Frequently Asked Questions

General FAQs

1. Why should employers participate?

NH PFML is an attractive worker benefit that can give you a competitive edge by providing:  

  • Wage replacement protection for your workers to help them cope during a health crisis or care need
  • Reduced turnover and improved worker retention as workers stay connected to work
  • Increased worker morale and productivity

2. What does the NH PFML insurance plan include?

The NH PFML Insurance Plan includes:

  • Paid Family and Paid Medical Leave together in a single insurance policy
  • 60% wage replacement benefits up to the Social Security wage cap for qualifying leave reasons
  • Leave can be taken all at once (continuous) or in partial days (intermittent) with a minimum of 4-hour increments
  • Employers will have the choice of duration to offer under their NH PFML Insurance Plan:
    • Option 1: 6 paid weeks of leave 
    • Option 2: 12 paid weeks of leave 
       

3. 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 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
     

4. What kinds of absences are covered under NH PFML?

Leaves of absence available to cover common life events include: 

  • 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

5. What are the benefits of NH PFML insurance?

Covered workers receive 60% wage replacement benefits (calculated up to the social security wage cap currently at $160,200/annually) if a qualifying common life event causes you to miss work.

6. What are some examples of common life events covered under NH PFML?

  • Non work-related conditions requiring an overnight stay in a hospital or medical care facility
  • Conditions that incapacitate you or a family member where you or your family member are unable to work or attend school for more than three consecutive days and have ongoing medical treatment (such as multiple appointments with health care providers, or a single appointment and follow-up care such as prescription medication).
  • Chronic conditions such as asthma or epilepsy where you or your family member are incapacitated and require treatment by a health care provider at least twice a year.
  • Pregnancy including  incapacity due to morning sickness, and medically required bed rest
  • Organ or tissue donation.
  • Unable to work because your child is coming home from oversees deployment

7. What will my benefits look like under an employer-sponsored NH PFML plan?

If your employer purchases NH PFML insurance coverage, it will include: 

  • Paid Family and Paid Medical leave 
  • 60% wage replacement benefits up to the social security wage cap
  • Leave can be taken all at once (continuous) or in partial days (intermittent) with a minimum of 4-hour increments.
  • 6 or 12 weeks of paid leave: Check with your employer on the number of weeks of paid leave included in your employer-sponsored NH PFML plan

8. I work for the State of New Hampshire. What do my benefits look like?

As of January 1, 2022, State of New Hampshire government employees receive paid family leave coverage provided by the State. For information about paid family leave, State workers can contact their agency human resources administrator or see the Paid Family Leave Wage Replacement Insurance Benefit Policy

9. How can I get NH PFML insurance if my employer doesn’t provide it?

If an employer does not provide NH PFML or equivalent coverage, a worker may purchase a NH PFML individual plan for themselves. An employee must work for a NH employer and be designated as such by their employer to be eligible to purchase a NH PFML individual plan.
A NH PFML individual plan includes:

The NH PFML individual plan includes:

  • Six (6) weeks of wage replacement at 60% up to the Social Security wage cap 
  • A single unpaid work week before benefits may be paid
  • Leave that can be taken all at once (continuous), at a reduced schedule, or in partial days (intermittent) with a minimum of 4-hour increments
  • A one-time 7-month waiting period before a claim may be submitted
  • Premiums of no more than $5 per week

Individuals may enroll in the NH PFML individual plan during the annual open enrollment period, December 1, 2023 – January 29, 2024.

The enrollment process begins by requesting a quote from MetLife. 
How to request a quote:

  1. Use MetLife's Individual Plan Quote Calculator to explore NH PFML plan options and connect with MetLife
  2. Call the MetLife Customer Solution Center at 1.866.595.PFML (7365)
     

10. Is there a pre-existing condition clause for NH Paid Family and Medical Leave?

No. NH PFML does not have a pre-existing condition requirement.

11. Is there a waiting period for NH PFML?

A NH PFML individual plan includes a one-time 7-month waiting period that must be satisfied before a claim may be submitted. Employer group plans may include a waiting period in the insurance policy they purchase from MetLife.

