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23 September 2024

Top 3 Things to Know About Delaware Paid Leave and Private Plans

Application Window For Private Plans Now Open

Top 3 Things to Know About Delaware Paid Leave and Private Plans

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As Delaware is gearing up for the DE Paid Leave State Plan to kick off in 2026, this soon-to-start requirement will provide a new benefit for employees while bringing new obligations to employers. With the Private Plan application window now open, it’s time to look at employer obligations and impacts of this new Paid Family & Medical Leave (PFML) program, which – most notably – include administering claims if coverage is through the State Plan. In this article we’re looking at the top 3 questions to know about this new program as you start to prepare. But first things first – let’s level-set:

What is Delaware Paid Leave?

Starting January 1, 2026, providing Paid Family & Medical Leave benefits to employees will be mandatory for most businesses with 10 or more employees working in Delaware. Coverage will be available by default via Delaware’s State Plan, also referred to as DE Paid Leave. Delaware is joining an increasing number of states across the US have been implementing similar programs; notably, neighboring Maryland, which is slated to go live with a PFML program in 2026 as well.

Once it goes into effect, this state-mandated benefit allows eligible employees to take job-protected, partially paid time off, providing up to 80% of wages (capped at $900 per week in 2026 and 2027) for certain qualifying events:

  • Parental Leave after welcoming a new child to the family (up to 12 weeks per year)
  • Family Caregiver Leave to care for a family member with a serious health condition (up to 6 weeks, every 24 months)
  • Qualified Exigency Leave to address the impact of a family member’s overseas military deployment (up to 6 weeks, every 24 months)
  • Medical Leave to address an employee’s own serious health condition due to illness or injury (up to 6 weeks every 24 months) – this also includes pregnancy or childbirth complications.

Employees can receive a maximum of 12 weeks of total, combined leave per application year.

#1. Is There a Private Plan Insurance Option?

Yes!  An approved Private Plan is an alternative to the DE Paid Leave State Plan, which at least meets or exceeds the rights, protections, and benefits of the State Plan. An approved Private Plan can be either self-insured by a Delaware employer or fully-insured through an approved insurance carrier like ShelterPoint*.

Why would an employer want to provide a Private Plan?

Private carriers like ShelterPoint have built the experience, scalability, and agility to manage state-mandated insurance benefits and have the resources to continuously expand and enhance capabilities to provide smooth service from onboarding to claims.

Download our Employer’s Guide to Private Plan to learn more and see if a Private Plan may be the right choice for your business!

We are here to help, every step of the way.

This includes helping employers remain in compliance and informed with updates on regulatory developments, annual contribution and benefit changes, and emerging lessons from claimants on best practices.

Are you an Insurance Broker? Our Broker's Guide to Private Plan Options dives deeper into important considerations and advantages of adding Private Plans to your portfolio – regardless of which state your clients may be required to provide a PFML program in. Find out why it may be a win-win for both you and your clients here!

#2. What Obligations Will DE Paid Leave Bring for Employers with Coverage through the State?

As of now, it looks like administering claims start to finish and coordinating claim payments will be the employer’s responsibility for coverage through the DE Paid Leave State Plan, such as:

  • Provide and collect documents related to a claim
  • Help employees complete forms
  • Adjudicate the claim applications within 5 days once the completed claim form is submitted with all supporting documents – this includes:
    • determine whether a claim should be paid
    • communicate determination via the Delaware LaborFirst portal, which is anticipated to provide claim management tools for employers
    • calculate weekly benefit amounts and how long benefits should be paid out based on the Healthy Delaware Families Act
  • Participate in appeals.

In essence, employers would need to build up expertise in DE Paid Leave well beyond working knowledge, become versed in Delaware employment/labor law, add new capabilities and resources, and learn how to navigate the dynamics of being intimately involved in their employees’ leave requests.

When choosing a fully insured Private Plan for coverage, the Private Plan carrier, like ShelterPoint, fully administers and pays claims.

#3. Should I Apply for a Private Plan Now?

Yes! Even though the benefits won’t go into effect until 2026, the first Private Plan application window is already open. The window to opt-out of the State Plan and apply to use a Private Plan is only open until December 1, which means that now is the time to get your applications in!

  • Employers who elect a Private Plan by December 1, 2024, are not required to participate in pre-funding the Delaware Paid Leave State Plan via contributions starting January 2025.
  • With Private Plans approved by December 1, 2024, an employer’s contributions only begin when benefits begin on January 1, 2026.

ShelterPoint Private Plans are available on a standalone basis for 10+ lives. Brokers, contact sales@shelterpoint.com to start a custom quote for your group today! 

Want to learn more about Delaware Paid Leave? Sign-up for updates and get information sent right to your inbox. Visit our Statutory Benefits Center for more information on all state-mandated Paid Family & Medical Leave Insurance programs ShelterPoint offers.
 


 

*The ShelterPoint family of companies operates under the “ShelterPoint” name strictly as a marketing name, and no legal significance is expressed or implied. The ShelterPoint family of companies consists of ShelterPoint Life Insurance Company (principal office in Garden City, NY) and its wholly-owned subsidiary ShelterPoint Insurance Company, a FL-domiciled carrier, depending on the state. ShelterPoint is a registered service mark.

This material is for informational purposes only and is not intended to provide legal counsel. Please consult with an appropriate professional for legal and compliance advice. Any program information is based on our knowledge and understanding of DE’s applicable laws and regulations as of the publication date and may change as regulations evolve or DE issues updated guidance. Further, this material is for illustrative purposes only, providing a general overview of the services described. It is not a contract nor intended as an offer of coverage.

Policies are subject to Underwriting approval. Policies are reviewed annually and may be cancelled for nonpayment. All coverage extends to limits reflected in the policy. Please refer to the policy for coverage details pursuant to its governing law, including a complete listing of covered services, provisions, conditions, exclusions, limitations, and terms under which the policy may be continued or cancelled. In the event of conflicting information with the policy and its governing Law, the policy and governing Law will take precedence over what is shown in this material. Claim payment is not guaranteed; benefit amount depends on wages.

The provisions of the Delaware Family and Medical Leave Insurance Program, 19 Del. C. § 3701 et seq., and its implementing regulations, 19 Del. Admin. Code § 1401 et. seq. govern this Private Plan and its interpretation and administration. Available in DE only.

Underwritten by: ShelterPoint Life Insurance Company (principal office in Garden City, NY) in: DE (form# SPL PFMLP 0624 DE)


 

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