Sun Life is eager to meet your Oregon Paid Family and Medical Leave (OR PFML) needs for equivalent plan administration. Sun Life’s OR PFML plan integrates with its Short-Term Disability plans, featuring one claim submission, one claim number, one case manager, and integrated reporting for employers.
Sun Life has created this website for employers and brokers to help comply with responsibilities under the OR PFML law. Please visit this site often for updates.
Additionally, the State of Oregon Employment Department is the agency responsible for administering the OR PFML law. Information from the Employment Department about equivalent plans can be found on the Paid Leave Oregon website.
Yes. Sun Life offers both fully insured and self-insured equivalent plan administration for employers.
Employers: All private employers, state agencies and local governmental agencies must provide PFML insurance for their employee.
Self-employed individuals and Tribal Governments can elect coverage.
Any employee working in the state of Oregon is eligible for benefits under the OR PFML law if they have earned at least $1,000 in wages during the base year. If an employee has not earned $1,000 in wages during the base year, employees may be eligible if they have earned at least $1,000 in wages during the alternate base year.
Base year means the first 4 of the last 5 completed calendar quarters preceding the benefit year.
Alternate base year means the last 4 completed calendar quarters preceding the benefit year.
Benefit amounts are based on an employees’ total wages with each employer.
The maximum weekly benefit is 120% of the SAWW which will be adjusted once per year.
The minimum weekly benefit is 5% of the SAWW which will be adjusted once per year.
Eligible employees may take up to 12 weeks in a benefit year to care for themselves or a family member, and up to 2 additional weeks for pregnancy, childbirth, or related circumstances.
No, there is no waiting period for benefits.
Medical leave is available due to employee’s own serious health condition*, including leaves for organ or body part donation.
Family leave is available to an employee:
Safe leave is available when needed due to Domestic Violence, Sexual Assault, Harassment, a Bias Crime or Stalking:
*The definition of serious health condition aligns with that under the federal FMLA. Namely, a serious health condition is an illness, injury, impairment or physical or mental condition involving inpatient care or continuing treatment.
Covered family members include a child, grandchild, grandparent, parent, sibling, spouse or domestic partner, or any individual who has a familial relationship with the employee.
To be eligible for job protection, the employee must have been employed for the employer for at least 90 days before taking leave under OR PFML.
For employers that employ fewer than 25 employees, if the position held by an eligible employee when the employee’s leave commenced no longer exists, an employer may, at the employer’s discretion based on business necessity, restore the eligible employee to a different position with similar job duties and with the same employment benefits and pay.
Yes, intermittent leave can be taken on a 1 work day or 1 work week basis. The definition of a "work day" in Oregon means any day on which the employee performs any work for an employer and is an increment of a work week. It is not defined as a specific number of hours.
The Paid Leave Oregon state plan is funded through a payroll-based contribution. For 2023, the rate is 1% of up to $132,900 in wages. Effective January 1, 2024, contributions will be subject to the Social Security Wage Cap of $168,600.
A replacement worker who is hired to temporarily replace an employee on OR PFML leave will not be counted as an employee in determining the number of employees working for an employer.
Employers are able to apply for an equivalent plan via the state's online portal, Frances Online. An employer may apply for approval of a self-administered or fully insured equivalent plan..
An employer seeking approval for a fully insured plan will be required to submit an application to the Director accompanied by an issued policy (or confirmation of insurance form), and an application fee of $250. Applications for a self-insured plan must be accompanied by proof of solvency, a Summary Plan Description and the application fee of $250.
Only after receiving approval of an application from the state of OR will the employer not be required to remit employer or employee contributions to the state plan.
Employers offering equivalent plans are required to meet reporting, notice, records, job protection and benefits continuation requirements.
Equivalent plans must remain in effect for a minimum of one year. Employers will be required to reapply once per year for three years following the initial approval of an equivalent plan. The cost for renewal each year has been set at $150. Thereafter, reapproval is required only for plan changes.
The Federal FMLA permits employers to choose from 1 of 4 leave year methods. Oregon PFML requires the use of the rolling forward 52-week period starting from the Sunday prior to the leave.
Example: If an employee goes out on leave on 9/21/23, their benefit year begins 9/17/23 (the Sunday prior to the leave start date) and ends on 9/16/24. The 12-week allotment is used during this time.
Yes, employers must maintain any healthcare benefits the employee had prior to taking leave for the duration of the leave. The employer can require that the employee pay their share of healthcare premiums while on leave.
No. Generally, Short Term Disability policies are not the same as OR PFML plans and cannot be used as an equivalent plan.
Yes. While the OR PFML law creates certain paid benefits for leave because of an employee’s own health condition or for covered caregiving reasons, the OR PFML law is not intended to replace benefits provided by employers through Short-Term Disability (STD) plans and programs. It is important to know that cancelling STD benefits could leave your employees unprotected if they become disabled for these reasons:
Sometimes when benefits are payable for an employee’s own serious health condition under OR PFML that condition may also meet the criteria as “Disabled” that is in their Short-Term Disability plan. If the situation meets the conditions of both programs, the Short-Term Disability benefit payment may be offset, or reduced, by any OR PFML benefit payments for the same condition, and the leaves will run concurrently.
OFLA and OR PFML are 2 different laws with different eligibility thresholds, leave reasons, and applicability. Sometimes the employee qualifies for leave under one program and not the other. When the leave is covered under both, the leave under each will run concurrently.
Sun Life reviews the Short-Term Disability rates for inforce clients on an annual basis to ensure they are appropriate. Due to the new offset for Oregon PFML benefits, we anticipate that clients with a Sun Life Short-Term Disability program and a high percentage of workers in Oregon, will need their Short-Term Disability rates adjusted. This adjustment will be determined and communicated to our clients as close to the start of the Oregon PFML program date as possible.
This decision may be based on many factors, including cost, ease of claimant experience, and placement of Short-Term Disability or other leave programs. Please consult your insurance broker for the best approach for your company.
Sun Life is committed to assisting you in complying with the requirements of the new OR PFML law and with providing valuable employee benefits to your employees. We also offer leave and accommodations administration services. Please reach out to us and we will evaluate your benefit plans and compliance needs from a holistic perspective and provide guidance and services to meet you and your employees’ needs.
Content is subject to change as Sun Life receives guidance from states and municipalities. This content is not to be considered legal advice. We recommend Clients speak with legal counsel specializing in labor and employment law to ensure your organization has met all of the requirements under the Oregon Paid Family & Medical Leave (PFML) Act, and other applicable leave laws including but not limited to the federal FMLA and the Oregon Family Leave Act. Sun Life’s fully insured OR PFML coverage is issued by Sun Life Assurance Company of Canada (Wellesley Hills, MA) under Policy Form Series 22-PFML-GP-01-OR Rev 3/23. Sun Life’s self-funded or administrative-services-only OR PFML solution is administered by Sun Life Assurance Company of Canada (Wellesley Hills, MA). This service is not insurance.
PFMLWC-918 SLPC 31728 09/23 (exp. 08/24)