Healthcare Providers
As a healthcare provider, you play an important role in the New Hampshire Paid Family and Medical Leave claim process.
NH Paid Family Medical Leave (NH PFML) is a voluntary paid family and medical leave insurance plan where NH employers and eligible NH workers can access 60% wage replacement (up to the Social Security wage cap) for up to six weeks per year for absences related to life events such as:
- A worker’s own serious health condition when disability coverage does not apply, including childbirth
- For a worker to bond with a child during the first year of birth, including placement for adoption or fostering
- For a worker to care for a family member with a serious health condition
- Any qualifying urgent demand or need arising out of the fact that the worker’s spouse, child, or parent is a covered military member on covered active duty
- For a worker to care for a covered service member with a serious injury or illness if the eligible worker is the service member’s spouse, child, parent or next of kin
Your responsibilities as a Healthcare Provider
When a worker makes a claim for NH PFML benefits, you will be asked to provide proof of a qualifying event. As a healthcare provider, you may be asked to provide documentation to serve as this proof for your patient or their family member’s condition.
MetLife is the State of NH’s insurance partner to provide NH PFML insurance to NH employers and workers. Although it is the worker’s responsibility to obtain proof in support of their NH PFML claim, you will be asked to complete:

- An NH PFML Serious Health Condition certification form, or
- MetLife may accept an FMLA certification form if it clearly states the serious health condition and the need to take benefits on a continuous basis, on a partial work schedule or on an intermittent leave schedule (asking for leave benefits in increments of at least 4 hours per workday)
MetLife will rely on the information you provide to approve or deny worker applications for NH PFML insurance benefits.
NH PFML Certification forms should be returned to MetLife by mail, fax or by uploading to the MetLife portal as soon as possible.
- Mail a paper form to: Metropolitan Life Insurance Company P.O. Box 14590 Lexington, KY 40512-4590
- Fax a paper claim form to 1-800-230-9531
- Submit a paper form via Metlife’s MyBenefits web portal
You can also call the MetLife Customer Solution Center for NH PFML, at 1-866-595-PFML (7365), with any questions.

Key Dates
Key Dates
NH PFML Plan: Begins January 1, 2023
Employer Enrollment (Ongoing): Begins December 1, 2022
Worker Open Enrollment: January 1, 2023 - March 2, 2023