12. When is NH PFML insurance coverage effective? 

NH PFML insurance coverage is subject to the policy effective date.

13. What is the definition of a serious health condition?

Under NH PFML, a serious health condition is defined as: 

  • Conditions requiring inpatient care
  • Incapacity for more than three (3) days with continuing treatment by a health care provider
  • Incapacity relating to pregnancy or prenatal care
  • Permanent or long-term incapacity
  • Certain conditions requiring multiple treatment, and
  • Chronic serious health conditions that may prevent a person from working for a minimum of 4 hours for example, a person with epilepsy may not be able to work due to an epileptic episode

14. Are premiums taxed?

NH PFML makes no changes to existing federal and applicable state tax reporting requirements. The Internal Revenue Service (IRS) has not yet provided taxation rules for paid family leave or paid medical leave. 

Please contact your employment counsel and tax experts for additional guidance on premium and benefit tax practices.

Taxation guidelines generally followed for PFML contributions are:

  • If premiums are taken prior to taxes, benefits are taxed
  • If premiums are taken post tax, benefits are not taxed
    • Only applies to paid medical leave
    • Not applicable to paid family leave 

Please contact your employment counsel and tax experts for additional guidance on premium and benefit tax practices.

Are NH PFML benefits taxed?

NH PFML makes no changes to existing federal and applicable state tax reporting requirements. NH PFML insurance benefits may be taxable at the federal level. They are not taxable at the state level, as NH does not have state income tax. 
As the IRS has not yet provided taxation rules for paid family leave (PFL) or paid medical leave (PML), MetLife follows the industry standard for NH PFML taxes, i.e., that NH employers include contributions for PFML in the gross income of the worker for federal income tax purposes.  

For the paid medical leave (PML) portion of NH PFML coverage, this means that the employer contribution portion is made on a pre-tax basis, while the worker contribution portion is made on an after-tax or post-tax basis. Benefit payments to workers are taxable if paid for by the employer, but not taxable if paid for by the worker. 

For example:

  • When an employer pays 100% of the premium, the PML portion of the benefit is 100% taxable  
  • When an employer pays 60% of the premium the PML portion of the benefit is taxed at 60%, while the remaining 40% that was paid for by the worker is not taxed
  • When a worker pays 100% of the premium the PML portion of the benefit is not taxed.

For the paid family leave (PFL) portion of NH PFML coverage, taxes will not be withheld from benefits automatically. Workers can request voluntary tax withholding. Workers will need to submit a W-4S tax form to MetLife for taxes to be withheld.

NH PML benefits are subject to both federal payroll tax under the Federal Insurance Contributions Act (FICA) and federal unemployment tax under the Federal Unemployment Tax Act (FUTA). 

NH PFL benefits are not subject to FICA and FUTA.

Please contact your employment counsel and tax experts for additional guidance on premium and benefit tax practices.

15. When are individual plan claims payable?

NH PFML individual plans become payable once the 7-month waiting period has been satisfied.

Eligibility FAQs

1. Do I have to have a physical location in NH to be eligible for NH PFML? 

Yes. Only employers with a physical location in New Hampshire are eligible for NH PFML insurance.

2. If I am a MA employer but have employees working 100% remotely in NH are those employees allowed to purchase NH PFML?

Employers must be located in New Hampshire to be eligible for NH PFML insurance. 

Workers must be designated as working for an NH employer and report wages to NH for unemployment purposes to be eligible for NH PFML insurance coverage.

3. Do I have to work for an employer located in NH to be eligible for NH PFML? 

Yes. To be eligible for NH PFML insurance, you must work for an employer with a location in New Hampshire and be designated as working for a NH employer, which means that your employer reports your wages to the state of New Hampshire for unemployment purposes.

4. Are all of my workers eligible for NH PFML coverage? 

To be eligible for NH PFML insurance, your workers must be designated as working for a NH employer, which means that you report their wages to the state of New Hampshire for unemployment purposes.

5. Could my NH PFML plan cover workers in other states?

No.

