Frequently

Asked Questions

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Find answers to common questions here.

FAQs

  • Applications are accepted by the State of Oregon on a rolling basis. The initial deadline to have an approved equivalent plan in place when benefits became effective in September was May 31, 2023. Approved equivalent plans filed after that date become effective on the first day of the calendar quarter immediately following the date of approval by the Oregon Employment Department (OED).

  • To ensure all employees understand the new plan and its requirements, it is necessary to provide a written notice. This notice must be displayed in every building where employees can access it — every building or worksite regularly visited by employees. For remote workers, the notice should be delivered by hand, mail, or electronic delivery when hired or assigned to remote work.

    Note: For new hires, employers must provide both the state notice and our equivalent plan notice. It’s important to note that the PFMLI plan may not cover new employees until after they have been employed for 30 calendar days, so these notices should be given to them at the time of hire.

  • To process PFMLI claims, you must upload an updated census file matching the required format and data specifications at initial onboarding, at least monthly, quarterly, or with your payroll cycles through your online account. This will also help with accuracy with calculating premiums for the PFMLI plan.

    View Census File Key

  • To upload your file, follow these steps:

    1. Log in to your online account
    2. Select Leave Management
    3. Click the Upload Leave Census File button
    4. Select the Location
    5. Browse for your census file
    6. Click Upload File
  • American Fidelity requires wage and historical salary information to be able to pay the correct benefit amount during the claims process. Additionally, we need to know who is covered so we don’t pay benefits for ineligible individuals.

  • Payroll should be reported to American Fidelity at the same cadence as your pay schedule (weekly, biweekly) and must be provided at least monthly.

  • American Fidelity does not charge additional fees to administer PFMLI claims under your approved equivalent plan. However, the state sets the current total premium contribution rate and if that changes in the future, our rate may also vary accordingly. Benefit payments may be subject to other tax obligations. We encourage you to work with your tax advisor.

  • The employer is required to cover at least 40% but can pay more if they choose. Employees pay the remaining percentage. Most employers cover the required 40%, with employees responsible for the remaining 60%.

    Note: Based on guidance issued by the Oregon Department of Revenue, employers paying more than 40% of the premium may increase the employee's tax liability for certain benefits.

  • American Fidelity will process PFMLI claims within the required timeframe set by the state. Delays may be caused due to employees not submitting required documentation to support their claim. American Fidelity can only process PFMLI claims with applicable information and verification, so timely responsiveness from applicants will help reduce processing delay times.

  • You can log in to your online account to view the status of a claim. From the home dashboard, click the Absences tab. Here you can view the status of any claim.

  • The designated contact will receive an email notification when an employee files a new claim. You can also view claims by logging in to your online account. Then, click the Absences tab on the home dashboard to view all new submissions.

  • To review reports, log in to your online account. Then, select the Reports tab on the left side from the home dashboard. Once in the Reports section, you can view Claims by Status and Claims by Type under the Report Name column.

  • To confirm an employee returning to work:

    1. Log in to your online account.
    2. Select the employee’s PFMLI claim from the Absences tab from the home dashboard.
    3. Now click the Report Return to Work button and continue the on-screen prompts.
  • To upload documentation for a PFMLI claim:

    1. Log in to your online account.
    2. Select the employee’s PFMLI claim from the Absences tab from the home dashboard.
    3. Now click the Upload Documents button and continue the on-screen prompts.
  • You must agree to and follow the guidelines in the Data Usage and Reporting Agreement. This agreement outlines specific data requirements that must be met, including requests for demographic/census data, historical earnings, and return-to-work information.

    Note: When your employees request PFMLI or an extension on a current leave, you may need to provide verification for their request.

  • Withholdings start with every pay period occurring on or after the effective date of your PFMLI plan and continue as long as you participate in the PFMLI plan.

  • To maintain approval of your plan, you must submit a reapproval application to the state through your Frances Online account every year for three years. The application for reapproval is due 30 days before the anniversary of the original plan’s effective date. You must provide us with a copy of your approval letter each year to help us confirm the state’s record of the plan’s effective date.

    Learn more at paidleave.oregon.gov/employer/plans/

  • You will receive an email notification at the email address you provided at onboarding when an employee files a PFMLI claim.

  • If an employee knows they will need to use paid leave, they must give you up to 30 days’ notice. In emergency situations, employees must notify employers that they plan to use paid leave within 24 hours. An additional written notice is required within three days of starting leave. 

