2024 Arch Disability & Paid Family Leave Reference Guide

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Linda Fallon has more than 30 years’ experience in the insurance industry, and has been at Arch Insurance since 2011. Thanks to her years of experience and dedication, Fallon was elected to the Insurance Business Magazine’s Hot 100 list, being identified as someone who has helped shape the insurance industry. She currently heads Arch’s Accident and Health unit, which includes all disability, accident and travel insurance products.

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JULIE LUNG

JEFF DAVIDSON

JIM IANNICELLI

THOMAS FOSCHINO

CALIFORNIA

State Disability Insurance (SDI) and Paid Family Leave (PFL)

What is the eligibility for employees and employers?

Employer: Have one or more employees and with a quarterly payroll of $100 or more; employ domestic employees with a quarterly payroll of $750 or more.

Employee: Earned at least $300 from which State Disability Insurance (SDI) deductions were withheld during their base period.

How is coverage provided?

State-administered OR

Voluntary plan (VP): Self-funded, must include SDI and PFL, must exceed state plan benefits in at least one provision and must be approved by the state’s Employment Development Department (EDD).

What are the contribution rates?

2024 Annual Taxable Wage Base: No limit

Employee: 0.9%

Employer: Optional, may elect to pay all or part of employee amount.

What are the covered conditions?

Applies to SDI

Employee’s own disability (illness, injury or pregnancy).

Applies to PFL

Care for a seriously ill family member.

Bonding with newly born minor child, adopted or fostered child.

Military exigency.

What are the weekly statutory benefits?

Payable at 60%–70% of employee’s average weekly earnings in highest quarter of base period.

2023 weekly benefits: Minimum is $50.00; maximum is $1,620.00 with up to $84,240.00 in total.

Benefits payable for less than one week will be paid in increments of one-seventh (1/7) of the weekly benefit.

When do benefits begin?

Applies to SDI

On eighth (8th) consecutive day of disability.

What is the maximum benefit period?

Applies to SDI

Fifty-two (52) weeks.

Exception: Employers and self-employed individuals who elect SDI coverage, the maximum duration is (39) weeks.

Who is exempt from coverage?

Applies to PFL

On first (1st) day of leave.

Applies to PFL

Eight (8) weeks in a twelve (12) month period (claims incurred July 1, 2020 and later).

Federal, state and municipal employees (including teachers) are not required to contribute to a SDI/VDI plan; however, the employer can elect to cover employees.

Note: The full list of employee types may be found at https://www.edd.ca.gov/pdf_pub_ctr/de231ee.pdf

Additional Resources: www.edd.ca.gov/disability

COLORADO

Family and Medical Leave Insurance (FAMLI)

What is the eligibility for employees and employers?

Effective January 1, 2024

Employer: A covered employer includes any person engaged in commerce or an industry or activity affecting commerce that employs one or more person each working day during each of 20 or more calendar work weeks in the current or prior calendar year, or that has paid wages of $1,500 or more during any calendar quarters in the preceding calendar year.

Employee: Any employee is eligible if they have worked for a covered employer and earned at least $2,500 in wages subject to premium during the person’s base period or alternative base period. Self-employed persons can elected coverage. An employee of a local government can also elect coverage where the local government has declined participation in the program.

Independent contractors are excluded as are persons subject to the Railroad Unemployment insurance act.

How is coverage provided?

State-administered OR

Private plan: An employer can establish a self-funded or fully insured private plan for providing CO PFML benefits. A private plan must confer the same rights, protections and benefits as the state plan and cannot cost the employees more than they would remit in the state plan. An employer with an approved private plan is not required to remit premiums to the fund.

Additional Resources: famli.colorado.gov

What are the contribution rates?

The program is funded by employee and employer premiums.

Employee: The premium rate is capped at 0.90% of wages in the program’s first two years and then will be set by the state PFML Division Director for years 2025 and beyond, though not to exceed one and two tenths of a percent (1.2%) of wages per employee.

Employer: Employers with ten or more employees may deduct up to 50% of the premium from employees’ wages and will be responsible to remit 100% of the premium required.

An employer with less than ten employees may deduct up to 50% of the premium required from the employees’ wages and will remit 50% of the premium required to fund the program.

Premiums shall not be required for the employees’ wages above the contribution and benefit base limit established annually by the federal Social Security Administration (SSA) for purposes of Old-Age, Survivors, and Disability insurance program limits. The 2024 SSA wage cap is $168,600.

What are the covered conditions?

Reasons for leave include:

Bonding with the employee’s newborn or newly placed child within a year of the birth, adoption, or foster care placement,

Caring for a family member with a serious health condition,

Employee’s own serious health condition,

Qualifying military exigency, or

Need for safe leave.

When do benefits begin?

On first day of leave.

Note: There is a 0-day waiting period for this program.

What is the maximum benefit period?

The maximum available leave that can be taken for any leave reason is 12 weeks. However, leave is available for an additional 4 weeks if leave is taken for a serious health condition related to pregnancy complications or childbirth complications. Therefore, the maximum available leave is 12 or 16 weeks. The leave maximums are available per “application year” which is measured as the 12 month period beginning on the 1st day of the calendar week in which an employee files an application for family and medical leave insurance benefits.

What are the weekly statutory benefits?

