Help with paid family and medical leave (PFML) claims

To start a PFML claim, complete and submit the claim online.

Or, complete and submit the appropriate PFML claim form:

• Bond with a child (PDF)
• Serious health condition (PDF)
• Care for covered service member or qualifying exigency - Colorado, Connecticut, and Massachusetts PDF) 
• Personal/family violence - Colorado, Connecticut, and Oregon (PDF)

As soon as possible, however, no more than 30 days prior to the date of the leave. 

In most instances, only one form (PFML) is needed. If we need additional information to process both the PFML and STD claims, we’ll reach out for the needed information.

No. To be eligible for benefits, an employee must meet all qualifications as defined by the policy. We must receive the specific documentation that is required depending on the type of leave requested. Each claim is reviewed to determine if it meets the contractual requirements for benefit payment.

Our goal is to make the PFML claim decision within 14 days after we receive the claim.

We issue benefits on a weekly basis. 

It depends how the premiums were paid.

• For premiums paid with pre-tax dollars, the benefit is taxable. However, we don’t withhold taxes from the paid family and medical leave benefit payment. If the claim is a medical leave for your employee, taxes will be withheld.   
• For premiums paid with post-tax dollars, the benefit is non-taxable. 
• For premiums paid with a mix, only the portion paid with pre-tax dollars is taxable.

PFML benefits will be offset by unemployment, workers’ compensation, and Social Security Disability Insurance (SSDI) benefits.