De 8686 Form PDF Details

In an era where business fluctuations can be unpredictable, mechanisms like the Work Sharing (WS) Unemployment Insurance Plan provide a lifeline for employers and employees alike. Essentially, the De 8686 form serves as the application for businesses in California looking to implement a work-sharing program, a concept designed to avert layoffs by allowing employees to receive a portion of their unemployment benefits while working reduced hours. The form details various aspects of the program application process, ranging from employer information, the type of plan (new, renewal, or expanded coverage), to specifics about the reduction in hours and wages. Additionally, it outlines requirements such as the provision of health and retirement benefits, the handling of holiday pay, and the necessity of adhering to union agreements, should they apply. By signing the form, employers commit to a series of understandings and attestations about the administration of the work-sharing plan, ensuring compliance with California's Employment Development Department (EDD) stipulations. This process not only serves as an administrative step but underscores a commitment to preserving jobs and stabilizing businesses during challenging economic times.

QuestionAnswer
Form NameDe 8686 Form
Form Length5 pages
Fillable?No
Fillable fields0
Avg. time to fill out1 min 15 sec
Other namesedd work sharing forms, de 8686 edd form, edd share, de 4581ws edd

Form Preview Example

Work Sharing (WS) Unemployment Insurance Plan Application

Mail: Employment Development Department Work Sharing Program

PO Box 989060, West Sacramento, CA 95798-9007

Questions? 916-464-3343

1) Please select the box of the type of Work Sharing plan you would like to file:

New

Renewal

Expanded Coverage

Requested plan start date (must be a Sunday): ____________________________________

Note: To renew a plan a new application must be received no later than 10 days after the expiration date of the prior plan.

If renewing, how many additional Work Sharing Certifications, DE 4581WS do you need? _____________

2)Employer Information Name/DBA: Business Type:

Employer Account Number: ____ ____ ____ – ____ ____ ____ ____ – ____

3)Employer Contact Information

 

Primary Contact

 

Alternate Contact

 

Name:

 

 

 

Name:

 

 

Address:

 

 

Address:

 

 

Phone:

 

 

 

Phone:

 

4)

Yes

No

Will the Work Sharing occur in a different location than the address provided above?

If yes, please provide the alternate contact and location information below:

 

Name (if different):

 

Name (if different):

 

 

Phone Number:

 

 

Phone Number:

 

 

Address:

 

 

 

Address:

 

5)

Yes

No Is your business/organization a public entity? Please check the appropriate box below.

City

County

State

Federal

School District

Other (Specify) _________

6)

Yes

No Your participation in the Work Sharing program is strictly confidential. Occasionally the

Employment Development Department (EDD) receives requests for the names of companies that would be willing to share their experiences with this program. Are you willing to have your name and contact information released for this purpose?

7) Fill in the table for the full-time and part-time workforce who will be covered by the Work Sharing plan.

a) Department/

b) Number of

c) Number of

d) Usual weekly hours

e) Estimated % of

Unit Name

employees in

employees in

of employees in

weekly hours

 

Dept/Unit

Dept/Unit who will

affected Dept/Unit

reduced

 

 

participate in WS

 

 

 

 

 

 

 

1.

 

 

 

 

 

 

 

 

 

2.

 

 

 

 

 

 

 

 

 

3.

 

 

 

 

 

 

 

 

 

 

Total: ______

Total: ______

Total: ______

Total: ______

 

EDD USE ONLY

 

 

 

 

 

 

 

 

 

 

 

 

First Contact Date:

 

 

 

 

 

Effective Date:

 

 

 

 

 

WS EE:

 

 

%:

 

SIC:

 

 

Union (Y/N)

 

 

Layoff (Y/N)

 

 

 

 

 

 

 

 

 

 

 

 

DE 8686 Rev. 20 (11-17) (INTERNET)

 

 

Page 1 of 5

 

 

 

 

CU

Work Sharing (WS) Unemployment Insurance Plan Application

Mail: Employment Development Department Work Sharing Program

PO Box 989060, West Sacramento, CA 95798-9007

Questions? 916-464-3343

8) Check the box below with the appropriate pay period cycle:

Weekly

Bi-weekly

Monthly

Other (Specify) ______________________

If your pay period is weekly or bi-weekly, select the payroll ending day below:

Mon

Tues

Wed

Thur

Fri

Sat

Sun

9)

Yes

No If you were not approved to participate in the Work Sharing program, would your

 

business lay off workers?

10)Estimate the number of employees who would need to be laid off if you were not participating in the Work Sharing program: _________

11)Describe the circumstances requiring your use of the Work Sharing program:

12)How do you plan to notify your employees of the Work Sharing program?