NH employers may purchase NH PFML insurance for their NH workers only. Workers must be designated as working for an NH employer and report wages to NH for unemployment purposes to be eligible for NH PFML insurance coverage. Eligibility will be verified by MetLife during the enrollment process.

6. Who is not eligible for NH PFML?

Workers that are not designated as working for a NH employer are not eligible for NH PFML insurance coverage. Talk with your employer's Human Resources representative if you have any questions and to see whether your employer is sponsoring NH PFML coverage.

7. Can all eligible NH workers buy a NH PFML individual plan?

No. 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

8. If a worker is pregnant or a child is placed with them for adoption or foster care before they purchase coverage, are they still eligible for NH PFML for that leave reason? 

NH PFML is available for bonding as long as it is taken within 12 months of birth or placement for adoption or foster care. Keep in mind there is a one-time 7-month waiting period that applies to the individual NH PFML plan.

9. What is a qualified worker?  Do they have to meet a certain number of hours? What happens if they work part of the year in other states? Does it match NH unemployment requirements?

Eligible NH workers must be designated through payroll reporting as working for a NH employer. There is no minimum number of hours that a worker must meet in order to be eligible for NH PFML coverage. Both full-time and part-time workers are eligible for coverage. Eligibility will be verified by MetLife during the enrollment process.

10. What is considered “employer equivalent benefit coverage”?

An employer's benefits, which may be provided through a combination of plans, must include the following to be considered a NH PFML equivalent plan:

  • Coverage for all qualifying events, including:
    • 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 following birth, or 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 service 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
  • 60% wage replacement benefits up to the Social Security wage cap for all qualifying leave reasons
  • A minimum of six (6) weeks of benefits for all qualifying leave reasons
  • Ability to take leave continuously, intermittently or on a reduced schedule with a minimum of four (4) hours of missed time for each covered day plan. 

Employers may complete the MetLife Employer Equivalent Plan Evaluation and Certification Checklist1 to help determine if they offer equivalent benefits. 
 

Enrollment and Purchasing FAQs

1. What if I want to purchase NH PFML through my current insurance company?

The New Hampshire Department of Insurance has created regulations that allow other insurance companies to provide NH PFML benefit plans. Employers who purchase NH PFML Insurance from insurance carriers other than MetLife will not qualify for the Business Enterprise Tax (BET) Credit. 

2. Do I have to purchase NH PFML insurance from MetLife?

No. NH PFML is a voluntary benefit available to all employers and workers but required of none. NH PFML Insurance was established in state law as a voluntary insurance program allowing employers and workers a choice whether or not to participate.

Employers are not required to purchase a NH PFML Insurance Plan. 

New Hampshire Department of Insurance regulations allow other insurance companies to seek approval to provide paid family and medical leave benefit plans. However, employers who purchase other paid family and medical leave insurance plans or employer equivalent coverage will not qualify for the BET Tax Credit.

Employers can choose to provide:

  • NH PFML Insurance issued by MetLife, the state’s insurance partner, and receive the 50% BET Credit;
  • Other paid family and medical leave insurance plans approved by the New Hampshire Department of Insurance; or 
  • Self-insured employer equivalent benefit coverage

If an employer does not provide employer equivalent benefit coverage, workers may purchase a NH PFML individual insurance plan for themselves from MetLife (employer obligations still apply). The NH PFML individual insurance plan provides workers: 

  • 6 weeks of wage replacement at 60% up to the Social Security wage cap 
  • A single unpaid work week  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
     

3. How do I buy NH PFML insurance?

Employers can purchase a NH Paid Family and Medical Leave plan through an licensed insurance agent, broker or third-party administrator who is appointed with MetLife to sell NH Paid Family and Medical Leave insurance. Workers can purchase NH Paid Family and Medical Leave individual plan coverage by using the MetLife Quote Calculator or calling the MetLife Customer Solution Center at 1-866-595-PFML (7365)

4. If an employer chooses not to offer NH PFML initially can they purchase it anytime thereafter?

Yes. Employers can purchase NH PFML insurance at any time. If the employer does not provide NH PFML or an equivalent plan,  individual workers will be able to enroll in a NH PFML individual plan during the state's annual 60-day open enrollment period.