Benefits are paid at 90% of the employee’s wages up to 50% of the state’s average weekly wage. Earnings greater than 50% of the state’s average weekly wage will be paid at 50%. The maximum benefit will be set to 90% of the state average weekly wage except that for the year 2024 the maximum will be $1,100 per week.

CONNECTICUT

Family and Medical Leave Insurance (FMLI)

What is the eligibility for employees and employers?

Employer: All private employers, except for non-public elementary or secondary schools. Public employers are generally excluded, except with respect to covered public employees.

Employee: Have earned at least $2,325 during his or her highest earning quarter within the base period and meet one of the following:

Are presently employed,

Have been employed by an employer in the previous 12 weeks, or Are self-employed or sole proprietors who opted into the program.

How is coverage provided?

State-run OR

Private plan: A private plan may be fully insured or self- insured, must fully meet or exceed the state plan, and be approved by the Connecticut Paid Leave Authority. A majority vote of employees is required for employers to move to a private plan.

What are the weekly statutory benefits?

Employees with an average weekly wage that is 40 times the minimum fair wage will receive 95% of their base week earnings; 40 times minimum fair wage is $627.60.

Employees with an average weekly wage greater than 40 times the minimum fair wage will receive the underlying 95% plus an additional 60% of their base weekly earnings above that amount.

The benefit rate is capped at 60 times the Connecticut minimum wage.

Note: 60 times the minimum wage will be equal to $941.40 as of January 1, 2024 based on the new minimum wage of $15.69.

When do benefits begin?

On first day of leave.

Note: There is a 0-day waiting period for this program.

What are the covered conditions?

PML: Employee’s own serious health condition.

PFL: Bonding with newly born child, adopted or fostered child; care of a family member with a serious health condition; military exigency or care of a covered service member, to serve as an organ or bone marrow donor, for reasons covered under Connecticut’s domestic violence leave law.

What are the contribution rates?

Employee: 0.5%* of an employee’s wages up to the 2024 Social Security wage cap of $168,600.

Employer: Optional, may elect to pay all or part of employee amount.

*Contribution rates as required under the state’s plan. Rates may differ under a private plan but may not exceed the employee contribution under the state plan.

What is the maximum benefit period?

Overall family and medical leave duration: Up to 12 weeks of CT FMLI benefits over a 12-month period. The program also provides two (2) additional weeks of benefits for a serious health condition that results in incapacitation during pregnancy.

Additional Resources: ctpaidleave.org

DELAWARE

Family and Medical Leave Insurance (FAMLI)

What is the eligibility for employees and employers?

Employer: Participation in Delaware Paid Leave is mandatory for most businesses with 10 or more employees. Employers with fewer than 10 employees, and seasonal operations that shut down for a month or more are exempt. Employers with 10-24 employees are required to provide Parental Leave only. Employers with 25 or more employees must provide full coverage.

Employee: Those who have been employed for at least one year and at least 1,250 hours with a single employer are eligible. Federal government employees are exempt.

What are the weekly statutory benefits?

Employees will get up to 80% of their wages up to $900 per week for approved leaves.

How is coverage provided?

State-run OR

Private plan: A private plan may be insured or self-funded, must meet or exceed the state plan benefits, and must be approved by the Division on an annual basis. The first opt-in/opt-out period is September 1 through December 1, 2024.

What are the covered conditions?

Care for a new child (up to 12 weeks per year)

Care for a family member with a serious health condition (up to 6 weeks, every 24 months)

Address a personal serious health condition or injury (up to 6 weeks, every 24 months)

Assist while loved ones are on overseas military deployment (up to 6 weeks, every 24 months)

What is the maximum benefit period?

Employees are limited to a maximum of 12 weeks of total combined leave per year.

Note: To read the legislation, visit: https://legis.delaware.gov/BillDetail?LegislationId=79186

Additional Resources: labor.delaware.gov/delaware-paid-leave-is-coming

What are the contribution rates?

The program will be funded by 0.8% of an employee’s earnings established by FICA rules. This rate is guaranteed through 2026, and component rates are available for each line of coverage. Employers can require employees to contribute up to 50% of the cost.

What is the Grandfathered Plan?

Employers who offer a private paid leave benefit that is comparable to Delaware Paid Leave can apply to opt out of the state plan. To qualify for grandfathering, your benefit program must:

Be in writing and have been in place before the Healthy Delaware Families Act was signed into law; Not cost employees more than the Delaware Paid Leave; Be within 10% of the main benefit provisions of Delaware Paid Leave; and Parental leave plans must cover employees regardless of sex, gender, or marital status.

Employers must make a choice to temporarily extend existing paid time off benefits by January 1, 2024.

Employers with between 10-24 employees can reduce employee’s maximum Parental Leave benefit duration from 12 weeks to between 6 and 11 weeks. This must be done by January 1, 2024 via the online application process.

DE PFML Timeline:

October 1, 2023 to January 1, 2024: Grandfathering portal opens September 1, 2024 to December 1, 2024: Opt-in for small employers and Opt-out for private plans.

January 1, 2025: State plan contributions begin.

January 1, 2026: Benefits become available.

DISTRICT OF COLUMBIA

Paid Family Leave (PFML)

What is the eligibility for employees and employers?

Employer: All District of Columbia (D.C.) employers who are required to pay unemployment insurance are required to participate. Self-employed individuals may choose to opt into the program.

