I certify, by my submission of this request, this plan affords current and future Washington employees employed under this Unified Business Identifier (UBI) leave and benefits that are greater than or equal to that of what the state plan offers. I acknowledge this plan will remain in effect for no less than one year from the initial start date and continuously thereafter unless withdrawn or the plan is terminated by the department for failure to comply. In the event my plan is withdrawn or terminated, I agree to remit all moneys collected and owed, including any interest accrued, to the department. I understand this plan must be approved annually for the first three years with any subsequent approval required for any changes made to the plan not mandated by law.
Carefully review your voluntary plan application before continuing. Once you move on to uploading your supporting documents, you will not able to make adjustments or corrections to your application.