5. When can I enroll my workers in NH PFML?

Employers can enroll their workers at any time.

6. Can workers decide to enroll in a NH PFML plan when there is a life event?

No. Workers may enroll in an employer-sponsored NH PFML plan during the employer's open enrollment period.

If the employer does not sponsor a NH PFML plan, a worker can enroll in an individual NH PFML plan during the annual 60-day open enrollment period. Workers cannot join outside of the open enrollment period unless they change jobs, which opens up a window of time to update their NH PFML coverage.

7. Once you enroll, are you committed to staying in the plan for the full year?

Employers are committed to remaining enrolled in the group plan for the full benefit year. 
It is preferred that individuals remain enrolled in the individual plan for the full year but it is not required that they do so. 
Plans are renewed automatically each year unless the worker or their employer makes a change.

Cost and Payment FAQs

1. How much does NH PFML cost for individual plan?

If your employer is not sponsoring NH PFML insurance or an equivalent plan, you may be eligible to purchase a NH PFML individual plan. Premiums for the NH PFML individual plan will cost no more than $5 per week

2. How much does NH PFML insurance cost for an employer group plan?

Employers will have the ability to get a quote from MetLife to customize NH PFML Insurance and premium to meet their business needs within regulatory parameters set by the state. NH PFML insurance can be purchased from MetLife through a licensed insurance agent, broker or consultant who is appointed with MetLife to sell the NH PFML insurance plan.

The NH PFML Plan incentivizes employers to purchase six weeks of coverage through the plan by providing a Business Enterprise Tax (BET) Credit equal to 50% of the NH PFML Insurance premium they pay each year.

An employer may fully fund the NH PFML Insurance premium cost on their workers’ behalf, split the premium cost with workers or pass on the full cost to workers.

3. If a worker buys an individual plan will it cost more than the premium an employer would pay under a NH PFML group plan?

Under the law, the cost of coverage for a NH PFML individual plan is capped at $5 per week, which may be greater or less than the cost of premium under an employer sponsored plan. Employer sponsored plans are individually underwritten based on the employer's census, selected NH PFML plan, cost sharing with workers, if any, and terms of any applicable short-term disability policy.

4. How do you get a quote for coverage and what information is needed?

Employers, Workers and Brokers can get a quote for coverage by using the MetLife Quote Calculator

5. What is the quote process for employers?

You can get a quote for employer sponsored plan coverage by using the MetLife Quote Calculator for Employers, or by calling the MetLife Customer Solution Center at 1.866.595.PFML (7365). 

Employer sponsored plans are individually underwritten based on the employer's census, selected NH PFML plan, cost sharing with workers, if any, and terms of any applicable short-term disability policy.

Employers will need to provide the following information to receive a quote: 

  • Workforce census including the following information:
    • Workplace zip code
    • Worker age or date of birth (DOB) 
    • Worker gender
    • Worker annual salary
  • Employer Standard Industrial Classification (SIC) or industry code
  • Employer situs/business location state
  • Whether or not the employer has disability coverage
  • Request for a 6-week or 12-week NH PFML plan
  • Funding choice to fully fund 100% of the NH PFML insurance premium cost on their workers’ behalf, share the premium cost with workers, or pass the full 100% premium cost on to workers
     
NH PFML vs Short-Term Disability (STD) FAQs

1. What is the difference between NH PFML and Short-Term Disability (STD)?

NH PFML is different from Short-Term Disability (STD). Although both NH PFML and STD might provide wage replacement for a worker's own health condition, the eligibility requirements, benefit amount, benefit length and qualifying reasons can be different, as follows:  

  • NH PFML provides not only wage replacement for a worker’s own serious health condition when disability coverage does not apply, including childbirth, but also covers several other qualifying events not covered by STD such as:
    • Child bonding due to birth, adoption or fostering;
    • Serious health condition(s) of a family member
    • Qualifying need arising from military deployment or service or 
    • Caring for a qualifying military service member.  
  • The six weeks of NH PFML coverage can be used for any one or several of the above reasons. STD is focused solely on wage replacement for illness or injury of the worker.
  • NH PFML wage replacement is 60% while STD typically ranges from 50% to 100% depending on employer policy
  • NH PFML benefit length is six weeks per year while STD is typically 13 or 26 weeks per event
  • STD benefits pay out before NH PFML benefits can begin. Therefore, STD and NH PFML complement each other if a worker has a serious health condition. They do not cancel each other out.

