• 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

• 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

“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

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

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”
• For leave due to the employee’s own serious health condition, a “Serious Health Condition Certification – Self Form”
• For leave due to a qualifying exigency: a “Military Exigency Leave Attestation Form” completed by the claimant
• For safe leave: a “Safe Leave Attestation Form” to be completed by the victim or a family member of the victim
• For all claims: any other reasonable documentation necessary to adjudicate the claim for benefits

None

• 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
    • 2024: $168,600
  • 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

• 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
• Maximum weekly benefit: 90% of state AWW except for benefits beginning before 1/1/2025, the maximum benefit will be $1,100 per week
• State AWW: set annually; $1,421.16 beginning 7/1/23
• Benefit recalculation: when the SAWW changes or if there is a change in the Regular Work Schedule

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

• 1 hour OR
• smaller increments if consistent with employer’s increments for other employee leave
• Benefits not payable under the state plan until employee accumulates at least 8 hours of PFML usage
• Weekly paid leave usage determined by dividing the number of hours of family and medical leave the Covered Individual takes per week by their aggregate Regular Work Schedule [the average number of weekly hours an individual would typically work at the job or jobs from which they are taking paid family and medical leave if not for their leave, plus the average number of hours they typically work at the job or jobs they maintain during family and medical leave] for that week

• 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)

Application Year:

• Definition from statute C.R.S. § 8-13.3-503(1): 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 “Benefit Year,” as used at C.R.S. § 8-13.3-521(1)(b) both mean “Application Year” under C.R.S. § 8-13.3-503(1). The 12-month period is measured forward from the date the claim is filed. Under this ‘‘measured forward” method, an employee would be entitled to the leave amounts described at C.R.S. § 8-13.3-505(1) during the year beginning on the first date a claimant files for paid family and medical leave, and the next 12-month period would begin the first time the claimant files for paid family and medical leave after the completion of any 12-month period. Solely for the purpose of determining the application year, the date the claim is filed is the benefit start date
• “Benefit start date” means the first day the covered individual is unable to work for which benefits are approved.
• "Calendar week" means any period of 7 consecutive days starting on the first day of the employee’s absence and benefits.

• Employers participating in the state plan must provide written notice to employees:
  • By posting in the workplace
  • By electronic means for remote employees
  • Upon hire
  • Within 5 days of learning an employee is experiencing an event that would be covered by CO PFML
• The required poster for employers in the state plan 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
• Private plan employers must post in the workplace and deliver a notice to each employee no later than 30 days before the effective date of an approved private plan or upon hire if after the effective date.

• 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

If employee has been employed with current employer for at least 180 days (doesn’t have to be consecutive) prior to commencement of PFML leave, restoration after leave to same or equivalent position and terms and conditions of employment

Continuation of health care benefits during leave

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

• Any party adversely affected by a determination may appeal to the Division within 49 days of the determination
• Judicial review permitted after exhaustion of administrative remedies
• Additionally, an employer may file a grievance with the Division due to a good faith belief the Division granted FAMLI leave and benefits in an amount, duration or frequency beyond which the claimant is entitled to

• Must be equal to or better than state plan, with no greater burdens to employee
• Private Plan Application Process
  • Employer Guide to Private Plans
  • Submit private plan applications in the employer portal at MyFAMLI+ Employer
  • Fully-Insured plans – file policy with DOI and FAMLI for approval
  • Self-funded plans – submit plan using the state template and a surety bond using this Form and Guidance
  • Submit $500 application fee
  • Submit forms for use by employees or health care providers 30 days prior to making them available to employees (forms may be approved at the carrier level for the first year)
• Effective Date of Private Plan
  • 60 days after the date of application, if approved
  • Employers must notify employees of approval to use a private plan instead of the state plan no later than 30 days before the effective date of the approved plan
• Plan Duration and Renewals
  • Private plans expire 8 years after the effective date
  • Thereafter, employers must submit a renewal application 60 days before the expiration of the plan

State plan: CT Paid Leave Authority

Private plan:

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

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

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 opted into the program

• 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 ill/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

None

None

• 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 2021-2024: 0.5%
• Employee's income subject to contribution is capped at Social Security taxable wages
  • 2023: $160,200
  • 2024: $168,600
• Rates may be revised every November 1st
• New contribution rates effective January 1.

