Streamline Your State PFML Program With a Private Carrier

Navigating the Evolving PFML Landscape

Thirteen states and the District of Columbia have enacted mandatory paid family and medical leave, or PFML, programs, providing partial income replacement for employees who need time away for medical reasons, bonding with a new child, or caring for a family member. Additionally, 10 states have adopted voluntary paid leave programs, allowing employers to purchase private insurance for their teams.

As PFML programs expand, employers face important decisions about how best to administer these benefits. In many states, employers can choose between state-run programs and private plan administration — either self-managed or through an insurance carrier or third party administrator, or TPA.

Why Consider a Private PFML Plan?

Opting for a private PFML plan, where permitted, offers several advantages:

• Streamlined Administration: Private carriers and TPAs bring specialized expertise to compliance, claims processing and reporting — reducing the administrative burden for employers.
• Integrated Benefits: Private plans can be coordinated with other employer-provided benefits, such as short term disability, long term disability, and Family and Medical Leave Act administration. This creates a seamless experience for employees and provides employers with a single point of contact for claims and support.
• Flexible Plan Design: Employers can tailor private plans to meet the unique needs of their workforce and company culture. Options like self-insurance may also offer significant cost savings.
• Enhanced Employee Experience: Experienced carriers and TPAs often deliver faster claims turnaround and smoother processes, especially during periods of high claim volume or when new state programs are ramping up.
• Richer Benefit Options: Private plans can be designed to match or exceed state plan benefits, including wage replacement rates, leave duration and elimination periods. Enhanced plan provisions can boost employee satisfaction and retention.

Meeting State Requirements

Employers considering a private PFML plan should be aware of key state regulations. To be approved, private plans must:

• Provide benefits equal to or better than the state plan
• Ensure employee contributions do not exceed those required by the state plan
• Guarantee the same rights and protections, including the right to appeal denials to the state agency

While the intent of PFML programs is consistent across states, eligibility, benefit structures and administrative rules can vary widely. Private plans offer flexibility and efficiency but must always meet or exceed state minimum requirements and secure state approval.

Evaluating Your Options

For employers operating in multiple states with mandated PFML programs, comparing state-run and private plan options is essential. By partnering with an experienced carrier, employers can simplify the approval process, integrate leave and disability programs, and receive reliable customer service.

Choosing the right PFML solution can help employers support their workforce, maintain compliance and deliver a positive employee experience.

Visit our PFML resource page for up-to-date information and practical tools to help you manage your leave programs with confidence. If you have questions or want to explore how The Standard can support your organization’s PFML and leave administration, connect with a local representative today.