Massachusetts: PFML Rules are Final!

Employers must begin providing Paid Family and Medical Leave (PFML) to employees on January 1, 2021. The Massachusetts Department of Family and Medical Leave (DFML) recently released the final regulations for PFML with some changes.

There were numerous changes to rules surrounding employers opting for private plans. Key changes to note include:

• Private plans must cover the entire workforce, not just certain classes of workers.
• Private plans must also provide employees with an internal appeals process, with specific timing and procedural requirements, through the private plan administrator before the employee can seek an appeal with the DFML.
• Employers with private plans must provide a notice of rights under both the private plan and the PFML as part of any determination.
• Private plans must use an employee’s wages earned at the time of applying for benefits to determine the weekly benefit amount.

The final rules also discuss requirements when transitioning between private and state-sponsored plans. An employer that does not renew a private plan must continue to provide paid leave benefits to covered individuals under the same terms and conditions of the private plan for the entire duration of the leave if the claim was initiated under the private plan prior to its termination. In the case of intermittent leave, the private plan must maintain coverage until the end of the employee’s benefit year.

Additionally, other changes of note include:

• Employees must provide employers with 30 days’ advance notice of the need for benefits, or as soon as practicable, and their benefit claims may be denied without proof of proper notice.
• Substance abuse disorders are not covered under PFML unless inpatient hospital care is required or complications develop.
• Intermittent leave must be taken in 15-minute increments.
• In the case of multiple births, no more than 12 weeks of leave benefits total are available in a benefit year for this purpose.
• For extensions of benefits, an employer may seek a medical recertification of the employee’s serious health condition following the expiration of the initial period of incapacity cited in the healthcare certification or where an intermittent leave has extended for a period of more than six months from the approval by the DFML, whichever occurs first.
• Leave taken by an employee for the same qualifying reason prior to January 1, 2021, will not count against the individual’s weekly benefit amount and/or leave allotment once benefits are available January 1^st.
• The weekly benefit amount may be reduced where the employee has an outstanding tax obligation or has an obligation for child support.

There are additional changes to requirements for the claims process, timing when responding to DFML requests, benefit reductions, initial seven-day waiting period, coordination with employer-sponsored leave policies, and employer reimbursement for benefits. With these new changes, employers should prepare for implementation of PFML at the start of the year.

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