Memo/Letter

Email

Staff Meeting

Other (Specify) ____________________

13)

Yes

No Will advance notice be given to the affected employees?

If not, please explain why advance notice is not feasible:

14)

Yes

No Are any participating employees covered by a union/collective bargaining agreement?

If yes, the below section(s) must be completed:

Union Name:

 

Union Local Number:

 

 

Phone Number:

 

 

Name of Authorized Union Representative:

 

 

Position Title:

 

 

Authorized Union Representative Signature:

 

 

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Union Name:

 

Union Local Number:

 

 

Phone Number:

 

 

Name of Authorized Union Representative:

 

 

Position Title:

 

 

Authorized Union Representative Signature:

 

Date:

 

 

 

 

 

 

 

 

 

 

 

 

 

15) Does your Work Sharing plan involve:

a. Yes

b. Yes

c. Yes

No At least two employees?

No At least 10 percent of your workforce or work unit(s)?

No At least a 10 percent reduction and no more than 60 percent in BOTH hours worked and wages each week?

16)

Yes

No Will a reduction in health benefits be scheduled to occur during the duration of the WS plan? If yes, answer the following question.

a.

Yes

No If so, will those reductions be applied equally to all employees (including those who are not participating in the WS plan)?

17)

Yes

No Will a reduction in retirement benefits be scheduled to occur during the duration of the WS plan? If yes, answer the following question.

a.

Yes

No If so, will those reductions be applied equally to all employees (including those who are not participating in the WS plan)?

DE 8686 Rev. 20 (11-17) (INTERNET)

Page 2 of 5

Work Sharing (WS) Unemployment Insurance Plan Application

Mail: Employment Development Department Work Sharing Program

PO Box 989060, West Sacramento, CA 95798-9007

Questions? 916-464-3343

By signing this application, we understand and certify the following is true and correct:

1.We understand that by participating in the WS program our reserve account will be charged in the usual manner or may have an adverse effect on our tax rate.

2.We understand that if we are a participating reimbursable employer, we will be billed quarterly for the cost of benefits paid.

3.We understand that we are not to utilize the WS program for total layoffs during the holiday weeks.

4.We understand that a holiday cannot be used as a WS day unless the employee(s) in the same position performed services (and was paid for those services) as a part of a regular work week, during the 12 months prior to the employer’s participation in the WS program.

5.We understand that any employee on the WS program must have worked at least one normal work week with no reductions prior to the issuance of certification forms for benefit payments.

6.We understand that if employees are attached to a school district and/or non-profit entity that we will provide dates the employee(s) are between successive academic terms/recess periods.

7.We understand that the plan approved by the EDD shall expire 12 months after its effective date.

8.We understand that we must continue to provide health and retirement benefits under the same terms and conditions as when the affected employees worked his/her usual weekly hours, unless health/ retirement benefits change for all employees (including employees not participating in the WS plan).

9.We understand that we must provide the weekly percentage of reductions in hours and wages for each participating employee, and we must furnish all reports and information as requested by the EDD to monitor and review our WS plan.

10.We understand that we must notify the EDD immediately if there are any changes to the information on this plan application, and that we must submit the specific changes in writing for review and approval.

11.We understand that leased or temporary service employees that are provided by another employer or that we provide to other employers, cannot be covered under the WS plan.

12.We understand that participating in the WS program is consistent with the employer’s obligation under applicable federal and state laws.

DE 8686 Rev. 20 (11-17) (INTERNET)

Page 3 of 5

Work Sharing (WS) Unemployment Insurance Plan Application

Mail: Employment Development Department Work Sharing Program

PO Box 989060, West Sacramento, CA 95798-9007

Questions? 916-464-3343

Work Sharing Employer’s Holiday Schedule

A holiday schedule is necessary to process employee’s WS payments. Please indicate which holidays your company was open/closed during the 12 months prior to the start of your WS plan.

Employer Account Number: ____ ____ ____ – ____ ____ ____ ____ – ____

HOLIDAY

OPEN

CLOSED

COMMENTS

 

 

 

 

New Year's Eve

New Year's Day (Observed)

Martin Luther King Jr. Day

Lincoln's Birthday

Washington's Birthday

President's Day

Cesar Chavez Day

Good Friday

Memorial Day

July 4th

Labor Day

Columbus Day

Veterans Day

Thanksgiving

Day After Thanksgiving

Christmas Eve

Christmas Day (Observed)

Other Holidays: Please list below

I have provided the information on this form so that our employees may participate in the Work Sharing Unemployment Insurance program. I understand failure to provide correct information, in accordance with this certification and in accordance with the provisions of the California Unemployment Insurance Code (CUIC), could result in a denial or cancellation of this plan. I certify that I agree to all Work Sharing terms per Section 1279.5 of the CUIC. If signing this form electronically, I understand and acknowledge that this electronic signature has the same meaning and validity as my handwritten signature. I further attest that I have signature authority with the named employer.

