No. Coverage will cease when employment is terminated.

The qualifying reasons for ME PFML include all of the following reasons:

• To bond with a child during the first 12 months after the child’s birth, adoption, or foster care placement.
• To care for a family member’s serious health condition.
• A qualifying military exigency.
• To care for a covered service member.
• To take safe leave.
• The placement of a child 16 years old or younger with the covered individual or covered individual’s domestic partner in connection with adoption.
• Organ donation.
• Death/serious health condition of the covered individual’s spouse/domestic partner, parent, sibling or child while on active duty in the state military forces or United States armed forces.
• The covered individual’s own serious health condition.

Legal, biological, adoptive, foster, step, de facto, legal guardian or a person who stood in loco.

“Family member” includes the following relationships to the employee:

• Child, regardless of age, determined by the Maine Parentage Act. Includes a child (biological, adoptive, foster, step) to whom the covered individual or spouse/domestic partner of the covered individual stood in any of these relationships (including in loco parentis or under legal guardianship) when the individual was a minor child.
• A parent (legal, biological, adoptive, foster, step, de facto, in loco parentis, legal guardian) or a person who stood in loco parentis when the covered individual or their spouse/domestic partner was a minor child.
• Grandchild (legal, biological, adopted, foster, step, de facto).
• Sibling (legal, biological, adopted, foster, step, de facto).
• Spouse/domestic partner.
• Individual with a significant personal bond, like a family relationship, regardless of biological or legal ties.

The benefit year is the 12-month period beginning on the first day of the calendar week immediately preceding the first date of approved family or medical leave. A covered individual may only have one valid application year at a time.

No. There is no specific mention of a relapse period applying to recurrent leaves.

Yes. Under Symetra’s insured plan, if the policyholder requests reimbursement for a payment prior to making an advance benefit payment, we will send the policyholder any PFML benefits due, or that become due for their advance payment of Family or Medical Leave benefits.

Yes. Leave is allowed on an intermittent or reduced leave schedule. The minimum duration of leave is one scheduled workday. Employers are not required to provide but may permit employees to take leave in smaller increments. The covered Individual and employer must agree in writing, and the increments may be no smaller than one hour.

Payments will be prorated based on the number of hours of leave used by a covered individual divided by the number of hours worked in a week. For the purposes of proration, “hours worked” means any hours the employee was scheduled to work, regardless of whether the employee actually worked those hours or used authorized leave to cover those hours.

The covered individual’s prorated benefit amount shall be calculated separately for each week in which the covered individual reports use of leave equaling less than a full scheduled workweek.

If the covered individual’s schedule is so variable that it is difficult to determine how many hours the covered individual would have worked if not taking leave, the workweek will be averaged over the previous 12 weeks. Absent this, a schedule of Monday through Friday, eight hours per day will be assumed.

Yes. Job protection and non-retaliation provisions apply to employees.

• Job protection: Employees are entitled to job restoration after leave if they’ve worked 120+ days before leave begins.
• Equivalent position: Must be restored to the same or an equivalent role with equal pay, benefits, and conditions.
• Benefit continuity: Leave does not affect accrual of vacation, sick time, bonuses, seniority, or other benefits.
• Health insurance: Employers must maintain health coverage as if the employee were actively working.
• FMLA coordination: PFML leave runs concurrently with FMLA if both apply.
• Probationary periods: Employers may pause probation during leave without violating the law.
• Job abandonment: If an employee declines to return and notifies the employer in writing, the employer is no longer required to hold the position.

Accrued leave may be used during waiting period for medical leave.

These types of benefits will reduce PFML benefits:

• Payments from workers’ compensation, unemployment, or state/federal disability programs (temporary or permanent).
• Payments from an employer’s permanent disability policy.

These types of income/benefits will NOT reduce PFML benefits:

• Hours worked during the week when the covered individual is on leave with the employer.
• Authorized paid time off used during the week (like vacation or sick leave) when the covered individual is on leave with the employer.
• Any benefit received from SNAP, TANF, HEAP or similar programs.
• Wages from another job (if not on leave with that employer).
• Supplementary wage top-ups from the employer to cover the difference between the PFML benefit amount and the employee’s usual weekly wage (employers may deduct this from leave balances).
• Short-term disability payments, as long as total income (PFML + STD) does not exceed the employee’s typical weekly wage.

Employers must submit a private plan application and receive approval from the Maine Department of Labor before opting out of the state PFML plan.

Fully Insured applications require:

• A completed online application through the employer portal.
• Attachment of “Proof of Purchase.” i.e., The first few pages of the insurance policy document that includes:
  • Type of coverage
  • Name and address of the insurance carrier
  • Policyholder’s name
  • Coverage term (effective and renewal dates)
  • Policy form number or identifier approved by the Maine Bureau of Insurance
  • Unique policy number for the employer
  • Signature of at least one officer of the carrier
• A non-refundable application fee.

Approval of a private plan only exempts the employer from paying state PFML contributions.

Employers must still:

• Submit quarterly wage reports to the department.
• Submit an annual data report by July 31 each year. (Data reports prepared by Symetra may meet this requirement.)
• Undergo audits to ensure the plan remains substantially equivalent.

Employers should note:

• Approved plans are valid for three years and cannot be canceled or changed without prior department approval.
• Employers must notify the department at least 10 days in advance if the insurer plans to cancel or not renew the policy.