Employee: Works for employer more than 50% of their time in the district, regularly spends a substantial amount of work time for that employer in the district and not more than 50% of time in another jurisdiction; employees must meet the requirements within 52 weeks.

How is coverage provided?

State-administered only, no insured or self-insured plans permitted.

What are the contribution rates?

Employer: 0.62% of the covered individual’s wages (there is no wage cap) – Functions like an employer payroll tax.

Employee: 0%

What are the covered conditions?

Medical leave: Employee’s own serious health condition.

Parental leave: Bonding with a newly born, adopted or fostered child.

Family leave: Care for a family member with a serious health condition.

When do benefits begin?

On the eighth (8th) day of leave.

What is the maximum benefit period?

Medical leave: Up to twelve (12) work weeks.

Parental leave: Up to twelve (12) work weeks.

Family leave: Up to twelve (12) work weeks.

Pre-natal leave: Up to two (2) work weeks.

Overall family, parental and medical leave duration: Up to twelve (12) weeks.

What are the weekly statutory benefits?

If the employee makes less than or equal to 150% of minimum wage multiplied by 40, the benefit is 90% of the employee’s weekly wage.

If the employee makes more than 150% of minimum wage multiplied by 40, the benefit is the underlying 90% benefit plus 50% of the remaining weekly wage over 150% multiplied by 40.

Maximum weekly benefit = $1,049 as of October 1, 2022.

Additional Resources: dcpaidfamilyleave.dc.gov

HAWAII

Temporary Disability Insurance (TDI)

What is the eligibility for employees and employers?

Employer: Have one or more employees and have a quarterly payroll of $225 or more (includes employers that employ domestic workers).

Employee: Must have 14 weeks of covered employment when they were paid for 20 hours or more and earned at least $400 in the first 52 weeks prior to first (1st) day of disability.

How is coverage provided?

Private-insured OR

Self-insured: Must meet minimum state requirements and must be approved by the state’s Disability Compensation Division (DCD).

What are the contribution rates?

Employer: Employer may deduct one-half (½) the premium cost capped at 0.5% of the state’s average weekly wage (for 2024, maximum weekly deduction is $6.87 based on the $1,374.78 state average weekly wage).

At least one-half (½) of plan costs, plus any additional costs not chargeable to employees.

Employee: At least one-half (½) of plan costs, plus any additional costs not chargeable to employees.

When do benefits begin?

On eighth (8th) consecutive day of disability.

What are the covered conditions?

Employee’s own disability (illness, injury or pregnancy).

What are the weekly statutory benefits?

Payable at 58% of employee’s average weekly earnings.

2024 weekly benefits: Minimum is $14.00; maximum is $798.00.

Benefits payable for less than one week will be paid in increments of one-fifth (1/5) of the weekly benefit.

What is the maximum benefit period?

Twenty-six (26) weeks.

Who is exempt from coverage?

Federal, state and municipal employees

Certain domestic workers

Student nurses and interns

Real estate salespersons paid solely on a commission basis

Certain family employees

Insurance agents

Note: The full list of employee types may be found at: labor.hawaii.gov/dcd/frequently-asked-questions/tdi/

Additional Resources: labor.hawaii.gov/dcd/home/about-tdi

MAINE

Paid Family and Medical Leave (PFML)

What is the eligibility for employees and employers?

Employer: All employers, including state and governmental employers, with at least one employee working in the state. A tribal government may opt into the state plan.

Employee: All employees having at least 6 times the state average weekly wage (SAWW) in earnings during the base period. The base period is the first four quarters before the first day of the benefit year.

Self-employed individuals may opt into the state plan.

How is coverage provided?

State administered plan OR

Private plan: State approved private plans may be self-funded or fully insured and must be substantially equivalent to the state plan.

What are the contribution rates?

Employer: Contributions begin January 1, 2025 and are initially capped at 1.0% of wages up to the Social Security cap ($168,600 for 2024). Starting in 2028, the state will annually adjust the rate by October 1 for the following year. Employers can charge employees up to 50% of the premium via payroll deduction. Employers with fewer than 15 employees do not have to contribute, but still must deduct the employee portion and remit to the state.

Employee: No more than 50% of the state rate up to the annual Social Security wage limit ($168,600 for 2024).

When do benefits begin?

Benefits begin on day eight for medical leaves. There is no waiting period for other qualifying leave reasons.

What is the maximum benefit period?

Employees may take up to 12 weeks of combined medical and/or family leave within a benefit year. A benefit year is the 12-month period beginning on the first day of the calendar week immediately before the leave start date.

Intermittent leaves may be taken for all qualifying leaves in increments of at least 8 hours or another reduced schedule agreed upon by the employer and employee.

What are the covered conditions?

Medical leave for one’s own serious health condition.

To bond with a child within 12 months after birth, adoption, or foster care placement.

To care for a family member with a serious health condition.

Qualifying military exigency of a family member.

Care of a family member who is a current or former service member requiring service related care.

Safety leave for employees and family members.

Organ donation leave.

Military bereavement leave.

ME PFML Timeline:

October 25, 2023: PFML program established

January 1, 2024: Authority appointed

Spring 2024: Rulemaking begins

January 1, 2025: State plan contributions begin

May 1, 2026: Benefits begin

Note: To read the legislation, visit: https://www.maine.gov/labor/docs/2023/pfml/2023PLc412PFMLExcerpt.pdf

Additional Resources:

https://www.maine.gov/labor/pfml/

MARYLAND

Family and Medical Leave Insurance (FAMLI)

What is the eligibility for employees and employers?

