• RB-89, Application for Board Review: This form is used to request a review of a decision by the Workers' Compensation Board. It's relevant for self-insurers managing claims and potentially contesting decisions impacting their assessment.
• Prima Facie Medical Report (Form C-4, C-4.2): Used by healthcare providers to document the initial medical evaluation of an injured worker. It impacts claims costs and, consequently, self-insurance assessments.
• EC-23, Annual Payroll Report: Although not directly related, this annual report of payroll to the New York State Insurance Fund might provide useful benchmarks for assessing payroll estimates and adjustments.
• Doctor's Initial Report (Form C-4): Used alongside the Prima Facie Medical Report, this document details the first medical examination for a work-related injury or illness, essential for the claims process.
• MG-2, Attending Doctor's Request for Approval of Variance: This form is used by physicians to request a variance from the Medical Treatment Guidelines. Variances can affect the cost of claims and self-insurance assessments.

Together, these forms and documents ensure that municipal self-insurers in New York maintain accurate records and comply with state workers' compensation laws. Completing and submitting these forms as required supports the integrity of the self-insurance program and aids in the accurate calculation of employer assessments. It's important for self-insured employers to familiarize themselves with these documents, stay compliant, and manage their workers' compensation responsibilities effectively.

The Quarterly Combined Withholding, Wage Reporting, and Unemployment Insurance Return (NYS-45) shares similarities with the GA-4 form in its core function—both require detailed payroll reporting from employers for a specific quarter. The NYS-45 specifically collects information on wages paid, taxes withheld, and unemployment insurance contributions for state purposes. Like the GA-4, it necessitates accurate payroll data to calculate financial liabilities accurately, emphasizing the importance of detailed and precise reporting in sustaining compliance with governmental regulations.

Another kindred document is the Federal Employer’s Quarterly Federal Tax Return (Form 941), which serves a parallel purpose at the federal level compared to the state-focused GA-4 form. Form 941 requires employers to report wages paid, federal income tax withheld, and both employer’s and employee’s shares of Social Security and Medicare taxes on a quarterly basis. This correlation underscores the meticulous financial disclosure required across both state and federal spheres to ensure accurate tax and insurance contributions.

The Workers' Compensation Annual Payroll Report is also aligned with the GA-4 form in its objective to collect payroll data, this time specifically for workers' compensation insurance premiums. Like the GA-4, it calculates liabilities based on payroll and classification codes but focuses on the insurance premium due for covered employees. This shared focus on payroll as a basis for financial assessment demonstrates the broader regulatory environment’s reliance on employment data for ensuring adequate insurance coverage.

The Unemployment Insurance Quarterly Tax Report is closely related to the GA-4, as it gathers information on wages paid to employees to determine unemployment insurance contributions. Both documents underline the necessity for employers to maintain accurate records of payroll data, with the specific aim of funding unemployment benefits out of these contributions. This represents the integrated role of payroll reporting in supporting social insurance programs.

Similarly, the Quarterly Report of Local Governmental Employers (often referred to by specific state designations) echoes the objectives of the GA-4 form by capturing payroll and employee data for locally employed personnel. This requirement for local governments to regularly report employment data helps in the administration and planning of local public sector compensation and benefits, illustrating another facet of public accountability and financial management paralleled in the GA-4’s design.

The Standard Industrial Classification (SIC) Report, while not a direct financial report, shares a conceptual linkage with the GA-4 through its classification of business activities possibly affecting payroll categorizations. By defining the nature of a business’s activity, the SIC codes potentially influence the assessment rates similar to those used in the GA-4’s basis for assessment. This connection highlights the broader context in which workplace activities are factored into financial and regulatory reporting.

Lastly, the Payroll-Based Journal (PBJ) reporting for healthcare facilities mandated by the Centers for Medicare and Medicaid Services (CMS) bears resemblance in its reliance on detailed payroll data for compliance and operational transparency. Required to be submitted quarterly, the PBJ reporting, like the GA-4, uses employment data as a measure for regulatory compliance, focusing on staffing and patient care ratios. This shared focus accentuates the critical role of accurate payroll reporting in various regulatory and compliance frameworks.

Filling out the GA-4 New York form accurately is essential for municipal self-insured employers. This form is used for reporting quarterly unified employer assessments to the Workers' Compensation Board. To help ensure that this process goes smoothly, here is a compiled list of dos and don'ts.

