Oregon PFMLI Support & FAQs

What you need to know, now.

We know managing your paid leave employer obligations can be challenging. Here you’ll find information on our Paid Family and Medical Leave Insurance (PFMLI) for you and your employees.

We are here to help you every step of the way.

Uploading Your Census File

To process PFMLI claims, you must upload an updated census file matching the required format and data specifications at initial onboarding, and with your payroll cycles. This will ensure accurate leave request processing.

Historical Earnings and Why It’s Needed

We need five quarters of earnings history to process claims for any employee’s PFMLI benefits. This data is necessary for the accurate calculation of applicable paid leave benefits.

There are two ways to provide historical earnings.

You can provide an Excel file to us containing the following data for all current, eligible employees: Social Security number, full name, date of birth, and earnings from five quarters. For new employees who have worked for less than five quarters, we need their earnings from their start date.

Download the Historical Earnings Template

If you didn’t choose option one, you’ll be required to provide five quarters of earnings history for every employee who applies for leave. We will notify you when this information is required.

Managing Paid Leave Requests

As an employer, you are responsible for ensuring that your employee’s paid leave request is being handled correctly so that we can accurately process their claim. It’s important to understand the responsibilities below. You can keep track of employee paid leave requests through your online account. If there are any outstanding tasks for you to complete, you will receive a call or email from American Fidelity to discuss what actions are needed from you.

Return-to-Work

During onboarding, you provided us with your preferences for reporting and verifying return to work information. You or your employee must provide return-to-work information through your online account to help manage PFMLI claims. You will select the employee’s paid leave request from the Pending Absences tab. Then, click the Report Return to Work button and continue with the on-screen prompts.

Payments

Payments

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

Notification

We’ll notify you when your premiums are due.

Worksheet

You’ll fill out an online premium worksheet every pay period and pay the required premiums. We recommend paying with electronic fund transfer (EFT) instead of checks to speed up posting premiums and processing claims.

View an example premium worksheet

Reporting and Taxes

To comply with the regulations for the equivalent plan and other payroll taxes, certain reporting and tax obligations must be fulfilled. You can fulfill your reporting requirements via Frances Online or by using paper forms.

Here is a brief overview of the requirements.

Taxable benefit payments under six months are subject to the Federal Insurance Contributions Act (FICA). For employees’ own medical leave benefits, which are generally taxable based on the ratio of employer contributions to total employer and employee contributions, the taxable benefit is subject to FICA and reported on Form W-2. Non-medical leave benefits are not subject to FICA, but the gross benefit must be documented on 1099-MISC. We will withhold the employee’s portion of FICA tax from qualifying benefits and provide your employees with IRS Form 1099 as required. You are responsible for remitting the employer’s portion of FICA tax and Form W-2 reporting.

The Oregon Combined Quarterly Report form is used to determine tax obligations and has been updated to include reporting on PFML subject wages.

You must submit a benefit usage report to the Oregon Employment Department (OED) by January 31, 2025 and each year thereafter. We can assist you with the necessary information to file this report.

While the IRS has not provided definitive guidance, generally all taxable benefit payments under six months are subject to the Federal Insurance Contributions Act (FICA). 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 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. We will withhold FICA tax from qualifying benefits and provide your employees with IRS Form 1099 as applicable. 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.

Third-Party Sick Pay Reporting

Certain paid leave benefits are considered third-party sick pay, which makes American Fidelity a third-party payer of sick pay. As an employer, you are responsible for reporting all sick pay benefits paid by third parties on Form W-2 and employment tax forms. To adhere to third-party sick pay reporting requirements, employers must report the entire amount of PFMLI benefits paid to an employee during their leave due to their serious health condition. This data must be reported on the employee's Form W-2 for the year in which the benefits were paid.

Follow this guide for using your report to complete Form W-2

View the employer guide
for your equivalent plan

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FAQs

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  • 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 went live 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 department.

  • To ensure all employees know 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. For remote workers, the notice should be delivered by hand or mail 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, and with your payroll cycles through your online account. This will also help with accuracy in billing.

    View Census File Key >

  • To upload your file, follow these steps:

    • Log in to your online account
    • Select Go to Leave Management
    • Click the Leave Census File button
    • Select the Location
    • Browse for your census file
    • Click Upload File
  • American Fidelity requires wage and historical salary information to be able to pay the correct amount during the claims process. Additionally, we need to know who is covered so we don’t pay claims 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 any 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. 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%.