Employer: All employers will be required to provide family and medical leave insurance.

Employee: Any worker in MD who has worked 680 hours in the past 12 months is automatically covered. Self-employed individuals may opt into the state plan.

How is coverage provided?

State administered plan OR

Private plan: Fully insured or self-funded plan with benefits equal to or greater than the state plan, subject to approval from the MD Department of Labor FAMLI Division.

What are the contribution rates?

Employee: The state rate effective October 1, 2024 will be 0.9% of covered wages up to the Social Security cap, and will be equally divided between employers and employees with 15 or more workers. Employers may choose to cover part or all of their employee’s contributions. Employers with 14 or fewer employees are not required to contribute but will still collect contributions from employees.

Employer: Employees cannot be charged more in a private plan than they would pay under the state plan.

What are the covered conditions?

Employee’s own serious health condition

Family member’s serious health condition

To welcome a child

To prepare for a family member’s deployment

What is the maximum benefit period?

Up to 12 weeks

What are the weekly statutory benefits?

Up to $1,000 maximum weekly benefit

MA FAMLI Timeline:

October 1, 2023: State plan contribution rate set. Early 2024: Rules and regulations published.

Fall 2024: Employers select state plan or seek approval for private plan. October 1, 2024: State plan funding begins. January 1, 2026: Benefits become available.

Note: To read the legislation, visit: https://mgaleg.maryland.gov/2022RS/chapters_noln/Ch_48_sb0275E.pdf

Additional Resources: dllr.state.md.us/famli/

MASSACHUSETTS

Paid Family and Medical Leave (PFML)

What is the eligibility for employees and employers?

Employer: All Massachusetts employers are required to participate. Self-employed individuals are excluded; however, they may elect coverage.

Employee: Have earned 30 times the weekly unemployment benefit that they are eligible to receive and have earned a minimum of $6,000.00 over the past 4 calendar quarters. Former employees (that previously met eligibility) separated from employment not more than 26 weeks at the start of their leave are eligible for benefits.

How is coverage provided?

Commonwealth-administered OR

Plan exemption (private plan): A private plan may be fully insured or self-insured and must fully meet or exceed the commonwealth plan and must be approved for exemption by the commonwealth’s Department of Family and Medical Leave (DFML).

Note: PFML is one joint program that provides medical leave and family leave benefits.

What are the weekly statutory benefits?

Employees with an average weekly wage less than or equal to 50% of the commonwealth’s average weekly wage will receive an 80% benefit. The 2024 commonwealth’s average weekly wage is $1,796.72.

Employees earning more than 50% of the commonwealth’s average weekly wage will receive the underlying 80% benefit plus an additional 50% of their average weekly wage that exceeds 50% of the commonwealth’s average weekly wage.

For 2024, the maximum weekly benefit will be $1,149.90

When do benefits begin?

Begins: On eighth (8th) day of leave.

Exception: No waiting period for a bonding leave when an employee immediately transitions from medical leave.

What are the covered conditions?

PML: PFL:

Employee’s own serious health condition.

Bonding with newly born child, adopted or fostered child; care of a family member with a serious health condition; military exigency or care of a covered service member.

What are the contribution rates?

The 2024 contribution rate is 0.88%* of an employee’s wages up to the 2024 Social Security wage cap of $168,600.

Employee: Approximately 0.46% of wages (0.28% for PML + 0.18% for PFL)

Employer: Approximately 0.42% of wages (PML contribution).

*Contribution rates as required under the commonwealth’s plan. Rates may differ under a private plan. Employee cannot be charged more under a private plan than they would pay under the state plan.

What is the maximum benefit period?

Medical leave: Up to twenty (20) weeks.

Family leave: Up to twelve (12) weeks.

Care of a service member: Up to twenty-six (26) weeks.

Overall family and medical leave duration: Up to twenty-six (26) weeks.

Military exigency: Up to (12) weeks

Additional Resources: www.mass.gov/info-details/paid-family-and-medical-leave-pfml-overview-and-benefits

MINNESOTA

Paid Family and Medical Leave (PFML)

Employee: What is the eligibility for employees and employers?

Employer: All employers (including state and local governmental employers) with at least one employee.

Employees with 50% or more of their calendar year employment in MN.

Employees who are not employed in MN, any other state, or Canada for 50% of the calendar year, but reside at least 50% of the calendar year in MN.

Employees who are not employed in MN, any other state, or Canada for 50% of the calendar year, but their employment is controlled and directed by the state.

Eligible employees include all full-time and part-time employees having wage credits of at least 5.3% of the state average annual wage (SAAW) over the base period (the most recently completed four quarters). Using the October 2023 SAAW of $69,524, this amounts to approximately $3,685.

Certain seasonal hospitality employees are excluded from the state plan, subject to employer earnings receipt certification filing with the Dept of Employment and Economic Development (MN DEED) and notice to each impacted employee.

How is coverage provided?

State administered plan OR

Private plan: State approved private plans for one or both leave types may be self-funded or fully insured, and must meet or exceed the state plan requirements.

What are the contribution rates?