2. If I offer a short-term disability policy to my workers do I need NH PFML? Does buying NH PFML mean I should cancel my STD coverage?

Although every policy is different, Short-Term Disability (STD) coverage typically provides wage replacement for illness or injury of the worker.  NH PFML insurance provides wage replacement for a worker's own serious health condition when disability coverage does not apply, including childbirth, and for several other qualifying events such as for child bonding due to birth, adoption or fostering, serious health condition(s) of a family member, qualifying need arising from military deployment or service or caring for a qualifying military service member.  
NH PFML coverage is broader than STD but is limited to six weeks and is shared with other qualifying reasons. This means that if NH PFML time is used up to care for someone else, a worker could be without coverage for themselves.  Therefore, NH PFML is not a replacement for STD, and STD is not a replacement for NH PFML. STD and NH PFML complement each other if a worker has a serious health condition that may need both continuous and intermittent time away from work.

3. Should a NH employee purchase NH PFML if their employer provides Short-Term Disability (STD)?

NH PFML is not a replacement for STD, and STD is not a replacement for NH PFML. NH PFML and STD complement each other if a worker has a serious health condition that may need both continuous and intermittent time away from work.

4. Can a worker collect NH PFML and Short-Term Disability (STD) at the same time?

No. NH PFML insurance is designed to coordinate with other types of leave and worker benefits in the following manner:

  • If a worker qualifies for Short-Term Disability (STD), they will not qualify for NH PFML insurance benefits for the same days absent
  • If a worker is eligible to receive workers’ compensation (WC), they will not qualify for NH PFML insurance benefits
  • NH PFML insurance will run concurrently with the federal Family and Medical Leave Act (FMLA) when a worker is eligible under both programs
  • Any other paid benefit coordination is based on employer policy, employer benefit structure, NH statute and rules of the MetLife agreement

The following scenario describes an example of coordination of benefits:
Rose is having a baby in 6 months and works for ABC Accounting with the following salary and benefits:
Weekly wage $1,000; 5 days/week
Paid Benefit Potential:

  • STD $600/week
  • Salary Continuation bonding 6 weeks $1,000/week
  • NH PFML $600/week or $120/day for 6 weeks
  • PTO $1,000/week

Rose experiences severe morning sickness and her doctor gives her a physician’s certification that she may miss partial days during this phase of her pregnancy. 
Paid Benefit Potential: 

  • STD – No
  • Salary Continuation – No
  • NH PFML – Yes- Paid Medical Leave $120/day
  • FMLA - Yes 

Rose starts to experience issues a few weeks prior to the due date. The doctor puts her on bedrest 2 weeks before the baby is due as a precaution. 
Paid Benefit Potential:

  • STD – Yes (continuous) $600/week
  • Salary Continuation – No
  • NH PFML – No
  • FMLA - Yes

Rose gives birth to a healthy baby girl.  
Paid Benefit potential:

  • STD – Yes (continuous)  8 weeks $600/week
  • Salary Continuation – starts after STD $400/week
  • NH PFML – Yes, family leave runs concurrent with Salary Continuation $600/week 

During this time, Rose was able to use:

  • October - 5 days: FMLA, PTO, and NH PFML
  • FMLA - job protection for her medical leave
  • PTO 100% wage replacement 
  • NH PML pre-natal incapacity satisfying her unpaid Elimination period
  • March-May - 10 weeks: STD and FMLA
  • FMLA - job protection for her medical leave
  • 60% wage replacement for mother’s incapacitation

5. Would it be advised to have a 6-week elimination Short-Term Disability (STD) plan with PFML?

MetLife does not recommend a 6-week elimination period for STD. NH PFML and STD complement each other if a worker has a serious health condition that may need both continuous and intermittent time away from work.

