FAQs

No, NH PFML does not have a provision for job protection. Job restoration provisions under the federal Family and Medical Leave Act (FMLA) may apply to employers that sponsor NH PFML insurance for their workers.

Coverage in the individual plan includes:

• Paid family and paid medical leave together in a single insurance policy
• 60% wage replacement (up to the Social Security wage cap)
• Up to 6 weeks of wage replacement benefits per benefit year (not including the elimination period)
• Full day, reduced schedule or partial day leaves (minimum of 4-hour increments)
• An elimination period of a single unpaid work week before benefits may be paid, if applicable
• A one-time 7-month waiting period that must be satisfied before the benefits begin
• Premiums of no more than $5 per week/$260 a year

NH PFML is a first-in-the-nation, voluntary plan where NH employers and eligible NH workers can purchase PFML Insurance providing 60% wage replacement (up to the Social Security wage cap) for up to six weeks per year for absences from work for covered common life events:

• 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
   

If you have more than one job, you may want a NH PFML insurance plan for each job so that your wages from each job are protected

Example:

• Paula has 2 jobs and contributes to NH PFML plans under each of her employers.
• Paula works full-time as a receptionist at a Dental Office Monday-Friday 8 a.m. – 4:00 p.m.
  • 40 hours a week
• Paula works part-time at a Bed and Breakfast Monday-Thursday 6 p.m. – 8 p.m., and Friday 6 p.m. – 10 p.m.
  • 12 hours a week
• Paula’s son broke his leg and needs outpatient surgery.
• He will be laid up for a week from 2/6/22 – 2/10/22
  • Paula had previously met her 7-day waiting period while utilizing NH PFML helping her son get to his pre-op appointments 
    • 1/23/23 – 1/31/23
  • Paula still has 6 weeks of NH PFML benefits remaining under both of her employer-sponsored NH PFML plans
• Paula could qualify for the following:
  • Benefits under the dental office – Paula could qualify for benefits for a full week as certified by her son’s Health Care Provider under her Dental Office employer-sponsored NH PFML plan
  • Benefits under the B&B – Paula could qualify for benefits for a full week as certified by her son’s Health Care Provider under her B&B employer-sponsored NH PFML plan
• Paula will qualify for benefits the first week while her son needs full attention, from 2/6/22 - 2/10/22.  
  • Paula’s normal weekly income between her Dental Office and B&B jobs equates to $720 weekly
    • Dental office: $15 x 40 hours = $600 weekly
• Paula would be eligible for 60% wage replacement while utilizing PFML
• 60% of $600 equates to a PFML benefit amount of $360
  • B&B: $10 x12 hours = $120 weekly
• Paula would be eligible for 60% wage replacement while utilizing PFML
• 60% of $120 equates to a PFML benefit amount of $72
• Paula’s NH PFML benefit would be a combined total of $432
  • $360 from her Dental Office employer sponsored NH PFML plan
• $72 from her B&B employer-sponsored NH PFML plan
• Paula now has 5 weeks of PFML remaining and needs to be available to take her son to the doctor and physical therapy as part of his post-op care.
  • Her son’s Health care provider has certified 8 intermittent hours per week for 5 weeks
    • Paula could be eligible for up to 5 weeks of NH PFML leave under her Dental Office employer sponsored NH PFML Plan
    • Paula will utilize a total of 40 hours of intermittent time (1 week)
    • Paula will have 4 weeks of NH PFML benefits remaining for future use under her Dental Office employer sponsored NH PFML Plan following he intermittent leave
    • Paula is eligible to receive $72 weekly for her Dental office employer sponsored NH PFML Plan:
• 8 hours x $15 = $120
• 60% of $120 = $72 per week under the Dental Office employer-sponsored NH PFML plan
  • Her son’s appointments do not interfere with her normal working schedule at the B&B
    • Paula will not qualify for NH PFML under her B&Bs employer sponsored NH PFML Plan
    • Paula will continue to have 5 weeks of PFML time remaining for future use under her B&B employer sponsored NH PFML Plan.

If your new employer does not provide a NH PFML insurance plan or an equivalent plan, you can purchase NH PFML individual insurance within 60 days of your termination date. If you miss the 60-day window, you can apply during the general open enrollment period each year if you continue to work for a NH employer that does not offer NH PFML coverage.
 

If your employer offers a NH PFML insurance plan or equivalent coverage and you choose not to participate in your employer's plan, you would not be eligible to purchase NH PFML individual coverage.

If your employer chooses to offer a NH PFML insurance plan through MetLife, the State's insurance partner, after you have already purchased NH PFML individual coverage, you will get a letter from MetLife alerting you that your individual coverage will end and your coverage will be aligned to your employer’s plan.  

Any premiums paid in advance by you would be pro-rated and refunded.

NH state law requires a one-time 7-month waiting period that must be satisfied before benefits begin to protect against anti-selection. 

If you change jobs, please ask your new employer if they have a NH PFML insurance plan. If they do, then you should ask to be covered under their plan and contact MetLife to update your employer details. You will get a letter from MetLife alerting you that your individual coverage will end and your coverage will be aligned to your employer’s NH PFML plan.  Any premiums paid in advance by you would be pro-rated and refunded.

If your new employer does not have a NH PFML plan, contact MetLife to update your employer information on your NH PFML individual plan.