• State minimum wage:
  • 7/1/2022 min. wage $14.00/hr.
  • 6/1/2023 min. wage $15.00/hr.
  • 1/1/2024 min. wage $15.69/hr.
• If employee earns less than or equal to 40x the state minimum wage:
  • Weekly benefit = 95% of base weekly earnings.
• If employee earns more than 40x the state minimum wage:
  • Weekly benefit = 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.

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).

• 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

• Leave can be taken continuously, as a reduced schedule or intermittently

Intermittent leave or reduced schedule for bonding requires employer/employee agreement

• 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
• Covered employees may use any employer-provided benefits concurrently with CT PFML benefits, provided that the total compensation received by the employee does not exceed the employee's regular rate of compensation
• Interaction of CTPL, FMLA, and CT FMLA

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

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”.
• 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:
  • CT Paid Leave Overview for Workers
  • General Infographic - Updated Aug 2022 (4 × 9 in) FINAL (ctpaidleave.org)

Certifications are required based on the leave reason. Resources can be found on the Claims (ctpaidleave.org) resource page on the state’s website which also includes the Application Document Checklist (ctpaidleave.org).

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.

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

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

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 the Private Plan Policy + Procedures 10.12.2023 (ctpaidleave.org), 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.

• 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

• Private plan must be equal to or better than state plan, with no greater burdens to employees.
• Review the Private Plan Policy + Procedures 10.12.2023 (ctpaidleave.org) and  How to Apply for a Private Plan (ctpaidleave.org)
• Employee Vote Process
  • Employer must first register with CT.gov account and register your business and then Go to My Account 
  • Employer must provide employees working in CT with sample CT PFML policy (fully-insured) or CT PFML plan template (self-funded) and a plain language guide (fully-insured or self-funded) (all available from your Reliance Matrix Account Manager). Employees have two weeks to review the documents.
  • After 2 weeks, the employer must hold an anonymous majority vote and needs a majority (50% +1) to apply for a private plan with CT.
  • Vote can occur no more than 6 months prior to the effective date of the plan
• Private Plan Application Process
  • Fully Insured Plan: Review the Policy Filing Guidance re CTPL insurance policy forms approved by CTPL Board 11.10.21 (ctpaidleave.org) and Private-Plan-Filing-Checklist.pdf (ctpaidleave.org).  Employer must submit to the portal the plain language guide (Exhibit B of the Private Plan Policy + Procedures 10.12.2023 (ctpaidleave.org) , declaration of insurance, & results of employee vote.
  • Self-funded Plans : Employer must submit to the portal the self-insured plan template (Exhibit A of the Private Plan Policy + Procedures 10.12.2023 (ctpaidleave.org)), the plain language guide (Exhibit B of the Private Plan Policy + Procedures 10.12.2023 (ctpaidleave.org), the declaration of self-insurance, results of employee vote, and a surety bond.
• Effective Date of Private Plan
  • The private plan must be approved at least 30 days prior to the effective date of the plan.
  • The plan is effective the first of the quarter after private plan approval.
• Plan Duration and Renewals
  • Private plan is effective for 3 years from the date of approval, or until the employer makes a material change to the private plan.

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 or 3^rd party administrator

• All employers
  • 10-24 employees during the previous 12-month period: Must provide Parental Leave only
  • 25 or more employees during the previous 12-month period: 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

• 12 months of service
• 1250 hours worked in 12 months prior to leave
• Working in Delaware at least 60% of each calendar quarter
• Individuals working outside Delaware or telecommuting outside of Delaware are not covered unless the employer and employee elect to cover them
• Self-employed may opt-in

• Parental Leave (birth, adoption, and foster care)
• Care of a family member with a serious health condition.
  • Parent (biological, adoptive, step, foster, in loco parentis)
  • Child (biological, adopted, or foster child, a stepchild, a legal ward, 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
  • Spouse (same definition as FMLA)
• Employee’s own serious health condition
• Qualifying military exigency

• 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 information regarding the condition
• Recertification allowed
• 2nd/3rd opinion process allowed

None specified

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

Contributions are capped at the FICA limit.

Private plans are not required to make contributions.