  • Under your approved equivalent plan, paid leave is calculated from the Sunday before the leave start date. The maximum allowed paid leave is 12 weeks per benefit year. The benefit year is typically 52 weeks beginning on a Sunday immediately before the employee uses covered paid leave. Paid leave can be extended to 14 weeks for limitations relating to pregnancy, childbirth, or related medical conditions.

  • Employees will make a PFMLI claim through their online account at americanfidelity.com/login or AFmobile®, our mobile app.

  • Benefits will depend on your employee's earnings compared to Oregon’s Average Weekly Wage. The state average weekly wage for 2023-2024 is $1,269.69. Based on that, the minimum weekly benefit is $63.48, and the maximum is $1,523.63. Amounts are determined by the Oregon Employment Department and are subject to change each July.

  • An employer cannot require an employee to use paid sick time, vacation leave, or any other earned paid leave during a PFMLI-covered leave. Employers and employees may agree, or employees may elect to supplement PFMLI benefits with accrued paid leave.

  • Spouses do not have to share/combine the total paid leave allotment. Each spouse eligible for PFMLI is entitled to the full amount of paid leave while eligible. Keep in mind that this is for PFMLI claims only. Other protected leave laws may apply different rules.

  • Yes. You’ll work with your employees to determine what is best for them when they request leave.

  • Employees can apply for paid leave benefits in increments of full workdays or full work weeks. If an employee claims benefits for less than a full workweek, their benefit will be calculated based on the number of workdays they typically work.

  • If an employee takes a week of paid leave and a holiday falls during that week, the entire week will be counted against their paid leave time. However, if the employee takes less than a whole work week of paid leave, the holiday will only count against their paid leave allotment if they were scheduled to work the holiday and chose to use paid leave instead.

  • American Fidelity PFMLI benefits began on September 3, 2023, for those employers who enrolled on or prior to May 31, 2023. For applications submitted after that date, benefits begin on the first day of the calendar quarter following the state's approval of the employer's PFMLI application.

  • An eligible employee may take up to 12 weeks per benefit year for any combination of approved leave:  

    • Medical Leave: Caring for their own serious health condition  
    • Family Leave: Bonding with a child or caring for a family member with a serious health condition  
    • Safe Leave/Personal Protected Leave: Seeking help related to domestic violence, harassment, sexual assault or stalking  

    An additional two weeks of paid leave may be available for complications related to pregnancy, childbirth or related medical condition.

  • To be eligible for American Fidelity’s Paid Family Medical Leave Insurance (PFMLI), the employee must have:

    • Earned at least $1,000 in four out of five quarters before requesting paid leave; and
    • Experience a qualifying event; and
    • Been continuously employed with your employer for 30 calendar days; or
    • Been eligible for benefits under your previous Oregon employer's equivalent plan
  • You must determine how to recoup that payment, as PFMLI is the primary payor.

  • If this happens, you must add the employee to the census file in the same manner as other employees. American Fidelity will determine eligibility for PFMLI based on applicable requirements.

  • No, we cannot share the details regarding why we approved or denied the eligible PFMLI claim, or if the PFMLI claim is eligible for FMLA or OFLA. This is because the information obtained to make that decision is Protected Health Information (PHI), which we cannot legally share. American Fidelity will only determine eligibility for PFMLI claims, not FMLA or OFLA.

    If you have our AFleave service, your AFleave analyst can assist you with locating FMLA and/or OFLA eligibility information.

  • Through your online account, you will manage and pay your premiums at the same time as your payroll cycle.

    We will notify you when premiums are due. You’ll fill out an online premium worksheet every pay period and pay the required premiums. We recommend paying with electronic fund transfer (EFT) speed up posting premiums and processing claims.

    View an example premium worksheet: americanfidelity.com/pfmli-worksheet

    How to Pay: To make your payment and submit your worksheet, follow these steps:

    1. Log in to your online account
    2. Select the Billing tab
    3. Select PFMLI Bills tab
    4. Select the payroll period you’d like to pay
    5. Complete the worksheet
    6. Submit your worksheet and payment
  • You will not receive a bill. You will complete a premium worksheet each pay period and send your payment by EFT or check. To help ensure faster posting of premiums and claims processing, we suggest paying by EFT instead of checks.

  • Yes. Employers with an approved equivalent plan must file annual aggregate benefit usage reports with the Oregon Employment Department (OED). We can assist you with the necessary information relevant to the administration of your PFMLI plan as part of your reporting requirements to file this report. Employers can file these reports through Frances Online or in a different format approved by the OED. The deadline for submission is on or before the last day of the month following the end of the calendar year. The first annual aggregate benefit usage report is due January 31, 2025.

