Policy 509 - New York Paid Family Leave

Policy Number:  509
Responsible Office:  HR/Employee Benefits
Effective Date: 1/1/18
Revised: 2/3/19

Overview of PFL

Effective January 1, 2018, the University will provide its employees working in New York with paid leave benefits and job protection in accordance with the New York State Paid Family Leave Benefits Law (“PFL”).  PFL is designed to enable eligible employees to have time away from work for any of the following reasons:

  • To bond with their newly born, adopted, or fostered child
    • In the case of adoption or placement, PFL may be taken prior to the adoption or placement if the employee’s absence is necessary for the placement or adoption to proceed.  PFL taken for these circumstances must be used within one year of the first day of leave, or within one year of the adoption / placement, whichever is earlier.
    • o In the case of the birth of a newborn child, PFL taken to bond with the child must be used within the first year following the child’s birth.
  • To care for their family member with a serious health condition
    • “Family member” includes the employee’s spouse, domestic partner, child (regardless of age), parent, parent-in-law, grandparent and grandchild.
    • “Serious health condition” is an illness, injury, impairment or physical or mental condition that involves either inpatient care in a hospital, hospice or residential health care facility; continuing treatment or continuing supervision by a health care provider; or transplantation preparation and recovery from surgery related to organ or tissue donation.
  • For a military exigency (for any qualifying reason as provided for under the Family and Medical Leave Act (“FMLA”) arising from the employee’s spouse, domestic partner, child or parent being on active military duty or alternatively, being notified of an impending call or order to active military duty in the Armed Forces of the United States).  

PFL coverage is provided to eligible employees by the University through an insurance carrier.

PFL is not available for the employee’s own disability or serious health condition; however, disability, FMLA or a non-FMLA medical leave may be available in those circumstances.  Please see the University’s Short-Term Disability, FMLA and other medical leave policies for additional information.

Eligibility for PFL

  • All full-time administrators, staff, student workers and graduate assistants after 26 consecutive weeks of employment;
  • All part-time administrators, staff, student workers and graduate assistants with a regular schedule of 20 or more hours per week after 26 consecutive weeks of employment; 
  • All part-time administrators, staff, student workers and graduate assistants with a regular schedule of less than 20 hours per week after 175 days worked.

Note:  Time spent on paid time off (e.g., vacation and sick time) will count towards an employee’s eligibility determination if deductions were taken during that period of paid time off.  Time that an employee spends on New York State Disability Leave or unpaid leave will not be counted towards an employee’s eligibility determination. 

Waiver

Employees shall be provided the option to file a waiver of PFL benefits if:

  • Regular employment is 20 hours or more per week but the employee will not work 26 consecutive weeks; or
  • Regular employment is less than 20 hours per week and the employee will not work 175 days in a 52 consecutive week period.

If an employee elects to waive PFL coverage, the University will not take PFL payroll deductions from that employee.  However, if an employee elects to waive PFL coverage and his/her regular schedule changes such that he/she works for either 26 consecutive weeks or 175 days in in a consecutive 52-week period, the employee’s waiver will be automatically revoked under the law.  When such a waiver is revoked the University will notify the employee regarding his/her contribution obligations.  Thereafter, the University may begin taking PFL payroll deductions from the employee, including any retroactive amounts from the employee’s date of hire or the amount necessary to prevent the University from having to pay the applicable PFL insurance premium.

Time Off and Compensation Phase-in Schedule

New York State has instructed that benefits phase in over four years, as follows:

Year

Weeks of Leave

Benefit

2018

8

50% of employee average weekly wage (up to 50% of the NYS average weekly wage

2019

10

55% of employee average weekly wage (up to 55% of the NYS average weekly wage)

2020

10

60% of employee average weekly wage (up to 60% of the NYS average weekly wage)

2021

12

67% of employee average weekly wage (up to 67% of the NYS average weekly wage)

Employees may take the maximum benefit length (see “weeks of leave” in the above chart) in any given 52-week period. The 52-week period is calculated by measuring backwards from each day for which PFL is taken (Example:  If an employee uses all 8 weeks of PFL in May and June of 2018 and then has another qualifying event  prior to May 2019, the employee may be eligible for up to two weeks of additional leave.  The maximum amount of leave in 2019 is 10 weeks in a 52 week period).

Leave must be taken in full-day increments. Leave benefits continue after the close of the calendar year (Example: If an employee commences a leave in 2018, the 2018 benefit amounts will continue to apply if the leave carries over into 2019). If, however, more than three months passes between days of PFL your next day or period of PFL is considered a new claim under the law and subject to the current year benefits.

Restrictions

The University will not permit more than one employee to use PFL to care for the same family member at the same time.

Example: If both spouses work for the University, the University may deny PFL to one spouse if both employees have requested to take PFL during the same period of time to bond with the same child.  However, both spouses could take PFL at different times to bond with the same child.

Employees may not use vacation or sick time to supplement the PFL benefit.

