Employee Eligibility

12 months of service:

• 1,250 hours worked
• At a worksite with 50 or more employees within 75 miles

Job Protection

Yes

Leave Reasons

• Employee’s own serious health condition
• Bonding
• Care for family member with Serious Health Condition
• Family Military exigencies
• Care of service member/veteran with serious illness/injury

Family Members

Yes (Parent/Child/Spouse)

Includes Bonding?

Yes

Benefit Amount

AWW = average weekly wage

Unpaid

Maximum Benefit

Unpaid

Duration

12 weeks/26 weeks (care of servicemember) in a 12-month period

Funding Mechanism

AWW = average weekly wage

N/A

Administered By

RSLI – Insured

Matrix – Self-funded

Covered Employer

Every person, partnership, association or corporation that employs one or more employees working in New York state for at least 30 days:

• Becomes a “Covered Employer” 4 weeks after the 30th day of employing one or more workers in New York
• 30 days do not have to be consecutive but must be within one calendar year
• Applies even if employer is based out-of-state
• Excludes the state, a municipal corporation, local governmental agency, other political subdivision or public authority

Covered Employee & Eligibility

• Full-time employees – 4 consecutive weeks of work with any covered employer
• Part-time employees – 25 days of work with a covered employer (need not be consecutive or within same year)
• Employees who change jobs from one Covered Employer to another Covered Employer (covered from the first day on the new job)
• Domestic or personal employees who work 40 or more hours per week for one Covered Employer

Exclusions include but are not limited to:

• Government, railroad, maritime laborers
• Various employees of religious organizations
• Uncompensated volunteers for nonprofit organizations
• Independent contractors and subcontractors
• To see full list and details, please visit NY WCB Covered Employee page and Definition of Employee

Qualifying Leave/Benefits Reasons

Off-the-job injury or illness

• Pregnancy included
• Elective surgery not included

Waiting Period

7 days per disabling condition; benefits begin on 8th consecutive day of disability

Relapse Period

• Successive periods of disability caused by the same or related injury or sickness constitute a single period of disability if separated by less than 3 months
• No new waiting period is required

Contribution Rate & Responsibility

Employee contribution –

• 0.5% of first $120/week, capped at $0.60/week
• Employer may pay employee contribution

Employer contribution – Pays balance of plan cost (if any) that exceeds employee contribution

Benefit Amount

• 50% average weekly wage for last 8 weeks worked
• Maximum $170/week (unchanged since 5/1/1989)
• Benefits payable every 2 weeks

Maximum Duration of Benefits/Leave

26 weeks (including a 7-day waiting period) during 52 consecutive calendar weeks

Increments of Leave Usage/Benefits

• Continuous only

Interaction with Other Leaves and Benefits

• NY PFL – combined amount of NY PFL and DBL cannot exceed a total of 26 weeks in a consecutive 52-week period. Cannot take DBL at same time as PFL.
• Unemployment – cannot collect DBL and unemployment insurance concurrently
• Social Security – DBL does not affect right to SSA benefits
• FMLA – Will apply concurrently with DBL if applicable
• NY Domestic Violence Leave – Will apply concurrently with DBL if applicable

Leave/Benefits Year

52 consecutive weeks retroactively (rolling back) from first week/day of leave

Employer Notice Requirements

Notice of Compliance: DB-120 (obtained from insurer) – employer must post and “maintain conspicuously” at their place/places of business

Statement of Rights: DB-271S – employer must provide to employee within 5 days after employee is absent from work due to disability for more than 7 consecutive days (or within 5 days after employer learns 7-day absence is due to a disability, whoever is later).

Employee Notice Requirements

Employee must file claim within 30 days of becoming disabled and must provide a statement of disability, completed by attending physician.

Employee Claim Documentation

Notice and Proof of Claim for Disability Benefits: DB-450

Filed with Employer or Insurance Carrier

Claimant’s Statement No Fault or Personal Injury: DB-450.1 – Required if employee was injured in a no-fault motor vehicle accident or the injury is result of negligence/wrongdoing of a third party

Job Protection

• None
• May be available under FMLA or NY Domestic Violence Leave, if applicable

Benefits Protections

Not addressed

Voluntary Plan Options

• Insured
• Self-funded
• See Plan Regulations for details

Miscellaneous

NY DBL forms

Administered By

RSLI – Insured

Matrix – Self-funded

Employer

Public employers may opt in

Private Employer of one or more employees working in New York state for at least 30 days:

• 30 days do not have to be consecutive
• 30 days must be in one calendar year
• Applies even if employer is based out-of-state

Employee

• All employees of a covered employer working in New York state

Exclusions include but are not limited to:

• Temporary or seasonal employees: May opt out of Paid Family Leave coverage if eligibility will never be met by completing a waiver form which is retained by the employer
• Government, railroad, maritime laborers
• Various employees of religious organizations
• Uncompensated volunteers for nonprofit organizations
• Independent contractors and subcontractors
• To see full list and details, please visit NY WCB Covered Employee page

Employee Eligibility

• Full-time employees – Regular work schedule of 20 or more hours per week: eligible after 26 consecutive weeks of employment
• Part-time employees – Regular work schedule of fewer than 20 hours per week: eligible after working 175 days (need not be consecutive or within same year)

Employees who change jobs from one Covered Employer to another Covered Employer must requalify for coverage with the current employer

Qualifying Leave/Benefits Reasons

• Bonding with a child during the first 12 months after birth, adoption or foster care placement
• Caring for a family member with a serious health condition (SHC)
• Assisting family member(s) when a spouse, domestic partner, child or parent is deployed abroad on active military service or on leave for rest and recuperation
• Employee or employee’s minor child is quarantined due to COVID-19 – see New York Paid Leave for COVID-19 Website for more information on this paid leave reason

Covered Family Member

• Spouse or Domestic partner
• Child, stepchild, or anyone for whom the employee has legal custody
• Parent, stepparent, or parent-in-law
• Grandparent
• Grandchild
• Sibling (For leaves starting on or after 01/01/2023)

Waiting Period

No waiting period

Relapse Period

• Successive periods of family leave caused by the same or related injury or sickness constitute a single period of disability if separated by less than 3 months

Contribution Rate & Responsibility

• 100% employee-funded through payroll deductions
• Contribution for 2022: 0.511% of the employee’s gross weekly wages, capped at $423.71/year
• Employer may pay employee contribution
• Contribution for 2023: 0.455% of the employee’s gross weekly wages, capped at $399.43/year
• Employer may pay employee contribution

Benefit Amount

• Maximum benefit 2022 – 67% of employee's average weekly wage, up to 67% of the statewide average weekly wage of $1,594.57. The maximum weekly benefit for 2022 is $1,068.36.
• Maximum benefit 2023 – 67% of employee's average weekly wage, up to 67% of the statewide average weekly wage of $1,688.19. The maximum weekly benefit for 2023 is $1,131.08.
• Benefits payable every 2 weeks.

Maximum Duration of Benefits/Leave

2021 and after – 12 weeks

(previous years: 2018 – 8 weeks, 2019 and 2020 – 10 weeks)

Increments of Leave Usage/Benefits

• Continuous
• Intermittent in full-day increments

Interaction with Other Leaves and Benefits

• NY DBL – combined amount of NY PFL and DBL cannot exceed a total of 26 weeks in a consecutive 52-week period. Cannot take PFL at same time as DBL.
• Unemployment – cannot collect PFL and unemployment insurance concurrently
• Social Security – PFL does not affect right to SSA benefits
• FMLA – applies concurrently when applicable
• Employer/insurer can count PFL-qualifying time toward PFL entitlement even if the employee does not apply as long as notice of NY PFL rights is given to the employee

Leave/Benefits Year

52 consecutive weeks retroactively (rolling back) from first week/day of leave

Employer Notice Requirements

• Post Notice of Compliance stating Employer has Paid Family Leave insurance – provided by Insurer
• Written notice of NY PFL rights
• May be included in employee handbook or provided separately (NY PFL Notice Sample Language)

Employee Notice Requirements

• Foreseeable leave: 30 days’ advance notice of intention to use Family Leave
• Unforeseeable leave: notice as soon as practicable
• Written notice is not required

Employee Claim Documentation

Forms and additional claim documentation information:

• Request for Bonding Leave: PFL-1 & PFL-2 Forms
• Request for Family Care Leave: PFL-1, PFL-3 & PFL-4 Forms
• Request for Military-Related Leave: PFL-1 & PFL-5 Forms

Job Protection

Job protected

Benefits Protections

Employer must continue existing health benefits during leave on the same terms as if the employee had continued working

Appeals

A rejection of PFL benefits must be appealed within 26 weeks of written notice. Information about the appeal process is available at NAM Case Management (namadr.com)

Administered By

State – State-administered

Matrix – Self-funded

Covered Employer

Employer with one or more employees working in the state of California.

Covered Employees & Eligibility

• Full or part-time employee who contributes to SDI program through payroll deductions
• Unable to do regular work for at least 8 days
• Employed or actively looking for work at time disability begins
• During base period, earned at least $300 and had SDI deductions withheld
• Under the care and treatment of licensed physician/practitioner or accredited religious practitioner within first 8 days of disability
• Beginning January 1, 2020, all workers, including those classified by a company as independent contractors, will be considered “employees” and entitled to SDI coverage unless the employer can prove otherwise. See AB 5, Worker v. Employee

Qualifying Leave/Benefits Reasons

Off-the-job injury or illness which results in lost wages. Includes:

• Pregnancy
• Elective surgery
• Inability to work based on an order from state or local health officer due to actual or exposure to a communicable disease
• Treatment for acute alcoholism or acute substance abuse

Waiting Period

7 consecutive or non-consecutive days. Benefits start on 8th day

• Benefits are payable once employee is out of work for disabling condition for 7 total days

Relapse Period

Successive periods of disability caused by the same or related injury or illness within 60 days of initial claim, will be considered a continuation and no new waiting period is required

Contribution Rate & Responsibility

• 2022: 1.1% of employee payroll deduction up to cap of $1,601.60/year (taxable income cap $145,600 x .011)
• 2023: 0.9% of employee payroll deduction up to cap of $1,378.48/year (taxable income cap $153,164 x .009)
• Contribution is for SDI and PFL combined
• Employers must withhold and send contributions to CA EDD (if no voluntary plan)
• See SDI Contribution Rate Chart

Benefit Amount

Claims beginning on or after January 1, 2022:

• Minimum weekly benefit: $50
• Maximum weekly benefit: $1,540

Claims beginning on or after January 1, 2023:

• Minimum weekly benefit: $50
• Maximum weekly benefit: $1,620

If you are eligible, you can receive about 60 to 70 percent (depending on income) of wages earned 5 to 18 months before your claim start date. You can be paid benefits for a maximum of 52 weeks. For more information, review Calculating Disability Benefit Payment Amounts.

Maximum Duration of Benefits/Leave

52 weeks from date of disability.

• Partial benefit may be paid for longer than 52 weeks if employee returns to work during benefit period.

Increments of Leave Usage/Benefits

• Continuous
• Reduced schedule – Must have a wage loss due to being unable to perform regular or customary work for at least 8 consecutive days

Interaction with Other Leaves and Benefits

• CA PFL – Cannot collect SDI and PFL concurrently
• Unemployment – Cannot collect SDI and unemployment insurance concurrently
• Social Security – SDI does not affect eligibility for SSDI
• FMLA – Unpaid leave runs concurrently when applicable
• CA Family Rights Act – Unpaid leave runs concurrently if applicable
• CA Pregnancy Disability Leave – Unpaid leave runs concurrently if applicable
• CA Michelle Maykin Memorial Donation Protection Act (Organ and Bone Marrow Donation Leave) – This is a paid leave and neither this statute nor SDI statute addresses which law is primary as to pay benefits; employers should assume the job-protected leave of absence runs concurrently with receipt of disability benefits if employee is off work to serve as an organ or bone marrow donor
• CA Leave for Victims of Domestic Violence, Sexual Assault, and Stalking – Unpaid leave runs concurrently if applicable

Leave/Benefits Year

52 consecutive weeks from the start of leave

Employer Notice Requirements

Notice to Employees (DE 1857A) – Employers required to provide Unemployment Insurance, Disability Insurance and Paid Family Leave

Notice to Employees (DE 1858) – Employers required to provide Disability Insurance and Paid Family Leave (no Unemployment Insurance)

Forms in other languages

Employee Notice Requirements

Employee must submit completed claim form (DE 2501) between 9 and 49 days after first day of disability begins

Employee Claim Documentation

Filed With Employer or Insurance Carrier

SDI Online – Online option

Claim for Disability Insurance Benefits (DE 2501) – Mail option

Employee must provide (Detailed Information):

• Medical certification by physician/practitioner
• For “normal” pregnancy: licensed midwife, nurse-midwife, or nurse practitioner may complete the medical certification

Religious practitioner care: Employee must request a Claim for Disability Insurance Benefits – Religious Practitioner’s Certificate (DE 2502). Certification only acceptable if the practitioner has been accredited by the Employment Development Department.

Job Protection

None – Job may be protected under other federal or state laws such as FMLA, CFRA, CA Pregnancy Disability Leave, CA Leave For Organ or Bone Marrow Donation, and/or CA Leave for Victims of Domestic Violence, Sexual Assault, and Stalking, if applicable.

Benefits Protections

Not addressed

Voluntary Plan Options

Employer’s Guide to Voluntary Plan Procedures – Insured and self-funded options are available with the mutual consent of the employer and a majority employee vote. The plan must have at least one right or benefit that is better than the rights provided by the state plan. Voluntary plans must include both PFL and SDI.

Administered By

State – State-administered

Matrix – Self-funded

Covered Employer

Employer with one or more employees working in the state of California.

Covered Employees & Eligibility

• All employees of a Covered Employer working in the state of California
• Employed or actively looking for work at time the family leave begins
• During base period, earned at least $300 and had SDI deductions withheld in the past 5 to 18 months
• Beginning January 1, 2020, all workers, including those classified by a company as independent contractors, will be considered “employees” and entitled to PFL coverage unless the employer can prove otherwise. See AB 5, Worker v. Employee

Qualifying Leave/Benefits Reasons

• To care for a seriously ill family member
• To bond with a new child through birth or adoption or foster care placement of a minor child, within the first year of the child's birth or placement
• EFFECTIVE January 1, 2021: Leave due to a “qualifying military event” arising out of the overseas military deployment of the employee’s spouse, registered domestic partner, parent, or child

Covered family members – Child (no age restriction), parent, parent-in-law, grandparent, grandchild, sibling, spouse, or registered domestic partner

Waiting Period

No waiting period

Relapse Period

Not applicable

Contribution Rate & Responsibility

• 2022: 1.1% of employee payroll deduction up to cap of $1,601.60/year (taxable income cap $145,600 x .011)
• 2023: 0.9% of employee payroll deduction up to cap of $1,378.48/year (taxable income cap $153,164 x .009)
• Contribution is for SDI and PFL combined
• Employers must withhold and send contributions to CA EDD (if no voluntary plan)
• See SDI Contribution Rate Chart

Benefit Amount

Claims beginning on or after January 1, 2022:

• Minimum weekly benefit: $50
• Maximum weekly benefit: $1,540

Claims beginning on or after January 1, 2023:

• Minimum weekly benefit: $50
• Maximum weekly benefit: $1,620

Weekly benefit amount is about 60 to 70 percent (depending on income) of wages earned 5 to 18 months before your claim start date and up to the maximum weekly benefit.

If your highest quarterly earnings are:

• Less than $929, weekly benefit amount is $50.
• Between $929 and $6,803.34, weekly benefit amount is approximately 70 percent of quarterly earnings.
• More than $6,803.34, weekly benefit amount is approximately 60 percent of quarterly earnings.

See Paid Family Leave Benefit Payment Amounts (ca.gov)

Maximum Duration of Benefits/Leave

8 weeks

Increments of Leave Usage/Benefits

• Continuous
• Intermittent

Interaction with Other Leaves and Benefits

• CA SDI – Cannot collect SDI and PFL concurrently
• Unemployment – Cannot collect PFL and unemployment insurance concurrently
• FMLA – Unpaid leave runs concurrently when applicable
• CA Family Rights Act – Unpaid leave runs concurrently if applicable
• CA Leave for Victims of Domestic Violence, Sexual Assault, and Stalking – Unpaid leave runs concurrently if applicable
• CA Family Military Leave – Unpaid leave runs concurrently if applicable

Leave/Benefits Year

12-month period from first day of leave

Employer Notice Requirements

Notice to Employees (DE 1857A) – Employers required to provide Unemployment Insurance, Disability Insurance and Paid Family Leave

Notice to Employees (DE 1858) – Employers required to provide Disability Insurance and Paid Family Leave (no Unemployment Insurance)

Forms in other languages

Employee Notice Requirements

Employee must submit completed claim by mail or online within 41 days from the date the family leave begins

Employee Claim Documentation

Filed With Employer or Insurance Carrier

SDI Online – Online option

Claim for Disability Insurance Benefits (DE 2501F) – Mail option

See Paid Family Leave Claim Process (ca.gov) for documentation required for each type of PFL claim

• Family member’s serious health condition: Medical certification by physician/practitioner for the family member
• Bonding with new child: Documentation showing proof of birth or placement
• Birth mother transitioning from a pregnancy-related disability claim: No additional documentation
• Religious practitioner care: Employee must request a Claim for Disability Insurance Benefits – Religious Practitioner’s Certificate (DE 2502F – only in SDI office). Certification only acceptable if the practitioner has been accredited by the Employment Development Department.
• Qualifying military exigency: A copy of the covered active duty orders or other documentation issued by the military and other documentation specific to the nature of the exigency for which the employee is requesting leave.

