FAQs
What is the NH PFML insurance plan?
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 6 weeks per year for absences from work for covered common life events.
Does NH PFML provide job protection?
Large Employers (50 or more workers) that sponsor NH PFML insurance for their workers, shall restore workers taking leave to the position held prior to such leave or to an equivalent position consistent with the job restoration provisions of the FMLA or RSA 275:37-d.
Small Employers (Less than 50 workers) are not required to restore a worker to their prior position. Workers employed with a Small Employer are strongly encouraged to coordinate NH PFML leave with their employer and discuss the status of their position prior to taking leave.
What does individual coverage include?
- 6 weeks of wage replacement at 60% up to the Social Security wage cap
- A single unpaid work week elimination period before benefits may be paid
- Leave that can be taken all at once (continuous) or in partial days (intermittent) with a minimum of 4-hour increments
- 7-month waiting period before a claim may be submitted
- Premiums of no more than $5 per week
If I have more than one job do I need more than one NH PFML plan?
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 had previously met her 7-day waiting period while utilizing NH PFML helping her son get to his pre-op appointments
- 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’s normal weekly income between her Dental Office and B&B jobs equates to $720 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:
- Her son’s Health care provider has certified 8 intermittent hours per week for 5 weeks
- 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.
- Her son’s appointments do not interfere with her normal working schedule at the B&B
Are all workers designated to a NH Employer eligible for a NH PFML individual plan?
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.
What if I change jobs and my new employer does not offer NH PFML?
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.
What if I have a NH PFML individual plan and my employer chooses to offer NH PFML?
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.
Why is there a 7-month waiting period for individual coverage?
NH law requires a 7-month waiting period for workers enrolled in an individual plan to protect against anti-selection.
If I change jobs, can I keep my NH PFML benefits?
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.