Employees who are covered under a University-provided group medical plan will continue to be covered under the plan for the duration of the leave period. Employees are responsible for continuing to pay their health insurance premiums during the period of leave. If payment is more than 30 days late, the employee’s health insurance coverage may be dropped for the duration of PFL.  The University will provide 15 days’ notice prior to terminating coverage.

Relationship with Other Leaves

Employees who are eligible for New York State statutory disability benefits may receive only a combined amount of 26 weeks of disability benefits and PFL benefits in a 52-consecutive calendar week period.

PFL will run concurrently with leave under the FMLA where the reason for leave qualifies under both PFL and FMLA.  In these cases, employees will be required to comply with all applicable employee requirements (e.g., application, certification, notice, etc.) under both policies.  Accordingly, employees should also review and refer to the University’s FMLA Policy.  If an employee’s leave qualifies under both PFL and FMLA, but the employee declines to apply for PFL benefits, any leave taken by the employee for such reason will be counted against the employee’s PFL allotment.

Intermittent Leave

PFL may be taken on either a weekly or intermittent basis (i.e., separate blocks of time).  Intermittent PFL must be used in full-day increments.

If an employee takes intermittent FMLA in partial day increments for a reason that also qualifies for PFL, and the employee is paid and works at least part of a work day, the University will track the hours taken against the employee’s FMLA allotment.  When the partial day increments taken total the number of hours in the employee’s regular work day, the University will deduct one day of PFL from the employee’s available PFL allotment.

Funding

The cost of PFL is paid for through employee contributions. All eligible employees must participate in the plan whether or not they intend to take PFL (unless they are eligible for and have signed a waiver). New York State determines the amount of deduction on an annual basis.

Procedures for Utilizing PFL

  1. Employees must notify the Human Resources Benefits Office at least 30 days prior to the leave if the leave is foreseeable. 
    Note: When the need for PFL is foreseeable, including intermittent leave, employees are encouraged to consult with their supervisor and the Human Resources Benefits Office regarding leave scheduling so as to minimize operational disruptions to the University. 
  2. If the need for PFL is not foreseeable because of a medical emergency, change in circumstances or lack of advance knowledge, the employee must notify the University as soon as practicable under the circumstances.  It should be practicable for the employee to follow the University’s usual and customary call-in procedure, which requires employees to notify their immediate supervisor as soon as possible prior to their scheduled starting time.
  3. If an employee fails to provide 30 days’ advance notice of foreseeable PFL and provides no reasonable excuse for the delay, the insurance carrier may partially deny the claim for a period of up to 30 days from the date the notice is given.
  4. If leave is taken on an intermittent basis, the employee must provide notice as soon as is practicable before each day taken as intermittent leave.
  5. To apply for benefits, employees must complete a Request for Paid Family Leave form (PFL-1). Claims forms are available on the HR Forms webpage.
  6. Employees shall submit the PFL-1 claim form and supporting documentation such as certifications directly to the insurance carrier.  The following Certifications are required:
    •Bonding Certification: PFL-2 Form plus documentation.
    •Health Care Provider Certification: PFL-4 Form plus Personal Health Information (PHI) Release (PFL-3 Form).
    •Military Qualifying Exigency: PFL-5 Form plus documentation.
  7. Employees have 30 days from the date PFL is taken to file the claim with the insurance carrier.  However, employees should consider filing the claim as quickly as possible to ensure prompt payment of PFL benefits if the claim is ultimately approved. 
  8. The insurance carrier will pay or deny a claim within 18 days of receipt of the completed claim.
  9. If an employee’s request for PFL has been denied by the insurance carrier, the employee has the right to appeal the determination through an arbitration proceeding.  Information regarding the appeal process is available from the insurance carrier.

An employee who is absent from work and whose PFL claim is later denied by the insurance carrier, may be authorized for leave, if eligible, under the University’s other leave of absence policies.  If the employee is not eligible under any other leave of absence benefit, the absence may be treated as unexcused and subject to the University’s attendance policy.

Restoration of Employment

An employee who returns to work at the conclusion of an approved period of PFL will be restored to the same position or to a comparable position (with comparable pay, benefits and other terms and conditions of employment).  If the employee has exhausted all weeks of available PFL and is still unable to return to work, the employee is no longer provided with any job restoration rights under PFL; however, other job protections apply (e.g., FMLA). 

Protection from Discrimination and Retaliation

The University will not discriminate and/or retaliate against any employee for inquiring about, applying for, or using PFL benefits.  Employees who believe they have experienced discrimination and/or retaliation should immediately notify their supervisor, the Human Resources Department or any other member of management.

Fraud

An employee who fraudulently obtains PFL, or who uses PFL in an improper manner, is subject to disciplinary action, up to and including termination.

Questions

An employee who has questions concerning PFL is encouraged to contact the Human Resources Benefits Office for more information, clarification and/or appropriate guidance. In addition, employees can obtain more information on PFL by visiting https://www.ny.gov/programs/new-york-state-paid-family-leave or calling (844) 337-6303 and by reading the Notice of Compliance (PDF) issued by the State of New York Worker's Compensation Board that is posted on the St. John's Federal and NY State Employment Posters website.

St. John's University, New York
Human Resources Policy Manual