What's new with statutory disability income and state paid family and medical leave?

Paid Family Leave (PFL)

PFL is designed to partially replace the wages of employees who need to take family leave to care for a child, parent, parent-in-law, grandparent, grandchild, sibling, spouse or registered domestic partner with a serious health condition; or to bond with a child during the first 12 months after birth, adoption, or foster care placement.

• Eligibility: Part-time or full-time employees who have earned at least $300 in the base period and contribute to the California State Disability Insurance program during the 18 months prior to their claim.
• Benefits: For 2023, the weekly benefit is 60% of weekly wages for employees who earned one-third or more of the state average quarterly wage during the prior four quarters, or 70% of weekly wages for those who earned less than one-third. The minimum weekly benefit is $50, and the maximum weekly benefit is $1,540 ($1620 for 2023 is projected but unconfirmed at the time of this publication). Leave can be taken for up to eight weeks within any 12-month period, not to exceed 52 weeks when combined with California State Disability Income (SDI) benefits.
• Contributions: For 2023, the program is funded by mandatory employee payroll deductions equal to 0.9% of employee's wages up to the maximum annual contribution amount of $1,378.48 (for SDI and PFL combined).

State website: www.edd.ca.gov

State Disability Insurance (SDI)

California SDI provides partial income replacement for non-work related injuries or sickness, including pregnancy.

• Eligibility:Part-time or full-time employees who have earned at least $300 in the base period and contribute to the California State Disability Insurance program during the 18 months prior to their claim.
• Benefits: For 2023, the weekly benefit is 60% of weekly wages for employees who earned one-third or more of the state average quarterly wage during the prior four quarters, or 70% of weekly wages for those who earned less than one-third. The minimum weekly benefit is $50, and the maximum weekly benefit is $1,540 ($1620 for 2023 is projected but unconfirmed at the time of this publication). Leave can be taken for up to eight weeks within any 12-month period, not to exceed 52 weeks when combined with California State Disability Income (SDI) benefits.
• Contributions: For 2023, the program is funded by mandatory employee payroll deductions equal to 1.1% of employee's wages up to the maximum annual contribution amount of $1,601.60.

Symetra Services:

• Our case managers will refer employees to the state website to file claims for SDI or PFL. We do not currently offer an insured policy or ASO services for the California PFL or SDI private plans. However, we continue to monitor the rulemaking process to determine the best offering to provide to our customers.

Symetra Resources:

California Disability Insurance and California Paid Family Leave Flyer >

Paid Family and Medical Leave Insurance (PFML) – effective 1/1/24

The Colorado Paid Family and Medical Leave program, with leave and benefits scheduled to begin on 1/1/24 continues to be a work in progress. CO PFML will provide eligible employees paid medical leave benefits for an employee’s own serious health condition, and paid family leave benefits to care for a family member with a serious health condition; to bond with a new child within 12 months of the date of birth, adoption or placement; or for leave needed for a qualifying military exigency; as well as paid safe leave due to family violence, stalking, or sexual assault or abuse. More details will be provided as Colorado drafts regulations and issues clarifying guidelines.

• Eligibility: Employees who have earned at least $2,500 during the base period.
• Benefits: The weekly benefit is 90% of the employee’s average weekly wages (AWW) that are less than or equal to 50% of the state average weekly wage (SAWW), plus 50% of the employee’s AWW that exceeds 50% of the SAWW. The maximum benefit is 90% of the SAWW; set at $1,100 through 1/1/25 and will be adjusted annually thereafter to 90% of the SAWW. The maximum combined duration for all paid family, medical and safe leave in a benefit year will be 12 weeks, or up to 16 weeks including leave for complications due to pregnancy or childbirth.
• Contributions: Employee contributions to the state plan will begin 1/1/23. This program will be funded equally by employees and employers. For 2023-2024, the state plan rate will be 0.9% of each employee’s AWW, not to exceed the Social Security maximum wage base. Employers with fewer than 10 employees do not have to contribute the employer’s share of contributions to the state plan, but would be required to submit the employer portion of premium payments under a private plan.