  • All employers, including employers with an approved equivalent plan must submit the Oregon Quarterly Tax Report and Oregon Employee Detail Report quarterly. These reports must provide information on all PFMLI wages and the number of employees. This report should be submitted to the state by the last day of the month following the end of the quarter.

  • Employers will file required state reports on Frances Online. For questions about quarterly reporting, contact the OED at contributions.unit@employ.oregon.gov or call (503) 947-1488.

  • The OED will notify employers who have yet to file all reports by June 30 each year. If an employer has yet to file all required reports before September 1, they will be penalized 0.02% of their employees’ wages, rounded to the nearest $100.

  • No, American Fidelity does not provide reporting. However, American Fidelity will provide third-party sick pay reporting for the employee's own "Serious Health Condition" which is included in the W-2. This will be available monthly, quarterly, and annually through your online account

    View additional reporting information 

    American Fidelity will withhold federal and state income taxes from PFMLI taxable benefits that are considered third-party sick pay to the extent required, including the employee’s portion of FICA tax. The employer is responsible for remitting any additional state, local or federal taxes, including W-2 reporting. Please consult an attorney or tax professional regarding your specific situation.

     

  • Yes, we will send a 1099 report to the employee after the end of year calendar year.

  • While we cannot provide tax or legal advice, current guidance indicates that family and safe leave/personal protected leave benefits are fully taxable, and medical leave benefits for the employee's own serious health condition are taxable based on employers’ contribution ratio.

  • Payroll deductions for PFMLI premiums are made on an after-tax basis.

  • While the Internal Revenue Service (IRS) has not provided definitive guidance, for medical leave benefits, the employer paid portion of the taxable benefit is subject to FICA and reported on Form W-2, unless the employer paid portion of the contribution is taxed as wages (imputed to the employee’s wages).

    Non-medical leave benefits are not subject to FICA, but the gross benefit must be documented on 1099-MISC.

    For medical leave benefits, we will withhold FICA tax and provide you with reporting information as outlined below and provide your employees with IRS Form 1099-MISC for other benefits.

    You are responsible for Form W-2 reporting. All employers and employees should consult their own tax advisors regarding the tax consequences of PFMLI contributions and benefits.

    The following benefits are subject to income tax:

    • Family leave benefits
    • Safe leave benefits

    Medical leave benefits are taxable based on the ratio of employer contributions to total employer and employee contributions

     

  • You can learn more about your state reporting requirements here.

  • The reason for using paid leave will affect how American Fidelity treats an employee’s benefit payments. Generally, family leave and safe leave/personal protected leave benefits are taxable income to the employee and will be reported on Form 1099-MISC by American Fidelity.

    Medical leave benefits for an employee’s own serious health condition are treated like disability benefits for tax purposes. They are taxable to the employee based on the ratio of employer contributions to total contributions of premiums. If the employer pays the mandatory minimum contribution of 40% of the total contribution rate, 40% of the medical leave benefits an employee receives would be taxable income to the employee.

    To the extent such medical leave benefits are considered taxable wages, they are subject to withholdings under the Federal Insurance Contributions Act (FICA) for the first six months of such leave. When applicable, American Fidelity is responsible for withholding the employees’ portion of the mandatory FICA taxes and any voluntary taxes requested by the employee (federal and state income taxes). The employer must remit the employer portion of the FICA taxes on the medical leave benefits.

  • PFMLI benefits paid due to an employee's serious health condition will be reported to the employer through third-party sick pay reporting. These reports will show how much medical leave benefits are taxable to the employee. This allows employers to have the information to report the income on a Form W-2 and remit the employer share of FICA on the taxable portion of employees' medical leave benefits. Employers are encouraged to work with their tax advisors on the specific circumstances where it is appropriate to impute income to employees. American Fidelity does not provide tax advice. 

  • No. Benefit payments by a third-party-run equivalent plan, including your American Fidelity equivalent plan, are not reduced for PERS. While generally third-party-run equivalent plan benefits are non-subject salary and not reportable to PERS, certain PERS employer requirements may still apply. It is the employer’s responsibility to contact PERS for specific reporting information. You may wish to consult Employer Announcement #102 Paid Leave Oregon and PERS Reporting, available here, or the Family and Medical Leave Employer Reporting Guide available here.

  • You can log in to your online account or call 800-662-1113 for support. 

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Content is provided for informational purposes only and should not be considered financial, legal or tax advice.

American Fidelity and its employees cannot give tax, legal or financial advice. You must work with your own advisors to determine how these requirements apply to you.

This page, any linked websites, and any downloadable items are up to date as of March 2024 and may not reflect changes in the law, finance, administration or current events.

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