*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%

• 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

12 weeks per Application Year

• Parental Leave: 12 weeks in an Application Year
  • Employers with 10-24 employees may temporarily reduce leave to a total of 6 weeks for claims before 1/1/2031 with notice to the Division by 1/1/2024 and to employees by 12/1/2024
• Medical and Family Caregiving Leave (including exigency): 6 weeks combined in any 24-month period. New claim applications require a look-back period -- the 24-month period that ends on the first day of requested leave.

• Continuous
• Intermittent leave in increments of 1 full workday
• Reduced schedule in increments of 1 full workday
• Benefits not payable for less than 1 workday of leave in 1 week

• 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

Application Year: 12-month period defined in FMLA, changes must be made in accordance with FMLA

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

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

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

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

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

• 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

• Plans may cover one or more of the 4 leave reasons
• Self-funded or insured plans permitted
  • Insured plans: issued by approved insurer
  • Self-funded plans:
    • must post bond equal to 1 year of total contributions
    • must have at least 100 covered individuals in the plan at all times, unless requirement waived by the Division based on demonstration of administrative capacity to manage a self-insured plan
• Must be offered to all of employer’s employees
• Must meet or exceed employee rights, protections, and benefits provided under state program

• District administered
• No private plan option

All private sector DC employers with one or more employees

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)

• 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)

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

None

• Employers cover the full cost of UPL not to exceed 0.62%. Office of Chief Financial Officer projects an adjustment to contribution rate every March 1st which begins July 1.
  • 7/1/22: Employers contribute 0.26% of the wages of covered employees
  • 7/1/23: no change

Minimum Benefit:

• 7/1/22: $16.10/hr.
• 7/1/23: $17.00/hr.

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:

• Adjusted annually each October 1 (effective immediately unless otherwise stated)
  • 10/1/22: $1,049
  • 10/1/23: $1,118

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.

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)

• Continuous
• Intermittent – in full day increments

• 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

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

• 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

• 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

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

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

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

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

Not allowed

• 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.

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

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

• 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

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

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

Employee Contribution cannot exceed:

• 0.5% of the employee’s weekly wages
• In 2023: Maximum weekly deduction of $6.59
• In 2024: Maximum weekly deduction of $6.87
  • See 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

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

As of January 1, 2024: 58% of employee’s average weekly wage, up to the maximum of $798 per week.

See Maximum Weekly Wage Base and Maximum Weekly Benefit Amount

26 weeks following expiration of the 7-day waiting period

Continuous only

• 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

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.

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 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 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.

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

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

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.

• 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

State program: Maine Department of Labor, Paid Family and Medical Leave Benefits Authority

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

• any person, sole proprietorship, partnership, corporation, association or other business entity that employs employees at a location in Maine
• the state
• a county, city, town, municipal agency
• an agent of an employer, the state, or a political subdivision of the state
• a public employer
• a tribal government

• Earned at least 6 times the State Average Weekly Wage (SAWW) in wages subject to premiums during the base period
• Self-employed and independent contractors may elect coverage

Family Leave

• Bonding during the first 12 months after birth or placement of a child
• To care for a family member with a serious health condition
• To attend to a qualifying military exigency
• To care for a family member who is a covered service member
• Safe leave
• Any additional reasons listed in 26 MRSA §843, sub. sec. 4, including:
  • Placement of a child 16 years old or less with the employee or employee’s domestic partner in connection with adoption by the employee or domestic partner
  • Organ donation
  • Death/serious health condition of the employee’s spouse/domestic partner, parent, sibling or child while on active duty in the state military forces or United States armed forces, including Air National Guard

Medical Leave - employee’s own serious health condition

"Family member" includes the following relationships to the employee:

• Spouse/Domestic partner
• Child (regardless of age: parentage determined by Maine Parentage Act or biological, adopted, foster, step, child of whom the employee stands in loco parentis, legal guardian, any individual to whom the covered individual or spouse/domestic partner of the covered individual stood in any of these relationships when the individual was a minor child)
• Parent (biological, adoptive, de facto, or foster parent, stepparent, or legal guardian of an employee or the employee's spouse, or an individual who stood in loco parentis to the covered individual or to a spouse/domestic partner when the individual was a child)
• Sibling (legal, biological, adoptive, foster, step, de facto)
• Grandchild (legal, biological, adoptive, foster, step, de facto)
• Grandparent (legal, biological, adoptive, foster, step, de facto)
• An individual, as designated by the covered individual in accordance with rule, with whom the covered individual has a significant personal bond that is or is like a family relationship, regardless of biological or legal relationship

