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DISABILITY & PAID FAMILY LEAVE

these forms only pertain to employees of hadestown broadway llc.

DISABILITY

HIPAA RELEASE FORM

Please fill out this form to authorize for your medical history to be disclosed to Standard Security Life Insurance Company of New York.

DISABILITY CLAIM FORM

Use this form to start a Disability claim. Our Policy # is R677250-00.

STATEMENT OF RIGHTS

If you are unable to work because of a non-occupational illness or injury, you may be entitled to New York State Disability Benefits.

PAID FAMILY LEAVE

PFL CLAIM FORM

Use this form for a

Bonding claim.

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PFL CLAIM FORM

Use this form for a

Family Member Care claim.

PFL CLAIM FORM

Use this form for a Military Qualifying Event claim.

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STATEMENT OF RIGHTS

If you need to take time off from work to care for a family member, you may be entitled to paid family leave benefits with New York State.

HADESTOWN BROADWAY LLC

c/o RCI Theatricals

630 9th Avenue, Suite 809

New York, NY 10036

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©2025 by Hadestown Broadway LLC

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