Employer: Contributions are initially set at 0.7% and cannot exceed 1.2% of wages up to the Social Security wage cap ($168,600 in 2024). Starting in 2027, the state will adjust the contribution rate by July 31 each year. Employers may charge employees up to 50% of the contribution rate via payroll deduction.

State plan medical leave only with private plan for family leave: Employers will pay an annual contribution of 0.4% of covered wages, 50% of which can be charged to employees.

State plan family leave only with private plan for medical leave: Employers will pay an annual premium of 0.3% of covered wages, 50% of which can be charged to employees.

Employee: Employees may contribute up to 50% of the state’s annual contribution rates via payroll deduction.

Note: The law creates a special revenue fund, administered by the Family and Medical Benefit Insurance (FMBI) Division and initially funded with over $650 million in seed money from the state, enabling employer and employee contributions to start January 1, 2026.

When do benefits begin?

All leaves except for child bonding are payable after seven calendar days from the leave start date.

What are the covered conditions?

Medical leave for one’s own serious health condition.

Bonding leave within 12 months of the birth, adoption or foster placement of a child.

Qualifying exigency leave for a military family member’s active-duty service or call to active duty.

Safe leave for employee or family member.

What are the weekly statutory benefits?

If the employee’s average weekly wage (EAWW) is less than or equal to 50% of the state’s average weekly wage (SAWW), the weekly benefit is 90% of the EAWW.

If the EAWW is more than 50% of the SAWW but no more than 100% of the SAWW, the weekly benefit is 90% of 1/2 of the SAWW, plus 66% of the excess EAWW.

If the EAWW is more than 100% of the SAWW, the weekly benefit amount is 90% of 1/2 the SAWW, plus 66% of the remaning 1/2 of the SAWW, plus 55% of the EAWW above the SAWW.

What is the maximum benefit period?

Medical leave: Twelve (12) weeks.

Family leave: Twelve (12) weeks.

Combined leave: Twenty (20) weeks in a benefit year (the 52 calendar weeks starting with the leave start date).

Minimum duration: One (1) workday per work week.

Intermittent leave: An employer may cap intermittent leave at 480 hours (12 weeks) per 12-month period and require the employee to take any remaining leave continuously.

MN PFML Timeline

Payroll contributions and benefits begin January 1, 2026. Arch will continue to monitor related program developments and guidance as released by the state.

To learn more about the law, visit: https://www.house.leg.state.mn.us/bills/Info/HF2#

https://mn.gov/deed/programs-services/paid-family/

NEW HAMPSHIRE

Family and Medical Leave Insurance (Granite State plan)

What is the eligibility for employees and employers?

Required for state employers.

Private and public non-state employers can voluntarily opt in to the Granite State plan underwritten by NH’s chosen partner, MetLife, or they can self insure or purchase an insurance plan that mirrors NH”s state plan.

If employers choose not to participate in the Granite State plan or do not offer an equivalent FMLI benefit, their employees can buy benefits by contracting indirectly with the state’s chosen partner, MetLife, through the state purchasing pool.

NOTE: If you purchase NH PFML coverage from MetLife and choose to pay all or a portion of the premiums, your business may qualify for a Business Enterprise Tax (BET) credit, which is not available if you purchase NH PFML from another carrier or if the NH PFML is self-insured.

How is coverage provided?

State administered through the state-chosen benefit partner (MetLife), or

A covered employer can self insure or purchase an equivalent insurance plan from a carrier of their choice.

What are the contribution rates?

For state employees, the program will be at state expense and at no cost to state employees.

The commissioner has established the procedures for contributory plans, partially contributory plans and noncontributory plans as well as payroll deductions and premium remittance for private and public non-state employers.

What are the covered conditions?

Employees own serious health condition, unless covered under a short term disability plan.

Child bonding within the first year of birth or placement if adopted or through foster placement.

Care for a family member with a serious health condition.

Military exigency or to care for a service member with a serious injury or illness.

Family member: A child, a biological, adoptive or foster parent, stepparent, or legal guardian of the child or the child’s spouse or domestic partner, a biological, adoptive, or foster grandparent or step grandparent, or a spouse or domestic partner under RSA 457.

When do benefits begin?

Day one for state employees and employers electing to provide the Granite State. For coverage through the individual pool, there is a seven month waiting period, a one-week elimination period and a 60-day open enrollment period.

What is the maximum benefit period?

Up to 6 weeks a year with no minimum duration required.

What are the weekly statutory benefits?

60% of the employees average weekly wage, capped at the Social Security Taxable Wage maximum.

Additional Resources:

https://www.governor.nh.gov/sites/g/files/ehbemt336/files/documents/family-leave.pdf

https://www.metlife.com/insurance/disability-insurance/paid-family-medical-leave/states/new-hampshire/

NEW JERSEY

Temporary Disability Insurance (TDI) and Family Leave Insurance (FLI)

What is the eligibility for employees and employers?

Employer: Have one or more employees for at least thirty (30) days in a calendar year with a minimum $1,000 annual in payroll.

Employee: Earned at least $283.00/week for twenty (20) weeks during the Base Year ($14,200/Base Year).

How is coverage provided?

State-administered OR

Private plan: A private plan may be fully insured or self-insured and must fully meet or exceed the Department of Labor and Workforce Development requirements.

When do benefits begin?