• May not exceed 1.0% of wages
• Rate set annually in October beginning in 2028; no rate at this time for 2025-2027
• Employees pay 50% of the total contribution
• Employers with 15 or more employees contribute 50% of the total contribution and may elect to pay some or all of the employee’s contribution
• Employers with fewer than 15 employees are not responsible for the employer portion of the contribution, but may elect to pay all or a portion of the employee contribution
• Employee's income subject to contribution is capped at Social Security taxable wages
• Employers with private plans and their employees are not required to make contributions to the state program; such employers may require employees to contribute no more than the state authorized amount to the costs of the private plan

• Maximum benefit:State Average Weekly Wage (SAWW)
• SAWW: determined annually
• Benefit amount:
  • Employee’s AWW equal to or less than 50% of SAWW replaced at 90%
  • Employee’s AWW more than 50% of SAWW replaced at 66% up to maximum weekly benefit

• Medical leave: 12 weeks.
• Family leave: 12 weeks
• Combined: Employees may only take up to 12 weeks total in a benefit year.

• Leave taken runs concurrent with FMLA if covered by both.
• Benefits reduced by any amounts received for workers’ compensation, unemployment, or other state or federal temporary or permanent disability benefits
• Benefits reduced by employer’s permanent disability policy
• Accrued leave may be used during waiting period

• Employer must post a notice provided by the department in English and each other language that is the primary language of  3 or more employees of that workplace, if such notice is available from the department.
• Notice must be provided to employees 30 days after the start of employment as provided/approved by the Department in the primary language of the employee.

• PFML leave may not affect right to accrue vacation and sick time, bonuses, advancement, seniority, length of service credit, or other benefits, plans or programs
• Employer must maintain employment-related health insurance as if the employee was not on leave

• Annually beginning 10/1/26, list of 15 data points that must be provided including, but not limited to:
  • total claims made
  • percentage of medical claims
  • percentage of family member serious health condition claims
  • percentage of family leave claims other than bonding
  • percentage of bonding claims
  • percentage of qualifying exigency claims
  • percentage of care for service member claims
  • demographics
  • percentage of denials

• Self-funded or insured plans permitted; surety bond required for self-funded plans
• Must be offered to all of employer’s employees
• Must meet or exceed employee rights, protections, and benefits provided under state program
• Plan administrative fee to be determined

State program: Secretary of the Maryland Department of Labor

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

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

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

• Care for or bond with a new child of the Covered Employee within one year after birth.
• During placement of a child with the Covered Employee through foster care, kinship care, or adoption and to bond with the child for one year after placement.
  • There is no single definition of "kinship care." Generally, it is when relatives step up to raise children 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)

"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
• Domestic partner
• Grandparent (biological, adoptive, foster, step)
• Grandchild (biological, adoptive, foster, step)
• Sibling (biological, adopted, foster, step)

• 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 information about the expected duration of the leave (frequency of intermittent absences not addressed)
• Documentation for qualifying exigencies to be established by regulation

None specified

• Paid by
  • Employees
  • Employers with 15 or more employees, and
  • Participating self-employed individuals
• Contributions start October 1, 2024
• Rate may not exceed 1.2% of wages up to the federal Social Security wage base ($168,600 for 2024)
• Contribution amount to be determined by the Secretary:
  • Rate from 10/1/24 to 6/30/26 - .90% of covered wages
  • Starting February 2026, the contribution rate will be set for the 12-month period starting the next July 1.
  • Employers with 15 or more employees pay 50% of the total contribution rate.
  • Employees pay 50% of the total contribution rate.
  • Employers may pay some or all of the employee’s contribution.

Minimum benefit: $50/week

Maximum benefit:

• 12-month period beginning 1/1/26: $1,000/week
• 12-month period beginning 1/1/27, and after:
  • An amount announced by the Secretary by 9/1/26, and each subsequent September 1, to be effective the next January 1
• Benefits cannot exceed 100% of the covered individuals’ average weekly wage.