Job Protection

None – Job may be protected under other federal or state laws such as FMLA, CFRA, CA Leave for Victims of Domestic Violence, Sexual Assault, and Stalking, and CA Family Military Leave, if applicable

Benefits Protections

Not addressed

Voluntary Plan Options

Employer’s Guide to Voluntary Plan Procedures – Insured and self-funded options are available with the mutual consent of the employer and a majority employee vote. The plan must have at least one right or benefit that is better than the rights provided by the state plan. Voluntary plans must include both PFL and SDI.

Miscellaneous

Employers with San Francisco employees may be required to supplement employee wages if they are receiving PFL benefits for bonding with a new child through birth, adoption, or foster care placement. For more information, view the San Francisco Paid Parental Leave Ordinance.

Administered By
3300H.8

Program oversight and enforcement: San Francisco Office of Labor Standards Enforcement (the “Agency”) Benefits are administered and paid by employer or through a CA PFL voluntary plan administrator

Covered Employer
3300H.3

Employers with 20 or more employees worldwide

Covered Employees & Eligibility
3300H.3

Employee must meet all of the following eligibility requirements:

• Started employment with the Covered Employer at least 180 days prior to start of leave period;
• Performs at least 8 hours of work per week in San Francisco for Covered Employer;
• Works in San Francisco for at least 40% of the weekly hours for Covered Employer; and
• Eligible to receive benefits under the CA Paid Family Leave law (CA PFL) for purposes of bonding with new child

Beginning January 1, 2020, all workers, including those classified by a company as independent contractors, will be considered “employees” and entitled to coverage unless the employer can prove otherwise. See AB 5, Worker v. Employee

Qualifying Leave/Benefits Reasons
3300H.3

3300H.4 (a), (b)(1)(A) & (c)

• To bond with a new child through birth or adoption or foster care placement of a minor child, within one year after the child's birth or placement
• Employee must apply for CA PFL and provide proof of CA PFL benefits amounts

Note: SF PPLO is not available for leave reasons other than bonding covered by the California PFL law

Waiting Period
FAQ March 2017.pdf (sfgov.org) Question 9

No waiting period

Relapse Period

Not applicable

Contribution Rate & Responsibility
3300H.4 (b)(1)(A)

Supplemental Compensation under the SF PPLO is paid directly by the employer; no employee contribution is required

Benefit Amount
3300H.4 (b)(2)

Claims beginning on or after January 1, 2022:

• Minimum weekly benefit: CA PFL wage replacement plus SF PPLO Supplemental Compensation must equal 100% of employee’s gross weekly wage subject to maximum weekly benefit, up to maximum
• Maximum weekly benefit: $2,567

Claims beginning on or after January 1, 2023:

• Minimum weekly benefit: CA PFL wage replacement plus SF PPLO Supplemental Compensation must equal 100% of employee’s gross weekly wage subject to maximum weekly benefit
• Maximum weekly benefit: $2,700

For a leave calculator click Understanding the Paid Parental Leave Ordinance | San Francisco (sf.gov)

Maximum Duration of Benefits/Leave
3300H.4 (b)(2)

8 weeks (must be at least the same amount required by CA PFL)

Increments of Leave Usage/Benefits
Final PPLO Rule 8

• Continuous
• Intermittent

Interaction with Other Leaves and Benefits
3300H.4(b)(5), (c), and (d)

• Vacation pay – A Covered employee must agree to allow the employer, in its discretion, to apply up to 2 weeks of employee's accrued, unused vacation leave to meet employer’s Supplemental Compensation obligations. If employee refuses, employer is not required to pay Supplemental Compensation
• Company paid parental leave policies – employer is not required to provide Supplemental Compensation if employer’s existing policy provides at least equivalent or better benefits (pay amount and duration)
• CA PFL – Employee must apply for and receive CA PFL for new child bonding in order to receive SF PPL. The two benefits will run concurrently
• FMLA – Unpaid leave runs concurrently if applicable
• CA Family Rights Act – Unpaid leave runs concurrently if applicable

Leave/Benefits Year

12-month period from first day of leave Final PPLO Rule, Introduction and Definitions

Employer Notice Requirements

Posting: Employers must post notice of SF PPLO rights in a conspicuous place in the workplace, in English, Spanish, Chinese, and any language spoken by at least 5% of the employees at the workplace or job site. The Agency makes available posters in the languages spoken by at least 5% of the San Francisco workforce.
Parental leave poster FINAL Print (sfgov.org) 3300H.5

Employers must provider SF PPLO Form to employees after employee tells employer of the fact that s/he is expecting a newborn, adopted, or foster child, or sooner if the employee enquires about paid parental leave.
Instructions and Form Combined 8.13.18 ENG.pdf (sfgov.org) Final PPLO Rule 4

If Covered Employer publishes an employee handbook that describes other kinds of personal or parental leave, Employer must include a description of PPLO rights Final PPLO Rule 4

Employee Notice Requirements

SF PPLO does not impose any advance notice requirements on the employee but employees must first file for California PFL benefits and then submit a claim for San Francisco supplemental benefits to their employer

Employee Claim Documentation

1. Employee must file a claim for CA PFL for new child bonding through the Employment Development Department (EDD).

• Employees can file a claim for PFL benefits using SDI Online or a paper claim form.
• When filing the claim for PFL benefits, EDD provides employees with the option to disclose benefit payment information to the employer. This will help ensure prompt payment from the employer.

2. Employee must complete the San Francisco Paid Parental Leave Form (PPL Form) and provide it to each Covered Employer.

3. Once the employee files a claim for State PFL, EDD will send the employee a form entitled Notice of Computation (DE429D) which will set forth the employee’s weekly State PFL benefit amount.

• The employee must then either provide the Notice of Computation to covered employer(s) and/or check the box on the PPL Form that permits EDD to share the State PFL weekly benefit amount with the employer(s). Doing both will expedite the process.

4. if requested by a covered employer(s), the employee must provide employer(s) with his/her Electronic Benefit Payment (EBP) Notification (form DE 2500E), which is provided by the State EDD and which verifies that an employee is in fact eligible for and receiving State PFL benefits. Your employer may refer to this as your "Notice of Payment."

Click Understanding the Paid Parental Leave Ordinance | San Francisco (sf.gov) for information about filing a claim, forms, and FAQs.

Job Protection

None – Job may be protected under other federal or state laws such as FMLA or CFRA, if applicable Law prohibits retaliation for exercising rights, and an adverse action within 90 days of protected activity raises a rebuttable presumption of a violation 3300H.7

Benefits Protections

Not addressed

Appeals

The Agency may issue notices of violation; the alleged violator has a right to hearing 3300H.8(b)

Civil enforcement is permitted after written notice to the Agency 3300H.8(c)

Voluntary Plan Options
3300H.4(b)(6)

• SF PPLO payments are administered and paid by the employer
• A Covered Employer who has received state approval for a CA PFL voluntary plan must provide the additional compensation required by the SF PFL through the approved voluntary plan or by paying compensation directly to employee

Administered By

• State plan: Colorado Department of Labor, Division of Family and Medical Leave Insurance (FAMLI)
• Private plan:
  • RSLI – Insured plans
  • Matrix – Self-funded plans; RSL-insured plans for joint clients

Statute:
C.R.S. §8-13.3-508
C.R.S. §8-13.3-521

Rules:
7 CCR 1107-3.1
Private plan rules under development

Covered Employers

• Private employers:
• With 1 or more employees during 20 weeks in the current or prior calendar year; or
• Who paid wages of $1,500 or more during any quarter in the prior calendar year
• The state and political subdivisions
• The federal government is excluded
• Local governments may opt out of CO PFML coverage
• “Local government” means any county, city and county, city, or town, school district, special district, authority, or other political subdivision of the state

Statute:
C.R.S. §8-13.3-503(8)
C.R.S. §8-13.3-522
C.R.S. §29-1-204.5(3)(b)

Rules:
7 CCR 1107-3.2.11
7 CCR 1107-2 (Local Government Rules)

Covered Individuals & Eligibility

“Covered Individual” means any person who:

• Earned at least $2500 in wages subject to premiums during the base period
• Base period: first 4 of the last 5 completed calendar quarters immediately preceding the first day of the individual's benefit year
• Alternative base period: last 4 completed calendar quarters immediately preceding the benefit year

OR

• Elects coverage for a minimum of 3 years (e.g., self-employed, sole proprietor, independent contractor, employees of local governments that have opted out of coverage, etc.)

Note: For simplicity, we use the term “employee” throughout this chart

Statute:
C.R.S. §8-13.3-503(3)
C.R.S. §8-13.3-514
C.R.S. §8-70-103(1.5) and (2)

Rules:
7 CCR 1107-3.4.3

Qualifying Leave/Benefits Reasons

Leave/benefits reasons:

• Employee’s serious health condition
• Caring for a family member with a serious health condition
• Caring for a new child during the first year after birth, adoption, or placement
• Qualifying military exigency
• Safe leave (leaves related to the employee or a family member being a victim of domestic violence, stalking or sexual assault or abuse)

Covered family relationships:

• Child of any age*
• Parent*
• Spouse
• Domestic partner
• Grandparent*
• Grandchild*
• Sibling*
• Like a family member: Any individual with whom the employee has a significant personal bond that is or is like a family relationship, regardless of biological or legal relationship

* Note: These relationships include biological, foster, adoptive, step, and in loco parentis relationships and the same relationships to the employee’s spouse or domestic partner, if applicable

Statute:
C.R.S. §8-13.3-504(2)
C.R.S. §8-13.3-503(11)
C.R.S. §8-13.3-503(16)
C.R.S. §8-13.3-5034(18)

Rules:
7 CCR 1107-3.4.5
7 CCR 1107-3.4.6
7 CCR 1107-3.4.7
7 CCR 1107-3.4.8

Required Claim Documentation

Applications for leave must be filed:

• 30 days in advance for foreseeable leave
• Within 30 days after start of leave if unforeseeable or if submitting an application in advance is otherwise impracticable
• Within 89 days after start of leave if the claimant shows good cause for failure to submit the application within 30 days

Documentation must include:

• For leave due to birth of a child: proof of birth and a statement establishing in loco parentis
• For leave related to adoption: proof of adoption placement
• For leave due to foster care: proof that the claimant is either a licensed or certified foster parent and proof the child has been placed in the claimant’s care OR other documentation of placement and relationship (see Rules for details)
• For leave to care for a family member with a serious health condition, a “Serious Health Condition Certification – Family Member Form” (to be developed by the Division)
• For leave due to the employee’s own serious health condition, a “Serious Health Condition Certification – Self Form” (to be developed by the Division)
• For leave due to a qualifying exigency: a “Military Exigency Leave Attestation Form” completed by the claimant (to be developed by the Division)
• For safe leave: a “Safe Leave Attestation Form” to be completed by the victim or a family member of the victim (to be developed by the Division)
• For all claims: any other reasonable documentation necessary to adjudicate the claim for benefits

Statute:
C.R.S. §8-13.3-516(2)

Rules:
7 CCR 1107-3.6.2 and .4
7 CCR 1107-3.5.A thru G

Waiting Period

None

Contribution Rate & Responsibility

• Start: January 1, 2023
• Amount:
• 2023-2024: 0.9% of employee’s wages
• 2025 and after: rate may be adjusted according to a described formula but not to exceed 1.2% of employee’s wages
• Wages subject to contribution capped at federal SSA limit
  • 2023: $160,200
• Employer can require employees to contribute up to ½ of total premium
• Employers with fewer than 10 employees do not have to contribute the employer’s share of premiums to the state; must still contribute the employees’ share

Statute:
C.R.S. §8-13.3-516(1)
C.R.S. §8-13.3-507

Rules:
Generally, 7 CCR 1107-1
7 CCR 1107-1.4
7 CCR 1107-1.5.5.B.1(a)
7 CCR 1107-1.5.5.D
7 CCR 1107-1.5.6.B

Benefit Amount

• Start: January 1, 2024
• Amount:
• 90% of the employee’s average weekly wage (AWW) that is equal to or less than 50% of the state AWW

PLUS

• 50% of the employee’s AWW that is greater than 50% of the state AWW
• Benefit awards for leaves in progress will be recalculated quarterly
• Maximum weekly benefit: 90% of state AWW
• Exception: for benefits beginning before 1/1/2025, the maximum benefit will be $1,100 per week

Statute:
C.R.S. §8-13.3-516(1)
C.R.S. §8-13.3-506

Rules:
7 CCR 1107-3.5.1.A thru G

Maximum Duration of Benefits

• 12 weeks in an Application Year
• Additional 4 weeks for a serious health condition related to pregnancy complications or childbirth complications

Statute:
C.R.S. §8-13.3-505(1)
7 CCR 1107-3.5.2

Increments of Leave Usage/Benefits

• 1 hour OR
• Smaller increments if consistent with employer’s increments for other employee leave
• Benefits not payable until employee accumulates at least 8 hours of PFML usage

Statute:
C.R.S. §8-13.3-505(3)

Rules:
7 CCR 1107-3.5.2.C
7 CCR 1107-3.5.3

Interaction with other Leaves/Benefits

• Federal Family & Medical Leave Act – runs concurrently with FAMLI if both apply BUT employee cannot be required to take FAMLI Act leave
• Colorado Family Care Act – runs concurrently with FAMLI if both apply BUT employee cannot be required to take FAMLI Act leave
• Unemployment & Workers’ Compensation – not available concurrently with benefits under FAMLI Act
• Employer-Provided Paid Leave – if employer and employee agree, available concurrently to top up FAMLI Act benefits not to exceed 100% of employee’s wages in total
• “Employer-Provided Paid Leave” – vacation, paid sick leave (including statutory) personal leave, parental leave, and any other employer-paid time off
• Doesn’t include “commercial” LTD/STD

STD/LTD: Employer can require any payment made or leave allowed under a disability policy be taken concurrently or otherwise coordinated (e.g. set-offs allowed not to exceed 100% of wages)

Statute:
C.R.S. §§8-13.3-510
C.R.S. §24-34-502.7

Rules: 7 CCR 1107-4.3 – 4.8

Leave/Benefits Year

Application Year:

• Definition from statute: 12-month period beginning on the first day of the calendar week in which an employee files an application for PFML benefits
• Definition from rules: “Application year” as used at C.R.S. 8-13.3-505(1), and as described at C.R.S. 8-13.3-521(1)(b) as a “benefit year,” means the 12-month period beginning on the first day of the calendar week in which an individual’s benefit start date occurs. The 12-month period is measured backward from the date an employee uses paid family and medical leave insurance benefits. Under this ‘‘rolling’’12-month period, each time an employee takes paid family and medical leave, the remaining leave entitlement would be the balance which has not been used during the immediately preceding 12 months.
• Interpretation by Division: FAMLI Act leave usage will be determined using the rolling back method: "A 'rolling' 12-month period measured backward from the date an employee uses any FMLA leave"
• "Calendar week": any period of 7 consecutive days starting on the first day of the employee’s absence and benefits

Statute:
C.R.S. §8-13.3-503(1)

Rules:
7 CCR 1107-3.2.2
7 CCR 1107-3.2.6
29 C.F.R. § 825.200(b)(4)

Employer Notice Requirements

• Employers must provide written notice to employees:
  • By posting in the workplace by January 1, 2023
  • Upon hire
  • Upon learning an employee is experiencing an event that would be covered by CO PFML
• The required poster plus a break room poster, paycheck stuffer, and other employer materials are available on the Division website in the FAMLI Toolkit for Employers | Family and Medical Leave Insurance (colorado.gov)
  • Employers should review these materials before use to determine whether any modifications are needed due to employer specifics and/or if the employer has a private plan. Any modified documents must remain compliant with the FAMLI Act notice requirements

Statute:
C.R.S. §8-13.3-511

Employee Notice Requirements

• 30 days if leave is foreseeable
• Such notice as is practicable if leave is not foreseeable or if 30 days is not possible
• Employer can require employee notice to include the anticipated start time, anticipated duration, and where applicable, anticipated frequency of leave
• Employee must make effort to schedule leave so as not to unduly disrupt the operations of the employer
• For employees on intermittent leave, notice and scheduling requirements apply to each absence
• Employers can require employees to comply with the employer’s usual and customary notice and procedural requirements for leave

Statute:
C.R.S. §8-13.3-505(4) and (5)

Rules:
7 CCR 1107-3.7.1, .2, and .3

Job Protection

If employee has been employed with current employer for at least 180 days prior to commencement of PFML leave, restoration after leave to same or equivalent position and terms and conditions of employment

Statute:
C.R.S. §8-13.3-509

Rules:
7 CCR 1107-3.10.8

Benefits Protection

Continuation of health care benefits during leave

Statute:
C.R.S. §8-13.3-509

Rules:
7 CCR 1107-3.10.8

Employer Reimbursement

Employer can receive reimbursement from state program or private plan insurance carrier for advance payments made by employer equal to or greater than CO PFML benefits

Statute:
C.R.S. §8-13.3-515

Appeals

Claimants:

• Claimants may appeal to the Division within 45 days of initial benefits determination, or within 60 days upon a showing of good cause for the delay
• Judicial review permitted after exhaustion of administrative remedies

Employers:

• An employer may file a grievance with the Division due to a good faith believe the Division granted FAMLI leave and benefits
  • In an amlunt, duration or frequency beyond which the claimant is entitled to or
  • In a way that unduly disrupts the employer’s operations

Statute:
C.R.S. §8-13.3-512

Rules:
7 CCR 1107-3.10
7 CCR 1107-3.11

Private Plans

Insured and self-funded private plans are available. Please see the Reliance Standard/Matrix Absence Management CO PFML Private Plan Application Guide

Statute:
C.R.S. §8-13.3-521

Rules:
7 CCR 1107-5

Administered By

• District administered
• No private plan option

Covered Employer

All private sector DC employers with one or more employees

Covered Employees & Eligibility

Full or part-time employee who works for a Covered Employer and:

• Spends more than 50% of the employee’s work time for that employer working in DC or
• Is based in DC and regularly spends a substantial amount of work time for that employer in DC and not more than 50% of work time for that employer in another jurisdiction

And:

• Has been a covered employee during some or all of the 52 calendar weeks immediately preceding the qualifying event for which paid leave is needed (pro-rated benefits for employees with less than a year of service with the covered employer)

Qualifying Leave/Benefits Reasons

• Family Leave - Caring for a family member who requires care or companionship because of a serious health condition
• Family member is defined as:
• Child (biological, adopted, foster, stepchild, legal ward, child of a domestic partner, or a person to whom an eligible individual stands in loco parentis)
• Parent (biological, foster, adoptive, in-law, stepparent, legal guardian, or person who stood in loco parentis to the employee when the employee was a child)
• Spouse
• Domestic partner
• Grandparent
• Sibling
• Parental Leave - Bonding with a newborn or newly placed child through adoption, foster care, or legally assumed parental responsibility for a child
• Parental leave must be completed within one year of the birth or placement
• Medical Leave - Leave needed due to the employee's own serious health condition
• Pre-natal Leave - Leave for routine and specialty appointments, exams and treatments associated with a pregnancy provided by a health care provider (includes pre-natal check-ups, ultrasounds, treatment for pregnancy complications, bedrest prescribed by a health care provided and pre-natal physical therapy)

Waiting Period

No waiting period for claims "filed after October 1, 2021, and before the 365th day after the end of the public health emergency"

Relapse Period

None

Contribution Rate & Responsibility

• Employers cover the full cost of UPL. Office of Chief Financial Officer to evaluate fund and provide adjustment to contribution rate every Mach 1st.
• Before July 1^st, 2022:
  • Employers contribute 0.62% of the wages of covered employees.
• After July 1^st, 2022:
  • Employers contribute 0.26% of the wages of covered employees.

