Private plan benefit requirements for PFML exemptions

To be eligible for an employer exemption from making Paid Family and Medical Leave (PFML) contributions, you must offer an approved private plan with paid leave benefits that are equal to or more generous than those provided under the PFML program. Exemptions are only available to and intended for employers, not individuals.

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General overview

If you're an employer who provides a paid leave benefit to your workforce, you may be eligible to receive an exemption from collecting, remitting, and paying contributions for paid family or medical leave under the state's Paid Family and Medical Leave (PFML) law. Exemption applications can be submitted through the Department of Revenue's MassTaxConnect.

Certain employers are automatically excluded and do not need to apply for an exemption

The benefits offered to your covered individuals by your approved plan must be greater than or equal to the benefits provided by the PFML law to be granted an exemption. This means your approved plan must meet all the minimum requirements listed below and must not cost your covered individuals any more than they would be required to contribute to the state plan under the PFML law.

Benefits offered under your approved private plan don't need to begin until January 2021.

If your benefits don’t meet the criteria described below or you choose to not apply for an exemption, there may be an opportunity to receive reimbursement for certain types of paid leave plans.

Minimum family leave benefit requirements

To qualify for an exemption from family leave contributions, your private plan must provide the following to all covered individuals:

  • All covered individuals (full-time, part-time, permanent, or seasonal) are eligible for family leave benefits
  • A weekly paid benefit amount that is greater than or equal to the benefit provided by the PFML program administered by DFML
  • A minimum of 26 weeks of paid leave during the benefit year to provide care to a family member, as defined by PFML, with a serious health condition suffered while on active duty in the armed forces
  • A minimum of 12 weeks of paid leave during the benefit year if their spouse, child, or parent is a current member of the Armed Forces (including the National Guard and reserves) and is on covered active duty or notified of an impending call or order to covered active duty
  • A minimum of 12 weeks of paid leave during the benefit year to provide care to a family member, as defined by PFML, with a serious health condition
  • A minimum of 12 weeks of paid leave during the benefit year to bond with a child during the first 12 months after a child’s birth, or the first 12 months after adoption or foster placement of a child under the age of 18
  • Job protection while the covered individual is on qualified leave
  • Continued employer contributions to employment-related health insurance benefits, if any, at the level and under the conditions coverage would have been provided if the covered individual had continued working continuously for the duration of qualified leave
  • Leave may be taken intermittently or on a reduced leave schedule, with the weekly benefit amount being prorated
  • Your plan specifically states that all presumptions shall be made in favor of the availability of leave and the payment of leave benefits

Minimum medical leave benefit requirements

To qualify for an exemption from medical leave contributions, your private plan must provide the following to all covered individuals:

  • All covered individuals (full-time, part-time, permanent, or seasonal) are eligible for medical leave benefits
  • A minimum of 20 weeks of paid medical leave in a benefit year if a covered individual is unable to work due to a serious health condition
  • A weekly paid benefit amount that is greater than or equal to the benefit provided by the PFML program administered by DFML
  • Job protection while the covered individual is on qualified leave
  • Continued employer contributions to employment-related health insurance benefits, if any, at the level and under the conditions coverage would have been provided if the covered individual had continued working continuously for the duration of qualified leave
  • Leave may be taken intermittently or on a reduced leave schedule if medically necessary, with the weekly benefit amount being prorated
  • Your plan specifically states that all presumptions shall be made in favor of the availability of leave and the payment of leave benefits

Approved insurance carriers

The Division of Insurance (DOI) has published a list of insurance carriers who are able to provide a PFML Declaration of Insurance which has been reviewed and meets DFML standards. This list will continue to be updated. 

If you are an employer who intends to apply for an exemption (or has been provisionally approved for an exemption), you should consult with your insurance carrier to obtain the required Declaration of Insurance to add to your exemption application file by December 20, 2019.  Your insurance carrier will issue you a full PFML policy form once it is submitted and reviewed by the DOI at a later date.  

Please note that most long-term and short-term disability insurance policies do not meet the PFML 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.  

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