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

Benefit amount:

• If Covered Individual’s AWW is 65% or less than the state AWW, benefit is:
  • 90% of Covered Individual’s AWW
• If Covered Individual’s 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

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

Private Plans: The weekly benefit amount is based on the average weekly wage earned from the employer sponsoring the plan; except if the employee has worked fewer than 680 hours for the sponsoring employer, then hours worked from prior employment up to 680 hours total are included to determine AWW.

• 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

• 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

• PFMLI runs concurrently with federal FMLA if applicable
  • Use of federal FMLA hours also counts as PFMLI hours as long as the employer provides notice to the employee; even if the employee doesn’t apply for PFMLI.
• Maryland unpaid Parental Leave Act is not addressed; presumably leave will run concurrently with PFMLI bonding leave if applicable
• A covered individual may not be required to use or exhaust paid vacation or sick leave or other employer provided paid leave before or while receiving PFMLI.
• A Covered Individual and employer may agree to use paid vacation or sick leave or other paid time off concurrently with PFMLI to replace the covered individual’s wages up to 100% of the AWW.
• Employer may require PFMLI benefits be made concurrently or coordinated with payments or leave under an employer leave policy for parental or family care, military leave or under a disability policy.
• 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

"Application year" – the 12-month period beginning on the Sunday of the calendar week for which benefits are approved.

• 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

• 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

• 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

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

No Employer reporting requirements specified

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

A covered individual must file an appeal within 30 days after the determination is made or benefits are denied, unless there is good cause.

• 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

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 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.

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.

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 2023, not less than $6,000 in the aggregate
  • For 2024, not less than $6,300 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.

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 (biological, adopted, foster, step, legal ward, in loco parentis) (age not addressed)
• Parent or parent of a spouse or domestic partner of the employee (parents-in-law) (biological, adoptive, step, foster)
• A person who stood in loco parentis to the employee when the employee was a minor child
• Grandchild
• Grandparent
• Sibling (biological, adoptive, step)

• 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

7 consecutive calendar days

• Starts on first day of leave
• Applicable to each application for medical or family leave 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

• 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
• Subject to income cap tied to Social Security taxable wages ($168,600 for 2024)

For 2023:

• 0.63% of employee’s Average Weekly Wage (AWW)
  • 0.52% attributable to medical leave – employee pays 40%, employer pays 60%
  • 0.11% attributable to family leave – employee pays all

For 2024:

• 0.88% of employee’s Average Weekly Wage (AWW)
  • 0.70% attributable to medical leave – employee pays 40% (0.28% of eligible wages), employer pays 60% (0.42% of eligible wages)
  • 0.18% attributable to family leave – employee pays all

• 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

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

2024 benefits will be based on SAWW of $1,796.72

Formula for calculating benefits:

• Employee’s AWW 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:

• 64% of SAWW
• 2022: $1,084.31/week
• 2023: $1,129.82/week
• 2024: $1,149.90/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 and Guidance

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

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

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: Effective 11/1/23 Employee CAN choose to use accrued paid leave to top off MA PFML benefits as long as benefits do not exceed the employee's AWW.
• Private plan: Effective 11/1/23 Employees can choose to use accrued paid leave to top off MA PFML benefits as long as benefits do not exceed the employee’s AWW.
• 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

How other leave and benefits can affect your Paid Family and Medical Leave | Mass.gov

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.

• 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.
• Notices are generally updated annually: (1) mandatory poster, (2) private plan notice, (3) notice for employers with <25, and (4) notice for employers with >25 employees.

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

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.

• 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

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

• 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

• Private plan must be equal to or better than state plan, with no greater burdens to employees
• Provide private plan notice to employees
• Private Plan Application process
  • Review Applying for a private paid leave exemption | Mass.gov
  • Employer must register with MassTaxConnect portal
  • Employer must request a private plan exemption through the portal and complete an application
  • Fully-Insured plans - Provide the MA PFML Confirmation of Insurance form (available from your Reliance Matrix Account Manager).
  • Self-funded plans – submit a Self-Insured Insurance Declaration Document, a surety bond form and MA PFML self-funded plan document (available from your Reliance Matrix Account Manager).
• Effective Date of Private Plan
  • Policy effective first of the quarter after private plan approval
• Plan Duration and Renewals
  • Private plan approvals are required to be renewed annually and may begin the quarter prior to the expiration of the exemption