Applies to TDI

On eighth (8th) consecutive day of disability (on first (1st) day if disability lasts longer than twenty-one (21) days).

On first (1st) day for TDI for organ or bone marrow donation.

Applies to FLI

On first (1st) day of leave.

What are the contribution rates?

Applies to TDI

Employee: 0.00%* of the employee taxable wage base (the first $161,400 of annual earnings) - 2024 Maximum deduction: $0.00.

Employer: Up to 0.75 of the employer taxable wage base (under the state plan). 2024 employer taxable wage base: $42,300.

Private plan: Premium will vary; employer responsible for all premium that exceeds allowed employee contributions.

* Employee rate is set annually by the state.

What are the covered conditions?

Applies to TDI

Employee’s own illness, injury or disability.

What are the weekly statutory benefits?

Applies to FLI

Employee: 0.09%* of the first $161,400 of annual earnings - 2024 Maximum deduction: $145.26.

Employer: Optional, may elect to pay all or part of employee amount.

* Employee rate is set annually by the state.

Applies to FLI

Bonding with newly born child, adopted or fostered child. Provide care for a seriously ill or injured family member.

Maximum is 85% (Claims incurred July 1, 2020 and beyond).

2023 weekly benefits: Maximum is $1,055.00; Benefits payable for less than one week will be paid in increments of one-seventh (1/7) of the weekly benefit.

What is the maximum benefit period?

Applies to TDI

Twenty-six (26) weeks or until benefits equal one-third of total wage base in base year.

Who is exempt from coverage?

Applies to FLI

Twelve (12) consecutive weeks; or intermittent weeks; or 56 intermittent days during a twelve (12) month period beginning with the first date of the claim (claims incurred July 1, 2020 and beyond).

The Federal Government is exempt from TDI coverage. TDI is optional for local governments (e.g. counties, municipalities and school districts) but these employers must participate in the state FLI program, or provide a private plan.

Additional Resources: www.myleavebenefits.nj.gov

NEW YORK

Disability Benefits Law (DBL) and Paid Family Leave (PFL)

What is the eligibility for employees and employers?

Applies to DBL

Employer: Have one or more employees for thirty (30) days in a calendar year.

Employee: Work four (4) consecutive weeks of covered employment. Employees that work less than the employer’s work week are eligible on the 25th day of regular employment.

Applies to PFL

Employer: Employers who are required to offer Statutory Disability coverage must also offer Paid Family Leave.

Employee: Full-time (working 20+ hours/week) are eligible after 26 consecutive weeks; part-time (working less than 20 hours/week) are eligible after 175 work days.

What are the contribution rates?

Applies to DBL

Employee: One-half of 1%* (0.5%) of the first $120 of weekly wage up to a maximum of $0.60 per week.

Employer: Balance of plan costs not covered by employee.

* The Employee DBL rate is set annually by the state.

How is coverage provided?

State-administered

Private-insured

Applies to PFL

Employee: Employee: 0.373% of the SAWW to a wage cap of $89,343.80 for 2024. For 2024, the SAWW is $1,718.15.

Employer: Intended to be 100% funded by employee; may elect to pay all or part of employee amount.

* The Employee PFL rate is set annually by the state.

Self-insured: Must meet minimum state requirements and must be approved by the state’s Workers’ Compensation Board (WCB).

Note: Insured DBL policies include PFL as a rider as required by the state. Self-insured plans may include one or both coverages.

Additional Resources: paidfamilyleave.ny.gov/employers

What are the covered conditions?

Applies to DBL

Employer: Employee’s own disability (illness, injury or pregnancy).

Applies to PFL

Employee: Bonding with newly born child, adopted or fostered child; provide care for a seriously ill family member; military exigency.

When do benefits begin?

Applies to DBL

Benefits begin on eighth (8th) consecutive day of disability.

What are the weekly statutory benefits?

Applies to DBL

Payable at 50% of employee’s average weekly wage.

2024 Weekly benefit: Minimum is $20; maximum is $170.

Benefits payable for less than one week will be paid in increments of one-fifth (1/5) of the weekly benefit.

What is the maximum benefit period?

Applies to DBL

Twenty-six (26) weeks

Overall duration: Up to 26 weeks of DBL and PFL benefits in a 52-week period.

What are Coverage Requirements?

Applies to PFL

Benefits begin on first (1st) day of leave.

Applies to PFL

Bonding with newly born child, adopted or fostered, payable at 67% of employee’s average weekly wage.

2024 Weekly benefit maximum is 1,151.76.

Applies to PFL

Twelve (12) weeks

Overall duration: Up to 26 weeks of DBL and PFL benefits in a 52-week period.

For a complete list of employer types and coverage requirements, visit: www.wcb.ny.gov/content/main/coveragerequirements-db/db-coverage-required.jsp

OREGON

Paid Family and Medical Leave (PFML)

Effective September 3, 2023

Employer: All private sector employers with one or more employees in the state of Oregon.

Employee: What is the eligibility for employees and employers?

During the base year or alternative base year, eligible employee must have earned at least $1,000 in wages and paid into the Paid Family and Medical Leave insurance fund.

Self-employed, or individual contractors may opt into the state plan.

Tribal governments may opt into the state plan.

How is coverage provided?

State-run OR

Private plan: Employers may apply to have an approved private plan to replace the State Plan. The self-funded or fully insured private plan must be equivalent to the state ‘s program.