6. How does NH PFML coordinate with other types of leave and worker benefits?

NH PFML insurance is designed to coordinate with other types of leave and worker benefits in the following manner:

  • If a worker qualifies for Short-Term Disability (STD), they will not qualify for NH PFML insurance benefits for the same days absent
  • If a worker is eligible to receive workers’ compensation (WC), they will not qualify for NH PFML insurance benefits
  • NH PFML insurance will run concurrently with the federal Family and Medical Leave Act (FMLA) when a worker is eligible for qualifying leave under both programs
  • Any other paid benefit coordination is based on employer policy, employer benefit structure, NH statute and rules of the MetLife agreement

7. Do employees need to exhaust their Paid Time Off before they can utilize the NH PFML?

It depends. Employer Paid Time Off (PTO) policies and benefit structure determine whether an employee must exhaust their PTO. Sponsoring employers decide how to coordinate PTO and other benefits with NH PFML. For individual coverage, when the employer does not sponsor NH PFML coverage or provide equivalent coverage, the worker will need to exhaust all available leave except for one week.

8. Can employers "top off" NH PFML benefits with additional employer sponsored benefits?

Yes, depending on employer policy and employer benefit structure. Employers may decide how their internal leave policies coordinate with NH PFML.

Employers FAQs

1. What are my obligations as an employer if I enroll my workers in NH PFML?

NH PFML Insurance comes with a few responsibilities.

All Employers Should:

  • Contact MetLife to select a NH PFML insurance plan for your eligible NH workers
  • Learn about the Business Enterprise Tax (BET) Credit for the portion of the NH PFML insurance premium you pay 
  • Recognize that your eligible NH workers can purchase a NH PFML individual plan if you do not offer a NH PFML insurance plan or equivalent benefit plan 
  • Not discriminate or retaliate against any worker for accessing PFML benefits
  • Address worker questions and direct workers to MetLife 
  • Support the claims process by providing wage and leave information, work schedules and other benefits information to MetLife 

In Addition, Employers with 50+ Workers Must:

  • Collect worker premium payments through payroll deductions 
    • This requirement applies whether the employer opts into the NH PFML insurance plan or if workers purchase coverage under a NH PFML individual plan
    • Employers paying 100% of premium do not have to take payroll deductions
  • Job restoration provisions under the federal Family and Medical Leave Act (FMLA) may apply to employers that sponsor NH PFML insurance for their workers.
  • Continue to provide health insurance during leave with workers paying any shared costs

Employers with Fewer Than 50 Workers:

  • Smaller employers are not required to collect premium payments through payroll deductions 
  • Smaller employers make premium payments through arrangements with MetLife
     

2. As an employer, how do I become eligible for the Business Enterprise Tax (BET) credit?

Employers purchasing NH PFML Insurance through MetLife qualify for a Business Enterprise Tax (BET) Credit equal to 50% of the NH PFML Insurance six-week premium the employer pays each year. Employers will need to complete and submit the most recent Schedule of Business Profits Tax (BPT) Credit (form DP-160) to the NH Department of Revenue Administration to claim the NH business tax credit.

Examples:

  • ABC B&B has chosen to provide the six-week PFML benefit and pay premiums on behalf of all 30 workers, which qualifies the company for a BET Credit equal to 50% of the premium paid to MetLife
  • XYZ Office has chosen to provide the 12-week PFML benefit and split the cost 50/50 with workers
    • The NH PFML BET will be calculated using the cost of the six-week benefit plan for only the portion XYZ pays
    • The BET Credit is not applied to worker-paid premiums
  • GHI Restaurant has chosen to pass the full cost to workers who want to participate
    • They do not qualify for any BET Credit since the employer is not contributing to the premium

3. Do employers need to have 50+ workers for payroll deduction of premiums?

Employers of any size are allowed to pay premiums through payroll deductions, however, the NH PFML law requires that large employers (50 or more NH workers) collect worker premium payments through payroll deductions, regardless of whether the employer purchases a NH PFML insurance plan, or their workers purchase a NH PFML individual plan. 
Smaller employers are not required to collect premium payments through payroll deductions but may do so through arrangements with MetLife.
Employers paying 100% of premium do not have to take payroll deductions.

