by Armando Rodriguez, Esq - Product Compliance Counsel, Compliance And Legal Department
December 22, 2021
And even after almost a year of paying benefits, many issues are still murky at best regarding how to administer – or how the state will administer – the Massachusetts Paid Family and Medical Leave program (MA PFML).
But last week the Massachusetts Department of Family and Medical Leave gifted employers with some easy to digest guidance regarding a couple of those loose ends.
Claim Benefit Calculations in 2022
- As a quick refresher, the MA PFML benefit rate is determined by considering both the employee’s individual average weekly wage and the SAWW. The SAWW increased from $1,084.31 for claims filed in 2021 to $1,694.24 for claims filed in2022. The guidance can be viewed here, but here are a few reminders and highlights: The employee’s individual average weekly wage, as well as the applicable SAWW is determined at the start of the employee’s benefit year (which starts the Sunday preceding the employee’s first date of leave), and remains the same for all claims in the following 52 weeks.
- Open claims initiated in 2021 that continue into 2022 will continue to receive the same benefit rate through the sooner of the expiration of the claim or the expiration of the benefit year
- New claims filed in 2022 during an open benefit year that began in 2021 will use the individual average weekly wage determined at the beginning of the benefit year; however, will use the SAWW rate from 2022 and will be subject to the 2022 benefit cap.
The Guidance also clarified an issue that has been the topic of much debate. It is now clear that a birth mother’s medical leave due to pregnancy/childbirth and time off to bond with the new child are two separate leave claims, and the SAWW will apply accordingly.
Claim Ownership when an Employer Switches PFML Plans
Additionally, the guidance includes direction concerning claim ownership and examples of scenarios that can arise when an employer switches from a private plan to a state plan, and vice versa, at different stages in the life of a claim. Essentially, employees are covered by the plan in effect at the time of the leave start. Consider the following:
- If an employee files for a leave with the state prior to the effective date of a private plan, but that private plan becomes effective as to that employee prior to the leave start date, then the private plan owns the claim, and the state plan will reject coverage.
- A timely filed extension is still considered part of the same claim even if the employer switches to another plan during the leave. Therefore, a leave that initiates under a private plan, and extends once the private plan is no longer in effect would still be owned by the private plan.
- However, as previously mentioned, medical leave for birth and leave for bonding are considered two separate claims, even if the leave for bonding begins immediately after the leave for birth. As such, an employee who was covered by the state plan for her leave for birth may need to file a new claim for bonding leave if a private plan has become effective prior to the start of that leave.
Matrix can Help! Have you checked out our overview of state paid programs? You can find it here. Be it leave management under the Family and Medical Leave Act and state laws, short-term disability, compliance with the ADA and reasonable accommodations, or private plans for statutory benefits, our team of experienced Absence Management Specialists are here to help. Contact your Matrix or Reliance Standard account manager or practice leader for more information, or send us a message at firstname.lastname@example.org.