Baby

Having a Baby?

Frequently Asked Questions Regarding Leave & Benefits

 

There are many types of employment leave, but the most common leaves are related to Maternity or Pregnancy Leave. If an employee is expecting a child, it is important to understand how the leave will affect employee’s benefits.

Paid Sick Days, FMLA and Other Programs

How is Washington Paid Family & Medical Leave (administered through the Employment Security Department) different from paid sick days?

Washington Paid Family & Medical Leave (administered through the Employment Security Department) is for times when something major keeps you away from work. Paid sick days can be used for less serious or short-term health conditions that keep you from working, typically for less than a week.

With Washington Paid Family & Medical Leave (administered through the Employment Security Department), unless you welcomed a new child into your family, there is a “waiting week” before you can begin receiving your benefit payment. Your “waiting week” is the first week you are approved to file a weekly claim and you will not be paid for that week (this does not apply to leave to bond with a new child). Claim weeks always start on Sunday and end the following Saturday. If your qualifying event occurs after Sunday in the first week you need to take leave, the waiting week may be less than a week. During this time, you may use paid time off from your employer, including paid vacation or sick days, without impact on your Paid Family and Medical Leave benefits. If the first week of your paid family or medical leave happens before you receive your approval letter and are able to begin filing weekly claims, that first week still counts as your waiting week.

Is Washington Paid Family & Medical Leave the same as the FMLA?

These programs are different. See attached comparison table

The Family & Medical Leave Act (FMLA) is a federal law that allows some employees to take unpaid leave for family and medical reasons. It only applies to people who work for businesses with 50 or more employees.

Paid Family & Medical Leave (administered through the Employment Security Department) is a new state insurance program in Washington that provides paid leave for people when they need to care for themselves or a family member after childbirth or a serious illness or injury, or for certain military-connected events. It applies to just about every business and employee in Washington.

How does this work with FMLA?

The use of FMLA does not reduce your allowed Washington Paid Family & Medical Leave benefit, so it is possible to use both types of leave. It is important to note that Paid Family and Medical Leave and FMLA can usually run concurrently too, since many Paid Family and Medical Leave events also qualify for FMLA.

What Happens to Benefits While Employee is on Leave?

The District contribution toward to the cost of the employee benefits will continue as long as the employee either is in a paid status, or as long as the employee’s leave is qualified as FMLA. Employee will be responsible for paying any premium that exceeds the District contribution for employee’s benefits. Premium is due on the first day of each month, and if employee’s paycheck is not sufficient to cover the cost or if employee is on an unpaid leave, employee must pay this premium via check directly to Payroll. Make check payable to HCA for the exact amount.

What is FMLA (Family Medical Leave Act)?

  • Family & Medical Leave Act (FMLA)
    The Family & Medical Leave Act (FMLA) provides eligible employees up to 12 workweeks of unpaid leave a year, and requires group health benefits to be maintained during the leave as if employees continued to work instead of taking leave. Employees are also entitled to return to their same or an equivalent job at the end of their FMLA leave.

    In order to be eligible to take leave under the FMLA, an employee must:

    • Work for a covered employer;
    • Have worked 1,250 hours during the 12 months prior to the start of leave (Paid leave and unpaid leave, including FMLA leave, are not included); and
    • Have worked for the employer for 12 months.

FMLA leave can be paid leave or unpaid leave. In either case, the District will continue its contribution for employee’s benefits for up to 12 weeks. If employee already pays part of own premiums through payroll deduction, employee’s share of the monthly premiums will have to continue as well. If employee’s leave is paid, this will be deducted from employee’s paycheck. Employee will receive a letter with payment instructions. If employee adds new baby to own health insurance coverage, the premium share may increase, so employee will have to pay the premium for the new baby in addition to the premium share employee paid before she went on leave. After 12 weeks, employee’s benefits could continue through COBRA. Information will be mailed to employee when he/she becomes eligible for COBRA, and then employee can make elections and pay premiums directly to COBRA.

How Does Maternity (Disability Period) Work?

Maternity Leave typically begins when employee’s baby is born and lasts 6‐8 weeks, but can include a period of time before childbirth, if medical conditions related to employee’s pregnancy prevents employee from working. This period runs concurrent with FMLA.

What if Employee Needs More Time with Baby?

Bonding Leave - This provides time during the 12 months following birth (or placement by adoption) to care for employee’s new child. This leave is continuous and unpaid.

Are There Any Other Types of Leave Related to Children?

The Washington State Family Care Act (FCA) allows employees to use available paid leave to care for a sick child with a routine illness; a spouse, parent, parent-in-law or grandparent with a serious or emergency health condition; and an adult child with a disability. District contributions for benefits would continue during this type of leave.

How Does Employee Enroll New Baby on Insurance Plans?

If employee wishes to add new baby to medical, dental and vision plans, employee must complete special open enrollment through “SEBB My Account” within 30 days of baby’s birth, and also notify Payroll ([email protected]) of event. Employee is not required to wait for baby’s social security number to add him/her to plan. Employee will be responsible for paying any premium that exceeds the District contribution for employee’s benefits. Premium is due on the first day of each month, and if employee’s paycheck is not sufficient to cover the cost or if employee is on an unpaid leave, employee must pay this premium via check directly to Payroll. Make check payable to HCA for the exact amount.

What Should Employee Do When Returns from Leave

If employee received District contributions for benefits throughout leave, employee will not need to do anything about benefits upon return. However, if employee was on COBRA, or if employee has allowed his/her benefits to lapse, employee must elect benefits through “SEBB My Account” within 30 days of return to work. Otherwise, benefits will be defaulted to the SEBB chosen plan. Benefits begin the first of the month following the return of active employment.

For information on Washington Paid Family & Medical Leave, select here.