Benefit Amount

Calculation:

• 90% of the employee’s average weekly wage if the employee’s average weekly wage is less than or equal to 150% of 40 times DC's minimum wage
• 90% of the employee’s average weekly wage, plus 50% of the amount by which the employee's average weekly wage exceeds 150% of 40 times DC's minimum wage, if the employee’s average weekly wage is greater than 150% of 40 times DC's minimum wage
• Employee's average weekly wage is calculated based on the 4 highest paid quarters of the most recent 5 completed calendar quarters

Maximum Benefit:

• $1,049 per week beginning in 2021 (increased from $1009)
• Adjusted annually each October 1 (effective immediately unless otherwise stated)

Intermittent leave is calculated based on the employee’s regular workweek. For example, an employee who works 5 days will be entitled to 1/5 of PFL weekly benefit amount for 1 day of leave.

Maximum Duration of Benefits/Leave

Before October 1, 2022:

• Family leave benefits: 6 workweeks in a 52 calendar week period
• Parental leave benefits: 8 workweeks in a 52 calendar week period
• Medical leave benefits: 6 workweeks in a 52 calendar week period
• Pre-natal leave benefits: 2 workweeks in a 52 calendar week period
• Total leave benefits: No more than 8 workweeks in a 52 calendar week period for all leaves combined EXCEPT parental/bonding leave may be combined with pre-natal leave (totaling 10 weeks as of 10/01/2021)

On or After October 1, 2022*:

• Family leave benefits: 12 workweeks in a 52 calendar week period
• Parental leave benefits: 12 workweeks in a 52 calendar week period
• Medical leave benefits: 12 workweeks in a 52 calendar week period
• Pre-natal leave benefits: 2 workweeks in a 52 calendar week period
• Total leave benefits: No more than 12 workweeks in a 52 calendar week period for all leaves combined EXCEPT parental/bonding leave may be combined with pre-natal leave (totaling 14 weeks as of 10/01/2022)

Increments of Leave Usage/Benefits

• Continuous
• Intermittent – in full day increments

Interaction with Other Leaves and Benefits

• UPL Leave – Cannot collect (UPL) Medical, Parental, and/or Family Leave concurrently
• Unemployment – Cannot collect UPL and unemployment insurance concurrently
• Short-term disability Benefits – Insured STD benefits cannot be offset by actual or estimated UPL benefits (not applicable to Self-Funded plans)
• Long-term disability Benefits – Cannot collect LTD and UPL concurrently
• Employer-provided short-term paid leave benefits – Available concurrently with UPL benefits if permitted by terms of employer policies (e.g., sick time, vacation time, short-term disability, parental leave)
• Social Security Retirement – Unknown
• FMLA and DC FMLA – Unpaid job-protected leave runs concurrently when applicable
• DC Parental Leave Act – DC has a separate “Parental Leave Act” that allows time off to attend a child’s school-related activities. Leave reasons do not overlap with DC UPL and so do not run concurrently

Leave/Benefits Year

52 calendar weeks (measuring method for the 52 weeks is not defined by the UPL statute or regulations)

Employer Notice Requirements

• Posting the Paid Family Leave Poster at the worksite or other common areas. Poster
• Employer must provide information about the paid family and medical leave program three times:
• At the time of hire
• At least once a year
• Any time the employee inquires about a potential family or medical leave event

Employee Notice Requirements

• Foreseeable leave: Written notice at least 10 days prior to taking leave, or as early as possible
• Unforeseeable leave: Oral or written notice before the start of work shift
• Emergency leave: Oral or written notice within 48 hours after the emergency occurred

Employee Claim Documentation

Paper form (send to Office of Paid Family Leave, 4058 Minnesota Ave. NE, Washington, DC 20019) or online at DC Paid Family Leave.

Additional documentation to support the need for leave:

• Medical leave: Documentation from a health care provider certifying the employee's serious health condition
• Family leave: Documentation from a health care provider certifying the family member's serious health condition and leave details
• Parental leave: Documentation of the child's birth or placement
• Pre-natal leave: Documentation from a health care provider certifying the employee's need for pre-natal leave

Job Protection

None; job protection may be available under the federal FMLA and/or DC FMLA if applicable

Benefits Protections

None; benefits protection may be available under the federal and/or DC FMLA if applicable

Appeals

Within 60 days after notice of an adverse determination, employee may appeal to the Office of Administrative Hearings:

• Eligibility for benefits
• The weekly benefits amount, or
• The duration of benefits

Voluntary Plan Options

Not allowed

Administered By

State program:

• Delaware Department of Labor oversees program and pays benefits
• Employers administer the claims

Private plans:

• Insured, administered by authorized Insurer
• Self-funded, administered by employer or3rd party administrator

Statute:
19 §3713, §3702(c)

19 §3716(a)(2)a, (a)(2)c
18 §1904(a)(1)

Covered Employer & Business Entity

• All employers
  • 10-24 employees: Must provide Parental Leave only
  • 25 or more employees: Must provide all leave types
• Excludes federal government and any business that is closed in its entirety for 30 consecutive days or more per year
• Employers with 10-24 employees can opt in for Medical and Caregiver Leave
• Employers with 9 employees or fewer can opt in for Parental Leave

Statute:
19 §3701(7)
19 §3701(23), §3717

Covered Individuals & Employee Eligibility

• 12 months of service
• 1250 hours worked in 12 months prior to leave

Statute:
19 §3701(3)

Qualifying Leave/Benefits Reasons

• Parental Leave (birth, adoption, and foster care)
• Care of a family member with a serious health condition.
• Employee’s own serious health condition
• Qualifying military exigency

Statute:
19 §3702(a)

Required Claim Documentation

• Certification issued by the health care provider of the covered individual or of the family member , including the following information:
  • When the condition commenced
  • Probable duration of the condition
  • Medical regarding the condition
• Recertification allowed
• 2nd/3rd opinion process allowed

Statute:
19 §3702(c)(1), (2)
19 §3702(c)(4)
19 §3702(c) (3)

Waiting Period

None specified

Contribution Rate & Responsibility

For 2025-2026:

• Medical Leave: 0.4% of employee’s wages
• Family Caregiving Leave: 0.08% of employee’s wages
• Parental Leave: 0.32% of employee’s wages

For 2027 Forward: To be determined*

Employer can require employee to contribute up to 50% of total contribution

*If contribution rate exceeds 1% of wages, department shall reduce benefit from 80% of AWW to the lowest percentage of AWW that would allow a contribution rate less than 1%

Statute:
19 §3705(b)
19 §3705(d), (e), (f)
19 §3705(c)

Benefit Amount

• 80% of employee’s Average Weekly Wage (AWW) during the 12 months preceding leave application
• Minimum: $100/week or employee’s actual AWW if lower than $100
• Maximum: $900/week 2026 and 2027; subject to annual adjustments 2028 forward

Statute:
19 §3704

Maximum Duration of Leave & Benefits

12 weeks per Application Year

• Parental Leave: 12 weeks in an Application Year
• Medical and Family Caregiving Leave (including exigency): 6 weeks combined in any 24-month period

Statute:
19 §3703

Increments of Leave Usage/Benefits

• Continuous
• Intermittent and reduced schedule permitted but increment size not specified
• Benefits not payable for less than 1 workday of leave in 1 week

Statute:
19 §3706
19 §3704(b)

Interaction with Other Leaves and Benefits

• PFMLI Runs concurrently with FMLA, if applicable
• Employer may require that PMLI payments be made concurrently or coordinated with payment or leave for the same reasons under a collective bargaining agreement or employer policy.
• Employer may require employees to use accrued paid time off, including sick and vacation time, before using PFMLI benefits
• If the employee is not required to exhaust all paid time off, use of accrued paid time off counts toward the total length of PFMLI leave and benefits provided. If employer requires employee to exhaust other paid time off, use of accrued paid time does not count toward the total length of PFMLI leave and benefits provided
• Cannot use FMLI if, when combined with other benefit, total benefit would be more than 100% of covered individual’s weekly wage

Leave/Benefits Year

Application Year: 12-month period defined in FMLA

Statute:
19 §3701(1)

Employer Notice Requirements

• Notice to Employees
  • Upon hire
  • By posting
  • Upon leave request
• Content of Notice:
  • The employee's PFMLI benefits, amount of benefits, procedure for filing a claim, right to job protection and benefits continuation, and other details

Statute:
19 §3710

Employee Notice Requirements

Notice of intention to take covered leave 30 days in advance, if known, or as soon as practicable

Statute:
19 §3710(e)

Job Protection

• Reinstatement to same or equivalent position
• Protection from interference and retaliation for employees with greater than 90 days of employment with employer

Statute:
19 §3707(a)
19 §3708(a), (g)

Benefits Protections

• Benefits continuation during leave
• Covered individual continues to pay share of health care benefits

Statute:
19 §3707(b)

Reporting Requirements

Employer must report approvals to Department within 3 days in a manner to be determined

Statute:
19 §3703(e)

Appeals

• Initial appeals to be requested within 60 days of the initial denial to the Department, or Insurer/Administrator if private plan
• Determinations by the Department and final determinations by a private plan may be appealed to the PFMLI Appeal Board within 30 days of the initial appeal

Statute:
19 §3711(a)(1)
19 §3716(a)(1)(m)
19 §3711(a)(2)

Private Plan Options

• Self-funded or insured plans permitted
  • Insured plans: issued by approved insurer
  • Self-funded plans: must post bond
• Must be offered to all of employer’s employees
• Must meet or exceed employee rights, protections, and benefits provided under state program

Statute:
19 §3716

Administered By

• State – State does not administer a State Plan.
• Private plans – Insured, self-insured, or any through approved collective bargaining agreement
• Matrix – Self-funded*

* Under the self-insurance option, the self-insurer must maintain an office which receives and processes temporary disability insurance claims and issues such benefit payments or engage an independent claims adjusting service as a claims agent in the State of Hawaii.

Covered Employer

Every employer in the state of Hawaii, including the state and political subdivisions, except to the extent the type of services performed by an employee are excluded from coverage. See “Covered Employee” below for exclusions. H.R.S. 392-3

Covered Employes & Eligibility

In the 52 weeks preceding the first day of disability, the employee:

• Has at least 14 weeks of Hawaii employment with any employer(s) (need not be consecutive);
• Has been paid for 20 hours or more and has earned at least $400 during each of those weeks; and
• Is in “current employment:”
• The employee was employed immediately before the date he/she suffered the injury or illness or
• If he/she was separated from employment, the disability occurred within two weeks of the last day of work

For a list of exclusions, see: H.R.S. 392-5

Qualifying Benefits Reasons

• Off-the-job injury or illness which results in lost wages and:
• Is not work-related
• Prevents the employee from performing his/her regular duties
• Is certified by a licensed physician
• Pregnancy included
• Organ donation included

Waiting Period

7 consecutive days. Benefits begin on 8th consecutive day of disability.

Relapse Period

Same or related cause or condition separated by not more than 2 weeks will be considered one continuous disability period

Contribution Rate & Responsibility

Employee Contribution cannot exceed:

• 0.5% of the employee’s weekly wages
• In 2022: Maximum weekly deduction of $6.00
• In 2023: Maximum weekly deduction of $6.59
  • See 2023 Maximum Weekly Wage Base and Maximum Weekly Benefit Amount

Employer Contribution:

• Employer may pay entire cost of TDI benefits, or
• Employer may share the cost equally with eligible employees, subject to above limitations

Benefit Amount

As of January 1, 2022: 58% of employee’s average weekly wage, up to the maximum of $697 per week.

As of January 1, 2023: 58% of employee’s average weekly wage, up to the maximum of $765 per week.

See 2023 Maximum Weekly Wage Base and Maximum Weekly Benefit Amount

Maximum Duration of Benefits/Leave

26 weeks following expiration of the 7-day waiting period

Increments of Leave Usage/Benefits

Continuous only

Interaction with Other Leaves and Benefits

• Unemployment: Cannot collect TDI if receiving unemployment insurance
• Worker’s Compensation: Cannot collect TDI if receiving Worker’s Compensation
• Social Security Disability: TDI does not affect eligibility for SSDI but TDI benefits cease upon date SSDI begins
• FMLA: Unpaid, job-protected leave may run concurrently when FMLA leave reason is employee's own serious health condition
• Hawaii Pregnancy Disability Leave, Leave for Victims of Domestic or Sexual Violence, and Donor leave (unpaid, job-protected) run concurrently when leave reason is for employee’s medical illness or injury
• Hawaii Family Leave Act: Not concurrent; does not cover employee’s own medical condition
• Other State Disability Benefits: TDI benefits reduced by the amount paid under the law of another state

Leave/Benefits Year

Benefit Year: The one-year period beginning with the first day of the first week of disability when the employee first files a claim.

Subsequent Benefit Year: The one-year period following a preceding benefit year, beginning either:

1. The first day of the first week of disability when the employee files a subsequent claim for temporary disability benefits; or
2. The first workday following the expiration of the preceding benefit year if a disability for which benefits are payable during the last week of the preceding benefit year continues and the employee is eligible for further benefit payments.

Employer Notice Requirements

Poster: Employers must publicly display notice of employee's disability rights and benefits Disability Compensation Law – Notice to Employees

After a claim is reported by the employee, employer must provide the TDI-45 Form to the employee.

• TDI-45 is not available online and must be obtained from the employer (if self-funded) or the TDI carrier
• After Part A (Claimant’s Statement) and Part C (Doctor’s Statement) are completed, employer completes Part B (Employer’s Statement) and forwards the TDI-45 Form to its claims administrator (if self-funded) or to the employer’s TDI carrier.

Employee Notice Requirements

• Employee must submit completed claim form (TDI-45) within 90 days of the start of the disability
• Failure to do so may result in the loss of some or all of their benefits unless good cause is shown
• If employee files a claim more than 26 weeks after the start of a disability, the employee will not be entitled to any benefits

Employee Claim Documentation

Employee must request Form TDI-45 from employer and complete Part A, Claimant’s Statement. Employee’s physician must certify the disability on Part C, Doctor’s Statement.

Form is provided to the employer's claims administrator (if self-funded) or to employer's TDI carrier.

Job Protection

None. However, job protection may be provided through the federal FMLA or Hawaii leave laws. See Interaction with Other Leaves and Benefits above.

Benefits Protections

Not addressed. However, benefits protection may be provided through the federal FMLA or Hawaii leave laws. See Interaction with Other Leaves and Benefits above.

Voluntary Plan Options

An employer may adopt one or more of the following methods to provide TD benefits:

• Purchase an insured plan from an authorized carrier.
• Adopt a self-insured plan that must be approved by the Division. Plan must be equivalent or better than the statutory plan. Must also show proof of financial solvency by furnishing auditing statements, depositing securities or posting a surety bond.
• Through collective bargaining agreement containing sick leave benefits as least as favorable as required by TDI law.