• State plan: MN Family and Medical Benefits Insurance Division of the Department of Employment and Economic Development
• Private plan: Insurance carrier, third party administrator, or employer; Reliance Matrix is assessing these opportunities and awaiting further plan definition through regulations

• A person, organization or entity that employs at least one individual in the state
• the state, state agencies
• state colleges and universities
• any municipality or local government entity

• An employee who has earned at least 5.3% of the state average annual wage over the “base period” rounded down to the next lower $100 (the statute provides a complicated definition of “base period,” but it is generally the most recent 4 completed calendar quarters before the date of the application for benefits)
• Self-employed and independent contactors can opt into the program
• Seasonal employees (those employed for no more than 150 days during any consecutive 52-week period in hospitality by specifically qualified employers) are excluded

The statute uses “employee” and “applicant” interchangeably. We are using employee throughout this page.

• The Employee’s own Serious Health Condition
• Qualifying military exigency arising out of a military member's active duty service or notice of an impending call or order to active duty in the United States armed forces
• Safety leave
• Family care
  • A Family Member with a Serious Health Condition
  • Caring for a Family Member who is an active military member
• Bonding
  • Must end within 12 months of birth
  • If the child is hospitalized longer than the mother, leave ends within 12 months after the child leaves the hospital
  • Must end within 12 months of adoption or foster placement; may be used before adoption or placement for counseling sessions, court appearances, medical/legal consultations, and travel to another country
• Medical care related to pregnancy – includes prenatal care or incapacity due to pregnancy or recovery from childbirth, stillbirth, miscarriage, or related health conditions

"Family member" includes the following relationships to the employee:

• Spouse/Domestic partner
• Child (biological, adopted, foster, step, child of whom the employee stands in loco parentis, legal guardian, de facto parent)
• Parent or Legal Guardian (biological, adoptive, de facto, or foster parent, stepparent, or legal guardian of an employee or the employee's spouse, or an individual who stood in loco parentis to an employee when the employee was a child)
• Sibling
• Grandchild (biological, adoptive, foster, step)
• Grandparent or Spouse's Grandparent
• Son-in-law or Daughter-in-law
• An individual who has a relationship with the employee that creates an expectation and reliance that the employee care for the individual, whether the employee and the individual reside together

• Certification from a licensed health care provider:
  • For the employee’s own Serious Health Condition; including frequency and duration for intermittent leave
  • To care for a Family Member with a Serious Health Condition; including medical necessity for intermittent leave
  • For the employee’s medical care related to pregnancy
• Certification for bonding leave for the birth or placement of a child
• Certification for qualifying military exigency leave
• Certification for safety leave

Except for bonding leave, benefits are based on one qualifying event of at least 7 calendar days (it is unclear from the statute if this is meant as a waiting period)

• Contributions are not required for private plans
• Employees pay 50% of the total rate of contribution
• Employers pay 50% of the total rate of contribution and may pay some or all of the employee’s contribution.
• Wages subject to contributions are capped at the federal Social Security wage base ($168,600 for 2024)
• For employers with fewer than 30 employees:
  • the amount of wages upon which premiums must be paid is reduced by the premium rate multiplied by the lesser of: (this is the statutory language; we are hoping for regulations to clarify this calculation):
    • $12,500 multiplied by the number of employees; or
    • $120,000
  • For each employee over 20 employees, the exclusion is reduced by $12,000
  • The premium paid as a result of these reductions must not be less than zero.
  • Employers allowed these reductions must still deduct the employee portion of the premium
• Employer rates for 2026:
  • 0.7% of taxable wages for an employer participating in the state plan for both family and medical benefits
  • 0.4% of taxable wages for an employer participating in the state medical benefit plan with an approved private plan for family benefits
  • 0.3% of taxable wages for an employer participating in the state family benefit plan with an approved private plan for medical benefits
• Maximum annual premium rate: 1.2% of taxable wages
• Rates are adjusted annually

• Minimum benefit: $50/week
• Maximum benefit: State’s average weekly wage (SAWW)
• SAWW: the average wage as calculated under §268.035, Subd. 23, at the time a benefit amount is first determined.
• Benefit amount: Generally (subject to the statutory definitions of Average Typical Workweek, High Quarter, and Base Period):
  • 90% of weekly wages that do not exceed 50% of the SAWW; plus
  • 66% of weekly wages that exceed 50% of the SAWW but not 100%; plus
  • 55% of weekly wages that exceed 100% of the SAWW

• Serious Health Condition (including pregnancy): 12 weeks.
• Bonding, safety leave, family care, or qualifying exigency: 12 weeks
• Combined: Employees may only take up to 20 weeks total in a benefit year.