  • American Fidelity will process PFMLI claims within the required timeframe. Factors may cause processing delays, such as delays receiving documentation after 14 days. American Fidelity cannot process PFMLI claims without applicable information and verification, so timely responsiveness from applicants will help reduce processing delay times.

  • Log in to your online account to see if a PFMLI claim is pending, approved or denied. Then, from the home dashboard, click the Absences tab. Here you can view the status of leave PFMLI claims under the Status column.

  • To view new PFMLI claims, log in to your online account. Then, click the Pending Absences tab on the home dashboard to view all new submissions.

  • To upload documentation for a PFMLI claim:

    1. Log in to your online account.
    2. Select the employee’s PFMLI claim from the Pending Absences tab from the home dashboard.
    3. Now click the Upload Documents button and continue the on-screen prompts.
  • 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 Pending Absences tab from the home dashboard.
    3. Now click the Report Return to Work button and continue the on-screen prompts.
  • You will continue to manage all other types of absences, including internal sick leave and absence management systems in your human resource information system (HRIS), as usual. Additionally, you can see statuses and deductions in real-time from your American Fidelity online account.

  • 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 paid leave or an extension, you may need to provide documentation 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 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 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 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 pregnancy or related medical conditions.

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

  • 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 top off benefits, using accrued paid leave to reach at least 100% wage replacement.

  • 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, 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 take paid leave or claim benefits for a single workday or a full workweek. 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.

  • September 3, 2023.

  • 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.

  • Employees earning at least $1,000 within four out of five quarters before requesting paid leave may be eligible.

  • To be eligible, employees who request paid leave on September 3 must have earned at least $1,000 within four out of five quarters. Alternatively, an employee may be eligible if they have earned at least $1,000 within the last four calendar quarters preceding the base year.

  • Yes. As long as the employee is eligible for paid leave for a qualifying reason, they can start a new request while still out.

  • 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 medical details regarding why we approved or denied the eligible paid leave claim. This is because the information obtained to make that decision is Protected Health Information (PHI), which we cannot legally share.

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

  • 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 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.

  • All employers, including employers with an approved equivalent plan must submit the Oregon Quarterly Combined 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 by the last day of the month following the end of the quarter.

  • Employers will file reports on Frances Online. For questions about 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.

  • To ensure accurate benefits reporting and payment of employer taxes, employers must submit Form W-2 to the IRS. However, American Fidelity can provide a report for the employee's own "Serious Health Condition" part of the W-2. This will be available monthly, quarterly, and annually through your online account.

  • Yes, we will send a 1099 report at the end of the 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.

  • Employee contributions are always after-tax.

  • While the IRS has not provided definitive guidance, generally all taxable benefit payments under six months are subject to the Federal Insurance Contributions Act (FICA). 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 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. We will withhold FICA tax from qualifying benefits and provide your employees with IRS Form 1099 as applicable. 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.

     

  • 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 to the employee and will be reported as taxable income 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 remit the employer share of FICA on the taxable portion of employees' medical leave benefits and to prepare Forms W-2 for the portion of benefits imputed to employees' taxable income. Employers are encouraged to work with their tax advisors on the specific circumstances where it is appropriate to impute income to employees. American Fidelity cannot provide tax advice. 

  • Employer-run PFMLI equivalent plans provide benefit payments that are eligible for PERS as a subject salary and service time is earned during leave under such plans. Employers should contact PERS for specific reporting information. For both the state-run plan and all insurance carrier PFMLI equivalent plans, payments for paid leave benefits are not eligible for PERS. Therefore, American Fidelity will not make deductions for PERS from any benefit payments remitted to employees under the American Fidelity PFMLI plan. Additionally, when paid leave is taken under the state plan or an insurance carrier’s PFMLI equivalent plan, service time is not earned during leave.

  • Through your online account, you will manage and pay your bills 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) instead of checks to 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:

    • Log in to your online account
    • Select the Billing tab
    • Select PFMLI Bills tab
    • Select the payroll period you’d like to pay
    • Complete the worksheet
    • 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.

  • 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 September 2023 and may not reflect changes in the law, finance, administration or current events.

AF-1871(a)-0124