PFML is a valuable foundation for employees’ income protection. STD insurance can help ensure adequate coverage for employees with potential income protection gaps, making it an important part of the overall benefits package.
These examples show when the leave reason is eligible under both PFML* and STD, and the member is eligible for the full benefit period.
Higher Benefit Amount
PFML plans often cap benefits well below the wage level of higher earners, which may not be adequate income replacement. Most STD plans replace a higher portion of an employee’s wages.
Sarah's Knee Surgery*
Sarah needs to have knee surgery and is unable to work for 10 weeks while she recovers. She earns $140,000 annually, or $2,692 per week. She files a PFML claim and an STD claim. They each have a seven-day waiting period.
- The PFML benefit offers $1,000 per week in income replacement.
- Without STD, Sarah would only receive her PFML benefit of $1,000 per week — $9,000 total — while she recovers from her surgery.
With STD Coverage
The STD plan offers 60% to $1,500 maximum per week, which means due to her earnings, she will be due for the maximum STD benefit of $1,500 per week.
The $1,000 PFML benefit is deducted from the $1,500 STD benefit to maintain 60% income replacement. As a result, Sarah receives $500 per week from her STD benefit after the PFML deduction.
As Sarah receives an additional $500 per week from STD — $4,500 over the nine-week period — her total combined STD and PFML benefit after the seven-day waiting period is $13,500.
Extended Benefit Duration
Severe medical conditions or multiple leaves can prevent an employee from returning to work, long after PFML payments end. When an employee exhausts their PFML, STD insurance may be able to provide the extended coverage the employee needs to continue focusing on their health.
Brett's Serious Health Condition*
Brett is taking time off for their serious health condition. The time they need to care for their chronic, serious health condition exceeds 12 weeks.
- Brett’s STD benefits cover 26 weeks of paid leave with no waiting period.
- Their PFML benefits cover 12 weeks of paid leave with no waiting period.
With STD Coverage
Brett continues to receive benefits from week 13 through week 26. If Brett didn’t have STD coverage, they’d only receive paid time off through PFML for 12 weeks.
Reduced Gap in Benefits
Long term disability insurance normally begins after a 90- or 180-day waiting period. Without STD coverage, employees may have an income gap of up to 14 weeks between PFML benefits ending and the start of LTD benefits.
Idris' Back Surgery*
Idris needs to have back surgery. He files a PFML claim and an LTD claim.
- The waiting period for his LTD plan is 180 days or 26 weeks without waiting periods.
- His PFML benefit stops at week 12, leaving a 14-week gap between weeks 13 and 26.
With STD Coverage
Idris won’t have to worry about a gap in benefit payments. His STD benefits will cover the additional time he needs to recover from surgery after PFML ends.