• Except for bonding leave, benefits are based on one qualifying event of at least 7 calendar days (it is unclear if this is intended as a waiting period)
• Minimum duration of leave is 1 workday in a work week
• An employer may elect to provide more than 480 hours of intermittent leave in any 12-month period. If an employer limits intermittent leave, the employee is entitled to take their remaining leave continuously up to the maximum amount of leave permitted.

• Vacation pay, sick pay, PTO, and disability insurance benefits may be used in lieu of PFML and the employee is still entitled to employment protections
• Employer cannot compel the use of accumulated sick, vacation, or personal time while taking PFML leave
• Employer may offer Supplemental Benefit Payments (as further defined in the statute) and an employee may choose to receive them; Supplemental Benefits and PFML may not exceed the employee’s usual salary
• An employee is not eligible for PFML benefits for any portion of a week the employee is receiving workman’s compensation benefits
• An employee is not eligible for PFML benefit for any week the employee receives separation pay, severance pay, bonus pay, or any other payments paid because of separation from employment
• An employer may require PFML leave taken under this chapter to run concurrently with leave taken for the same purpose under section 181.941 or the FMLA.

State plan: 52 calendar weeks beginning the date an employee establishes a Benefit Account (as further defined by the statute)

Private plan: May select any of 4 leave year calculation methods:

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

According to the statute, an application for family or medical leave benefits is effective the Sunday of the calendar week that the application was filed.

• Posting is required in a form to be approved by the commissioner in paper or electronic format.
• Notice must be provided 30 days after the start of employment or 30 days before premium collection, whichever is later, in the primary language of the employee.
• Seasonal employees must receive notice that they are not eligible for PFML benefits at the time an offer is made or by 12/1/25, for existing seasonal employees

• Verbal, telephone, or text 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

• Employer may not retaliate against an employee for taking actions protected by the PFML statute
• 90 calendar days after employment, an employee is entitled to restoration to the same or an equivalent position following leave
  • If the employee is no longer qualified for their position because of the inability to attend a necessary course, renew a license, or fulfil a minimum number of hours as a result of the leave, the employee must be given a reasonable opportunity to fulfil the conditions after returning from leave
• Employee is entitled to any unconditional pay increases which occurred during the leave; conditional pay increases must be granted according to the employer’s policy for leave reasons other than PFML

• Employer must maintain group insurance coverage or health care plan for the employee and any dependents as if the employee was not on leave; employee must continue to pay the employee’s share of the cost of those benefits
• Benefits continuation includes group life insurance, health insurance, disability insurance, sick leave, annual leave, educational benefits, and pensions
• An employee may, but is not entitled to, accrue any additional benefits or seniority during PFML leave

• Employees’ earning statements must identify any amounts deducted from the employee for PFML and amounts paid by the employer for PFML
• Employers must submit quarterly wage detail reports to the state

An appeal must be filed within 60 days after the determination or amended determination is sent

• Self-funded or insured plans permitted; surety bond required for self-funded plans
• Must be offered to all of employer’s employees
• Must meet or exceed employee rights, protections, and benefits provided under state program
• Plan approval and oversight fee charged based on employer size
• Plans in effect for at least one year and then continuously until withdrawal or termination

• 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

• 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

• 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

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

• 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

• 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

• Start: January 1, 2023
• Amount: 60% of the employee’s average weekly wage (AWW)
• Maximum weekly benefit: Capped at 60% of taxable Social Security wages, which can change annually. $160,200 for 2023, $168,600 for 2024.

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

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

• 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

Any of 4 leave year calculation methods can be used:

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

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.

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.

• 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

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

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

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

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

• 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

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

• 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

• 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 times 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
• For 2024:
  • Earned at least $283.00 per week for 20 calendar weeks during the Base Year or earned $14,200 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)

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

• 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”

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

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
• The employer contribution is experience rated up to the $41,100 taxable wage base

2024:

• There will be no employee contribution for 2024.
• The employer contribution is experience rated up to the $42,300 taxable wage base

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
  • 2024: $1,055
• 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.

