New York Paid Family Leave – Final Regulations Out but No Surprises

Posted on: July 20, 2017 0

By Marti Cardi, VP-Product Compliance

& Gail Cohen, Director-Employment Law/Compliance

On July 19, the New York Workers’ Compensation Board issued its final regulations in support of the state’s Paid Family Leave law (NY PFL), which requires employers to provide paid leave benefits to employees starting January 1, 2018.  The final regulations follow a public comment period on the proposed rules issued on May 24, 2017.   The Board received 58 comments and has also issued an Assessment of Public Comment on Revised Proposed Regulations which provides a summary of the comments receive and the Board’s response.   Few substantive changes were made as a result of the comments, but the Assessment provides helpful clarifications on many provisions – even those for which it did not make any changes.

Here is a summary of the more noteworthy (or more interesting) changes and clarifications.

Coverage of employees outside the state of New York

Several comments requested the Board to change the regulations so that employees who do not live and work in New York are not covered by NY PFL.  The Board declined to make this change and clarified that an employee is entitled to NY PFL leave and benefits if some of his or her work is performed in New York and the employee is either: (1) based in New York; (2) controlled from New York; or (3) lives in New York.

In addition, the Board received a request to amend the regulations to allow employers to include non-New York employees in their coverage under NY PFL .  The Board pointed out it does not have authority to regulate employees or insurance outside the state of New York and declined to amend the regulations per this request.

Multiple or extended leaves under NY PFL and other programs

The Board confirmed that an employee may be able to take leave in 2017 under company policies (or the FMLA) and then be entitled to leave and benefits under NY PFL for the same qualifying event in 2018.  Examples:

  • An employee who receives a new child on August 1, 2017, could take bonding leave under company policies

(which may provide a pay benefit) and/or FMLA in 2017, then take up to 8 weeks of bonding leave under NY PFL any time from January 1 through July 31 in 2018.

  • An employee could take up to 12 weeks of FMLA leave in late 2017 to care for a covered family member

with a serious health condition, then take up to 8 weeks of leave starting January 1, 2018, to continue care for the same family member.

Fortunately, this anomaly will only occur for certain leaves in 2017 and 2018, and not for subsequent years.

Notice of payroll deductions to employees

There is no requirement in either the statute or the regulations for employers to give notice to their employees of NY PFL payroll deductions.  However, Matrix recommends that employers should, in fact, provide notice of the employees’ contributions and other aspects of NY PFL so that employees have the facts and appropriate expectations.  Matrix has prepared a sample introductory communication to employees for consideration, and will work with clients to craft additional messaging in Q4 2017. Employers should consult with employment counsel to ensure employee communications are appropriate to the law as well as their own corporate policies and practice.

Military exigency leave

NY PFL provides leave to care for several defined family members with a serious health condition, including the employee’s child, spouse, domestic partner, parent, grandchild, and grandparent.  However, the Board has confirmed military exigency leave under NY PFL (which adopts the provisions of the FMLA for this leave) is NOT available for leave necessitated by the military service of a grandparent or grandchild.

Leave and benefits under both New York disability and paid family leave laws

The Board received inquiry about an employee’s ability to receive both disability (DBL) and PFL benefits for the same birth of a child.  The Board pointed out that the regulations clearly state an employee can collect both disability benefits and paid family leave in the post-partum period, but not at the same time.  Thus, a new mother could receive disability benefits for some period of time following giving birth, and then take paid family leave within the one year period following the date of birth.

The Board did not address the possibility of using NY PFL for the week following birth during the 7-day waiting period for disability benefits, then switch to disability benefits followed with more paid family leave for bonding.  There appears to be nothing in the statute or the regulations that would prohibit this, since NY PFL can be taken in increments of one day or more.

The NY disability and PFL laws limit an employee’s total benefits under both programs to 26 weeks in a 52-week period.  The Board clarified that because the employee’s use of benefits is calculated retroactively backward from each day of usage, this will bridge the 52-week period back into year 2017 during 2018.

Employee waiver of NY PFL coverage and deductions

NY PFL allows an employee who expects that his/her term of employment will be less than 26 weeks for employees working 20 hours per week or more (or 175 work days for employees working fewer than 20 hours per week) can elect to waive coverage and payroll deductions.  In response to a request for clarification, the Board has amended the regulations such that employers MUST provide notice to employees of their right to waive coverage.  The waiver must be in writing and if the employee’s term of employment exceeds 26 weeks or 175 work days, the employer must start payroll deductions and can collect back premiums from the employee.  The regulations do not address how the employer is allowed to collect the back premiums, but other provisions make it unlikely that additional deductions from the employee’s paycheck would be permissible.

