Paid Family and Medical Leave Employee FAQs

Disability

Group Benefits

Massachusetts

Paid Family and Medical Leave Employee FAQs

Updated as of October 2020

Starting January 1, 2021 or July 1, 2021, depending on the leave reason, an employee may apply for MA PFML benefits available based on their qualified leave reason.

? Maximum weeks of leave is 26 weeks in a benefit year.

? A waiting period may apply to the first seven calendar days of the leave. Waiting period is waived for an employee who is on medical leave due to childbirth that transitions directly into family leave.

? Leaves may be taken intermittently or on a reduced leave schedule, under certain circumstances.

? Employees are eligible for job protection as well as wage replacement benefits when approved.

? When the leave qualifies for the state benefit and an employer Short-Term Disability, paid family leave, or the Federal FMLA program, they should be taken at the same time.

How can an employee apply for MA PFML benefits?

? MetLife has a Paid Family and Medical Leave claim form that can be used to file for benefits. If applicable, employers may provide a telephone number for employees to call in the claim request.

? An employee will need to sign a Consent to allow MetLife to gather information to support the claim.

? Certifications will be required based on the leave type.

? Employers will be contacted to confirm employment and coordinate other benefits the employee may be eligible to use during the MA PFML leave.

? When the leave qualifies for more than one benefit administered by MetLife, the same forms, authorizations, and certifications can be used to support them all (Examples include Short-Term Disability, MA Paid Medical Leave and FMLA-Medical).

What are the various Certification Documents needed to support leaves?

Documentation is needed to support an employee's MA PFML leave. Here are the various documents that may be needed:

? Healthcare Provider Certification ?? Employee's own Serious Health Condition ?? Family member's Serious Health Condition ?? Military Caregiver

? Child Bonding ?? Birth Certificate ?? Foster/Adoption Placement ?? Healthcare provider notice

? Military Exigency ?? A copy of the family member's active duty orders ?? Letter of Impending Activation from the family member's Commanding Officer ?? Other documentation reasonably acceptable to MetLife

What are some tips for filing for claim benefits?

? Review employer's benefit website and/or handbook to see how to file for benefits and identify any other paid or job protected leaves that may be taken at the same time based on the reason an employee needs to take the MA PFML leave.

? An employee may be asked to write down their intermittent leave or reduced leave schedule and have their manager approve it. MA PFML includes job protection; however, an employer can apply their normal attendance and absences policies when an employee's attendance and/or absence is different than the agreed upon schedule.

? An employee should file for benefits within 30 days prior to a leave when a leave is foreseeable or as soon as practical if a delay is beyond the employee's control.

What should I expect after filing for MA PFML benefits?

Employee

Plan Administrator

Employer

Plan Administrator

Apply for benefits

Send employer verification

Employer response sent

Decision

Benefit Payments

30-60 days in advance if foreseeable

Within 5 days of receiving

Within 10 days of receiving request from

Administrator

Within 14 days of receiving all materials

Within 14 days of approval or first

absence date

Who is eligible to take MA PFML benefits?

? W-2 employees are always covered individuals ?? This includes full time, part-time, and seasonal employees ?? Former employees are also covered for up to 26 weeks post separation

? Independent contractors are only covered individuals if they meet certain criteria: ?? Employers provide them with a 1099 ?? Performed services as an individual entity >> Lives in Massachusetts >> Performed services in Massachusetts >> The 1099-MISC contractor MUST NOT have been classified as an independent contractor as defined the three part test under MA law (Title 21, Chapter 149, Section 148B). 1. such individual has been and will continue to be free from control and direction in connection with the performance of such services, both under his contract for the performance of service and in fact; and 2. such service is performed either outside the usual course of the business for which the service is performed or is performed outside of all the places of business of the enterprise for which the service is performed; and 3. such individual is customarily engaged in an independently established trade, occupation, profession or business of the same nature as that involved in the service performed.

What are the qualified Paid Medical Leaves under MA PFML?

Employee's Own Serious Health Condition

Starting January 1, 2021, Medical Leave provides up to 20 weeks per year of paid leave to manage a serious health condition.

When the employee applies for medical leave the employee will need information from the employee's health care provider that says: ? When the employee's condition began ? How long they think the employee's condition will continue ? Any other relevant details about the employee's condition

Please note: An employee can take Medical Leave for treatment for a substance use disorder by a health care provider, by a provider of health care services on referral by a health care provider or by a program licensed or approved by the Massachusetts Department of Public Health.

An absence because of the employee's use of the substance, rather than for treatment, does not qualify for leave.

As a best practice, we recommend reviewing your company benefits regarding Substance Use Disorders and updating benefits available to include the MA PFML benefits for both wage replacement and job protections.

What are the qualified Paid Family Leaves under MA PFML?

Child Bonding -- Newborn

Starting January 1, 2021, Family Leave can be taken by a parent or legal guardian to bond with a child during the first 12 months after the child's birth, adoption, or foster care placement.

Eligibility for Family Leave used for bonding with a child is limited to the child's parents or legal guardians.

A parent or legal guardian can take up to 12 weeks of Family Leave to bond with a child per year. The annual 12-week maximum stays the same even if the employee has multiple childbirths, adoptions, or foster care placements in the same year. Both parents/caregivers may choose to take Family Leave to bond with the child at the same time, or separately.

To take Family Leave to bond with a newborn child, the employee will need to submit any one of these three documents: ? A copy of the child's Birth Certificate, or ? A statement from child's health care provider stating child's date of birth, or ? A statement from mother's health care provider stating child's date of birth

Depending on the situation, an expectant mother may be eligible to take Medical Leave during her pregnancy. If she does, she can transition directly into Family Leave for child bonding after the child's birth or can choose to take bonding leave some other time within the next 12 months. The waiting period can be waived if moving from Medical Leave directly into Family Leave.