Appeals

• Appeal of claim denial: written explanation of why employee disagrees with denial
• Must send 2 copies to the Division or the nearest Department of Labor & Industrial Relations District Office.
• Employee has 20 days from date of mailing the denial to appeal
• Appeal of amount of award: written appeal with pay stubs or other evidence of incorrect benefit amount
• Must send 2 copies to the Division or the nearest Department of Labor & Industrial Relations District Office.
• Employee has 20 days from date of initial incorrect payment to appeal
• Judicial review after appeal: Available to any party in circuit court

Administered By

• Plan for state employees: New Hampshire has designated a single carrier to provide paid family leave to state employees
• Plan for employees of private and non-state governmental employers: Voluntary coverage available through designated carrier.
  • • This program entitles participating employers to a NH Business Enterprise Tax Credit in the amount of 50% of premiums paid by the employer for up to 6 weeks of coverage

Statute:
N.H. Rev. Stat. Ann. §21-I:108
N.H. Rev. Stat. Ann. §21-I:111
N.H. Rev. Stat. Ann. §21-I:104

Covered Employers

• The state and political subdivisions
• Private employers with a physical presence in New Hampshire and more than 50 employees in total (not just in New Hampshire) may choose to sponsor coverage
• Individual workers can opt into coverage if the individual:
  • Works for a private employer with more than 50 employees in New Hampshire that chooses not to sponsor coverage AND that does not offer a company paid leave program with benefits at least equivalent to state coverage, or
  • Works for a private employer with fewer than 50 employees that does not offer a company paid leave program with benefits at least equivalent to state coverage; or
  • Is an independent contractor or sole proprietor

Statute:
N.H. Rev. Stat. Ann. §21-I:103

Covered Individuals & Eligibility

• Individual workers can opt into coverage if the individual:
  • Works for a private employer with more than 50 employees in New Hampshire that chooses not to sponsor coverage AND that does not offer a company paid leave program with benefits at least equivalent to state coverage, or
  • Works for a private employer with fewer than 50 employees that does not offer a company paid leave program with benefits at least equivalent to state coverage; or
  • Is an independent contractor or sole proprietor
• Workers who opt in to the program individually have a 7-month "waiting period" before benefits will be paid

Statute:
N.H. Rev. Stat. Ann. §21-I:102
N.H. Rev. Stat. Ann. §21-I:103

Qualifying Leave/Benefits Reasons

Leave/benefits reasons:

• Caring for a family member with a serious health condition
• Bonding with a new child during the first year after birth, adoption, or placement
• Qualifying military exigency
• Leave for employee’s serious health condition not available to state employees, but is available for private and non-state public employees without short term disability coverage

Covered family relationships:

• Child – biological, adopted, or foster, step, or legal ward, or a child of a person standing in loco parentis
  • Under 18 years of age, or
  • 18 years of age or older and incapable of self-care because of a mental or physical disability
• Parent – biological, adoptive foster, step, or legal guardian of the child or the child’s spouse or domestic partner
• Spouse
• Domestic partner
• Grandparent – biological, adoptive, foster, step

Statute:
N.H. Rev. Stat. Ann. §21-I:101
N.H. Rev. Stat. Ann. §21-I:102
N.H. Rev. Stat. Ann. §282-B:2

Waiting Period

• None for state employees
• 1 week for employees of private and non-state public employers
• 1 week for individual workers who opt in to the program
• The waiting period does not count toward the employee’s 6 weeks of coverage

Statute:
N.H. Rev. Stat. Ann. §21-I:103

Contribution Rate & Responsibility

• State Employees: No employee contribution
• Private and Non-State Public Employees
  • Plans for employers of more than 50 employees who purchase the insured NH PFML plan will be individually underwritten. There is no statutory direction or limitation on whether or in what amount these employers can take payroll contributions from employees.
  • Employers of more than 50 employees who do not opt in must withhold payroll deductions for employees who opt in individually
  • Employers of fewer than 50 employees do not have to take payroll deductions for employees who opt in individually
  • Individuals who work for employers who do not offer FMLI coverage and who do not offer benefits equivalent to or better than FMLI benefits can purchase family and medical leave insurance from the New Hampshire carrier partner individually
    • Premium for individuals who opt in cannot exceed $5 per subscriber per week

Statute:
N.H. Rev. Stat. Ann. §21-I:103
N.H. Rev. Stat. Ann. §282-B:3
N.H. Rev. Stat. Ann. §282-B:5

Benefit Amount

• Start: January 1, 2023
• Amount: 60% of the employee’s average weekly wage (AWW)
• Maximum weekly benefit: Capped at 60% of taxable SS wages, which can change annually. $160,200 for 2023

Statute:
N.H. Rev. Stat. Ann. §21-I:102

Maximum Duration of Benefits

• Private and non-state governmental employers can elect either 6 or 12 weeks per weeks per benefit period
• Individual workers who opt in: 6 weeks per benefit period

NH PFML website

Increments of Leave Usage/Benefits

• Continuous
• Reduced Schedule in periods of not less than 4 hours
• Intermittent in periods of not less than 4 hours

State PFML website; also based on N.H. Rules Ins 8001.02(d)

Interaction with Other Leaves and Benefits

• If a worker qualifies for short-term disability (STD), they will not qualify for NH PFML insurance benefits for the same days absent
• If a worker is eligible to receive workers’ compensation, they will not qualify for NH PFML insurance benefits
• NH PFML insurance will run concurrently with the federal Family and Medical Leave Act (FMLA) when a worker is eligible for qualifying leave under both programs
• Any other paid benefit coordination is based on employer policy, NH statute and rules of the carrier partner agreement
  • The rules of the carrier partner agreement are not stated

Statute:
N.H. Rev. Stat. Ann. §282-B:2.VI(e); §275:37-d NH PFML website

Leave/Benefits Year

Any of 4 leave year calculation methods can be used:

• Calendar year
• Any fixed 12-month period
• Measured forward
• Rolling back

Based on NH Rules Ins 8001.02(d)

Employer Notice Requirements

Because this is a voluntary program, there are no employer notice requirements. The state and its carrier partner have developed materials participating employers can use such as a poster and paycheck insert.

NH PFML website

Employee Notice Requirements

Because this is a voluntary program, there are no statutory employee notice requirements. Refer to the policy issued by the state’s carrier partner and/or company absence reporting procedures, if applicable.

Required Claim Documentation

• None specified by the statute. The state’s carrier partner will develop claim forms that will be made available to workers.
• Employers must provide wage and leave information, work schedules and other benefits information to the state’s carrier partner to support NH PFML insurance claims processing

NH PFML website

Job Protection

Employees of an employer with 50 or more total employees that sponsors a Granite State Plan are entitled to restoration to the same or an equivalent position following leave

Statute:
N.H. Rev. Stat. Ann. §275:37-d

Benefits Protection

Employees of an employer with 50 or more total employees that sponsors a Granite State Plan are entitled to continued health insurance during leave, with employees continuing to pay their share of costs

Statute:
N.H. Rev. Stat. Ann. §275:37-d

Reporting Requirements

Employers must provide wage and leave information, work schedules and other benefits information to the state’s carrier partner to support NH PFML insurance claims processing

NH PFML website

Appeals

The state plan offered through its carrier partner will provide rights to appeal adverse benefit determinations.

Details expected on NH PFML website

Private Plan Options

• Insured: Insurance carriers may develop their own paid family and medical leave insurance policies separate from the New Hampshire plan. Rules issued by the New Hampshire Insurance Department are available here: ins-8000-adopted.pdf (nh.gov)
• Company policy/self-funded: Nothing in the NH PFML law affects an employer’s ability to offer paid family leave or disability benefits outside of the NH PFML program
• No paid leave program other than the state plan offered through its carrier partner is eligible for the Business Enterprise Tax credit

ins-8000-adopted.pdf (nh.gov)

Administered By

• State plan: Division of Temporary Disability and Family Leave Insurance
• Private plans:
  • RSLI fully insured plans
  • Matrix self-funded plans

Covered Employer

• All New Jersey employers with one or more employees and a minimum payroll of $1,000 (i.e., those that are subject to the Unemployment Compensation Law)
• State of New Jersey (including Rutgers, The State University, and the New Jersey Institute of Technology)
• Limited exceptions for certain governmental entities

Statute:
NJ Rev Stat §43:21-27

Covered Employees & Employee Eligibility

• Full or part-time employee employed by a Covered Employer
• Established at least 20 base weeks during the base year or earned at least 1000 the state minimum wage in a base year
  • “Base week”: a calendar week where the employee earned at least 20 times the state minimum wage
  • “Base year”: first 4 of the last 5 completed calendar quarters before the employee files a claim
• For 2022:
  • Earned at least $240.00 per week for 20 calendar weeks during the base year or earned $12,000 in a base year
• For 2023:
  • Earned at least $260.00 per week for 20 calendar weeks during the base year or earned $13,000 in the base year
• Under the care of a licensed health care provider
• Former employees are covered if disability started less than 14 days after the employee’s last day of employment with a Covered Employer

Exclusions:

• Federal government employees
• Members of the New Jersey state police
• Workers who are not technically employees (such as properly classified independent contractors)

Statute:
NJ Rev Stat §43:21-27, 30, -41(2), -39(d)

Qualifying Benefits Reasons

Employee is unable to perform the duties of the position due to an off-the-job accident or sickness. Includes:

• Pregnancy
• Elective surgery (to remedy a sickness or injury)
• Organ or bone marrow donation
• Cosmetic surgery IF surgery is reconstructive in nature or necessary to correct a disabling condition
• Employee is the victim of domestic violence or a sexually violent offense and is unable to work due to a resulting physical or mental illness, injury, or disability
• Quarantine of the employee due to an illness caused by or known or suspected exposure to a communicable disease, ordered or recommended by a healthcare provider or public health authority during a state of emergency declared by public officials

Statute:
NJ Rev Stat §43:21-29
NJ Rev Stat §43:21-27(e)(1)

Waiting Period

• 7 consecutive days. Benefits begin on 8th consecutive day of disability
• If benefits are payable for 3 consecutive weeks, the first 7 days become payable
• No waiting period for disability resulting from organ or bone marrow donation
• No waiting period for disability resulting from quarantine, as described above in “Qualifying Benefits Reasons”

Statute:
NJ Rev Stat §43:21-38, -39

Relapse Period

If the employee has returned to work and experiences the same or related cause or condition separated by no more than 14 days from prior period of disability, it will be considered one continuous disability period

Statute:
NJ Rev Stat §43:21-27(g)(1)

Contribution Rate & Responsibility

2022:

• Employee Contribution: 0.14%
• Maximum Annual Contribution: $212.66 based on $151,900 wage limit
• Employer Contribution: Remaining portion of the total rate

2023:

• There will be no employee contribution for 2023

Benefit Amount

For periods of disability commencing on or after July 1, 2020

• Minimum Benefit: None
• Maximum Benefit: 85% of the employee’s average weekly wage, up to 70% of the state average weekly wage
  • 2022: $993
  • 2023: $1,025
• The maximum total benefits payable for any period of leave shall be either 26 times the individual’s weekly benefit amount or 1/3 of total wages in the base year, whichever is the lesser, computed in the next lower multiple of $1.00.

Statute:
NJ Rev Stat §43:21-40(b), §43:21-38(b)

Maximum Duration of Benefits/Leave

Up to 26 weeks with respect to any one period of disability.

Statute:
NJ Rev Stat §43:21-39

Increments of Leave Usage/Benefits

• Continuous
• Reduced schedule:
• Partial disability benefits available after 7 consecutive days of total disability
• Employer must agree to reduced schedule
• Available for up to 8 weeks, or up to 12 weeks if supported in writing by a qualified healthcare provider

Statute:
NJ Rev Stat §43:21-40

Interaction with Other Leaves and Benefits

• NJ Family Leave Insurance (FLI) – Cannot collect TDI and FLI concurrently
• Unemployment – Cannot collect TDI and unemployment insurance concurrently
• Workers’ compensation – Cannot collect TDI and workers’ comp concurrently, other than for permanent partial or permanent total disability previously incurred
• Employer Paid Leave – No TDI benefits are payable for any period during which the employee receives sick, vacation, or other leave at full pay from the employer.
  Sick pay received by employee will reduce TDI benefit amount; however employee not required to exhaust last week of sick leave prior to receiving TDI benefit (with exception of governmental employees)
• Social Security Disability – TDI does not affect eligibility for SSDI but TDI benefits cases upon date SSDI begins
• Social Security Retirement – TDI does not affect or offset SSI benefit
• Retirement, pension, or permanent disability benefit program to which most recent employer contributed – TDI benefits reduced by amount of payments received
• FMLA – Unpaid leave runs concurrently when applicable
• Other State Disability Benefits – TDI benefits reduced by the amount paid under the law of another state

Statute:
NJ Rev Stat §43:21-30
NJ Rev Stat §43:21-49(j)

Leave/Benefits Year

52 weeks immediately preceding the week in which the disability began

Employer Notice Requirements

• Post the Unemployment and Temporary Disability Benefits poster in a conspicuous place for all employees
• Within 9 days after employee is disabled or gives notice of an anticipated period of disability, issue to the employee and the Division the claim form with pertinent information completed Claim for Disability Benefit Form (Form DS-1)
• For further guidance see Employer and HR Professional Toolkit (nj.gov)

Statute:
NJ Rev Stat §43:21-49

Employee Notice Requirements

Employee must submit completed Claim for Disability Benefit Form (Form DS-1) within 30 days of the start of the disability. Failure to do so may result in the loss of some or all of their benefits.

Employee Claim Documentation

Filed with Employer or Insurance Carrier

• File with Division, or for a private plan, file with employer (self-funded) or insurance carrier (insured)
• For state plan, can be completed online at www.nj.gov/labor or employee can download and complete a paper form of Claim For Disability Benefits (Form DS-1).
• Employee completes Part A and must submit the Medical Certificate (Part B) for completion by the health care provider treating the employee. Employer completes Part C.

Job Protection

• Generally none
• Disability due to organ and tissue donation: employee entitled to restoration to same or equivalent position
• Job protection may be available under federal FMLA, if applicable

Statute:
NJ Rev Stat §43:21-29.2

Benefits Protections

• None
• Benefits protection may be available under federal FMLA, if applicable

Appeals

• State plan claims – appeal must be filed within 7 days after delivery or within 10 days after mailing of decision
• Private plans – appeal to Division within 1 year of start of period of claimed benefits period

Statute:
NJ Rev Stat §43:21-50

Private Plan Options

• Must be approved by the state. Options:
• Self-funded
• Insured y authorized and licensed insurer
• Pursuant to a collective bargaining agreement
• Information available from the Division of Temporary Disability and Family Leave Insurance | Information for Employers (nj.gov)

Statute:
NJ Rev Stat §43:21-32

Administered By

State – Division of Temporary Disability and Family Leave Insurance

Private Plan – Self-funded – Matrix will administer

Covered Employer

• All N.J. employers with one or more employees and a minimum payroll of $1,000 (i.e., those that are subject to the Unemployment Compensation Law).
• Limited exceptions for certain government entities.

Covered Employees & Employee Eligibility

• Full or part-time employee employed by a Covered Employer
• Established at least 20 base weeks during the base year or earned at least 1000 the state minimum wage in a base year
  • “Base week”: a calendar week where the employee earned at least 20 times the state minimum wage
  • “Base year”: first 4 of the last 5 completed calendar quarters before the employee files a claim
• For 2022:
  • Earned at least $240.00 per week for 20 calendar weeks during the base year or earned $12,000 in a base year
• For 2023:
  • Earned at least $260.00 per week for 20 calendar weeks during the base year or earned $13,000 in the base year
• Under the care of a licensed health care provider
• Former employees are covered if disability started less than 14 days after the employee’s last day of employment with a Covered Employer

Exclusions:

• Federal government employees
• Members of the New Jersey state police
• Workers who are not technically employees (such as properly classified independent contractors)

Statute:
NJ Rev Stat §43:21-27, 30, -41(2), -39(d)

Qualifying Leave/Benefits Reasons

• Bond with a newborn, newly adopted or newly placed foster child taken within a year after the birth or placement
• Care for a family member with a serious health condition
• Handle matters related to being a victim of domestic violence or a sexually violent offense
• If the employee is unable to work due to a physical or mental illness, injury, or disability related to domestic or sexual violence, the employee is covered by NJ TDB
• Matters related to domestic or sexual violence include without limitation medical treatment, counseling, victims’ services, legal assistance, and safety measures
• Care for a family member who is the victim of domestic violence or a sexually violent offense or tend to related matters
• Provide care to a family member due to a known or suspected exposure to a communicable disease, if the family member is quarantined by order or recommendation of a healthcare provider or public health authority during a declared state of emergency

Covered family relationships:

• Child (less than 19 years of age or 19 years or older but incapable of self-care because of mental or physical impairment)*
• Parent*
• Spouse
• Domestic partner/civil union
• Grandparent
• Grandchild
• Sibling
• Any other individual related by blood
• any other individual that the employee shows to have a close association with the employee which is the equivalent of a family relationship

* Note: These relationships include biological, foster, adoptive, step, surrogacy, and legal ward relationships and the same relationships to the employee’s spouse or domestic partner, if applicable

Statute:
NJ Rev Stat §43:21-27(o), -39.3(c); NJ ST 34:11B-3 NJ Rev Stat §12:21-1.2

Waiting Period

None

Statute:
NJ Rev Stat §43:21-38

Relapse Period

• No official relapse period since there is no waiting period for FLI claims.
• Employee with a continued or recurrent need for family leave for the same reason should complete the Family Leave Insurance Continued Claim Certification form (FL3). The claim is extended if the request is received with supporting documentation.

