Do Medical Benefits Continue During Pfl
FAQ
Q. What is Massachusetts' Paid Family and Medical Leave (MA PFML)?
A. The MA PFML regulation mandates that covered individuals in Massachusetts (MA) are eligible to receive paid, job-protected time off of work for medical and family leave situations.
Q. Which employers are subject to the law?
A. All MA employers are required to participate, but some employers and employment types are exempt. The same types of employment that are excluded under Section 6 of the unemployment statute are also excluded from the PFML law.
Find a complete and updated list on the MA PFML website.
Q. Which employees are considered statutory, eligible covered individuals?
A. Generally, W-2 employees (full-time, part-time, or seasonal) eligible under the unemployment insurance program in MA. count as covered individuals for MA PFML. If an employer is required to report W-2 wages to the Department of Unemployment Assistance (DUA), that employee should be considered a MA PFML statutory eligible employee. Employees DO NOT need to reside in MA to be MA PFML statutory eligible employees.
Q. Can covered individuals/employees opt out of coverage?
A. See below:
- Employees paid through W-2 and considered a covered individual under the statute cannot opt out of coverage, even if they don't plan to use the benefit
- An owner paid through a W-2 is considered an employee of the company and cannot opt out of coverage
- Owners can opt out of coverage if they are K-1 earners
Q. Who pays the premiums?
A. Employers can fund all the contributions on behalf of the employee, or employers can collect payroll deductions up to the MA published caps of 100% of the paid family leave benefit or 40% of the paid medical leave benefit for employers with 25 or more eligible employees.
Q. What are MA PFML plan benefits?
A. Employees may be entitled to one of the following leaves each benefit year:
- Up to 12 weeks of family leave (includes active-duty family military leave plus bonding time)
- Up to 12 weeks for care of a family member
- Up to 20 weeks of personal medical leave
- Up to 26 weeks of caregiver benefit for a service member
- A total of 26 weeks for a combination of paid family and medical leave
Eligible employees will be paid a percentage of their gross wage, not to exceed a maximum benefit per week during the leave period.
Q. What is a benefit year?
A. The period of 52 consecutive weeks beginning on the Sunday immediately preceding the first day that job-protected leave under M.G.L. c. 175M commences for the covered individual.
Q. Who is considered a covered family member?
A. A covered family member is a spouse, domestic partner, child, parent or parent of a spouse or domestic partner; a person who stood in loco parentis to the employee when the employee was a minor child; or a grandchild, grandparent, or sibling of the employee.
Q. Does MA PFML provide intermittent leave?
A. Yes, employees may take leave on a continuous or intermittent basis.
Q. How will the MA PFML benefit be calculated?
A. The benefits are paid at 80% of the employee's average weekly wages, up to 50% of the state's average weekly wage (SAWW).
Any portion of the employee's average weekly wages that exceed 50% of the SAWW will be paid at 50%.
Wages are defined within M.G.L. c. 151A, § 1(s).
Q. What is the maximum benefit payable under the MA PFML plan?
A. The maximum weekly benefit amount will be 64% of the SAWW.
No later than Oct. 1 of each year, the department will establish a maximum weekly benefit amount at a level that is 64% of the then-applicable state average weekly wage. The adjusted maximum weekly benefit amount will take effect on Jan. 1 of the year following the new calculation.
Q. Is there a waiting period before the benefit is paid?
A. MA PFML benefits are not payable during the first seven calendar days of MA PFML leave.
The MA PFML law provides that an employee may use accrued sick or vacation pay or other paid leave provided under an employer policy during the first seven calendar days of leave.
There is no seven-day waiting period if the employee takes medical leave during pregnancy or childbirth and immediately takes family leave afterward.
A seven-day waiting period counts against the total available period of leave.
The waiting period is seven consecutive calendar days and not the aggregate accumulation of seven days of leave for intermittent or reduced schedule leave.
Q. Can an employer require an employee to use accrued paid sick, vacation, or personal time before taking or during MA PFML?
A. No, an employer may not require an employee to exhaust rights to any sick, vacation, or personal time before or while taking MA PFML. However, employees may choose to use accrued paid leave rather than apply for a benefit through the MA PFML program.
Q. What are the recordkeeping obligations for private plans?
A. Employers with private plans must retain all reports, information, and records related to the approved plan, including those claims for benefits made under the plan, for three years, and must furnish these records to the Department of Family and Medical Leave (DFML) upon request.
Source: https://www.usablelife.com/ma-pfml-general-frequently-asked-questions/