*If a private business, below signature must be of corporate officer, sole proprietor, or general partner.

*If a public entity, below signature must be of executive officer or person with authorization.

Authorized Signature:

 

Title:

Print Name:

 

 

Date:

Please complete the WS Employee Participant Roster on page 5 and ensure the number of employees listed matches the total number of employees listed on page 1, question 7c.

DE 8686 Rev. 20 (11-17) (INTERNET)

Page 4 of 5

Work Sharing (WS) Unemployment Insurance Plan Application

Mail: Employment Development Department Work Sharing Program

PO Box 989060, West Sacramento, CA 95798-9007

Questions? 916-464-3343

Work Sharing Employee Participant Roster

*Employee Participant Roster must match the number indicated on Question #7c on page 1 of 5.

Employer Account Number: ____ ____ ____ – ____ ____ ____ ____ – ____

Employee’s Full Name Employee’s

Department/

Indicate if WS employee

If applicable, enter

Full SSN

Work Unit

is a Corporate Officer or

title/role of Corporate

 

Name

Sole or Major stockholder

Officer or Sole or

 

 

( Yes / No )

Major stockholder

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

11.

12.

13.

14.

15.

16.

17.

18.

19.

20.

21.

22.

23.

24.

25.

26.

27.

28.

29.

30.

NOTE: A complete list of employees participating must be included with your application. Copy this page if additional space is needed. The WS plan cannot be approved without a WS Employee Participant Roster.

DE 8686 Rev. 20 (11-17) (INTERNET)

Page 5 of 5

How to Edit De 8686 Form Online for Free

Once you open the online editor for PDFs by FormsPal, it is easy to complete or edit ca workshare program right here. To retain our editor on the cutting edge of convenience, we strive to integrate user-driven capabilities and improvements regularly. We are routinely grateful for any suggestions - help us with remolding how you work with PDF files. With just a couple of basic steps, you'll be able to start your PDF journey:

Step 1: Open the PDF file in our editor by clicking the "Get Form Button" at the top of this page.

Step 2: The editor will let you change PDF forms in various ways. Transform it by writing your own text, correct existing content, and put in a signature - all within the reach of a few clicks!

This form will require specific details to be entered, thus be sure to take your time to type in what's asked:

1. You need to fill out the ca workshare program accurately, therefore take care when filling out the parts including all these blanks:

edd work sharing writing process clarified (step 1)

2. When the last part is completed, you should include the necessary specifics in Yes, No Is your businessorganization a, City, County, State, Federal, School District, Other Specify, Yes, No Your participation in the Work, Employment Development Department, Fill in the table for the, a Department, b Number of, and c Number of in order to move forward to the next part.

Stage # 2 for filling out edd work sharing

3. The next step is going to be straightforward - fill out all the form fields in Check the box below with the, Weekly, Biweekly, Monthly, Other Specify, If your pay period is weekly or, Mon, Tues, Wed, Thur, Fri, Sat, Sun, Yes, and No If you were not approved to to complete the current step.

Completing part 3 in edd work sharing

4. The next part requires your details in the subsequent parts: If yes the below sections must be, Union Name, Union Local Number, Phone Number, Name of Authorized Union, Authorized Union Representative, Position Title, Date, Union Name, Union Local Number, Phone Number, Name of Authorized Union, Authorized Union Representative, Position Title, and Date. Be sure you provide all of the requested info to go onward.

Completing segment 4 in edd work sharing

Be extremely attentive while filling in Phone Number and If yes the below sections must be, as this is the part where most people make some mistakes.

5. The pdf should be wrapped up with this section. Below you will notice a full listing of blank fields that require specific information for your document submission to be complete: who are not participating in the, Yes, No Will a reduction in, the WS plan If yes answer the, Yes, No If so will those reductions be, who are not participating in the, DE Rev INTERNET, and Page of.

Tips on how to fill in edd work sharing part 5

Step 3: Revise the details you've inserted in the blank fields and then click on the "Done" button. Acquire the ca workshare program the instant you join for a free trial. Immediately access the pdf form from your personal account page, with any edits and adjustments being conveniently preserved! FormsPal offers safe form tools with no personal data recording or distributing. Feel comfortable knowing that your information is in good hands here!

De 8686 Form isn’t the one you’re looking for?

Related Documents