What are the contribution rates?

The cost of the program is shared by employers and eligible employees.

Employee: Each contribute a percentage established by the Employment Department Director, not to exceed 1% of the employee’s wages, up to the 2024 Social Security wage cap of $168,600 ($1,686). This is subject to change annually.

Employer: Employers with 25 employees or more will contribute 40% of that premium, and will collect 60% (of that 1%) through a payroll deduction from employee wages.

Employers with fewer than 25 employees are not required to contribute the employer 40% (though are “encouraged” to do so).

The Employment Department Director will adjust the maximum amount annually.

When do benefits begin?

On the first day of leave.

Note: There is a 0-day waiting period for this program.

What are the covered conditions?

Bonding with the employee’s newborn or newly placed child within a year of the birth, adoption, or foster care placement,

Caring for a family member with a serious health condition, or Employee’s own serious health condition or injury or sexual assault, domestic violence, harassment, or stalking.

What are the weekly statutory benefits?

The cost of the program is shared by employers and eligible employees.

An employee’s weekly benefit amount is capped at 120% of state average weekly wage. The state average weekly wage is $1,307.17 from July 1, 2024, through June 30, 2025, resulting in a maximum benefit of $1,568.60 and minimum benefit of $65.36. For 2024 the maximum benefit is $1,523.63 with a minimum benefit of 5% of the SAWW. For 2024, the minimum benefit is $63.48.

Employees who earn less than 65% of the state average weekly wage will receive 100% of their average weekly wage.

Employees who earn more than 65% of the state average weekly wage will receive 65% of the state average weekly wage plus 50% of the amount by which the employee’s average weekly wage exceeds the state average weekly wage.

What is the maximum benefit period?

Overall family and medical leave duration: Eligible employees in Oregon are entitled to 12 weeks of paid leave and may use up to 16 weeks in a benefit year for any combination of PFML and unpaid leave under OFLA.

Women with pregnancy related medical conditions may take two extra weeks for a total of 14 weeks of paid medical leave.

Additional Resources: paidleave.oregon.gov

PUERTO RICO

Seguro por incapacidad No Ocupacional Temporal (SINOT)

What is the eligibility for employees and employers?

Employer: Have or have had one or more employees during any day of the current or preceding calendar year.

Employee: Received wages of at least $150.00 during first four (4) of the last five (5) consecutive quarters.

How is coverage provided?

Commonwealth-administered OR

Private-insured OR: Once approved, employers may provide a private plan.

Self-insured: Must meet or exceed the commonwealth plan and must be approved by the commonwealth’s Department of Labor (DOL).

What are the contribution rates?

0.6% of first $9,000 of annual earnings; the contribution may be shared. - Maximum deduction: $54.00

What are the weekly statutory benefits?

Payable at 65% of employee’s weekly earnings.

Weekly benefits: Minimum is $12.00; maximum is $113.00 ($55 maximum for agricultural workers).

Benefits payable for less than one week will be paid in increments of one-seventh (1/7) of the weekly benefit.

Additional benefits for death or dismemberment.

When do benefits begin?

On eighth (8th) consecutive day of disability (or first (1st) day of hospitalization, if earlier).

What is the maximum benefit period?

Twenty-six (26) weeks in a rolling 52 week period.

Additional Resources:

www.trabajo.pr.gov/sinot.asp

RHODE ISLAND

Temporary Disability Insurance (TDI) and Temporary Caregiver Insurance (TCI)

What is the eligibility for employees and employers?

Employer: Have one or more employees in the State of Rhode Island who earn more than $1,000 per calendar quarter.

Employee: Earned at least $15,600 in base period wages OR $2,600 in one of the base period quarters and total base period wages of at least 1.5 times the highest quarters earnings, and total base period earnings of at least $5,200.

How is coverage provided?

State-administered only, no insured or self-insured plans permitted.

What are the contribution rates?

Employee: 1.1% of the first $84,000 of annual earnings.

Employer: Optional, employer may elect to pay all or part of employee amount.

What are the covered conditions?

Applies to TDI

Employee’s own non-work-related disability (illness, injury or pregnancy).

What are the weekly statutory benefits?

Applies to TCI

Providing care for a seriously ill family member. Bonding with newly born child, adopted or fostered child.

Payable at 4.62% of total highest quarter wages in base period.

Weekly benefits: Minimum = $121/week; maximum = $1,043/week.

Benefits payable for less than one (1) week will be paid in increments of one-fifth (1/5) of the weekly benefit.

Max dependent allowance: Greater of ten (10) or 7% weekly benefit rate.

Maximum benefits up to five (5) dependents: Weekly is $1,408.

When do benefits begin?

On eighth (8th) day; however, benefits are paid retroactively to the first (1st) day if the employee is unemployed for at least seven (7) days due to a non-job-related illness or injury.

What is the maximum benefit period?

Applies to TDI

Thirty (30) weeks in any benefit year.

Overall duration: Thirty (30) weeks.

Additional

Applies to TCI

Up to (6) weeks in any benefit year.

Overall duration: Thirty (30) weeks.

VERMONT

Voluntary Paid Family and Medical Leave Insurance (VT FMLI)

What is the eligibility for employees and employers?

Employer: State government employers and employers with two or more employees per phased roll-out (see timeline).

