Disability Insurance – Elective Coverage Forms and Publications
Find important forms, publications, and the specific application for Disability Insurance Elective Coverage (DIEC) on Online Forms and Publications.
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- Print two copies of the form. Keep one for your records and mail one to us.
- Annual Income Report for Disability Insurance Elective Coverage (DE 945)
- Application for Disability Insurance Elective Coverage (DE 1378DI)
- Application For Unemployment Insurance, State Disability Insurance, And Paid Family Leave Elective Coverage Under Section 708(A) Of The California Unemployment Insurance Code (CUIC) (DE 1378a)
- Request for Preliminary Worker Classification Assessment or Audit Lead Referral (DE 230)
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- Disability Insurance Elective Coverage Pamphlet
- Disability Insurance Elective Coverage (DIEC) Rate Notice and Instructions for Computing Annual Premiums
- Disability Insurance (DI) and Paid Family Leave (PFL) Weekly Benefit Amounts
- Disability Insurance (DI) and Paid Family Leave (PFL) Weekly Benefit Amounts in Dollar Increments
- Fact Sheet: California Paid Family Leave
- Fact Sheet: Disability Insurance Elective Coverage Program Fact Sheet
- DE 8714CC - English
- Information Concerning Elective Coverage for State Disability Insurance
- Information Sheet: Elective Coverage for Employers and Self-Employed Individuals
- Information Sheet: Specialized Coverage (Elective Coverage for Exempt Workers)
- Instructions For Reporting Wages And Contributions For Employers Who Have Elected Unemployment And State Disability Insurance Coverage Under Section 708(A) Of The California Unemployment Insurance Code (CUIC)
- State Disability Insurance Bookmark
Disability Insurance and Paid Family Leave Benefits
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Last Revised: 07/26/2022