Contribution Rate & Responsibility

2022:

• Employee Contribution: 0.14% on $151,900 wage limit
• Maximum Annual: $212.66
• 100% employee-paid contribution

2023:

• Employee Contribution: 0.06% on $156,800 wage limit
• Maximum Annual: $94.08

Benefit Amount

For periods of disability commencing on or after July 1, 2020

• Minimum Benefit: None
• Maximum Benefit: 85% of the employee’s average weekly wage, up to 70% of the state average weekly wage
• 2022: Maximum of $993 per week.
• 2023: Maximum of $1,025 per week.
• The maximum total benefits payable for any period of leave shall be 12 times the individual’s weekly benefit amount, computed in the next lower multiple of $1.00.

Statute:
NJ Rev Stat §43:21-40(b), §43:21-38(b)

Maximum Duration of Benefits/Leave

• Continuous leave: 12 weeks (84 days) during a 12-month period
• Intermittent leave: 8 weeks (56 days) in a 12-month period
• Maximum of 12 weeks in a 12-month period for all leaves, continuous and/or intermittent.

Statute:
NJ Rev Stat §43:21-38

Increments of Leave Usage/Benefits

• Intermittent Leave (full day increments): up to 8 weeks
• Continuous leave: up to 12 weeks

Maximum leave is 12 weeks in a 12-month period

Statute:
NJ Rev Stat §43:21-38

Interaction with Other Leaves and Benefits

• NJ TDI – Cannot collect TDI and FLI concurrently
• Unemployment – Cannot collect Unemployment and FLI concurrently.
• Employer Paid Leave – No FLI benefits are payable for any period during which the employee receives sick, vacation, or other leave at full pay from the employer
• Social Security Retirement – FLI does not affect or offset SSI benefit
• FMLA – Runs concurrently if applicable
• NJ Family Leave Act – Runs concurrently if applicable

Statute:
NJ Rev Stat §43:21-39.1(b) and (c), -39

Leave/Benefits Year

365 consecutive days from the first day of leave (also referred to as “12 month period”)

Statute:
NJ Rev Stat §43:21-27(t)

Employer Notice Requirements

• Post the provisions of the New Jersey Family Leave Law poster in a conspicuous place for all employees.
• Within 9 days after employee takes FLI leave or gives notice of intent to take FLI leave, issue to the employee and Division claim form with pertinent information completed
• Provide information on how to file a claim to the employee or give the employee an application for Family Leave Benefits (form FL-1) Form

Statute:
NJ Rev Stat §43:21-39.1

Employee Notice Requirements

• Employee must submit a complete claim form (FL-1) within 30 days from the first day of family leave. Failure to do so may result in the loss of some or all benefits.
• Bonding leave: Employee must give employer 30 days’ advance notice of continuous leave and 15 days’ advance notice of first usage of intermittent leave

Statute:
NJ Rev Stat §43:21-39.1, -39.3

Employee Claim Documentation

• File with Division, or for a private plan, file with employer (self-funded) or insurance carrier (insured)
• Claims can be completed online at myleavebenefits.nj.gov or the employee can download and complete a paper form for Family Leave Benefits (form FL-1).
• Employee completes Parts A and B
• Part C is completed by the care recipient and their doctor if the leave is to care for a family member

Statute:
NJ Rev Stat §43:21-39.1

Job Protection

None – However, job protection may be available under NJFLA or federal FMLA if applicable

Benefits Protections

None – However, benefits protection may be available under NJFLA or federal FMLA if applicable

Appeals

• State plan claims – appeal must be filed within 7 days after delivery or within 10 days after mailing of decision
• Private plans – appeal to Division within 1 year of beginning of claimed benefits period

Statute:
NJ Rev Stat §43:21-50

Private Plan Options

• Must be approved by the state. Options:
• Self-funded
• Insured by authorized and licensed insurer
• Pursuant to a collective bargaining agreement
• Information available from the Division of Temporary Disability and Family Leave Insurance | Information for Employers (nj.gov)

Statute:
NJ Rev Stat §43:21-32

Administered By

Managed by the State of Rhode Island Department of Labor and Training

No Private Plan Option

Covered Employer

Any non-government employing unit that has employed one or more individuals for any portion of a day

• Employing unit: any person, partnership, association, trust, estate, or corporation, whether domestic or foreign, or its legal representative, trustee in bankruptcy, receiver, or trustee, or the legal representative of a deceased person

Political subdivisions and/or instrumentalities of political subdivisions may elect coverage.

Covered Employees & Eligibility

• Non-monetary eligibility: Worked for a Rhode Island covered employer
• Monetary eligibility:
• Meet all 3 of these requirements:
• One quarter of base period wages of at least $2,600 in 2023 (was $2,450 in 2022) and
• Total base period wages of at least 1.5 times the highest quarter earnings, and
• Total base period earnings of at least $5,200 in 2023 (was $4,900 in 2022);

OR

• Earn $15,600 in 2023 in base period wages (was $14,700 in 2022)
• Base period: The first 4 of the most recently completed 5 calendar quarters immediately preceding the first day of an individual's benefit year; or, if eligibility is not established under this measure, the last four 4 completed calendar quarters immediately preceding the first day of the claimant's benefit year

Qualifying Leave/Benefits Reasons

Employee’s own illness or injury unrelated to work, including pregnancy, childbirth, miscarriage, or abortion

Waiting Period

Must be out of work for 7 days, but benefit is payable since first day out

Relapse Period

None

Contribution Rate & Responsibility

2022: Employee wage deductions of 1.1% of first $81,500 earned

2023: Employee wage deductions of 1.1% of first $84,000 earned

Benefit Amount

Prior to July 1, 2022:

• 4.62% of the wages earned during the highest quarter of the base year
• Minimum weekly benefit: $107
• Maximum weekly benefit: $978
• Dependent's allowance: Greater of $10 or 7% of weekly benefit rate (up to 5 dependents), up to maximum of $1,320 per week

After July 1, 2022:

• 4.62% of the wages earned during the highest quarter of the base year
• Minimum weekly benefit: $121
• Maximum weekly benefit: $1,007
• Dependent's allowance: Greater of $10 or 7% of weekly benefit rate (up to 5 dependents), up to maximum of $1,359 per week

Maximum Duration of Benefits/Leave

• 30 weeks per benefit year
• Combined total of TDI and TCI cannot exceed 30 weeks per benefit year

Increments of Leave Usage/Benefits

No intermittent leave; however, can return to work on a reduced schedule if medically supported, for 8 weeks, but not to exceed 12 weeks

Interaction with Other Leaves & Benefits

• RI TCI – combined amount of RI TCI and RI TDI cannot exceed a total of 30 weeks within the benefit year. Cannot take RI TDI at same time as RI TCI.
• Vacation, sick pay, salary, etc. – Employee can receive TDI benefit while receiving pay from employer
• Unemployment – Cannot collect RI TDI and unemployment insurance concurrently
• Workers’ Compensation – Cannot collect RI TDI and Workers’ Compensation concurrently
• Social Security – RI TDI does not affect right to SSA benefits
• FMLA – Will apply concurrently with RI TDI, if applicable

Leave/Benefits Year

52 weeks starting on the Sunday of the week in which employee became unable to work

Employer Notice Requirements

Display approved poster where all employees can see it, or email or text poster link to remote workers

Required Posters For the Workplace - Rhode Island - Department of Labor and Training (ri.gov)

Employee Notice Requirements

Must file with the Department of Labor and Training within 90 days of the first week of taking leave

Employee Claim Documentation

• Qualified Healthcare Provider (QHP) must certify the patient functionally unable to perform their customary and regular work duties and provide the length of time the patient is expected to be unable to work
• For eligibility to begin the first day he/she is disabled, the patient must have an in-office examination by a licensed QHP that week, the week before or the week after the disability began
• May require assessment by Impartial Medical Examiner

Claim Filing

File with the State of Rhode Island Department of Labor and Training

Job Protection

None, but may be eligible for protection under FMLA if applicable

Benefits Protections

None, but may be eligible for protection under FMLA if applicable

Voluntary Plan Options

None

Administered By

Managed by the State of Rhode Island Department of Labor and Training

No Private Plan Option

Covered Employer

Any non-government employing unit that has employed one or more individuals for any portion of a day

• Employing unit: any person, partnership, association, trust, estate, or corporation, whether domestic or foreign, or its legal representative, trustee in bankruptcy, receiver, or trustee, or the legal representative of a deceased person

Political subdivisions and/or instrumentalities of political subdivisions may elect coverage.

Covered Employees & Eligibility

• Non-monetary eligibility: Worked for a Rhode Island covered employer
• Monetary eligibility:
• Meet all 3 of these requirements:
• One quarter of base period wages of at least $2,600 in 2023 (was $2,450 in 2022) and
• Total base period wages of at least 1.5 times the highest quarter earnings, and
• Total base period earnings of at least $5,200 in 2023 (was $4,900 in 2022);

OR

• Earn $15,600 in 2023 in base period wages (was $14,700 in 2022)
• Base period: The first 4 of the most recently completed 5 calendar quarters immediately preceding the first day of an individual's benefit year; or, if eligibility is not established under this measure, the last four 4 completed calendar quarters immediately preceding the first day of the claimant's benefit year

Qualifying Leave/Benefits Reasons

• Care for a child, parent, parent-in-law, grandparent, spouse or domestic partner who has a serious health condition, or
• Bonding with a newborn or newly placed child for adoption or foster care within the first year of birth or placement

Waiting Period

Must be out of work for 7 days, but benefit is payable since first day out

Relapse Period

None

Contribution Rate & Responsibility

2022: Employee wage deductions of 1.1% of first $81,500 earned

2023: Employee wage deductions of 1.1% of first $84,000 earned

Benefit Amount

Prior to July 1, 2022:

• 4.62% of the wages earned during the highest quarter of the base year
• Minimum weekly benefit: $107
• Maximum weekly benefit: $978
• Dependent's allowance: Greater of $10 or 7% of weekly benefit rate (up to 5 dependents), up to maximum of $1,320 per week

After July 1, 2022:

• 4.62% of the wages earned during the highest quarter of the base year
• Minimum weekly benefit: $121
• Maximum weekly benefit: $1,007
• Dependent's allowance: Greater of $10 or 7% of weekly benefit rate (up to 5 dependents), up to maximum of $1,359 per week

Maximum Duration of Benefits/Leave

• 4 weeks per benefit year
• Increases to 5 weeks per benefit year starting 01/01/2022
• Increases to 6 weeks per benefit year starting 01/01/2023
• Combined total of TCI and TDI cannot exceed 30 weeks per benefit year

Increments of Leave Usage/Benefits

Continuous leave only

Interaction with Other Leaves & Benefits

• RI TDI – combined amount of RI TDI and RI TCI cannot exceed a total of 30 weeks within the benefit year. Cannot take RI TDI at same time as RI TCI.
• Unemployment – Cannot collect RI TCI and unemployment insurance concurrently
• Workers’ Compensation – Cannot collect RI TCI and Workers’ Compensation concurrently
• Social Security – RI TCI does not affect right to SSA benefits
• FMLA – Will apply concurrently with RI TCI
• RI Parental and Family Medical Leave – Will apply concurrently with RI TCI if applicable

Leave/Benefits Year

52 weeks starting on the Sunday of the week in which employee became unable to work

Employer Notice Requirements

Display approved poster where all employees can see it, or email or text poster link to remote workers

Required Posters For the Workplace - Rhode Island - Department of Labor and Training (ri.gov)

Employee Notice Requirements

Must give employer 30 days notice, unless unforeseeable. Must apply with State within 30 days after the first day of leave is taken for caregiving or bonding.

Employee Claim Documentation

• For care of a family member, a certification including diagnosis, date condition commenced, probable duration, estimate of time needed to care for family member and a statement that the serious health condition of the family member warrants the participation of the employee
• For bonding, a birth certificate, certificate of adoption or other competent evidence

Claim Filing

File with the State of Rhode Island Department of Labor and Training

Job Protection

Job restoration to the same or position with equivalent seniority, status, employment benefits, pay, fringe benefits, service credits, and other terms and conditions of employment

Benefits Protections

Must maintain any existing health benefits of the employee during leave on same terms as during active employment, including employee payment of share of cost, if applicable.

Voluntary Plan Options

None

Administered By

State plan: Employment Security Department (ESD)

Private plan:

• Self-funded plans – Matrix
• Insured plans not permitted

Covered Employers & Entities

Covered Employers:

• All private employers with 1 or more employees in Washington
• State and municipal governments and agencies
• Federal government exempted
• Self-employed individuals and federally recognized tribes can opt in
• WA PFML does not apply to employers covered by a collective bargaining agreement (CBA) in effect prior to 10/19/2017
• Employers covered by a CBA that expired, went into effect, or was reopened or renegotiated on or after 10/19/2017 must comply with WA PFML
• Employers may have different employee populations under different CBAs and/or no CBA

Statutes:
RCW 50A.05.010​(7)(a), (b)
RCW 50A.05.090
RCW 50A.10.010, .020

Regulation:
WAC 192-500-010

Covered Employees & Employee Eligibility

State plan:

• Employees who have worked 820 hours in the qualifying period
• The 820 hours can be with any Washington employer

Voluntary plan:

• Employees who have worked 820 hours in the qualifying period for any Washington employer AND
• Employees who have worked 340 hours for the current employer qualifying period (included in the 820 hours)
• Exception:When employee moves from one employer to another, and both have a voluntary plan, employee is immediately eligible under the new employer’s voluntary plan "Qualifying period:"
• The first 4 of the last 5 completed calendar quarters or, if eligibility is not established, then
• The last 4 completed calendar quarters immediately preceding the application for leave

"Qualifying period:"

• The first 4 of the last 5 completed calendar quarters or, if eligibility is not established, then
• The last 4 completed calendar quarters immediately preceding the application for leave

Employee Pandemic Leave Assistance:

• Available upon application directly to the state;
• Payable through a special state fund; not paid from regular state PFML program or private plans):
  Available to employees who did not meet eligibility from 01/01/2021 through 03/31/2022 due to the impact of COVID-19
  • 820 hours during the 1st through 4th quarters of 2019; or
  • 820 hours during the 2nd through 4th quarters of 2019 and 1st quarter of 2020

Statutes:
RCW 50A.05.010​(5), (8), (20)
RCW 50A.15.010
RCW 50A.30.020

Regulation:
WAC 192-530-030

Qualifying Leave/Benefits Reasons

Medical Leave:

• Employee’s own serious health condition

Family Leave:

• Bonding (birth, adoption, placement for foster care)
• Care for a family member with a serious health condition
• Qualifying military exigencies arising from a family member's active duty military service or call to active duty

Postnatal Period Leave (effective June 9, 2022)

• Any leave taken by the birth mother in the first 6 weeks following the birth of a child is subject to the maximum family or medical leave duration and will be counted as medical leave except when: 1) medical leave is fully or partially exhausted prior to the child’s birth; or 2) employee chooses to use family leave, if available, for the postnatal period. Birth mothers who are not eligible or will not be eligible for family leave to bond may only use medical leave for the postnatal period. Birth mothers taking leave during the postnatal period are not required to provide a medical certification

Limited Bereavement Leave (effective June 9, 2022)

• Leave for 7 calendar days following the death of a family member for whom the employee would have been eligible to bond with or was bonding with. This leave is available for up to 7 calendar days beginning the day after the date of the child’s death or delivery of the deceased child

“Family member” includes the employee’s:

• Spouse (including state registered domestic partnership)
• Child*, including child's spouse, regardless of age or dependency status
• Grandchild
• Grandparent
• Parent*, including parent of employee's spouse
• Sibling
• Any individual who regularly resides in the employee's home with an expectation that the employee care for the individual.**
• Any individual whose relationship with the employee creates an expectation of care and that individual depends on the employee for care.**

* “Child” and “Parent” include biological, adoptive, de facto, foster, step, in-law, legal guardianship, and in loco parentis relationships
**Effective 07-24-2021

Statutes:
RCW 50A.05.010​(2), (10), (11), (12), (13), (15), (17), (19) RCW 50A.15.020 (4)

Regulation:
WAC 192-500-080, -190
WAC 192-610-025

Waiting Period

7 consecutive calendar days

• Starts on the Sunday prior to employee’s first day of qualifying leave
• Employee must take at least 8 consecutive work hours of leave in a week to satisfy the waiting period
• Only one waiting period per claim year
• There is no waiting period for:
  • Medical leave taken upon the birth of a child
  • Family leave for bonding
  • Military exigencies
  • Bereavement leave for the loss of a child within 1 year of birth or placement
• Employee can use accrued paid time off during waiting period
• Waiting period does not reduce the maximum duration of an employee’s available paid family or medical leave

Statutes:
RCW 50A.15.020​(1)(a)

Regulation:
WAC 192-500-185

Contribution Rate & Responsibility

For 2022: 0.6% of employee’s gross wages

• Premium for family leave = 1/2 of total premium; employee is responsible for all
• Premium for medical leave = 1/2 of total premium; employee pays 45%, employer pays 55%
• Of the total premium, employee pays 73.22% and employer pays 26.78%
• Exemption: Employers with fewer than 50 employees in Washington can opt out of paying employer share of premium contributions, but still must: (1) collect or cover employee's share and remit to ESD; and (2) provide job-protected leave
• Employer can elect to cover some or all of employee’s share of premiums
• Employee’s income subject to premium is capped at Social Security taxable wages ($147,000 for 2022)

For 2023: 0.8% of employee’s gross wages

• Premium for family leave = 1/3 of total premium; employee is responsible for all
• Premium for medical leave = 2/3 of total premium; employee pays 45%, employer pays 55%
• Of the total premium, employee pays 72.76% and employer pays 27.24%
• Exemption: Employers with fewer than 50 employees in Washington can opt out of paying employer share of premium contributions, but still must: (1) collect or cover employee's share and remit to ESD; and (2) provide job-protected leave
• Employer can elect to cover some or all of employee’s share of premiums
• Employee’s income subject to premium is capped at Social Security taxable wages ($160,200 for 2023)

Total premium amount can change annually based on the state’s family and medical leave insurance account balance ratio as of September 30 of each year, effective the next January 1

Statutes:
RCW 50A.10.030​(1)(b) & (c), (3)(a), (b), (c) & (d), (4), & (5)

Regulation:
WAC 192-510-040

Benefit Amount

• Adjusted annually, effective the next January 1
• Employees who make 50% or less than the state’s average weekly wage (AWW) will receive 90% of the employee’s AWW
• Employees who make greater than 50% of the state’s AWW will receive:
  • 90% of 50% of the Statewide AWW; PLUS
  • 50% of the difference of the employee’s AWW and 50% of the state’s AWW (subject to the maximum)
• Maximum benefit is 90% of the state’s AWW
  • For 2022:
    • State’s AWW: $1,475
    • Maximum: $1,327 per week
    • Minimum: $100 per week (or employee’s actual wages if less)
  • For 2023:
    • State’s AWW: $1,586
    • Maximum: $1,427 per week per week
    • Minimum: $100 per week (or employee’s actual wages if less)
• Leave taken on intermittent or reduced schedule: Benefit amount prorated accordingly
• Benefits calculator: Estimate your weekly pay – Washington State's Paid Family and Medical Leave

Statutes:
RCW 50A.15.020​(2), (4), (5)

Regulation:
WAC 192-620-035, -040

Maximum Duration of Benefits

Per claim year:

• Medical leave – 12 weeks
• Additional 2 weeks available if employee experiences a serious health condition with a pregnancy that results in incapacity
• Family leave for bonding, care for a family member, and military exigencies – 12 weeks
• Total for all leave reasons combined – 16 weeks
• Additional 2 weeks available if employee experiences a serious health condition with a pregnancy that results in incapacity for a total of 18 weeks

Statutes:
RCW 50A.15.020​(3)

Regulation:
WAC 192-620-026

Increments of Leave Usage/Benefits

• An employee must take at least 8 consecutive hours of leave in a week to qualify for benefits that week:
• "Week": Seven consecutive calendar days beginning on Sunday 12:00 a.m. and ending at 11:59 p.m. the following Saturday
• If the employee satisfies the 8 consecutive hours in a week, all other time taken in the same week is payable
• Leave taken in less than full hour increments is rounded down to the next lower full hour.
• These increments are applicable to all WA PFML leave reasons.
• The weekly WA PFML benefit will be prorated in accordance with the hours or days taken as leave compared to the employee’s typical workweek hours.