Employers will not be permitted to automatically waive PFL coverage for short-term workers.  According to the Board, it is the employee’s election to make.

Notice to employee of completed pre-filed claim

The draft regulations required carriers to provide employees who pre-filed a claim a confirmation of receipt of the completed claim within one business day.  Due to objections about the practicality of processing and assessing a claim for completeness within one day, the regulations have been changed to allow a carrier or self-insured employer three business days to send the confirmation.  The payment must still be made within 18 days of receipt of the complete claim.

Inconsistency between carrier’s and employer’s determination of NY PFL benefits and leave rights

The Board received a comment recognizing that “there could be a disconnect between the carrier’s determination and the employer’s determination about whether or not leave should be denied.”   I’m quoting here because I’m not sure how else to explain this issue:  The Board’s less-than-satisfactory response is, “Because the employer does not decide whether to approve or deny a paid family leave claim, and if the employer suspects fraud it is free to contact the carrier, no change to the regulations has been made.”  The Board did not address the question whether the employer would be acting properly if it chooses to use the carrier’s benefits determination as a proxy for the leave determination, thus eliminating the possibility of such inconsistency.

Rights of employees with more than one job

An employee working simultaneously for more than one New York employer will have NY PFL contributions deducted from their pay from each employer.  The Board confirmed that yes, an employee can take NY PFL leave and receive benefits from multiple employers at the same time for the same leave reason.  The Board acknowledged that this might result in the employee receiving total benefits in excess of the statutory cap available from employment with a single employer.  However, the Board confirmed that the total number of weeks of NY PFL leave and benefits available to an employee in a 52-week period is still subject to the 8-week limit in 2018 (increasing to 12 weeks by 2021).

WHAT IS MATRIX DOING NOW?

Whew!  That is about all I can bring to light in the 24-ish hours since the final regulations were published.  But we are FAR FROM DONE!

In June Matrix presented webinars, FAQs, and other materials to help employers and brokers understand and prepare for New York Paid Family Leave.  Over the coming days and weeks, we will use the final regulations and comments to update all materials, and develop additional ones as warranted. In August we will host another round of webinars.

In the meantime you can always learn more about the law as follows:

  • Check out these prior blog posts (but remember some information has changed due to revisions to the

regulations, including those discussed above):

May 2017

March 2017

April 2016

great introductory primer).

  • Ask a question OR sign up for our NY PFL Tip-Of-The-Week by emailing nypfl@rsli.com.

 

MATRIX CAN HELP!  Matrix provides leave, disability, and accommodation management services to employers seeking a comprehensive and compliant solution to these complex employer obligations. We monitor the many leave laws being passed around the country and specialize in understanding how they work together. For leave management and accommodation assistance, contact us at ping@matrixcos.com.

Ten Years Later, Washington State Makes Its Paid Family Leave Dream a Reality

Posted on: July 6, 2017 0

By Marti Cardi, VP-Product Compliance

Gail Cohen, Director-Employment Law/Compliance

The state of Washington has enacted a law requiring paid family and medical leave for eligible employees.  The state was on the forefront of the paid family leave movement when it passed a paid parental leave law in 2007, but the law never went into effect because the legislature was unable to fund the benefit.  Now, a paid family leave bill much broader than the 2007 law was signed into law by Governor Jay Inslee on July 5, 2017.  The law will begin providing paid leave benefits to eligible employees on January 1, 2020.*

States with paid family leave programs currently in effect are California, New Jersey and Rhode Island, plus New York (benefits beginning January 1, 2018), and the District of Columbia (benefits beginning January 1, 2020).  The groundswell is huge, with more than 25 states introducing some sort of paid family leave bill so far this year!

Here is a summary of key provisions of the Washington law:

Effective date Employees can start taking paid family leaves January 1, 2020.

Employers can begin employee payroll deductions on January 1, 2019.

Eligible employees Must work 820 hours in the “qualifying period,” defined as the first 4 of the prior 5 calendar quarters; OR, if the employee is not yet eligible, the preceding 4 calendar quarters.  Equates to about 15.75 hours per week.
Covered employers An individual or entity with one or more employees; includes private companies, the state and subdivisions, and local governments.
Leave benefits reasons Employee’s own serious health condition.

Bonding with a newborn or newly placed or adopted child.

Care for a family member with a serious health condition.

Military exigency (leave necessitated for various reasons due to a family member’s active duty deployment).

Duration of leave benefits Employee’s own serious health condition  – 12 weeks per 52 consecutive calendar weeks.

Bonding with a new child, to care for a family member with a serious health condition, or due to a military exigency – 12 weeks total per 52 consecutive calendar weeks.

Limited to 16 weeks total per 52 consecutive calendar weeks for employee’s leave and family leave reasons; plus additional 2 weeks if needed for pregnancy complications.