State website: https://famli.colorado.gov/employers

Symetra Services:

• Colorado will allow both state and private (insured and self-insured) plans. Symetra will continue to monitor all developments to determine the best offering to provide to our customers.

Paid Family and Medical Leave Insurance (PFML)

This program provides eligible Connecticut employees paid family leave benefits to care for a family member who has a serious health condition, for a qualifying exigency or to bond with a child during the first 12 months after birth, adoption or placement. An eligible family member includes a child, spouse, sibling, grandparent, grandchild, or parent, or an individual related to the employee by blood or affinity whose close relationship with the employee is the equivalent of a familial relationship. Eligible employees can receive paid medical leave benefits for their own serious health conditions, including serious health conditions
resulting in incapacity and/or prenatal care during pregnancy.

• Eligibility: Employees must have earned at least $2,325 within the first four of the five most recently completed quarters and be presently employed or employed within the previous 12 weeks.
• Benefits: The weekly benefit is 95% of weekly wages up to 40 times Connecticut’s minimum wage ($14/hour, $15/hour effective 6/1/2023), plus 60% of weekly wages above 40 times the minimum wage. The maximum benefit is 60 times the minimum wage (currently equals $840, increasing to $900, effective 6/1/2023). Leave can be taken for up to 12 weeks in a 12-month period for family and medical leave combined, including up to 12 days of paid leave for employees who are victims of family violence, with an extra two weeks allowed if the employee experiences incapacity and/or prenatal care during pregnancy.
• Contributions: Employee contributions to the state plan began on 1/1/21. Contributions will be capped at 0.5% of weekly wages up to the Social Security maximum ($160,200 for 2023). Employers do not have a financial obligation under the state plan.

Symetra Services:

• Connecticut allows both state and private (insured or self-insured) plans. We offer a fully insured product for combined Paid Family and Medical Leave benefits. This includes tracking, management and payment of all benefits. We also offer ASO services for employers with 200 or more covered Connecticut employees if the employer is willing to fulfill state bonding requirements associated with CT PFML. A majority vote of all eligible employees working in Connecticut is required to receive a private plan exemption from the state.

Resources:

CT PFML employee vote requirements FAQ >

CT PFML general FAQ >

Paid Family and Medical Leave (PFML)

PFML can partially replace the wages of employees who need to take family or medical leave. Family leave is available for the employee to care for any of the following “family members” (including in-laws and step relations) who have a serious health condition: spouse, domestic partner, child, grandparent, parent, legal guardian or other person who stood in loco parentis when the employee was a child; or to bond with a child within 12 months after birth, adoption or foster care placement. Medical leave is available for the employee’s own serious health condition.

• Eligibility: Employee must work for a Washington DC employer for at least 50% of their work time and must meet that requirement at least one week during the 52 weeks prior to their leave.
• Benefits: The weekly benefit is 90% of the employee’s average weekly wage that is equal to or less than 150% of DC’s minimum wage $16.10 per hour as of 7/1/22, multiplied by 40, plus 50% of the employee’s average weekly wage that is more than 150% of DC’s minimum wage multiplied by 40. The maximum benefit is $1,049/weekly for leaves occurring on or after 9/25/22. The maximum benefit durations increased as of 10/1/22. Family leave can be taken for up to 12 weeks for all Paid Family Leave qualifying events such as care of a family member or bonding. Medical leave can be taken for up to 12 weeks in a 52-week period. Employees can also receive up to two additional weeks of medical leave for prenatal care. The total combined maximum duration for DC PFML is 12 weeks in a 52-week period (or 14 weeks including medical leave for prenatal care). These durations are effective 10/1/22. The waiting period requirement has been removed for all claims filed after 7/25/22.
• Contributions: This program is funded by a quarterly employer payroll tax of 0.26% effective 7/1/22, of their covered employees' total wages.

State website: www.dc.gov

Symetra Services:

• The District of Columbia requires all covered employers to participate in the Department of Employment Services’ DC PFML program. As such, Symetra cannot offer fully insured or ASO coverage for DC PFML. Our case managers will refer employees to the DC website to file their PFML claim. Employers can use private disability insurance to complement DC PFML and fill gaps in pay and leave duration.