Statutes:
RCW 50A.15.020​(1), (2), (2)(b) & (c)

Regulation:
WAC 192-500-110
WAC 192-620-005, -035, -040

Interaction with Other Leaves and Benefits

• Paid time off benefits:
• Can be used during the waiting period without penalty
• WA PFML benefits will be reduced or prorated if during the WA PFML leave the employee receives other paid leave such as vacation leave, sick leave, or other paid time off that is not designated as a supplemental benefit payment by the employer
• A “supplemental benefit payment” can be used concurrently with WA PFML (e.g., to top off WA PFML benefits up to 100% of the employee’s AWW) without reduction of WA PFML benefits:
• “Supplemental benefit payment”: A payment offered by employer to an employee who is taking WA PFML leave
• Employer can elect to designate paid benefits as a supplemental benefit, including but not limited to, salary continuation, vacation leave, sick leave, or other paid time off
• Employer cannot require employee to use supplemental benefit payments during WA PFML leave
• Company-provided short-term & long-term disability benefits:
• Receipt of disability benefits does not affect an employee’s entitlement to WA PFML
• WA PFML can serve as an offset against disability plan benefits, determined by the terms of the plan
• Paid sick leave: Employee can elect but cannot be required to use paid sick leave in lieu of WA PFML and/or during the WA PFML waiting week.
• FMLA:
• An employee cannot be required to take WA PFML for a covered leave reason; the employee can take leave for a reason covered by both FMLA and WA PFML but choose to defer WA PFML benefits and job-protected leave until a later date
• If an employee elects to use WA PFML, FMLA will run concurrently if the employee’s leave is covered by both statutes
• Paid Disability Leave (PDL)
• An employee cannot be required to take WA PFML for a covered leave reason; the employee can take leave for a reason covered by both PDL and WA PFML but choose to defer WA PFML benefits and job-protected leave until a later date
• PDL will run concurrently if the employee’s leave is covered by both statutes
• State and federal benefits laws do not run concurrently with WA PFML:
• WA PFML benefits are in addition to benefits provided by unemployment, workers’ compensation, or disability insurance laws
• Employee is disqualified from receiving WA PFML benefits during any week in which the employee received/will receive such benefits
• State leave laws:
• Washington repealed its Family Leave Act to coincide with the effective date of the PFML law
• WA Military Family Leave (available to the spouse or domestic partner of a military member) may run concurrently with WA PFML if both statues are applicable

Statutes:
RCW 50A.15.060​(2)
RCW 50A.15.100, .110

Regulation:
WAC 192-620-005, -035, -040
WAC 192-500-180
WAC 192-610-075

Leave/Benefits Year

"Claim year:" 52 consecutive weeks beginning on the Sunday of the week an eligible employee files a complete initial application for benefits

Statutes:
RCW 50A.15.065

Regulation:
WAC 192-500-070

Employer Notice Requirements

Posting:

• Poster in a conspicuous place in each workplace
• Poster provided by ESD: Your role and responsibilities – Washington State's Paid Family and Medical Leave

Individual notice:

• Written notice of WA PFML rights must be provided when an eligible employee is absent from work for a covered reason for more than 7 consecutive days
• Provided within 5 business days after the employee's 7th consecutive day of absence, or within 5 business days after the employer has received notice that the employee's absence is due to family or medical leave, whichever is later
• Use form provided by ESD: Paid-Leave-ER-notice-to-EE-2021-03-01.pdf (wa.gov)

Statutes:
RCW 50A.20.010, .020

Regulation:
WAC 192-540-010, .020

Employee Notice Requirements

• Foreseeable leave: 30 days’ advance notice
• Unforeseeable leave: As soon as practicable
• Leave for military exigency: As soon as practicable even if greater than 30 days

Statutes:
RCW 50A.05.020​(5)

Regulation:
WAC 192-600-005

Required Claim Documentation

• Medical leave: Certification from a health care provider
• Postnatal Leave: Birth certificate, certification from the child’s health care provider, or other sufficient documentation to verify birth
• Bereavement Leave: Certification from the child’s health care provider, or other sufficient documentation to verify birth or death
• Bonding leave: Birth certificate, certification from the child’s health care provider, or court orders
• Care for a family member with a serious health condition: Certification from the family member’s health care provider
• Qualifying military exigencies: Active duty orders and other information to substantiate the qualifying event
• Documentation of family relationship may also be requested

Statutes:
RCW 50A.15.040​(1)(e), (g)

Regulation:
WAC 192-610-020, -025, -030, -035

Job Protection

Restoration to employee’s same or equivalent job following leave

• State plan: Employee worked 12 months with employer and 1,250 hours in 12 months preceding leave
• Voluntary plan: Employee worked 9 months with employer and 965 hours for that same employer in 12 months preceding leave
• Key employee provision applies to top 10% paid salaried employees

Statutes:
RCW 50A.30.010​(5)(h)
RCW 50A.35.010

Regulation:
WAC 192-700-005

Benefits Protections

• No loss of any employment benefits accrued before leave start date (e.g., insurance, PTO, education and retirement benefits).
• Continuation of health insurance benefits during WA PFML leave under same conditions as during active employment if any part of the leave is also covered by FMLA.

Statutes:
RCW 50A.35.010, .020

Regulation:
WAC 192-700-020

Reporting Requirements

Employers: Quarterly employment and wage detail reports must be sent to ESD

Statutes:
RCW 50A.20.030
RCW 50A.30.080

Regulation:
WAC 192-540-030, -040, -050

Appeals

Appeals of denial of benefits, plan revocations, or other adverse decisions are made to the ESD

• Includes appeals from voluntary plan decisions

Statutes:
RCW 50A.50.010 et seq.

Regulation:
WAC 192-500-040
WAC 192-800-005 et seq.

Voluntary Plan Options

• Must be equal to or better than state plan, with no greater burdens to employee
• Self-funded plans only; must maintain employee funds (if any) in a separate trust account
• Initial plan valid for 1 year; must get annual reapproval for first 3 years; then reapproval only required if plan is changed (other than statutorily required changes)

Voluntary plans – Washington State's Paid Family and Medical Leave

Statutes:
RCW 50A.30.010 et seq.

Regulation:
WAC 192-530-010 et seq.

Administered By

State plan: Paid Leave Oregon and Frances Online

Private plan:

• RSLI – Insured plans
• Matrix – Self-funded plans; RSL-insured plans for joint clients

Covered Employer & Business Entity

All employers.

• Includes political subdivisions of the state, county, city, district, authority, or public corporation
• Does not include the federal government
• Does not include a tribal government unless it has elected to provide coverage

Statute:
O.R.S. §657B.010(14)

Covered Individuals & Employee Eligibility

Covered Individual:

• An eligible employee
• A self-employed individual (if opts in and meets certain requirements) or
• An employee of a tribal government (if tribe elects to provide coverage)

Eligible Employee: Earned at least $1,000 in wages during the base year or alternate base year

• Base Year: First 4 of the last 4 completed calendar quarters preceding the benefit year
• Alternate Base Year: Last 4 completed calendar quarters preceding the benefit year

Statute:
O.R.S. §657B.010(1), (3), (8), (11)
O.R.S. §657B.015

Rules:
OAR 471-070-1010

Qualifying Leave/Benefits Reasons

• Medical Leave (employee’s own serious health condition)
• Family Leave:
• Bonding (birth, adoption, placement for foster care)
• Care for a family member with a serious health condition
• Safe Leave: Matters related to the employee or employee’s minor child as a victim of domestic violence, harassment, sexual assault, or stalking
• Specifically excludes other leave reasons covered by OFLA (sick child, bereavement) and military spousal leave

“Family member” includes the following relationships to the employee:

• Spouse
• Domestic partner
• Child (any age; biological, adopted, step, foster, legal ward, in loco parentis) or the child's spouse or domestic partner
• Parent (biological, adoptive, step, foster, legal guardian, in loco parentis), the parent's spouse or domestic partner, or the parent of the employee’s spouse or domestic partner
• Sibling or stepsibling, or the sibling's or stepsibling's spouse or domestic partner;
• Grandparent or the grandparent's spouse or domestic partner;
• Grandchild or the grandchild's spouse or domestic partner;
• Any individual related by blood or affinity whose close association with the employee is the equivalent of a family relationship.

Statute:
O.R.S. §657B.010(17), (19), (21)
O.R.S. §657B.020(1)
O.R.S. §657B.010(6), (18), (20)

Rules:
471-070-1000, 471-070-1010, 471-070-1100

Required Claim Documentation

• For all leaves: A completed application containing the information described in OAR 471-070-1100 (Batch 3 Rules, Benefits)
• Medical leave: Certification from a health care provider
• Family leave to care for or bond with a child during first year after birth: Birth certificate, Consular Report of Birth Abroad, document from the child’s or pregnant parent’s health care provider, hospital admission form or other sufficient documentation
• Family leave to care or bond with a child during first year of placement: court order verifying placement, letter signed by the attorney representing the prospective foster or adoptive parent confirming placement, document from the foster care, adoption agency, or social worker involved in the placement that confirms the placement, a document for the child issued by the United States Citizenship and Immigration Services, or other sufficient documentation
• Family Leave to care for a family member with a serious health condition: Certification from the family member’s health care provider
• Safe Leave: Government report or formal complaint to schools’ Title IX Coordinator, protective order or other evidence from a court, administrative agency, school’s Title IX Coordinator, or attorney of court proceedings related to domestic violence, harassment, sexual assault, or stalking; documentation of treatment or counseling, obtaining services, or relocating as a result of domestic violence, harassment, sexual assault, or stalking. If there is good cause for not providing the safe leave documentation, a statement attesting that employee is taking eligible safe leave
• Two additional weeks of leave for limitations due to pregnancy, childbirth, or related medical condition: Documentation that employee is currently pregnant or was pregnant within the year prior to the start of leave

Statute:
O.R.S. §657B.090(1)(a)

Rules:
OAR 471-070-1100
OAR 471-070-1110
OAR 471-070-1120
OAR 471-070-1130
OAR 471-070-1200
OAR 471-070-1210

Waiting Period

None

Contribution Rate & Responsibility

Contributions start January 1, 2023

• Employers without an approved equivalent plan must set aside employee contributions in a separate bank account and pay the employee and employer contributions to Paid Leave Oregon by the 30th day following the close of each quarter
• Total rate for employer and employee contributions are set at 1% (note: may not exceed 1% of employee wages)
  • 2023: Subject to maximum of $132,900 of employee’s wages
  • 2024 and after: the maximum wage amount is adjusted by the annual percentage increase in the August Consumer Price Index for All Urban Consumers West Region as Published by the Bureau of Labor Statistics of the U.S. Department of Labor
  • Contribution rate and maximum wage amount announced by the Director by November 15 each year
• Of total rate, employer pays 40% and employee pays 60%
• Employers with fewer than 25 employees are exempt from paying employer contribution
• But if a small employer elects to pay the employer contribution, is eligible for grants from the state

Statute:
O.R.S. §657B.150, .200

Rules: OAR 471-070-1000, OAR 471-070-3000 - 3340

Benefit Amount

Benefits start September 3, 2023

• Maximum benefit: 120% of state Average Weekly Wage (AWW)
• Minimum benefit: 5% of state AWW
• Employees who make 65% or less than the state AWW are paid 100%
• Employees who make greater than 65% of state AWW are paid:
• 100% of 65% of the state AWW – PLUS – 50% of the employee’s AWW over 65% of the state AWW

Statute:
O.R.S. §657B.050

Rules: OAR 471-070-1000 - 1100; 471-070-0400 -00465 (wages)

Maximum Duration of Leave & Benefits

Per benefit year:

• 12 paid weeks for all covered leave reasons in a benefit year
• 2 additional paid weeks for limitations related to pregnancy, childbirth, or a related medical condition (including lactation)
• 4 additional weeks UNPAID for any reason covered by Oregon Family Leave Act (employee’s SHC, family member SHC, mildly ill child, bonding, bereavement)

Maximum total: 18 weeks per benefit year (14 paid, 4 unpaid)

Statute:
O.R.S. §657B.020

Rules:
OAR 471-070-1000 OAR 471-070-1030

Increments of Leave Usage/Benefits

• Benefits are payable for leave taken in increments equivalent to 1 work day or 1 work week
• Employee may request leave in either consecutive or nonconsecutive periods
• Increments of 1 work day may be taken in nonconsecutive periods of leave
• Benefits will be paid in increments equivalent to 1 work week
• Workday increments shall be paid a prorated benefit amount based upon the number of work days of leave taken in the work week
• Increments of less than a full work week: Limited per week to the average number of work days typically worked per week by employee
• The total benefit amount paid for leave taken in increments is calculated by multiplying the benefit amount paid for a workday by the number of work days of leave taken for the work week, rounded to the nearest whole cent, and not to exceed the weekly benefit amount

Statute:
O.R.S. §657B.090

Rules:
OAR 471-070-1000
OAR 471-070-1100
OAR 471-070-1420
OAR 471-070-1440

Interaction with Other Leaves and Benefits

• Employee eligibility for workers’ compensation or unemployment benefits in any week disqualifies the employee from receiving PFMLI benefits in that week
• Interaction with disability plans and benefits not addressed
• PFMLI runs concurrently with FMLA and Oregon Family Leave Act, if applicable
• PFMLI benefits are in addition to paid sick time under ORS §653.606
• Leave taken under PFML is in addition to paid vacation or other paid time off earned by the employee
• Employer may allow employee to use paid sick time, vacation leave or other paid leave earned by the employee to replace wages up to 100% of employee’s AWW

Statute:
O.R.S. §657B.025, .030

Leave/Benefits Year

52 consecutive weeks beginning the Sunday before leave commences;

or

53 weeks if necessary to avoid overlap with any quarter of the base year on a previously filed claim

Statute:
O.R.S. §657B.010(5) (a)-(b)

Rules:
OAR 471-070-1000

Employer Notice Requirements

By January 1, 2023, provide this Model notice

• Notice must be in the language the employer typically uses to communicate with the employee
• Post at all worksites and provide to remote employees.
• Equivalent plan notices are required and can be found on Paid Leave Oregon's Resources page under "More Resources" as "Equivalent Plan Model Notice Template"

Statute:
O.R.S. §657B.440

Rule: OAR 471-070-1300;
OAR 471-070-2330

Employee Notice Requirements

• Written notice 30 days in advance for foreseeable leave
• Less than 30 days’ notice if leave is not foreseeable (examples: unexpected serious health condition of employee or family member, premature birth, unexpected placement for adoption or foster care, or safe leave)
• If employee commences leave without prior notice, must give oral notice within 24 hours and written notice within 3 days
• Advance notice for safe leave not required if not feasible

Statute:
O.R.S. §657B.040

Rule:
OAR 471-070-1310

Job Protection

For employees employed 90 days or more before leave, reinstatement to same or equivalent position

• Based on business necessity, employers with fewer than 25 employees may restore employee to a different position with similar duties and same benefits and pay

Statute:
O.R.S. §657B.060

Benefits Protections

Maintenance of health benefits during leave under same conditions as if actively working

Statute:
O.R.S. §657B.060

Rule:
OAR 471-070-1330

Reporting Requirements

Quarterly report of wages earned and contributions paid

Statute:
O.R.S. §657B.150(12)

Rule: OAR 471-070-3030

Appeals

State plan: Affected party may request a hearing of a final decision by the Director regarding:

• Employer: Application for an equivalent plan
• Employee: Approval or denial of a claim for PFMLI benefits, weekly benefit amount, or disqualification from benefits (including repayment)

Equivalent plans:

• Employee: 20 days from date of written denial to request appeal.
• Employer, employee, or administrator have 20 days from date appeal is received to resolve the appeal and for the employer or third-party administrator to issue a written appeal determination letter
• If unable to resolve the appeal, employee has 20 days to request dispute resolution assistance through Oregon Employment Department
• Department must issue advisory decision within 20 days

Statute:
O.R.S. §657B.410, .420

Rules:
471-070-2220(13);
471-070-2400;
471-070-8005 - 8080

Private Plan Options

• Private plans (“equivalent plans”) available (self-funded or fully insured) must be equal to or better than state plan and not impose any additional conditions or restrictions
• By May 31, 2023, employers who filed a declaration of intent (had to have been filed by November 30, 2022) to have an equivalent plan with Paid Leave Oregon must file their equivalent plan application. If an employer who filed a declaration does not complete their equivalent plan application by this date, the employer will owe contributions retroactively from January 1, 2023. Otherwise, equivalent plan applications can be filed at any time, but the employer will have to pay contributions to the state program until the effective date of an approved plan. Employers will not be able to collect employee contributions retroactively.
• Equivalent Plan Application Process:
  • Employers can access applications online through Frances Online or download and print applications (to submit by mail) from the Paid Leave website; or request by phone: 833-854-0166
  • Equivalent plans must be submitted with a separate and complete application containing:
    • $250 application fee
    • Business Identification Number and Federal Employer Identification Number
    • Employer name, address, and contact information
    • A copy of one the following:
      • Employer-administered equivalent plan or,
      • Insurance policy with the insurance product and chosen options
    • Completed questionnaire
    • For self-funded plans only: proof of solvency by providing either:
      • Proof of sufficient assets
      • A bond or an irrevocable letter of credit with the Oregon Employment Department named as the payee or beneficiary, issued by an insured institution
    • For fully insured plans only, information about the insurance policy and carrier, including:
      • Business and contact information for the insurance carrier
      • The date the policy begins and ends
  • Reapproval: Must reapply for equivalent plan approval annually, for three years. After three years, the equivalent plan will remain in place until withdrawn or terminated.