4. What if I choose not to provide a NH PFML benefit to my workers? 

Individuals who work in New Hampshire for employers who choose not to offer NH PFML coverage or employer equivalent benefit coverage can purchase a NH PFML individual plan for themselves. 

Large employers (50 or more workers) must still collect premium payments through payroll deductions for their workers with individual coverage.

All employers must address worker questions and direct workers to MetLife. Employers must also provide wage and leave information, work schedules and other benefits information to MetLife to support claims processing.
 

5. What are my obligations when a worker files a claim under a NH PFML individual plan? 

Employers may be contacted by MetLife when a worker applies for benefits to confirm employment and use of other employer benefits, if needed.

6. What are my obligations for premium payments if my worker(s) enroll in a NH PFML individual plan? 

Employers with 50 or more workers will be required to set up payroll deductions to support individuals who have purchased NH PFML through the state’s insurance partner, MetLife. If a worker enrolls as an individual, you will be contacted by MetLife to set up the payroll deductions and will be given remittance instructions.

Employers with fewer than 50 workers may have individuals who enroll for individual coverage. These workers will be responsible for premium payments. 
 

7. How frequently will the employer need to remit payroll deductions to the state?

Employers will work with MetLife to make applicable premium payment arrangements, which may involve taking payroll deductions. 

When employers are responsible for remitting premiums to MetLife, they will receive billing statements from MetLife to support the premiums due on a monthly or quarterly basis based on the employer's preference. If a different payment frequency is needed, employers are encouraged to discuss those options with MetLife.

8. How does NH PFML coordinate with other worker benefits?

NH PFML Insurance is designed to coordinate with other types of leave and worker benefits in the following manner:

  • If a worker qualifies for Short-Term Disability (STD), they will not qualify for NH PFML Insurance benefits for the same days absent
  • If a worker is eligible to receive workers’ compensation, they will not qualify for NH PFML Insurance benefits
  • NH PFML Insurance will run concurrently with the federal Family and Medical Leave Act (FMLA) when a worker is eligible for qualifying leave under both programs
  • Any other paid benefit coordination is based on employer policy, NH statute and rules of the MetLife agreement
     

9. How is an employer notified when an individual enrolls in an individual plan and when an employer is required to withhold premiums?

MetLife requires workers enrolling in a NH PFML individual plan to disclose the name of their employer and provide employer contact information. MetLife will contact the employer to confirm  worker eligibility and ensure the employer does not offer equivalent plan coverage. A MetLife representative will contact the employer about payroll deduction and remittance details.

10. If an employer chooses not to offer NH PFML, is there an employee notice requirement?

No. Employers are not required to provide workers with notice that they are not offering NH PFML, however, employers should expect to be contacted by MetLife to provide wage and benefit information if their employees enroll in an individual NH PFML plan.

11. If an employer contributes only 50% of the NH PFML premium, are they required to continue health insurance for the worker when they are receiving NH PFML benefits?

Continuation of health insurance is not related to NH PFML employer contributions. Under the law, large employers (50+ employees) are required to continue providing health insurance to workers receiving NH PFML benefits.  Workers are responsible for any employee-shared costs associated with the health insurance benefits, just as they were prior to having an NH PFML claim.

12. If an employer owns several different companies (different EINs), how are the number of employees counted in regard to the large or small employer designation?

It is recommended the employer speak with their employment attorney on how to define total lives for a company with more than one EIN.

13. Is there a minimum number of employees needed to enroll in NH PFML?

There is no minimum number of NH workers required for an employer to purchase NH PFML.

14. Is employer size determined by the number of NH employees only or do employees in other states count?

Employers should count the number of NH workers (i.e., designated as working for a NH employer, whereby the employer is reporting worker payroll to NH). 

