Standards for fully insured paid leave Plans
The Department of Family and Medical Leave (DFML) and the Massachusetts Division of Insurance (DOI) are working with insurance carriers to develop tools to more easily determine whether a private Paid Family and/or Medical Leave (PFML) plan satisfies paid leave law requirements in order to exempt an employer from the state plan. Additionally, the DFML has refined its internal review process to be more responsive to private plan submissions and evaluate plans more efficiently.
There are two types of plans that can qualify for an exemption:
A self-insured plan funded by an employer (which may be administered by a third-party administrator)
A fully insured paid leave private plan offered by an insurance carrier licensed by the DOI
DOI Acknowledged Insurance Carriers
The DOI has published a list of insurance carriers who are able to provide a paid leave Declaration of Insurance that has been reviewed and meets DFML standards. This list will continue to be updated.
Employers who intend to apply for an exemption (or have been provisionally approved for an exemption) should consult with their insurance carrier to obtain the required Declaration of Insurance to add to their exemption application file. In order to be valid, your Declaration of Insurance must be signed by both a representative of the employer and a representative of the insurance carrier (electronic signatures are acceptable), and list your insurance carrier’s approved DOI policy number. Insurance carriers will issue a full PFML policy form once this document is submitted and reviewed by the DOI.
Please note that most long-term and short-term disability insurance policies do not meet the paid leave requirements to qualify for a medical leave exemption. To be approved for an exemption, a private plan must confer all the same or better benefits to its workforce, as those required by M.G.L. c. 175M. Section 11.
In addition to the same benefits, the private plan must provide equivalent or better rights and protections as those specified in M.G.L. c. 175M. Sections 2 and 9.
Applying for a Private Plan exemption
If you're an employer who is interested in getting an exemption from contributing to family leave, medical leave, or both, you will need to submit an annual approved plan application to the DFML. The application is available through MassTaxConnect.
The benefits provided by your approved plan must be greater than or equal to the benefits provided by the paid leave law to be granted an exemption. This means your approved plan must meet all the minimum requirements and must not cost your covered individuals any more than they would be required to contribute to the state plan under the paid leave law.
The DFML will continue to accept applications on a rolling basis but applications must be approved in the quarter prior to the quarter in which they go into effect.
Employers applying for an exemption will receive an email notification within 1-2 business days indicating that a determination has been made. Once you've received the notification, you can log into MassTaxConnect to review the decision.
If the exemption is approved, you'll receive a letter with instructions listing the steps you should take next.
If the exemption is denied, you'll be notified why it was denied. If you disagree with the basis for denial, you may request a follow-up review.
If you're granted an exemption because your approved plan offers benefits that match or exceed those provided under the state's program, your covered individuals will still be entitled to rights and protections. This includes:
The right to an appeal if their application for benefits is denied
The right to job protection during any leave taken
Protections against retaliation from taking leave or exercising other rights under paid leave law
|Last updated:||June 14, 2019|