Statute:
O.R.S. §657B.210 et seq.

Rules: OAR 471-070-2200-2460

Administered By

• Commonwealth Administered
• Private and Self-Funded plan options not administered by Matrix/RSL

Covered Employer

• Any individual or organization which during any day of the current or preceding calendar year has or had in employment 1 or more individuals; or
• Any individual or organization which has not ceased to be an employer; or
• Any individual or organization which has elected coverage with the director

Covered Employee

All eligible employees of covered Employment Units. Employment Unit is defined as: “any individual, organization (including agencies and instrumentalities of the Commonwealth or of any political subdivision thereof), partnership, association, trust, estate, joint-stock company, insurance company, corporation, receiver, trustee in bankruptcy, or legal representative of a deceased person, who has or has had one or more individuals in his service within Puerto Rico.” See 11 L.P.R.A. § 202(i) for full definition of Employment Unit and exclusions from Employment.

Employee Eligibility

An individual shall be considered as insured worker if he has received wages of at least $150 in a covered employment during his base year. His base year shall be the first four of the last five consecutive calendar quarters which immediately precede the date of filing the application for benefits.

Qualifying Leave/Benefits Reasons

An inability to do his/her customary work or any other work due to non-work-related injury or illness, or pregnancy.

Waiting Period

Benefits shall be paid on the 8th day of disability, unless hospitalized within the first 7 days of disability, at which point benefits shall commence on the first day of disability.

Relapse Period

Subsequent periods of disability caused by the same illness or injury shall be deemed recurrent if within 90 days, as long as the waiting period was satisfied during the first period of disability.

Contribution Rate & Responsibility

Shared Costs: Contributions to the Disability Fund can be collected from both the employee and employer, or just the employer. The contribution will be .60% of the employee’s first $9,000.00 dollars of annual earnings, per calendar year. The employee's contribution may not exceed .30%.

Benefit Amount

• For an agricultural worker’s illness or injury, $12-$55 per week, based on statutory schedule and base year earnings
• For a non-agricultural worker’s illness or injury, $12-$113 per week, based on statutory schedule and base year earnings
• If Disabled due to Pregnancy, Benefit is 25% of weekly wage or statutory benefit under TDB, whichever is more
• Statutory Schedule for Dismemberment
• $4000 Death benefit plus any benefits owed to deceased worker

Maximum Duration of Benefits/Leave

26 weeks of paid benefit

Increments of Leave Usage/Benefits

Continuous only

Interaction with Other Leaves and Benefits

• Cannot collect Workers Compensation and PR TDB concurrently
• Cannot collect Unemployment and PR TDB at the same time; however, can receive TDB for period of disability when unemployed
• 8 weeks of Maternity is covered under the Working Mothers Protection Act
• Runs concurrently with FMLA

Leave/Benefits Year

26 paid weeks per 52 consecutive weeks

Employer Notice Requirements

• Must provide employee a written notice of determination of eligibility or ineligibility upon filing of request for benefits, including a statement of appeal rights
• Statute and Regulation are silent to Posting Notice; however, Department of Labor and Human Resources website includes SINOT poster under mandatory postings

Employee Notice Requirements

Must file with the state within 3 months of taking leave

Employee Claim Documentation

Application for Disability Benefits Covered by Act 139 (DI-1)

Job Protection

Employer must reinstate employee if:

• Employee requests reinstatement within 360 days of the commencement of the disability and within 15 days of the employee being discharged from medical care
• At the time of the reinstatement request, the employee is mentally and physically able to perform job
• Employee’s job has not been eliminated at the time of the request (job is deemed to exist if occupied by another person or if reopened and filled by another person within 30 days of the reinstatement request).

Benefits Protections

Not addressed

Voluntary Plan Options

• Must be equal or more beneficial than state plan
• Employee contributions must not be higher than employer contributions

Administered By

State plan: Massachusetts Department of Family and Medical Leave (DFML)

Private plan:

• RSLI – Insured plans
• Matrix – Self-funded plans; RSL-insured plans for joint clients

Covered Employer & Business Entity

Covered Employers: All employers except municipalities and federal government

Covered Business Entity: A business or trade that contracts with self-employed individuals for services and is required to report the payment for services to such individuals on IRS Form 1099-MISC for more than 50% of its workforce.

Statute:
M.G.L. 175M § 1

Regulation:
458 CMR § 2.02

Covered Individuals & Eligibility

Covered Individual:

• An employee who meets the “Financial Eligibility Test” through employment with an employer in Massachusetts;
• A self-employed individual who has: (A) elected coverage under the regulations and (B) reported earnings to the Massachusetts Department of Revenue from self-employment that meet the “Financial Eligibility Test,” as if the individual were an employee; or
• A former employee who: (A) met the “Financial Eligibility Test” through employment in Massachusetts at the time of separation from employment; and (B) has been separated from employment for not more than 26 weeks at the start of his/her family or medical leave.

An employer may also be required to provide coverage to "Covered Contract Workers'' if the employer reports payment for services on IRS Form 1099-MISC and the number of Covered Contract Workers exceeds 50% of their total work force.

Statute:
M.G.L. 175M § 1

Regulation:
458 CMR § 2.02

“Financial Eligibility Test”

Total wages from Massachusetts employment in the 12 months preceding application for benefits:

• Equal or exceed 30 times the individual's weekly benefit amount, and
• Is not less than a minimal amount, adjusted annually
  • For 2021 and 2022, not less than $5,700 in the aggregate
  • For 2023, not less than $6,000 in the aggregate

Wages received from multiple employers are aggregated to determine financial eligibility for leave.

Note: Mass PFML is portable; an employee is eligible for benefits with a new employer if the employee satisfied the “Financial Eligibility Test” with one or more prior employers.

Statute:
M.G.L. 175M § 1

Regulation:
458 CMR § 2.02

Qualifying Leave/Benefits Reasons

Medical Leave (employee’s own serious health condition)

Family Leave:

• Bonding (birth, adoption, placement for foster care)
• Care for a family member with a serious health condition
• Qualifying military exigencies arising from a family member's foreign active duty service or notice of an impending call or order to foreign active duty in the Armed Forces
• Care for a seriously ill or injured family member who is a Covered Servicemember

“Family member” includes the following relationships to the employee:

• Spouse
• Domestic partner
• Child
• Parent or parent of a spouse or domestic partner of the employee (parents-in-law)
• A person who stood in loco parentis to the employee when the employee was a minor child
• Grandchild
• Grandparent
• Sibling

Statute:
M.G.L. 175M §§ 1, 2(a) and (b)

Regulation:
458 CMR § 2.02

Required Claim Documentation

• Medical leave: Certification from a health care provider
• Bonding leave (birth): Birth certificate or statement from newborn’s or mother’s health care provider
• Bonding leave (adoption or foster care): Certification from the child's health care provider; an adoption or foster care agency involved in the placement; or the Massachusetts Department of Children and Families
• Care for a family member with a serious health condition: Certification from the family member’s health care provider and a statement of the family relationship
• Qualifying military exigencies: A copy of the family member's active duty orders or other reasonable proof of active duty and a statement of the family relationship and the reason for leave
• Care for a seriously ill or injured servicemember: Certification from the servicemember’s health care provider and a statement of the family relationship

Statute:
M.G.L. 175M § 5

Regulation:
458 CMR § 2.08(5)

Waiting Period

7 consecutive calendar days

• Starts on first day of leave
• Applicable to each medical or family leave taken for different reasons within a benefit year
• The 7 days count toward employee’s MA PFML entitlement (e.g., 12 weeks of leave to care for a family member will be 1 week of unpaid leave to satisfy the waiting period and 11 weeks of paid leave; all 12 weeks will be job-protected)
• Waiting period is satisfied by 7 consecutive calendar days regardless of how many hours or days of leave the employee takes during those 7 days
• No waiting period for birth mother’s bonding leave if it immediately follows the mother’s medical leave for pregnancy or childbirth
• Employee can use accrued vacation sick leave or other PTO during waiting period

Statute:
M.G.L. 175M §§ 3(a), 2(c)(1)

Regulation:
458 CMR § 2.12(7)

Contribution Rate & Responsibility

For 2022:

• 0.68% of employee’s Average Weekly Wage (AWW)
  • 0.56% attributable to medical leave – employee pays 40%, employer pays 60%
    • Exemption: Employers under 25 employees can opt out of paying employer share of premium contributions, but still must collect or cover employee share and pay to DFML and must provide job-protected leave
  • 0.12% attributable to family leave – employee pays all
• Subject to income cap tied to Social Security taxable wages ($147,000 for 2022)

For 2023:

• 0.63% of employee’s Average Weekly Wage (AWW)
  • 0.52% attributable to medical leave – employee pays 40%, employer pays 60%
    • Exemption: Employers under 25 employees can opt out of paying employer share of premium contributions, but still must collect or cover employee share and pay to DFML and must provide job-protected leave
  • 0.11% attributable to family leave – employee pays all
• Subject to income cap tied to Social Security taxable wages ($160,200 for 2023)

• Amounts can change annually October 1, effective the next January 1
• Private plan rates may be different than the state plan

MA PFML Contributions Calculator

Statute:
M.G.L. 175M §§ 6, 7(e)

Regulation:
458 CMR § 2.05

Benefit Amount

Benefits are based on the employee’s Average Weekly Wage (AWW) compared to the Massachusetts State Average Weekly Wage (SAWW)

AWW is defined as 1/26 of the total wages earned in the employee’s highest 2 quarters

2022 benefits will be based on SAWW of $1,694.24

2023 benefits will be based on SAWW of $1,765.34

Formula for calculating benefits:

• Employee’s average weekly wage that is less than or equal to 50% of SAWW will be covered at 80%
• Employee’s AWW that is greater than 50% of the SAWW will be covered at 50%, up to the maximum allowed benefit amount

Maximum benefit:

• 0.64% of SAWW
• 2022: $1,084.31/week
• 2023: $1,129.82/week
• Leave taken on intermittent or reduced schedule: Benefit amount prorated accordingly

Amounts can change annually October 1, effective the next January

MA PFML Benefits calculator

Statute:
M.G.L. 175M § 3

Regulation:
458 CMR § 2.12(1)-(4)

Maximum Duration of Benefits

Per benefit year:

• Medical leave: 20 weeks
• Family leave for bonding, care for a family member, and military exigencies: 12 weeks
• Family leave for care of an injured servicemember: 26 weeks
• Total for all leave reasons combined: 26 weeks

Statute:
M.G.L. 175M § 2(c)(1)

Regulation:
458 CMR § 2.08(8)

Increments of Leave Usage/Benefits

Increments:

• Employee can take intermittent leave in increments consistent with the employer’s policy for other leaves
• State plan:
• DFML will not pay in increments of less than 15 minutes
• DFML will pay only for 8 hours or more – or 30 days from first date of leave if employee has not used 8 hours
• Private plan: Employer can pay for time as it is used or follow state plan rules and pay only after 8 hours of leave cumulative or after 30 days

Intermittent usage per leave reason:

• Bonding: With employer agreement only; can be in longer increments than intermittent leave for other leave reasons
• Serious health condition: Employee or family member, as medically necessary (appointments and/or flare-ups)
• Military exigencies: as needed for the event/reason
• Care for injured servicemember: not addressed, but assume as medically necessary to provide care

Statute:
M.G.L. 175M § 2(c)(2)

Regulation:
458 CMR §§ 2.2, 2.13

Interaction with Other Leaves and Benefits

MA PFML benefits are reduced by amount received for:

• Unemployment
• Workers’ compensation
• State or federal temporary or permanent disability benefits law
• Employer’s permanent disability policy or program

MA PFML benefits are not reduced by amounts received for:

• “Temporary” disability (STD and LTD) benefits paid by the employer – can serve as a top-off
• Amounts received per employer-paid family and/or medical leave policy that are equal to or greater than amount of MA PFML benefit entitlement – however, employer is entitled to reimbursement

Accrued paid leave (including without limitation sick leave, annual leave, vacation leave, personal leave, compensatory leave or paid time off):

• Waiting period: Employee can use accrued vacation sick leave or other PTO during waiting period
• State plan: Employee CANNOT use accrued paid leave to top off MA PFML benefits or will lose MA PFML benefits for that time
• Private plan: Employer can allow employee to top off MA PFML benefits with accrued paid leave
• FMLA – runs concurrently if applicable
• Massachusetts Parental Leave – runs concurrently if applicable
• Massachusetts Small Necessities Leave – runs concurrently if applicable
• Massachusetts Earned Sick Leave – employee can elect to use during waiting period or, if allowed by the terms of an applicable private plan, can be used to top off MA PFML benefits up to 100% of wages

Statute:
M.G.L. 175M § 3(c)

Regulation:
458 CMR § 2.12(8) and (9)

Leave/Benefits Year

52 consecutive weeks beginning on the Sunday immediately preceding the first day of employee’s job-protected leave under PFML.

Note: Leave is job-protected if taken for a PFML covered reasons, even if the employee has not applied for PFML benefits.

Statute:
M.G.L. 175M § 1

Regulation:
458 CMR § 2

Employer Notice Requirements

• Poster in a conspicuous place in each workplace
• Must be in English and each additional language which is the primary language of 5 or more employees or self-employed individuals of that workplace (if notice is available in such language from DFML).
• Individual notice in employee’s primary language to each employee and self-employed individual contracting with the employer, and to new hires within 30 days (if notice is available in such language from DFML).
• Employer must request employee to sign an acknowledgment of receipt or a statement declining to sign an acknowledgment.

See 2023 Mandatory Poster PowerPoint Presentation (mass.gov)

All required notices: PFML workforce notifications and rate sheets for Massachusetts employers (mass.gov)

Statute:
M.G.L. 175M § 4(a)

Regulation:
458 CMR: Not addressed

Employee Notice Requirements

30 days’ advance notice of need for leave, or as soon as practicable if the delay is due to reasons beyond the employee’s control.

