Oregon Administrative Rules › Chapter 471 - EMPLOYMENT DEPARTMENT › Division 70 - Paid Family Medical Leave Insurance › Section 471-070-2270 - Equivalent Plans: Proration of Benefit Amounts for Simultaneous Coverage

Current through Register Vol. 63, No. 7, July 1, 2024
(1) An employee is
			 considered to have simultaneous coverage when the employee is covered by more
			 than one employer's equivalent plan at the same time or is covered by the state
			 plan established in ORS
			 657B.340 and at least one
			 employer with an equivalent plan, at the same time. An employee does not have
			 simultaneous coverage if they work for multiple employers covered by the state
			 plan.
(2) An employee with
			 simultaneous coverage at the start of a leave event shall apply separately
			 under all plans they are covered under and from which they are taking leave by
			 following the respective application guidelines for each plan. An equivalent
			 plan employer may ask an employee whether the employee has additional Paid
			 Family and Medical Leave Insurance (PFMLI) coverage but may not require that
			 the employee provide details on the other employers or the plans. The employer,
			 employee, or administrator may request information from the department as
			 described in OAR 471-070-2260.
(3)
			 Each equivalent plan is required to pay benefit amounts that are equal to or
			 greater than the benefits offered under the state plan as described in OAR
			 471-070-2260  and ORS 657B.050 and applicable
			 administrative rules. Upon request, the department may provide information to
			 equivalent plan employers or administrators regarding prorated benefit amounts,
			 if the department is aware of simultaneous coverage. Each respective plan
			 benefit amount shall be prorated by the average number of work days worked per
			 work week by the claimant for each respective plan rounded to the nearest whole
			 cent. When rounding, any number with the last figure five or greater is rounded
			 up, while numbers less than five are rounded down.
(a) The state plan shall pay benefits based
			 on the prorated weekly benefit amount and shall further prorate the weekly
			 benefit amount as described in OAR 471-070-1440  for leave taken in work day
			 increments.
(b) The equivalent plan
			 shall pay benefits equal to or greater than the prorated weekly benefit amount
			 and may further prorate the weekly benefit amount when leave is taken in work
			 day increments based on the number of work days of leave taken in the work
			 week.
Example 1: Alondra is employed by two employers. One employer
				is a state plan employer and the other is an equivalent plan employer. Alondra
				works five days per work week for the state plan employer and three days per
				work week for the equivalent plan employer. Alondra is unable to work for both
				employers due to the need to provide care for a seriously ill parent for the
				next five weeks. Alondra must apply for benefits separately for the state plan
				and the equivalent plan. Alondra's weekly benefit amount is $1,040. Alondra
				will receive two separate benefit payments each week. The state plan will pay
				the prorated weekly benefit in the amount of $650 [($1,040 weekly benefit
				amount divided by 8 total days worked at both jobs) x 5 days worked for the
				state plan employer]. The equivalent plan employer will pay at least the
				prorated weekly benefit in the amount of $390 [($1,040 weekly benefit amount
				divided by 8 total days worked at both jobs) x 3 days worked for the equivalent
				plan employer].
Example 2: Same typical work schedule and weekly benefit amount
				as in example 1; however, Alondra is unable to work for the state plan employer
				one day per work week and is unable to work for the equivalent plan employer
				one day per work week (for a total of two days of leave each week) to provide
				care for a seriously ill parent for the next five weeks. Alondra must apply for
				benefits separately for the state plan and the equivalent plan. Alondra's
				weekly benefit amount is still the same at $1,040 (the state plan prorated
				weekly benefit amount is $650 and the equivalent plan prorated weekly benefit
				amount is at least $390). Because the leave is taken in work day increments and
				not an entire work week, once the prorated weekly benefit amount is determined,
				the state plan will further prorate the state's weekly benefit amount by the
				number of work days on leave. The state plan will pay weekly benefits in the
				amount of $130 [($650 state plan portion of the weekly benefit amount divided
				by 5 work days) x 1 day on leave in the work week)]. The equivalent plan
				employer may choose to further prorate the weekly benefit amount by the number
				of work days on leave [($390 equivalent plan portion of the weekly benefit
				amount divided by 3 work days) x 1 day on leave in the work week) for a minimum
				weekly benefit amount of $130].