Temporary Disability Insurance (TDI)

TDI provides partial wage replacement to eligible employees for non-work-related injuries or sickness.

Please refer to our grid for more information >

• Eligibility: Employees working in Hawaii who have worked at least 14 weeks (non-consecutive weeks and multiple employers allowed) in Hawaii and been paid for 20+ hours and have earned at least $400 in 52 weeks preceding first day of disability.
• Benefits: Employees receive 58% of average weekly wages rounded to next highest dollar up to the maximum weekly benefit of $765 (2023).
• Contributions: Not more than .5% of average weekly wages or $6.59/week, whichever is less, up to the maximum weekly wage base of $1,318.48/week. The employer pays at least half of the plan costs or can pay the entire cost.

Symetra Services:

• We offer an insured HI TDI plan, but not on an ASO basis. Hawaii's TDI plan is administered and paid by John Mullen & Company, a third-party vendor in Hawaii.

Paid Family and Medical Leave (PFML) – effective 1/1/25

The Time to Care Act of 2022 establishes a Paid Family and Medical Leave insurance program which will be administered by the Maryland Department of Labor. The program will provide eligible employees job-protected benefits for bonding with a new child, care of a family member with a serious health condition, care of the employee’s own serious health condition, or leave needed for a military qualifying exigency or next-of-kin care for an injured service member.

• Eligibility: Employees must have worked at least 680 hours over the 12 month period for a covered employer prior to the start of leave. A covered employer includes each employer with 1 or more employees working in the state.
• Benefits: Benefits are available beginning 1/1/25. The weekly benefit will be 90% of the employee’s average weekly wages (AWW) that are less than or equal to 65% of the state average weekly wage (SAWW), plus 50% of the employee’s AWW that exceeds 65% of the SAWW, subject to a minimum of $50 and a maximum of $1,000 per week in 2025 (adjusted annually). Eligible employees can take up to a combined maximum of 12 weeks of job-protected paid family and medical leave in a 12-month period for qualifying paid medical and family events. In certain situations involving an individual who qualifies for separate periods of leave in a benefit year for bonding and PML for the individual’s own serious health condition, covered individuals may also receive an additional 12 weeks of benefits during that same benefit year (for a combined total maximum benefit period of 24 weeks per 12-month period).
• Contributions: Contributions to the state plan begin on 10/1/23. The plan will be funded by both the employer and the employee. The maximum contribution to the state plan cannot exceed .75% of the employee’s average weekly wage, capped at the Social Security maximum wage base. Employers with fewer than 15 employees do not have to contribute the employer’s share of contributions to the state plan, but would be required to submit the employer portion of premium payments under a private plan.

Symetra Services:

• Maryland allows both state and private (fully insured and self-funded) plans. Symetra will continue to monitor all developments to determine the best offering to provide to our customers.

Paid Family and Medical Leave (PFML)

PFML can partially replace the wages of employees who take family or medical leave. Family leave is available to employees to care for any of the following “family members” who have a serious health condition: spouse, domestic partner, child, parent or parent of a spouse or domestic partner, a person who stood in loco parentis when the covered individual was a minor child, or a grandchild, grandparent or sibling. Other paid family leave is available to bond with a child during the first 12 months after birth, adoption or foster placement; to manage family affairs when a family member is on or is notified of an impending call to active duty in the armed forces; or to care for a family member who requires medical care as a result of illness or injury related to active service in the armed forces. Paid medical leave can be taken for employees who are unable to work due to their own serious health conditions.