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

• 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

• 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 cease 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

52 weeks immediately preceding the week in which the disability began

• 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)

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.

• 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.

• 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

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

• 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

• 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)

RSLI – Insured

Matrix – Self-funded

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
• Is Disability and Paid Family Leave Coverage Required? (ny.gov)

• 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

Off-the-job injury or illness

• Pregnancy included (effective 1/1/24 disability presumed at least 4 weeks prior to due date, and 6 weeks after vaginal birth or 8 weeks after Cesarean; further disability requires medical certification)
• Organ donation (effective 1/1/24)
• Elective surgery not included

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

• 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

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

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

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

• Continuous only

• 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.
• Employer Provided Accrued Paid Leave – the statute is silent as to whether an employer may offer an employee the choice to use accrued leave to top off benefits and receive full pay; there is nothing in the statute that prohibits the employer from offering and the employee using accrued paid leave
• 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

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

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, whichever is later).

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

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

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

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

Not addressed

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

NY DBL forms

State plan: Paid Leave Oregon and Frances Online

Private plan:

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

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

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

• Medical Leave (employee’s own serious health condition)
• Organ, Body part, or Tissue Donation leave (incorporated into the definition of 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, stalking, or bias crimes
• 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.

• For all leaves: A completed application containing the information described in OAR 471-070-1100
• 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

None

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: capped at Social Security taxable wages ($168,600 for 2024)
  • Contribution rate and maximum wage amount announced by the Director annually by November 15
• 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

Benefits start September 3, 2023

• Maximum benefit: 120% of state Average Weekly Wage (AWW); $1,523.63 beginning 7/1/23
• Minimum benefit: 5% of state AWW; $63.48 beginning 7/1/23
• 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
• State AWW is determined each fiscal year beginning July 1; beginning 7/1/23 $1,269.69

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)

• 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 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

• 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

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

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"

• Verbal notice to the employer at least 30 calendar days in advance for foreseeable leave
• Employer may require written notice 30 calendar days before 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
• Employee must apply for benefits up to 30 calendar days prior to leave starting and up to 30 calendar days after the start of leave, late applications will be denied unless there is "good cause"

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

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

Quarterly report of wages earned and contributions paid

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: 60 calendar days from date of written denial to request appeal, or as soon as practicable if there is "good cause"
• 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 60 calendar days to request dispute resolution assistance through Oregon Employment Department, or as soon as practicable if there is "good cause"
• Department must issue advisory decision within 20 days

• Must be equal to or better than state plan and not impose any additional conditions or restrictions
• Must cover all Oregon employees continuously employed with the employer for at least 30 calendar days, regardless of hours worked, including temporary workers, and replacement employees hired to temporarily replace eligible employees during PFMLI leave.
• Any employees who were eligible for benefits under their previous Oregon employer's equivalent plan, who begin working for a new employer with an approved equivalent plan, must be automatically covered for benefits under the equivalent plan offered by the new employer
• Equivalent Plan Application Process:
  • Review the Equivalent Plan Guidebook and the Equivalent Plans Checklist.
  • Submit equivalent plan applications through the portal “Frances Online”
  • Fully-Insured plans – file carrier cover letter and sample policy document
  • Self-funded plans – file template (obtained from your Reliance Matrix account manager) and provide proof of solvency
  • Submit $250 application fee
• Effective Date of Plan
  • OED has 30 days to issue a decision regarding a plan
  • Pre-filed equivalent plans were effective starting on 9/3/23, when benefits started.
  • Otherwise, policies are effective first of the quarter after private plan approval
• Plan Duration and Renewals
  • Plans must be renewed annually for the first 3 years, 30 days before the expiration date
  • Thereafter, the equivalent plan will remain in place until there is a change to the plan, or the plan is withdrawn or terminated
  • "Substantive" changes require an application for renewal and non-substantive changes must be submitted to the department when the change becomes effective

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

• 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

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.

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.

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

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.

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.

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%.

• 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

26 weeks of paid benefit

Continuous only

• 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

26 paid weeks per 52 consecutive weeks

• 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

Must file with the state within 3 months of taking leave

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

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).

Not addressed

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

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

No Private Plan Option

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.

• 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

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

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

None

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

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

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

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

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

• 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

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