15. Is there anything large employers (50 or more workers) need to do if they decide not to purchase NH PFML?

If a large employer (50 or more workers) chooses not to enroll in NH  PFML, they must still collect premium payments through payroll deductions for their workers who enroll in an individual NH PFML plan. All employers must address worker questions and direct workers to MetLife. Employers must also provide wage and leave information, work schedules and other benefits information to MetLife to support NH PFML claims processing.

16. Is the 50% BET tax credit based on employer paid premiums for a 6 week period or for all premiums paid by employer for the year if they purchase a 6 week plan?

Employers purchasing NH PFML insurance through MetLife qualify for a Business Enterprise Tax (BET) Credit equal to 50% of the premium the employer pays for six weeks of coverage each year. The tax credit is claimed at the time the employer files Form DP-160 with the NH Department of Revenue Administration. 

Examples:
1. ABC B&B has chosen to provide the six-week PFML benefit and pay premiums on behalf of 30 workers, which qualifies the company for a BET Credit equal to 50% of the premium paid to MetLife.
2. XYZ Office has chosen to provide the 12-week PFML benefit and split the cost 50/50 with workers. The NH PFML BET tax credit will be calculated using the cost of the six-week benefit plan for only the portion XYZ pays. The BET tax credit is not applied to worker-paid premiums.
3. GHI Restaurant has chosen to pass the full cost of NH PFML to workers who want to participate. They do not qualify for any BET tax credit since the employer is not contributing to the premium.
 

17. What happens if an employer furloughs an employee who is currently covered? Would they be able to continue their coverage?

NH PFML is a wage replacement benefit. If a worker is not earning wages, they may not be eligible for the wage replacement benefit.

18. What is the waiting period for an employer sponsored NH PFML plan? 

NH PFML group plans do not have a required waiting period, however, employers may decide to include a waiting period in the insurance policy they purchase from MetLife.
 

Workers FAQs

1. Does NH PFML provide job protection?

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.

2. 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
  • A one-time 7-month waiting period that must be satisfied before benefits begin. 
  • Premiums of no more than $5 per week
     

3. 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 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
     

4. 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 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.

5. 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.

6. 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.
 

7. 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.

8. Why is there a 7-month waiting period for individual coverage? 

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

9. 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.

Brokers FAQs

1. Are commissions paid on this product? 

Yes. For brokers to be paid a commission on NH PFML insurance, they must be licensed in the state of New Hampshire, contracted with MetLife to sell MetLife products, and appointed to sell MetLife Disability and Absence products. Please reach out to your MetLife Sales office to discuss the process. 

2. Do you have any NH PFML marketing materials available for brokers?

Information for brokers is published on the Brokers page, www.paidfamilymedicalleave.nh.gov/brokers

3. Is a broker appointment required for quoting? How do I get appointed with MetLife to sell NH PFML insurance?

Yes. To become appointed with MetLife, a broker must be licensed in the state of New Hampshire. Please reach out to your MetLife Sales office to discuss the process. 

Healthcare Providers FAQs

1. Who is considered a healthcare provider for NH PFML?

Like FMLA, a healthcare provider for NH PFML can be a licensed practitioner working in a:

  • Doctor’s office
  • Hospital
  • Health care center
  • Clinic
  • Post-secondary educational institution offering health care instruction
  • Medical school
  • Local health department or agency
  • Nursing facility
  • Retirement facility
  • Nursing home
  • Home health care setting
  • Any facility that performs laboratory or medical testing
  • Pharmacy or any similar institution
  • Location or site where medical services are provided epilepsy may not be able to work due to an epileptic episode

2. What is a serious health condition under NH PFML?

In general, NH PFML considers a health condition to be serious when paid leave is taken for these reasons:

  • Inpatient care
  • Incapacity for more than three days with continuing treatment by a health care provider
  • Incapacity relating to pregnancy or prenatal care
  • Permanent or long-term incapacity
  • Certain conditions requiring multiple treatment, and
  • Chronic health conditions that may prevent a person from working during a flair up, for example, a person with epilepsy may not be able to work due to an epileptic episode

3. What is certification for NH PFML and why is it required?

Certification for NH PFML is evidence or proof of a qualifying event and in some instances the time needed to address the qualifying event period.