• Eligibility: All W-2 employees working in Massachusetts earning at least $6,000 in the previous 12 months and at least 30 times the weekly benefit that the employee are eligible to receive. 1099-MISC Contractors are eligible under the employer's plan if the employer reports 1099-MISC forms for more than 50% of its workforce.
• Benefits: The weekly benefit is 80% of the covered individual’s average weekly wage that is equal to or less than 50% of the State Average Weekly Wage (SAWW) $1,765.34 (2023); plus 50% of the covered individual’s average weekly wage that is more than 50% of the SAWW, not to exceed 64% of the SAWW (which equates to $1,129.82/week for 2023). Medical leave can be taken for up to 20 weeks. Family leave can be taken for up to 26 weeks to care for a family member who requires medical care related to active service in the armed forces and up to 12 weeks for all other periods of family leave. The total combined maximum duration of benefits is 26 weeks in a benefit year, and all benefit durations include the unpaid waiting period(s).
• Contributions: Under the state plan, the total cost for PFML coverage is currently .68% of gross wages up to the Social Security maximum amount, with a medical leave rate of .56% (with 60% funded by the employer and 40% funded by the employee) and a family leave rate of .12% (100% funded by the employee). For 2023, the state rate reduces to 0.63% of gross wages (which equals 0.11% for PFL and 0.52% for PML) up to the Social Security maximum wage base. The employees cannot be required to contribute more under a private plan than they would have under the state plan. The employer can contribute more than the stated percentages. Employers under 25 lives do not have to contribute the employer portion under the state plan, but must contribute the employer portion for a private plan. For more information about the State plan rate requirements please see: https://www.mass.gov/info-details/pfml-workforce-notifications-and-rate-sheets-for-massachusetts-employers#2023-rate-sheets-for-employers-.

State website: www.mass.gov

Symetra Services:

• Symetra offers a fully insured product for combined Paid Family and Medical Leave benefits. This includes tracking, management and payment of all benefits. We also offer ASO services for a self-insured private plan for employers with 200 or more covered Massachusetts employees if the employer is willing to fulfill state bonding requirements associated with Massachusetts PFML.

Resources:

• MA PFML Private Plans Flyer >
• MA PFML Frequently Asked Questions >
• MA PFML Filing an Exemption Flyer >
• MA PFML MA PFML Coordination of Offsets Flyer >
• MA PFML Employee FAQ >
• MA PFML Premiums FAQ >

Family Leave Insurance (FLI)

FLI is designed to partially replace wages of employees who need to take family leave to care for a “family member” (defined as a spouse, domestic partner, child, parent, parent-in-law, sibling, grandparent, grandchild, and any other individuals related by blood or whom you consider to be family) with a serious health condition; or to bond with a child within 12 months after birth, adoption, or foster care placement.

• Eligibility: Employees who have paid into the program through their employer and have met the minimum gross earnings requirements are eligible for leave. Employees need to have worked 20 weeks while earning at least $260 weekly, or have earned a combined total of $13,000 within the base year of the claim submission.
• Benefits: The weekly benefit is 85% of average weekly wages to a maximum of $1,025/wk. Leave can be taken for up to 12 weeks (56 intermittent days) in a 12‐month period. An eligible employee may take up to 20 days of leave in a 12-month period to care for a family member who is a victim of domestic or sexual violence.
• Contributions: Employee pays 0.06% of their first $156,800 of annual earnings up to a maximum annual contribution of $94.08. Employers do not contribute toward the State FLI plan.

State website: www.myleavebenefits.nj.gov

Temporary Disability Insurance (TDI)

TDI provides partial wage replacement to employees who suffer from a non-work-related illness or injury.

• Eligibility: Employees who have paid into the program through their employer and have met the minimum gross earnings requirements are eligible for leave. Employees need to have worked 20 weeks while earning at least $260 weekly, or have earned a combined total of $13,000 within the base year of the claim submission.
• Benefits: The weekly benefit is 85% of the employee's average weekly wages up to the maximum benefit of $1,025.
• Contributions: Employee pays 0.00% of their first $156,800 of annual earnings up to a maximum annual contribution of $0.00. The State Plan rate varies based on each group's experience, and the employer pays the balance of the plan's cost.

Symetra Services:

• Symetra offers a fully-insured NJ TDB product.
• Symetra does not offer NJ FLI at this time.

Paid Family Leave (PFL)

PFL is designed to partially replace wages of employees who need to take family leave to care for a “family member” (defined as spouse, domestic partner, child/stepchild, sibling or anyone for whom the employee has legal custody, parent/step-parent/ in loco parentis, parent-in-law, grandparent or grandchild) with a serious health condition; to bond with a child during the first 12 months after birth, adoption or foster care placement; or to care for a family member when a spouse, domestic partner, child or parent is deployed abroad on active military service. Effective 1/1/23, coverage is expanded to include "siblings." Siblings means a biological or adopted sibling; a half-sibling; or a stepsibling.