Maximum total leave benefit is 18 weeks per 52 consecutive calendar weeks.

Increments of leave benefits Minimum of 8 hours, rounded down to the next full hour.
Waiting period for benefits There is no waiting period for bonding leave benefits following the birth or placement of a child.

For other types of leave benefits, there is a waiting period of 7 calendar days.

Family members for whom leave can be taken Child (any age), parent, spouse, state-registered domestic partner, sibling, grandparent, grandchild.
Benefits Maximum of $1000 per week starting in 2020, subject to adjustment by the state for each subsequent calendar year.

Employees who make 50% or less than the state’s average weekly wage (AWW) will receive 90% of their AWW.

Employees who make greater than 50% of the state’s AWW will receive:

o   90% of their wages up to 50% of the state’s AWW; PLUS

o   50% of their AWW in excess of 50% of the state’s AWW (subject to the $1000 cap)

Funding For 2019 and 2020, the total premium is 0.4 percent of the employee’s wages, capped at the state’s AWW, beginning on January 1, 2019. Annual adjustments may be made thereafter.

An employee pays about 2/3 of the total premium through payroll deductions.

The employer pays about 1/3 of the total premium.

An employer may elect to pay all or a portion of the employee’s share of the premium.

Self-funded plans The law authorizes employers to operate their own equivalent voluntary plans.
Miscellaneous Includes special provisions for small businesses with fewer than 50 employees.

Allows tribes and self-employed individuals to opt in.

Job protection Following leave and benefits, an employee is entitled to restoration to the same position held before the leave; or to an equivalent  position with equivalent benefits, pay, and other terms and conditions of employment at a workplace within 20 miles of the employee’s original workplace.

What’s next?

There are many unanswered questions about this law and how it will interact with the existing Washington Family Leave Act and the federal Family and Medical Leave Act, which provide unpaid job-protected leave for many of the same reasons.  We expect robust regulations to be passed before the effective date of January 1, 2020.  In the meantime, for your reading pleasure we provide this link to the full text of the Washington law.

*Please be patient!  We have over 2 years to implement this law.  In the meantime, we are working diligently to be ready for the New York paid family leave law and the ERISA disability claims handling rules changes, both effective January 1, 2018!  You can find prior posts on the New York law here  and here.  A primer on the new ERISA regulations is available here.

 

 

MATRIX CAN HELP!  Matrix provides leave, disability, and accommodation management services to employers seeking a comprehensive and compliant solution to these complex employer obligations. We monitor the many leave laws being passed around the country and specialize in understanding how they work together. For leave management and accommodation assistance, contact us at ping@matrixcos.com.

NEW YORK HONING IN: Paid Family Leave Revised Regulations are Out, but Still Not Final

Posted on: May 29, 2017 0

By Marti Cardi, VP-Product Compliance

 

The New York Workers’ Compensation Board has issued revised regulations interpreting and supporting the state’s Paid Family Leave law that will start providing employees with pay benefits on January 1, 2018.  This revised version of the regulations, published on May 24, 2017, is still not final.  The Board is accepting comments for 30 days, or until June 23, 2017.

As a reminder, the law phases in from 2018 through 2021.  Job-protected leave starts at 8 weeks per 12-month period and increases to 12 weeks; pay benefits start at 50% and increase to 67% in 2021.  Leave is available to bond with a new child, care for a family member with a serious health condition, and tend to matters due to the active duty military deployment of a family member.    A more detailed review of the law’s provisions is available on our prior Matrix Radar blog post here.

Along with the revised proposed regulations, the Board published a summary of the 117 comments received during the public comment period from advocacy groups, individual employees, and associations representing businesses, insurance carriers, law firms, unions, and employees.   Here are a few interesting issues raised by the comments and the Board’s responses:

Employee Eligibility. NY PFL requires employees to become eligible for family leave after either 26 weeks or 175 days of work, depending on their schedule. The original regulations applied the 175-day eligibility rule only to part-time employees who worked fewer than 5 days per week.   Section 380-2.5 has been amended to apply the 26 week eligibility criteria to employees who work 20 or more hours per week, and the 175-day eligibility criteria to those who work less than 20 hours per week.  380-2.5(a) and (b).

Employer’s Lack of Cooperation. Some insurance carriers requested clarity around their obligations if an employer refuses to cooperation in the PFL benefits process.  The Board responded that the regulations then require the carrier to communicate directly with the employee, and the employer’s lack of cooperation is not grounds for denial of benefits.   380-5.4(e).