Statute:
M.G.L. 175M § 4(b)

Regulation:
458 CMR § 2.08(2)(a)

Job Protection

• Restoration to employee’s same or equivalent job following leave
• No retaliation or discrimination against employee
• Any negative employment action within 6 months of a PFML-protected leave or activity creates a presumption of retaliation

Statute:
M.G.L. 175M §§ 2(e), 9

Regulation:
458 CMR § 2.16

Benefits Protections

• Protection of employment benefits (vacation, sick leave, seniority, bonuses, advancement, etc.)
• Continuation of health insurance benefits under same conditions as during active employment

Statute:
M.G.L. 175M § 2(f)

Regulation:
458 CMR § 2.16

Reporting Requirements

• State plan: Quarterly employment and wage detail reports to DFML through MassTaxConnect
• Private plans: No reporting requirements to DFML at this time; regulations empower DFML to require reporting by private plans

Statute:
M.G.L. 175M: Not addressed

Regulation:
458 CMR §§ 2.04, 2.07

Voluntary Plan Options

• Must be approved by DFML
• Effective on first day of the calendar quarter following approval
• Must be equal to or better than state plan, with no greater burdens to employee
• Insured plan through state-approved insurer
• Self-funded plan: Must post bond

See more about Private PFML Plans

Statute:
M.G.L. 175M § 11

Regulation:
458 CMR § 2.07

Administered By

State plan: CT Paid Leave Authority

Private plan:

• RSLI – Insured plans
• Matrix – Self-funded plans; RSL-insured plans for joint clients

Statute:
C.G.S. §31-49o

Covered Employer

All private employers are covered, regardless of size. Does not include:

• The federal government
• The state, municipalities, or local or regional boards of education, except to the extent their employees are “covered public employees”
• Nonpublic elementary or secondary schools

Statute:
C.G.S. §31-49e(8)

Covered Employee & Employee Elegibility

Has earned wages of at least $2,325 from employment in Connecticut in the employee’s highest-earning quarter of the base period (the first 4 of the 5 most recently completed quarters), and:

• Is currently employed and working in CT, or
• Has been employed and working in CT within the last 12 weeks, or
• Is self-employed, a sole proprietor and a CT resident who have opted into the program

Statute:
C.G.S. §31-49e(4)

PLA Policies:
CTPL-002-ELIG(e)

Qualifying Leave/Benefits Reasons

• Employee's own serious health condition
• Serve as an organ or bone marrow donor
• Care for a Family Member with a serious health condition
• Care for an I'll/injured service member
• Bonding (birth, adoption or foster-care placement) with a child
• Employee’s status as a victim of family violence
• Military exigency arising from the active duty or call to active duty military service in a foreign country of employee’s spouse, child, or parent

“Family Member” includes the following relationships to the employee:

• Spouse
• Sibling (related by blood, marriage, adoption or foster care placement)
• Son or daughter (regardless of age) (biological, adopted, foster child, stepchild, legal ward or a child of a person standing in loco parentis)
• Grandparent (related by blood, marriage, adoption or foster care placement)
• Grandchild (related by blood, marriage, adoption or foster care placement)
• Parent (biological, foster, adoptive, step, in-law, legal guardian of the employee or the employee’s spouse; in loco parentis)
• An individual related to the employee by blood or affinity whose close association with the employee shows to be the equivalent of those family relationships

Statute:
C.G.S. §31-49e
C.G.S. §31-49g(c)(1)
C.G.S. §31-51kk
C.G.S. §31-51ll(a)(2)
C.G.S. §31-51ss

PLA Policies:
CT ADC §31-51qq-1
CTPL-001-DEF(p)

Waiting Period

None

Relapse Period

None

Contribution Rate & Responsibility

• Program is funded by employee contributions.
• An employer who elects a private plan may decide to cover the costs of the plan without taking employee contributions.
• Statutory cap on the contribution rate: 0.5% of total wages.
• Contribution rate since 2021: 0.5%
• Employee's income subject to contribution is capped as Social Security taxable wages
  • 2022: $147,000
  • 2023: $160,200
• Rates may be revised every November 1st beginning November 1, 2022.
• New contribution rates effective January 1.

Statute:
C.G.S. §31-49g

Benefit Amount

Benefits start 1/1/2022:

• If employee earns less than 40x the state minimum wage: Weekly benefit is 95% of base weekly earnings.
  • Based on 2021 state minimum wage and scheduled increases, 40x the minimum wage will be:
    • $520/week starting 1/1/2022
    • $560/week starting 7/1/2022
    • $600/week starting 6/1/2023
• If employee earns more than 40x the state minimum wage:
• Weekly benefit is 95% of base weekly earnings, up to 40x the current state minimum wage PLUS 60% of base weekly earnings above that amount.
• Maximum weekly benefit is capped at 60x the state minimum wage.
• Based on 2021 state minimum wage and scheduled increases, 60x the minimum wage will be:
• $780/week starting 1/1/2022
• $840/week starting 7/1/2022
• $900/week starting 6/1/2023

Base weekly earnings: 1/26 of an employee’s covered total wages (cash and noncash remuneration) during the 2 highest-earning quarters in the base period (the first 4 of the 5 most recently completed quarters).

Statute:
C.G.S. §31-49e(c)(2)

Maximum Duration of Benefits

• Up to 12 weeks in any 12-month period for all leave reasons
• Up to an additional 2 weeks available in a 12-month period for a "serious health condition resulting in incapacitation that occurs during a pregnancy”
• Spouses employed by the same employer are each eligible for up to 12 weeks of benefits
• Leave due to employee’s status as a victim of family violence is limited to 12 days

Statute:
C.G.S. §31-49g
C.G.S. §31-51ll

Increments of Leave Usage/Benefits

• Leave can be taken continuously, as a reduced schedule or intermittently
• Intermittent leave or reduced schedule for bonding requires employer/employee agreement
• For intermittent leave, the CT Paid Leave Authority, per the Employer Fact Sheet [Right-click link and select "Open in New Tab"], has referenced minimum increments of 15 minutes. Additional details on intermittent leave are expected to be included in the CT PFML regulations, when available

Statute:
C.G.S. §31-49g

PLA Policies:
CTPL-004-CALC(k)

Interaction with Other Leaves and Benefits

• Covered employees are NOT eligible for CT PFML if receiving the following:
• Workers’ compensation benefits
• Unemployment compensation benefits
• Any other state or federal benefit that provides wage replacement
• An employer may require covered employees, or may allow the employee to choose, to use their accrued paid time off concurrently with CT PFML benefits, provided that (1) the total compensation received by the employee does not exceed the employee's regular rate of compensation, and (2) the employer must allow the employee to retain at least two weeks of vacation leave or equivalent paid time off.

Statute:
C.G.S. § 31-51ll

PLA Policies:
CTPL-004-CALC(e)

Leave/Benefits Year

Under the state plan leave usage is determined by the rolling 12-month period measured backward from an employee’s first day of leave taken

A private plan may select any of 4 leave year calculation methods:

• Calendar year
• Any fixed 12-month period
• Measured forward
• Rolling back

Statute:
C.G.S. §31-51ll

PLA Policies:
CTPL-004-CALC(b)

Employer Notice Requirements

As of 7/1/2022, an employer must at time of hiring and annually thereafter provide written notice to each employee of employees' CT PFML rights

• The Paid Leave Authority provided the following “Prototype Notice”. [Right-click link and select "Open in New Tab"]
• Employers can draft their own notice as long as it includes the following information:
• The employee's entitlement to leave under the CT FMLA, including leave for victims of domestic violence
• The employee's right to file for payment under the CT PFML
• That retaliation by the employer against the employee for requesting, applying for, or using CT FMLA is prohibited
• The employee can file a complaint for any violations with the Labor Commissioner
• The following employee materials are available from the Authority:
• Poster [Right-click link and select "Open in New Tab"]
• Guide for Employees [Right-click link and select "Open in New Tab"]

Statute:
C.G.S. §31-49q

Employee Claim Documentation

Certifications will be required based on the leave reason, but details have not yet been released.

Statute:
C.G.S. §31-51ll
C.G.S. §31-51mm

PLA Policies:
CTPL-005-CLSB(f) – (n)

Employee Notice Requirements

30 days’ advance notice of need for leave, or as soon as practicable if the delay is due to reasons beyond the employee’s control.

Statute:
C.G.S. §31-51ll(f)

PLA Policies:
CTPL-005-CLSB(c)

Job Protection

None provided; job protection may be available under FMLA, CT FMLA, or the CT Leave for Family Violence law, if applicable

Benefits Protections

None provided; benefits protections may be available under the FMLA, CT FMLA, or CT Leave for Family Violence law, if applicable

Reporting Requirements

State Plan: The CT PFML law provides no details regarding employer reporting responsibilities. Details of reporting requirements may be included in the CT PFML regulations, when made available.

Private Plan: While the CT PFML law includes no details about employer reporting, the Authority has stated in its Private Plan Policy & Procedures that annual reporting is expected to include the number of claims submitted and data on how many have been approved or denied, the reasons for leave taken and amount of leave benefits paid.

Appeals

• A denial of CT PFML benefits to an employee or the imposition of a penalty on any person may be appealed by filing a complaint with the Labor Commissioner. The decision of the commissioner may be appealed to the Superior Court
• Benefits decisions by private plans are subject to administrative appeal and appeal to the Superior Court

Statute:
C.G.S. §31-49h
C.G.S. §31-49p

PLA Policies:
CTPL-007-APPL(a), (b)

Private Plan Options

• Self-funded and insured private plans allowed
• Private plan must be equal to or better than state plan, with no greater burdens to employee
• Self-funded plan must post a bond
• Insured private plan policy must be issued by a state-approved insurance carrier
• Private plan must be approved by a majority of employer’s CT employees
• An approved private plan will remain in effect for 3 years
• An approved self-funded private plan must update its surety bond annually

Additional information regarding private plans:

• CT Paid Leave Authority's Private Plan Page
• CT Paid Leave Authority’s Private-Plan-Policy-and-Procedures Guide
• Reliance Standard and Matrix Absence Management information regarding private plan vote of employees

A Private Plan Transition policy was adopted by the Connecticut Paid Leave Authority Board of Directors effective December 9, 2022. The transition policy applies when there is a change from:

• The CT Paid Leave Authority’s program to a private plan,
• A private plan to the Authority’s program, or
• One private plan to another

Where the Private Plan Transition policy applies:

• Any open pending claims (as of the effective date of the transition) will remain the responsibility of the prior benefit provider; and
• The new provider must provide all covered employees with a new allotment of 12 weeks of income-replacement benefits as of the effective date of the new plan, regardless of whether any of those employees received benefits under the previous plan.

Statute:
C.G.S. §31-49o

PLA Policies:
CTPL-009-PRVP(a) - (f)

Administered By

State program: Secretary of the Maryland Department of Labor

Private plans: Insurance carrier, third party administrator, or employer; Matrix and Reliance Standard are assessing these opportunities and awaiting further plan definition through regulations

Statute:
§8.3-401

Covered Employer & Business Entity

Employer: A person or governmental entity that employs at least one individual in the state

• "Person" not defined; presumably includes businesses
• "Employer" does not include sole proprietors or sole employee of a business entity

Statute:
§8.3-101(h)

Covered Individuals & Employee Eligibility

Covered Employee: An employee who has worked at least 680 hours in the 12-month period immediately preceding the date leave begins

• The statute does not specify whether the 680 hours must be work for the employer from whom leave is being taken, or even that the work must be within the state of Maryland

Covered Individual: A Covered Employee or a self-employed individual who elects to participate in the family and medical leave program

Statute:
§8.3-101(d) and (e)

Qualifying Leave/Benefits Reasons

• Bonding with a new child within one year after birth or placement of the child with the Covered Individual through foster care, kinship care, or adoption
  • There is no single definition of “kin¬ship care.” Generally, it is when rel¬a¬tives step up to raise chil¬dren when their parents can’t care for them for the time being.
  • KinshipCare_Factsheet-Final_2021.pdf (maryland.gov)
• To care for a family member with a serious health condition
• Due to the Covered Individual’s own serious health condition
• To care for a service member who is the Covered Individual’s next of kin (not defined)
• Due to a qualifying exigency arising out of the deployment of a service member who is a family member (defined similar to federal FMLA qualifying exigencies)

Statute:
§8.3-302

"Family member" includes the following relationships to the Covered Individual:

• Child (biological, adopted, foster, step, child of whom the employee has legal or physical custody or guardianship, in loco parentis)
• Ward of the Covered Individual or the Covered Individual’s spouse
• Parent (biological, adoptive, foster, stepparent, or person in loco parentis of the Covered Individual or the Covered Individual’s spouse)
• Legal guardian of the Covered Individual
• Ward of the Covered Individual or the Covered Individual’s spouse
• Spouse
• Grandparent (biological, adoptive, foster, step)
• Grandchild (biological, adoptive, foster, step)
• Sibling (biological, adopted, foster, step)

§8.3-101(i)

Required Claim Documentation

• Certification from a licensed health care provider:
  • For care of a family member or service member with a serious health condition
  • Of inability to work due to the Covered Individual’s own serious health condition
  • For intermittent leave, the certification must include informant about the expected duration of the leave (frequency of intermittent absences not addressed)
• Documentation for qualifying exigencies to be established by regulation

Statute:
§8.3-403(c)

Waiting Period

None specified

Contribution Rate & Responsibility

• Paid by
  • Employees
  • Employers with 15 or more employees, and
  • Participating self-employed individuals
• Contributions start October 1, 2023
• Contribution amount to be determined by the Secretary:
  • Announced by June 1 every 2 years beginning in 2025
  • To be in effect for the 24-month period beginning on the following January 1
  • Addressing:
    • The total rate of contribution
    • The cost-sharing formula between employers and employees, to range between 75-25% paid by employers and 25-75% paid by employees
• Contributions applicable to all wages up to the federal Social Security wage base

Statute:
§8.3-601

Benefit Amount

Minimum benefit: $50/week

Maximum benefit:

• For 2025: $1,000/week
• For each 12-month period beginning January 1, 2026, and after:
  • An amount announced by the Secretary by September 1, 2025, and each subsequent September 1, to be effective the next January 1

Increases in weekly benefit amount: apply only to claims for benefits filed after the date the increase becomes effective

Benefit amount for full time leave:

• If Covered Individual’s average weekly wage (AWW) is 65% or less than the state AWW, benefit is:
  • 90% of Covered Individual’s AWW
• If Covered Individual’s average weekly wage (AWW) is more than 65% of the state AWW, benefit is:
  • 90% of Covered Individual’s AWW up to 65% of the state AWW plus
  • 50% of Covered Individual’s AWW that is greater than 65% of the state AWW

Benefit amount for partially paid leave:

• If the covered individual is taking partially paid leave, the lesser of:
  • The amount required to make up the difference between the wages paid to the Covered Individual while the Covered Individual is taking partially paid leave and the full wages normally paid to the Covered Individual; and
  • If the Covered Individual's AWW is greater than 65% of the state AWW, the sum of:
    • 90% of the Covered Individual's AWW up to 65% of the state AWW; and
    • 50% of the Covered Individual's AWW that is greater than 65% of the state AWW

Employee’s AWW: The wages paid for the Employee’s last 680 hours of work divided by the number of weeks worked

State AWW: The wage calculated under §9-603 of the Maryland workers’ compensation law

Statute:
C.R.S. §8-13.3-516(1)
C.R.S. §8-13.3-506

Maximum Duration of Leave & Benefits

• 12 weeks total for all leave reasons in an Application Year
• An additional 12 weeks is available if during the same Application Year, the Covered Individual:
  • Receives benefits for either (1) bonding leave or (2) due to the employee’s own serious health condition, and then
  • Becomes eligible for benefits for (1) the employee’s own serious health condition or (2) bonding leave

Statute:
§8.3-702(a)

Increments of Leave Usage/Benefits

• A Covered Employee must attempt to schedule intermittent leave so as not to unduly disrupt the employer’s operation
• Intermittent leave must be taken in increments of at least 4 hours

Statute:
§8.3-701(b)(2)(i) and (3)

Interaction with Other Leaves and Benefits

• PFMLI runs concurrently with federal FMLA if applicable
• Maryland unpaid Parental Leave Act is not addressed; presumably leave will run concurrently with PFMLI bonding leave if applicable
• Covered Individual must exhaust all employer-provided leave that is not required to be provided under law before receiving PFMLI benefits
  • Employer-provided leave being exhausted is treated same as leave from work under the Program (e.g., job protection) but does not reduce amount of PFMLI leave or benefits available
• PFMLI benefits are not available concurrently with benefits under Maryland’s unemployment insurance or workers’ compensation laws except:
  • Receipt of benefits for a permanent partial disability under Maryland’s workers’ compensation law does not preclude eligibility for PFMLI benefits
• Interaction with employer policies such as PTO, paid sick leave, parental leave, etc., not addressed

Statute:
§8.3-702(b), (c), (d)

Leave/Benefits Year

"Application year" – the 12-month period beginning on the first day of the calendar week in which a covered individual files an application for benefits

§8.3-101(b)

Employer Notice Requirements

• Written notice of PFMLI rights to each employee:
• At the time of hire
• Annually thereafter
• When an employee requests PFMLI leave or the employer knows an employee’s leave may be covered by the Program:
  • Including general notice of PFMLI rights and duties and notice of specific claim procedures, job protection, and other details

Statute:
§8.3-801

Employee Notice Requirements

• Written notice 30 days in advance for foreseeable leave
• Notice as soon as practicable for unforeseeable leave
• Employee must comply with employer’s notice or procedural requirements for requesting or reporting leave

Statute:
§8.3-701(a)(2)

Job Protection

• Employee is entitled to restoration to an equivalent position following leave unless:
  • Restoration would cause substantial and grievous economic injury to employer’s operations and
  • Employer gives notice to the Covered Individual of the Employer’s intent to deny restoration at the time the determination is made and
  • Employee elects not to return to work after receiving Employer’s notice
• Employer many terminate Covered Individual’s employment during leave only for cause (not defined)
• Employer may not retaliate against a Covered Individual for taking actions protected by the PFMLI statute

Statute:
§8.3-706(b), (c)

Benefits Protections

Employer must continue Covered Individual’s health benefits in the same manner as required by the federal FMLA

Statute:
§8.3-707

Reporting Requirements

No Employer reporting requirements specified

Appeals

Secretary shall establish a system for appeals by Covered Individuals in the event of a denial of benefits

Statute:
§8.3-906

Private Plan Options

• Self-funded or insured plans permitted
• Must be offered to all of Employer’s Employees
• Must meet or exceed employee rights, protections, and benefits provided under state program

Statute:
§8.3-705