Educate Your Customers on FMLA for Family Members in Massachusetts

The recent Massachusetts Family and Medical Leave Act legislation has caused some confusion regarding who is eligible for FMLA, since the definition of “Family” according to the Massachusetts Commonwealth extends beyond what many people think of as immediate family.

As Massachusetts insurance brokers grapple with new legislation surrounding the Massachusetts Family and Medical Leave Act (FMLA), your clients and their employees probably have questions regarding coverage of both the “Family” and “Medical” portions of FMLA in Massachusetts.

The DBL Center is working closely with our top-rated carriers to report breaking news FMLA for family members, along with other details of FMLA claims, as it becomes available.

PFML vs. FMLA: What’s the Difference Between Massachusetts Paid Leave and the U.S. Family and Medical Leave Act?

It’s important not to get confused between Massachusetts’ new PFML laws and the federal Family and Medical Leave Act, which was signed into law in 1993.

FMLA only provides job protection for employees under certain circumstances. It does not provide paid leave. The reasons for taking leave through FMLA or taking paid leave in Massachusetts overlap to an extent.

When Does FMLA Apply to Employees?

The Family and Medical Leave Act provides 12 weeks of unpaid job protection should an employee stop working:

  • To care for a newborn child, adopted or foster child
  • To care for a spouse, child, or parent with a serious health condition
  • Due to a serious medical condition

Who Can Claim PFML in Massachusetts?

Employees can use PFML:

  • For an off-the-job injury or illness not covered by a private short-term disability plan
  • To care for a newborn, newly adopted or new foster child within the first year
  • To care for any family member with a health condition
  • To run a household while a military spouse is deployed

Understand Who Qualifies for FMLA Claims to Care for Family Members

Massachusetts has a much broader definition of family than federal legislation provides. Covered parties include virtually anyone you may have the responsibility of caring for under your roof. This includes:

  • Spouse
  • Domestic Partner
  • Child
  • Parent
  • Grandchild
  • Grandparent
  • Sibling
  • Parent of a spouse or domestic partner
  • Person who stood “in loco” to the employee when the employee was a minor

PFML also helps support military families during deployment or if a military service member should become ill or injured.

FMLA and PFML can – and typically are – taken concurrently, since one offers job protection and the other offers partial pay replacement.

STD v. PFML: Understanding the “Medical” Portion of the Massachusetts Paid Family and Medical Leave Act

PFML and the federal FMLA job protection have nearly identical standards defining a “serious health” condition for an employee. It includes any period of in-patient (hospital) care, or a period of incapacity of 3 or more days with continuing treatment from a medical professional.

These standards align with FMLA job protection. If a Massachusetts employer already provides provide short-term disability coverage on a voluntary basis for employees, they may find the standards for PFML less restrictive. MA PFML is not a “disability” standard, per se, so it provides benefits more frequently and is more likely to pay for certain health conditions not covered by STD.

For instance, the following conditions, which may require ongoing treatment or a hospital stay, would often be covered under MA PFML but not under short-term disability plans in Massachusetts:

  • Migraines
  • Physical therapy
  • Asthma
  • Overnight hospital stay for monitoring with next day release

If STD and MA PFML claims happen concurrently, such as in the case of the childbirth recovery period, which provides STD for six to eight weeks for people who have just given birth, MA PFML pays first.

The STD benefit then offsets with the amount received by the claimant under MA PFML. This can get complicated, but The DBL Center is here to walk you and your clients through specific circumstances, leveraging our years of insurance industry experience and carrier relationships with the best disability insurance companies that write this new benefit.

Three More Facts You Need to Know About the Family and Medical Leave Act in Massachusetts

Below are some more key points about the Family and Medical Leave Act that brokers should understand in order to knowledgeably field client questions:

  1. Under the Massachusetts Paid Family and Medical Leave Act, employees who are covered can expect to get as much as 12 weeks of unpaid leave to care for a newborn, newly fostered, or newly adopted child; or family members who are ill or injured beginning July 1, 2021.
  2. Employees can use up to 20 weeks of paid leave per year if they are suffering from a serious illness or injury incurred off the job starting January 1, 2021. (On-the-job injuries and illness are covered by Workers’ Compensation claims.)
  3.  Companies in Massachusetts with at least 50 employees are required to provide PFML coverage for any employee who has worked at least 1,250 hours in the last 12 months. It is a shared benefit, where employers and employees both pay a portion of the costs.

It’s important to understand both the “medical” and “family” portions of FMLA to answer employers’ questions knowledgably. Through consultative selling and building relationships, you can turn this new benefit in Massachusetts into a profit opportunity for ongoing commissions.

Remember, employers have the option to write PFML plans through private firms and receive not only the same benefits provided by the state PFML plans, but concierge-level service and access to state-of-the-art technology and customer portals to make managing benefits plans easier.

Contact The DBL Center to learn more about FMLA Certification for a family member and other aspects of the new MA PFML Act in Massachusetts.