• Do ensure that the form is completed each quarter on a calendar year basis and submitted within thirty days of the quarter's end. Timeliness is crucial to avoid penalties.
• Do include the WCB Identification Number ("W Number") accurately. This is assigned when approved to self-insure and is essential for tracking and verification purposes.
• Do report the full legal name of the municipal self-insured employer. This helps in avoiding any confusion or misidentification.
• Do accurately report the Federal Employer Identification Number (FEIN) for the municipal self-insurer and any additional employers covered under the W number.
• Do ensure that the full mailing address of the municipal self-insurer is correct. This is necessary for all correspondences related to the unified assessment.
• Don't forget to check the assessment rate for the reporting period established by the Chair pursuant to WCL Section 151, which can be found on the WCB's website.
• Don't neglect to include all necessary information and addendums, such as the Payroll by FEIN Addendum (GA-4.1) if more than one employer is approved to self-insure under the W number shown.
• Don't miscalculate the total assessment due. Remember, it is equal to the total loss cost multiplied by the assessment rate. Any errors could result in underpayment and potential penalties.
• Don't submit inaccurate or incomplete forms. Inaccurate reporting can lead to underpaid assessments, interest charges, and additional penalties. In severe cases, it may even risk the revocation of self-insured status.

Filling out the GA-4 form accurately and on time helps ensure compliance with New York State laws and avoids any unnecessary penalties. Always double-check the details and refer to the instructions on the form to clarify any doubts.

There are several misconceptions about the Quarterly Unified Employer Assessment Municipal Self-Insurers Remittance Form, also known as the GA-4 New York form. Below are five common misunderstandings and their clarifications.

• Misconception 1: The GA-4 form is required from all employers in New York State.
  

  Clarification: The GA-4 form is specifically required from municipal employers in New York State that are actively self-insured for workers' compensation. This does not apply to private sector employers or those that are not self-insured.

• Misconception 2: One form covers all municipal entities.
  

  Clarification: While the GA-4 form is used by self-insured municipal employers, additional municipal entities covered under the same W number must be reported on a separate form, the GA-4.1 (Payroll by FEIN Addendum). This is for cases such as those under a county plan or municipal group.

• Misconception 3: Payroll data does not need to be detailed.
  

  Clarification: The form requires a detailed breakdown of the payroll, specifically differentiating between school districts and other municipal employees. Payroll must be accurately reported and reconciled, especially if discrepancies exist with the NY-45 form.

• Misconception 4: Payments can be made without specifying the quarter and W number.
  

  Clarification: To ensure proper application of payment, the W Number and applicable quarter must be included on the check or in the payment instructions. This is crucial for accurate record-keeping and to avoid processing errors.

• Misconception 5: Only the GA-4 form needs to be submitted for comprehensive reporting.
  

  Clarification: In addition to the GA-4 form, the GA-4.1 addendum may also need to be submitted if there are additional municipal employers covered under the W number. This addendum ensures that all payroll data relevant to the unified employer assessment is reported accurately.

Understanding these clarifications can help municipal self-insured employers comply with reporting requirements more efficiently and avoid common mistakes associated with the GA-4 New York form.

Filling out the GA-4 New York form correctly is crucial for municipal self-insurers to ensure compliance with the Workers’ Compensation Board. Here are some essential takeaways.

• Timely submission is critical: The form must be completed and submitted every quarter within thirty days after the quarter ends, accompanied by the appropriate payment.
• The form requires detailed municipal self-insurer information, including the WCB Identification Number or "W Number", the full legal name of the municipal self-insured employer, and the Federal Employer Identification Number (FEIN).
• For municipalities covering additional employers under their W number, a GA-4.1 addendum is required, providing a consolidated reporting for all such employers.
• Communication with the Workers' Compensation Board should be directed to WCBFinanceOffice@wcb.ny.gov for any questions or clarifications needed regarding the form or submission process.
• Payments should be made to the Chair, NYS Workers' Compensation Board, and must clearly indicate the W Number and the applicable quarter for which the payment is being made to ensure proper application.
• Accurate payroll information is vital for the calculation of the assessment. Payrolls are categorized between school district employees and all other municipal employees without needing to breakout by class.
• The form includes sections on basis for assessment, detailing required information such as total payroll, loss costs per hundred dollars of payroll, and the total loss cost which determines the assessment due.
• The assessment rate for the rating period is established pursuant to WCL Section 151 and is essential for calculating the total assessment due.
• Penalties may apply for underpayment of assessments due to inaccurate reporting, incomplete information, or late submissions, including possible revocation of self-insured status for failure to comply.
• Employers found to have knowingly made a material misrepresentation of required information can be guilty of a class E felony, underscoring the importance of accuracy and honesty in completing this form.

Overall, the GA-4 and GA-4.1 forms are essential tools for municipal self-insurers in New York to report and contribute to workers' compensation and disability benefits accurately and on time. Understanding and following the outlined requirements helps ensure compliance and avoid potential penalties.