Employee: Employees who work for the state government; those who work for an employer who elects to purchase voluntary coverage; and eligible individuals who elect to purchase coverage per phased roll out (see timeline).

How is coverage provided?

Voluntary coverage provided through The Hartford may be fully insured or self-funded.

What are the contribution rates?

Voluntary coverage is underwritten by The Hartford. Employers can choose to purchase the coverage for their employees, share the cost or simply sponsor the coverage. The coverage may also be customized in terms of leave durations, salary replacement ranges, and the maximum weekly benefit amounts. There is no state contribution requirement.

When do benefits begin?

For medical leaves only, benefits are payable on the 8th day after a seven (7) calendar day waiting period. Benefits are payable on the 1st day for all other leaves.

What are the covered conditions?

Medical leave for one’s own serious health condition.

Care of a family member with a serious health condition.

Bonding leave within 12 months of the birth, adoption, or foster placement of a child.

Qualifying military exigency for an employee’s spouse, child or parent while on active duty.

Military caregiver leave for an employee’s spouse, child, parent or next of kin.

What are the weekly statutory benefits?

Generally, 60% of an employee’s average weekly wage, capped at the Social Security wage limit ($168,600 for 2024).

What is the maximum benefit period?

Up to six (6) weeks of combined Medical and Family Leave in a 12-month period.

VT FMLI Timeline

July 1, 2023: Phase 1 roll out for VT State Government employees.

July 1, 2024: Phase 2 roll out of voluntary coverage for VT non-state public and private employers with 2 or more employees.

July 1, 2025: Phase 3 roll out of voluntary coverage for employers with 1 employee, and eligible individuals including self-employed individuals who wish to purchase through the VT FMLI individual purchasing pool insured by The Hartford.

Additional Resources: https://www.thehartford.com/paid-family-medical-leave/vt

WASHINGTON

Paid Family and Medical Leave (PFML)

What is the eligibility for employees and employers?

Employer: All employers in the state of Washington, including out-of-state employers with employees working in Washington; exempt employers include federal employees, federally recognized tribes, self-employed individuals and people who work temporarily in Washington.

Employee: Worked 820 hours during the qualifying period.

Specific to voluntary plans: 340 of the 820 hours with current employer; those who have not met 340 hours with employer will be covered by the state plan until the 340 hours are met. If previously covered under a voluntary plan with previous employer, eligible immediately.

What are the covered conditions?

Applies to PML

Employee’s own serious health condition.

When do benefits begin?

Applies to PFL

Bonding with newly born child, adopted or fostered child under age 18.

Care of a family member with a serious health condition.

Assist loved ones when a family member is deployed abroad on active military service.

A seven-day waiting period begins on the Sunday before the employee’s first day of leave. The waiting period does not apply to bonding leaves or military exigency leaves.

How is coverage provided?

State-administered OR

Voluntary plan (VP): Must fully meet or exceed the state plan and must be approved by the state’s Employment Security Department (ESD).

Note: PFML is one joint program that provides medical leave and family leave benefits.

What are the contribution rates?

The 2024 contribution rate is 0.74%* of an employee’s wages up to the 2024 Social Security wage cap of $168,600.

Employee: The employee pays up to 71.43% of the premium and the employer pays the remaining 28.57%.

Employer: Employers with fewer than 50 employees for the 2024 calendar year are not required to pay the employer portion of premium. However, they must still collect employee premium, or pay employee’s premium on their behalf.

*Contribution rates as required under the state plan. Rates may differ under a voluntary plan.

Medical leave (PML): Proportioned as approximately two-thirds (2/3) of the overall state plan rate.

PML: 55% employer/45% employee split

What are the weekly statutory benefits?

Family leave (PFL): Proportioned as approximately one-third (1/3) of the overall state plan rate.

PFL: 100% employee-funded.

Employees with an average weekly wage less than or equal to 50% of the state average weekly wage will receive a 90% benefit. The 2023 average weekly wage is $1,586.00.

Employees earning more than 50% of the state average weekly wage will receive the underlying 90% benefit plus an additional 50% of their average weekly wage that exceeds 50% of the state average weekly wage. The 2023 maximum weekly benefit will be $1,427.00, and may increase in future calendar years.

What is the maximum benefit period?

Applies to TDI

PML: Twelve (12) weeks.

PFL: Twelve (12) weeks.

An employee is eligible for an additional two (2) weeks of leave for a pregnancy that results in incapacity.

Overall family and medical leave duration: Up to a maximum of sixteen (16) weeks (up to eighteen (18) weeks for a pregnancy that results in incapacity).

STATE PROGRAM TIMELINE

*

As of 2026 (18 states)

California

As of 2023 (13 states)

California

As of 2018 (6 states)

California Hawaii New Jersey

New York

Puerto Rico

Rhode Island

As of 2022 (10 states)

California

As of 2024 (14 states)

Minnesota*

New Jersey

New Hampshire

New York

Oregon

Puerto Rico

Rhode Island

Vermont

Washington Washington, D.C.

Bold states indicate new benefit plan effective dates in that year.

*As of January 2024. Regulations are subject to change.

CONTACT

This reference guide is provided for general and informational purposes only, without any warranty or liability. It should not be construed as legal or regulatory advice and should not be acted upon as such. Information is current as of the publication of the guide and may be subject to change, without notice.