Massachusetts Paid Family & Medical Leave, Coverage Requirements

The Paid Family & Medical Leave (PFML) is a required insurance program for most Massachusetts employers, providing employees with job-protected, partially paid time off for certain qualifying events.

Does your business have to provide MA Paid Family & Medical Leave Coverage? Let’s walk through the requirements:

Which Employers Are Required to Provide MA PFML to Their Employees?

Private employers

The State - including all its branches and departments and its hospitals and institutions of higher education

What size employer does this apply to?

Employers are required to provide Paid Family & Medical Leave coverage if they have at least one individual working in Massachusetts.

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Which Employers Are Not Required to Provide MA Paid Family & Medical Leave?

Municipalities, districts, political subdivisions or their instrumentalities. City and town departments, such as school departments or departments of public works, are considered part of the municipality they serve. These employers may opt-in by a majority vote of by the local legislative or governing body.
- Please note: Charter schools are not part of a municipality and are not excluded under the MA PFML law, with the exception of the Horace Mann Charter School. Horace Mann Charter school employees are considered employees of the municipality.
Housing authorities, regional school districts, and regional planning commissions. These employers may opt-in by a vote of their board members or governing committees.

Are there other types of excluded employment?

Yes. The same types of employment that are excluded under Section 6 of the MA Unemployment law are also excluded under the MA PFML law. These employers may opt-in to provide PFML coverage but must do so for all employees—they cannot opt-in for only a portion of their workforce.

Can businesses opt-out?

No, if you are a business that is required to provide PFML coverage as outlined above, you can’t opt-out.

Which Individuals Are Considered Part of a “Covered Workforce,” and Therefore Required to Be Covered?

W-2 employees (includes full-time, part-time, seasonal). They don’t need to live in Massachusetts to be counted, but do need to work in Massachusetts.
Business owners who pay themselves through a W-2 are considered an employee of that business and part of the covered workforce under PFML.
1099 MISC contractors if they make up more than 50% of your workforce.
Former employees are covered for up to 26 weeks from their separation from employment, provided they remain unemployed.

Can covered individuals opt-out?

No, employees or individuals who are required to be covered under the PFML law can’t opt-out.

Are Self-employed individuals eligible for PFML?

Self-employed individuals are not required to participate in the MA PFML program but may opt-in to the State Plan. However, they are required to commit to an initial period of 3 years of PFML coverage and will not be eligible to begin receiving benefits until they have made contributions for at least 2 calendar quarters.

MA Paid Family & Medical Leave Benefit Eligibility & Claims

Are covered individuals automatically eligible to receive benefits?

Whether a MA PFML claim qualifies for benefit payments depends on several factors. When filing a Paid Family & Medical Leave claim, each specific situation will be evaluated.

Get more detailed MA PFML Private Plan claims guidance with Shelterpoint* and additional information here.

Massachusetts ABCs of PFML

Our in-depth guide provides everything you need to know about Paid Family & Medical Leave in Massachusetts. Here’s what you’ll find inside this 31-page guide:

PFML Basics
Benefits
Private Plans Explained
Contributions
Coverage Requirements
Eligibility & Claims
Compliance
Tips from your PFML Experts
…and more!

Download your copy now

Learn More About MA Paid Family & Medical Leave

Overview

Private Plan Option

Coverage Requirements

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Premium & Contributions

Claims

Regulatory Updates

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The information in this document is based on our knowledge of the MA Paid Family and Medical Leave statute and regulations, and may change as regulations evolve or the MA Department of Family and Medical Leave issues guidance regarding the regulations. 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. The information in this material is not intended as an offer of coverage. It is for illustrative purposes only, providing a general overview of the MA PFML program. It is not a contract. ShelterPoint Life policies are subject to Underwriting approval. Claim payment is not guaranteed; benefit amount depends on wages. All coverage extends up to policy limits. Policies are reviewed annually and may be cancelled for nonpayment. Please refer to the policy for terms under which it may be continued or cancelled, and for policy exclusions and limitations. In the event of conflicting information with the policy, the policy will take precedence over what is shown in this material.

*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, a NY-domiciled carrier, and its wholly-owned subsidiary ShelterPoint Insurance Company, a FL-domiciled carrier, depending on the state.

Available in Massachusetts only. Underwritten by: ShelterPoint Life Insurance Company (principal office in Garden City, NY)
Policy Form# SPL PFMLP 0820 MA

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MA PFML: Coverage Requirements