Private SINOT plan: what changes if your employer has one

What a private SINOT plan is

The SINOT almost everyone knows is paid by the Labor Department's **Fund**. But **Section 5 of Act 139** (11 L.P.R.A. § 205) allows something else: an employer may, **with the Secretary of Labor's authorization**, establish a **private plan** to pay its employees the same disability benefits the law provides.

If your employer has an approved one, three things change at once, and subsection (b) of that same section says so: the employer **does not pay the contribution** Section 8 requires; covered workers **receive the plan's benefits instead of payments from the Fund**; and **your own** Section 8 contribution may be deducted by the employer and used as contributions to the approved private plan.

That last detail is what confuses people: **the deduction on your pay stub does not disappear** because there is a private plan. It still comes out; what changes is where it goes and who you claim from.

It cannot be worse than the government plan: the conditions

A private plan is not “the employer does as it pleases.” Section 5(a) sets **ten conditions** for the Secretary to approve it. These are the ones that protect you:

• **Benefits must be, in every respect, equal to or more favorable** to employees than those provided by Section 3 of the law. Equal or better, never worse.
• The plan must **cover all of the employer's employees** or a **reasonable classification** of them.
• **Your contribution cannot be greater** than the one under Section 8 and, the law says, **in no case greater than the amount the employer pays**.
• Either it is **underwritten by an authorized insurance company**, or the employer must **prove its solvency** to the Secretary's satisfaction and **post a bond or guarantee**.
• If employees are to contribute to the plan, **a majority of them must accept** its establishment.
• The plan also pays **former employees**, for disability periods beginning while they are unemployed or in non-insured work, up to the limit the Secretary sets.
• The employer or insurer must **give each claimant notice of their eligibility or ineligibility**, and that notice **must include a statement about your right to appeal to the Secretary**.

Where you file, which is what changes in practice

Under the government plan, the claim is filed at the Labor Department's local offices. **Under a private plan, it goes through the plan** — the employer or the insurance company that underwrites it. The law expressly allows this: the insurer “may take charge of making any payments and reports required of the employer under this section.”

That is why the question to ask **before** you need it is which of the two applies to you. Filing at the wrong window does not take away your right, but it eats days, and in this insurance the calendar is the one thing you cannot get back.

If they deny it, you still appeal

Here is the protection almost nobody knows about, and it is worth the whole guide. Subsection **(d)** of Section 5 says a claimant who is not satisfied with the disposition of their claim **under a private plan** has the right to appeal **in the same manner** provided in Section 4 for the Director's determinations.

And it closes with something that changes where the parties stand: in that proceeding, **the employer or the insurance company shall be a party for all purposes of law**. This is not an internal complaint settled in the HR office: it is the same administrative proceeding, with your employer or its insurer sitting on the other side as a party.

The terms of that route — reconsideration, the appeal to the Secretary, judicial review, and who pays attorney's fees — are explained with their deadlines in the unemployment and SINOT appeals guide, linked at the end. They are not repeated here because they are the same.

The calendar: a private plan does not start or end any day

Section 5(c) puts fixed dates on this, which is why an employer cannot switch your system from one month to the next.

A private plan may be **established as of July 1 of any year**, through a **written application to the Secretary filed no later than April 30** of that year. **Discontinuing** it works the same way: effective July 1, with a written application filed no later than April 30.

**Modifying it can happen at any time**, but through a written application to the Secretary and **after being duly approved by them**. So neither entry, nor exit, nor changes happen without the Secretary's approval.

How to find out whether it applies to you

**The pay-stub deduction does not tell you.** Since the employer may deduct your Section 8 contribution and use it as a contribution to the private plan, seeing the withholding does not distinguish one system from the other. It is the most common confusion on this topic.

What does work: **ask HR directly which of the two applies**, and keep the answer. And if you already filed, the **eligibility or ineligibility notice** required by Section 5(a)(10) has to tell you in writing and also inform you of your right to appeal to the Secretary. If you received a determination that does not mention that right, that alone is a sign something was not done the way the law requires.

What could not be verified

**No public list of employers with an approved private plan** could be located, and the law does not require one to be published. That is why this guide names none: the answer to who has a private plan comes from your employer, not from here.

**The private-plan regulation could not be located either.** Section 5(a) authorizes the Secretary to establish regulations, rules and procedures to implement the section, after holding public hearings, and to delegate their application to particular plans to the Director. This guide stays with what the statute says; the procedural detail living in that regulation is not guessed at.