• Eligibility: Full-time employees who work 20 or more hours a week on a regular schedule are eligible after 26 consecutive weeks of employment. Part-time employees working less than 20 hours/wk will be eligible after working 175 days.
• Benefits: The benefit is 67% of the employee's average weekly wages up to the maximum of $1,131.09 (67% of the state average weekly wage). Payable for a maximum of 12 weeks during a 52-week period. The maximum combined duration for NY PFL and DBL is 26 weeks in a 52-week period. The State Average Weekly Wage (SAWW) is $1,688.19.
• Contributions: This program is funded by payroll deductions from covered employees. Each year, the Department of Financial Services sets the employee contribution rate to match the cost of coverage. Employees pay 0.455% of weekly wages up to the annual taxable wage base of $87,785.55, to a maximum of $399.43/year.

State website: www.paidfamilyleave.ny.gov

Disability Benefits Law (DBL)

DBL requires employers to provide employees partial wage replacement benefits if the employee is disabled by a non-work-related injury or illness.

• Eligibility: Full-time employees who have worked for at least 4 consecutive weeks in New York.
• Benefits: For 2023, the benefit is 50% of the employee's average weekly wages up to the maximum of $170. Payable for a maximum of 12 weeks during a 52-week period, subject to a combined NY DBL and PFL maximum duration of 26 weeks in a 52-week period.
• Contributions: This program is funded by payroll deductions from covered employees. The employee pays 0.5% of the first $120 of weekly wages, up to a maximum of 60 cents per week. The employer pays the balance of the plan costs.

First Symetra Services:

• Symetra offers a fully-insured NY DBL policy and a NY PFL rider. We manage and track these leaves and complete all state reporting requirements. First Symetra does not currently offer ASO services for an employer’s self-insured private plan.

Resources:

• NY PFL Frequently Asked Questions >
• NY PFL Frequently Asked Questions for Employees >
• NY DBL vs. NY PFL Comparison Flyer >

Paid Family and Medical Leave Insurance (PFML) – Contributions begin January 1, 2023; benefits begin September 3, 2023

PFML can provide partial wage replacement benefits to employees who take family or medical leave. Family leave is available to employees to care for any of the following “family members” who have serious health conditions: spouse, domestic partner, child, parent, anyone related by blood or affinity whose close association is the equivalent of a family member, or a grandchild, grandparent or sibling; or to bond with a child within 12 months after birth, adoption or foster care placement. Medical leave is available for care for the employee’s own health condition, or for safe leave covering victims of domestic violence, harassment, sexual assault or stalking.

• Eligibility: Employees must earn at least $1,000 in wages during the base year or during an alternate base period. Self-employed individuals, the federal government and tribal governments are not required to provide coverage, but self-employed individuals and tribal governments may opt-in.
• Benefits: The weekly benefit is 100% of the employee’s average weekly wage that is equal to or less than 65% of the State Average Weekly Wage (SAWW), plus 50% of the employee’s average weekly wage that is more than 65% of the SAWW, with a minimum benefit of 5% of the SAWW ($61.24) and a maximum benefit of 120% of the SAWW ($1,469.78). Leave can be taken for up to 12 weeks for any combination of family and medical leave, with an additional two weeks for leaves related to pregnancy, childbirth or a related medical condition. The State Average Weekly Wage (SAWW) is $1,224.82.
• Contributions: This program is funded through a combination of employee payroll deductions (up to 60% of the cost) and employer contributions (not less than 40% of the cost), not to exceed 1% of employee wages, up to the Social Security maximum ($132,900 through 12/31/2023). Contributions will begin January 2023. Small businesses with fewer than 25 employees are exempt from employer contributions to the state plan.

Symetra Services:

• Symetra offers a fully insured equivalent (private plan) product for Paid Family and Medical Leave benefits. This includes tracking, management and payment of all benefits. We do not offer ASO services for self-insured equivalent plans.