ICD-10 Code. The proposed regulations originally required that certifications from medical providers of a family member’s serious health condition include the ICD-10 code for the diagnosed condition.  Commenters identified various concerns, ranging from possible delays caused by incomplete forms, to health privacy concerns. In light of these comments, this section has been amended to remove the provision requiring that the ICD-10 code be included as part of the family member’s certification.  380-4.2(a)(3).

Employee Language Preference.  The original proposed regulations required an insurance carrier or self-insured employer to make all communications with an employee in the language identified by the employee on the Request for Paid Family Leave.  The Board received several comments expressing concern that complying with this requirement will be overly burdensome and prohibitively expensive. As a result, the Board has indicated that it will translate the request for paid family leave forms and instructions into seven languages (not identified), and has revised the regulation to state that insurance carriers or self-insured employers must make all reasonable efforts consistent with the principles set forth in Executive Order 26.”  §380-5.4(h).

Denial of Claim. Any denial of a claim for PFL benefits must be issued within 18 days of receipt of a completed claim.  The revised proposed regulations have added a section specifying that the notice to the employee must state the reason for the denial, repeat any relevant information filed in the request for PFL, and include any other information considered by the carrier in making the denial decision.  380-5.4§(a)(1).

Employer Size for Coverage. Several small employers and individuals expressed concerns about the adverse effect of paid family leave on small employers. The statute defines a covered employer as an employer with one or more employees, and this cannot be modified by regulation. Therefore, no change has been made.

Employee Contributions during Leave. The Board has revised the regulations to clarify that an employer can continue to deduct PFL contributions while an employee is receiving disability or PFL benefits.  380-7.2(b)(4).

The full text of the revised proposed regulations, a summary of all comments received, and other NY PFL information is available on the Paid Family Leave page of the Workers’ Compensation Board website:  http://www.wcb.ny.gov/PFL/pfl-regs.jsp.

MATRIX CAN HELP!

Matrix provides leave, disability, and accommodation management services to employers seeking a comprehensive and compliant solution to these complex employer obligations. We monitor the many leave laws being passed around the country and specialize in understanding how they work together. For leave management and accommodation assistance, contact us at ping@matrixcos.com.

New York Paid Family Leave – Proposed Regulations Announced

Posted on: March 2, 2017 0

By Marti Cardi, VP-Product Compliance

The New York Paid Family Leave act goes into effect on January 1, 2018.  This law provides both job protection similar to the FMLA, and also provides a pay benefit to employees during covered leaves of absence.  Now, New York Governor Cuomo has announced that the proposed regulations in support of the law have been published in the State Register and are open for public comment for 45 days.  Links to the text of the proposed regulations and related materials can be found on the New York State website here.

The law phases in from 2018 through 2021.  Job-protected leave starts at 8 weeks per 12-month period and increases to 12 weeks; pay benefits start at 50% and increase to 67% in 2021.  Leave is available to bond with a new child, care for a family member with a serious health condition, and tend to matters due to the active duty military deployment of a family member.    A more detailed review of the law’s provisions is available on our prior Matrix Radar blog post here and in the state’s announcement of the proposed regulations.

The state has also created a new helpline (844) 337-6303 and a new website to answer questions and provide more information about the paid leave program.

Part of a Trend

Three other states – California, New Jersey, and Rhode Island –  also have state programs for paid family leave, and Washington, D.C., has passed such a program to go into effect in 2020 (subject to review by the U.S. House and Senate).  These states and also Hawaii, New York, and Puerto Rico offer separate programs for disability insurance for an employee’s own health condition.

But that’s not all!  As of February 28, the following 10 states have also introduced legislation for paid family leave:  Connecticut, Hawaii, Illinois, Missouri, Oklahoma, Oregon, South Dakota, Tennessee, Texas, and Virginia (died in committee within 3 weeks of proposal – that was quick!).  Some of these also include pay benefits for leave due to the employee’s own health condition.  In addition, the state of Washington passed paid family leave legislation in 2007 but it never went into effect due to lack of funding.  Washington has introduced new bills this year to provide that funding and implement its paid leave law.

Matrix and Reliance Standard Can Help!

At Matrix we have been waiting for this development. We will closely review the proposed regulations, inform our clients, business partners, and readers of any significant provisions, and submit comments to the state if appropriate. We’ll do the same when the regulations – as is or revised – become final.

In the meantime, Matrix’s compliance and product leaders are guiding a team with representatives from all affected functional areas in preparing to administer the job-protected leave provisions of the law effective January 1, 2018.  Our sister company, Reliance Standard Life Insurance Company, has likewise assembled a team of representatives from all functional areas to design the product offering.  In order to be ready by the effective date, Reliance Standard has already created system requirements and is preparing to start development.

If you have questions or want more information, contact us at ping@matrixcos.com or salesandmarketingHQ@rsli.com.