Parents or legal guardians, can apply for Family Leave to bond with a child before the child is born, using the employee's child's expected birth date. After the child's birth, the employee will need to contact MetLife with proof of birth in order to start receiving payments. ? Parents of children born during 2020 may be eligible for Family Leave to bond with their new child in 2021, regardless

of the duration or type of leave taken in 2020. Leave may be taken until the child's first birthday.

Child Bonding -- Adoption/Foster Placement

Starting January 1, 2021, employees can apply for Family Leave to bond with a child before the child has been adopted or placed in the employee's home for foster care.

To take Family Leave to bond with a child who has been recently adopted or placed in the employee's home for foster care, the employee will need to provide documentation from the child's health care provider, or the foster or adoption agency confirming the date of the child's adoption or placement. ? Parents of children adopted or placed in foster care during 2020 may be eligible for Family Leave to bond with their

new child in 2021, regardless of the duration or type of leave taken in 2020. Leave may be taken until the child's first anniversary of their adoption or foster care placement.

Military Exigency

Starting January 1, 2021, employees can take up to 12 weeks of Family Leave per year to manage any needs that take place immediately after a family member is deployed in a foreign country or has been notified of an upcoming deployment in a foreign country. These needs may include: ? Caring for a deployed family member's child or other family member immediately before their deployment ? Making financial or legal arrangements for deployed family member ? Attending counseling ? Attending military events or ceremonies ? Spending time with a deployed family member during a rest or recuperation period ? Spending time with a family member when they return from deployment ? Making necessary arrangements following the death of a family member who had been deployed

What are the qualified Paid Family Leaves under MA PFML?

Military Caregiver

Starting January 1, 2021, employees can take up to 26 weeks of Family Leave per year to care for a family member who is a current member of the Armed Forces, including the National Guard and Reserves, who is:

? Undergoing medical treatment, recuperation, or therapy for a serious health condition that was received or aggravated while they were deployed in a foreign country

? In outpatient status for a serious health condition that was received or aggravated while they were deployed in a foreign country

? On the temporary disability retired list for a serious injury or illness that happened while deployed in a foreign country ? On the temporary disability retired list for a serious injury or illness that existed before the beginning of the member's

active duty, and was aggravated by service while deployed in a foreign country

Care of Family Member

Starting July 1, 2021, employees can take up to 12 weeks of Family Leave per year to care for a family member with a serious health condition.

Family Leave may be taken to care for a family member. Family members include the employee's spouse, domestic partner, child, parent, grandchild, grandparent or sibling; the parent of the employee's spouse or domestic partner; and guardians who legally acted as a parent when the employee was a minor.

When the employee applies for Family Leave to care for a family member, the employee will need to provide: 1. Information from the employee's family member's health care provider that states:

?? That the employee's family member has a serious health condition ?? When the employee's family member's condition began ?? How long they think the employee's family member's condition will continue ?? Any other relevant details about the employee's family member's condition ?? Information about how often and how long the employee's family member needs the employee to care for them 2. The name and address of the employee's family member and their relationship to the employee 3. Proof of the employee's family member's identity

What is the paid benefit for MA PFML? The benefit percentage is based on the state's average weekly wage and an employee's own qualified wages.

Step 1

The part of an employee's average weekly wage that is less than or equal to 50% of the average weekly wage for Commonwealth workers will be paid at a rate of 80%.

Step 2

The part of an employee's average weekly wage that is greater than 50% of the average weekly wage for Commonwealth workers, will be paid at a rate of 50%, up to the maximum allowed benefit amount.

Example

The average weekly wage in Massachusetts for 2021 is $1,478.78. Fifty percent of $1,478.78 is $743.87. Wages that are less than or equal to $743.87 will be replaced at a rate of 80%. Any part of the average weekly wage that is greater than $743.87 will be replaced at a rate of 50%, up to the maximum allowed benefit amount. $850.00/week maximum for 2021.

What does a reduction to the weekly benefit mean?

If an employee is receiving funds from any of the following sources, the MA PFML benefit will still provide job protection, but the wage replacement benefit may be reduced. ? Government programs/laws (unemployment/workers' comp, disability) ? Employer sponsored permanent disability program ? Leave allotment reduced by PFML taken during the benefit year ? Benefits reduced by PFML received during the 12 months before filing an application (excluding 2020) ? If PFML plus other sources exceed the employee's average weekly wage, the following will reduce PFML benefits:

?? Employer's temporary disability program ?? Employer's internal PFML policy ?? Wages from another employer or through self-employment

Where can I find more information?

? Your employer's benefit handbook or website ? MA PFML State Benefit Guide ? If an employee has filed for benefits, the MetLife's Claim Specialist



Like most insurance policies, insurance policies offered by MetLife and its affiliates contain certain exclusions, exceptions, waiting periods, reductions, limitations, and terms for keeping them in force. Please contact MetLife or your plan administrator for complete details. The information presented in this brochure is not legal advice and should not be relied upon or construed as legal advice. Any information in this brochure is for general informational purposes only. It does not purport to be complete or to cover every situation. You must consult with your own legal advisors to determine how the Massachusetts Paid Family Medical Leave ("MA PFML") law affects you.

Metropolitan Life Insurance Company|200 Park Avenue|New York, NY 10166

L1020008731[exp1221][All States] ? 2020 MetLife Services and Solutions, LLC.

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