Temporary Caregiver Insurance (TCI)

TCI provides partial wage replacement benefits to employees who need to take family leave to provide care for a child, spouse, domestic partner, parent, parent-in-law or grandparent with a serious health condition; or to bond with a child within 12 months after birth, adoption or foster care placement.

• Eligibility: Employees must earn wages in Rhode Island and pay into the TDI/TCI fund. Employees must have earned at least $14,700 in the base period. If the employee did not earn that amount, they may still be eligible if:

• They earned at least $2,450 in one of their base period quarters;
• Their total base period taxable wages are at least 1½ times their highest quarter of earnings; and
• Their base period taxable wage equals at least $4,900.

• Benefits: The weekly benefit equals 4.62% of wages in the base period quarter in which wages were the highest, to a minimum of $114/wk and a maximum of $1,007/wk, with an additional benefit payable per dependent up to five dependents. Leave can be taken for up to five weeks in a benefit year and will reduce the allowable number of weeks under RI TDI. In 2023, the benefit duration increased to 6 weeks.
• Contributions: This program is funded exclusively by employees equal to 1.1% (when combined with TDI) of the first $84,000 (2023) of annual wages.

State website: www.dlt.ri.gov

Temporary Disability Insurance (TDI)

TDI provides benefit payments to employees who are unable to work due to a non-work-related temporary disability or injury.

• Eligibility: Employees must earn wages in Rhode Island and pay into the TDI/TCI fund. Employees must have earned at least $14,700 in the base period. If the employee did not earn that amount, they may still be eligible if:
• They earned at least $2,450 in one of the base period quarters;
• Their total base period wages of at least 1 1/2 times their highest quarter of earnings; and
• Their base period taxable wages equal at least $4,900.
• Benefits: The weekly benefit equals 4.62% of wages from the highest earning quarter of the base period, to a minimum of $114/wk and a maximum of $1,007, with an additional benefit payable per dependent up to five dependents. Leave can be taken for up to 30 weeks in any benefit year.
• Contributions: This program is funded exclusively by employees equal to 1.1% (when combined with TDI) of the first $81,500 of annual wages.

Symetra Services:

• Rhode Island TDI and TCI are state plans only.
• As such, we cannot offer RI TDI or TCI plans. Our case managers will refer employees to the RI Department of Labor & Training website to file their TCI or TDI claim.

Paid Family and Medical Leave (PFML)

PFML can partially replace wages of employees who take family or medical leave. Family leave is available to employees to care for a family member (defined as a spouse, domestic partner, child, parent, parent-in-law, guardian, sibling, grandchild or grandparent/grandparent-in-law) with a serious health condition; to bond with a child within 12 months after birth, adoption or foster care placement; or to assist a family member when a spouse, domestic partner, child or parent is deployed abroad on active military service. Medical leave can be taken for employees to care for the employee’s own serious health condition.

• Eligibility: Employees must work 820 hours or more in the qualifying period, whether through one or multiple jobs.
• Benefits: The weekly benefit is 90% of the employee’s average weekly wage that is equal to or less than 50% of the State Average Weekly Wage (SAWW); plus 50% of the employee’s average weekly wage that is more than 50% of the SAWW, with a $100/wk minimum benefit and a $1,427/wk maximum benefit. Leave can be taken for up 12 weeks for family leave (including bereavement leave for the first seven calendar days after the death of a qualified family member for whom the employee would have qualified for medical leave for birth or for family leave to bond following birth, placement or adoption), and 12 weeks for medical leave, not to exceed a combined maximum family and medical leave of 16 weeks/year, or 18 weeks if a serious health condition during pregnancy results in incapacity.
• Contributions: This program is funded by employees and employers. The rate is 0.8% of the employee’s wages, capped at the Social Security maximum of $167,000, with approximately 72.76% paid by the employee and 27.24% paid by the employer. Employers have the option to cover some or all of the employees’ portion of the contributions.

State website: www.paidleave.wa.gov

Symetra Services:

• We are providing ASO services for employers’ self-insured plans that will give employers the option to have Symetra determine eligibility, track the leaves and offer advice regarding benefit calculations.

Resources:

• WA PFML Frequently Asked Questions >
• WA PFML ASO Solutions Flyer >