Chapter 187
2013 -- S 0231 SUBSTITUTE B
Enacted 07/11/13
A N A C T
RELATING TO
LABOR AND LABOR RELATIONS -- TEMPORARY DISABILITY
INSURANCE
Introduced By: Senators Goldin, Paiva Weed, Miller, Nesselbush, and Metts
Date Introduced: February 06, 2013
It is enacted by the
General Assembly as follows:
SECTION 1. Chapter 28-41 of the General Laws entitled
"Temporary Disability
Insurance - Benefits"
are hereby amended by adding thereto the following sections:
28-41-34.
Temporary caregiver insurance. – The purpose of
this chapter is to establish,
within the state temporary disability insurance program, a
temporary caregiver insurance program
to provide wage replacement benefits in accordance with
the provisions of this chapter, to
workers who take time off work to care for a seriously ill
child, spouse, domestic partner, parent,
parent-in-law, grandparent, or to bond with a new child.
Definitions as used
in this chapter:
(1) "Child"
means a biological, adopted, or foster son or daughter, a stepson or
stepdaughter, a legal ward, a son or daughter of a domestic
partner, or a son or daughter of an
employee who stands in loco parentis to that child.
(2) "Newborn
child" means a child under one year of age.
(3) "Adopted
child" means a child adopted by, or placed for adoption with, the
employee.
(4) "Bonding or
bond" means to develop a psychological and emotional attachment
between a child and his or her parent(s) or persons who stand
in loco parentis. This shall involve
being in one another's physical presence.
(5)
"Parent" means a biological, foster, or adoptive parent, a
stepparent, a legal guardian,
or other person who stands in loco parentis to the
employee or the employee's spouse or domestic
partner when he/she was a child.
(6) "Domestic
partner" means a party to a civil union as defined by chapter 15-3.1.
(7)
"Spouse" means a party in a common law marriage, a party in a
marriage conducted
and recognized by another state or country, or in a
marriage as defined by chapter 15-3.
(8)
"Grandparent" means a parent of the employee's parent.
(9)
"Parent-in-law" means the parent of the employee's spouse or domestic
partner.
(10)
"Employee" means any person who is or has been employed by an
employer subject
to chapters 39 through 41 of this title and in
employment subject to those chapters.
(11) "Serious
health condition" means any illness, injury, impairment, or physical or
mental condition that involves inpatient care in a hospital,
hospice, residential health care facility,
or continued treatment or continuing supervision by a
licensed health care provider.
(12)
"Department" means the department of labor and training.
(13) "Persons
who stand in loco parentis" means those with day-to-day responsibilities
to
care for and financially support a child or, in the case
of an employee, who had such
responsibility for the employee when the employee was a child. A
biological or legal relationship
shall not be required.
28-41-35.
Benefits. – (a) Subject to the conditions set
forth in this chapter, an employee
shall be eligible for temporary caregiver benefits for any
week in which he or she is unable to
perform his or her regular and customary work because he or
she is:
(1) Bonding with a
newborn child or a child newly placed for adoption or foster care with
the employee or domestic partner in accordance with the
provisions of subdivision 28-41-36
(c)(1); or
(2) Caring for a child,
a parent, parent-in-law, grandparent, spouse, or domestic partner,
who has a serious health condition, subject to a waiting
period in accordance with the provisions
of section 28-41-12. Employees may use accrued sick time
during eligibility waiting period in
accordance with the policy of the individual's employer.
(b) Temporary
caregiver benefits shall be available only to the employee exercising his or
her right to leave while covered by the temporary
caregiver insurance program. An employee
shall file a written intent with their employer, in
accordance with rules and regulations
promulgated by the department, with a minimum of thirty (30) days
notice prior to
commencement of the family leave. Failure by the employee to
provide the written intent may
result in delay or reduction in the claimant's benefits,
except in the event the time of the leave is
unforeseeable or the time of the leave changes for unforeseeable
circumstances.
(c) Employees cannot
file for both temporary caregiver benefits and temporary disability
benefits for the same purpose, concurrently, in accordance
with all provisions of this act and
chapter 39-41.
(d) Temporary
caregiver benefits may be available to any individual exercising his or her
right to leave while covered by the temporary caregiver
insurance program, commencing on or
after January 1, 2014, which shall not exceed the
individual's maximum benefits in accordance
with chapters 39-41. The benefits for the temporary
caregiver program shall be payable with
respect to the first day of leave taken after the waiting
period and each subsequent day of leave
during that period of family temporary disability leave.
Benefits shall be in accordance with the
following:
(1) Beginning January
1, 2014 temporary caregiver benefits shall be limited to a
maximum of four (4) weeks in a benefit year;
(e) In addition, no
individual shall be paid temporary caregiver benefits and temporary
disability benefits which together exceed thirty (30) times his
or her weekly benefit rate in any
benefit year.
(f) Any employee who
exercises his or her right to leave covered by temporary caregiver
insurance under this chapter shall, upon the expiration of that
leave, be entitled to be restored by
the employer to the position held by the employee when
the leave commenced, or to a position
with equivalent seniority, status, employment benefits,
pay, and other terms and conditions of
employment including fringe benefits and service credits that
the employee had been entitled to at
the commencement of leave.
(g) During any
caregiver leave taken pursuant to this chapter, the employer shall maintain
any existing health benefits of the employee in force for
the duration of the leave as if the
employee had continued in employment continuously from the
date he or she commenced the
leave until the date the caregiver benefits terminate;
provided, however, that the employee shall
continue to pay any employee shares of the cost of health
benefits as required prior to the
commencement of the caregiver benefits.
(h) No individual
shall be entitled to waiting period credit or temporary caregiver benefits
under this section for any week beginning prior to January
1, 2014.
(i)
Temporary caregiver benefits shall be in accordance with federal Family and
Medical
Leave Act (FMLA) P.L.
103-3 and
accordance with section 28-48-1, et. seq.
An employer may require an employee who is entitled
to leave under the federal Family and Medical Leave Act,
PL 103-3 and/or the
Parental and Family
Medical Leave Act, 28-41 et seq., who exercises his or her right to benefits
under the temporary caregiver insurance program under this
chapter, to take any temporary
caregiver benefits received, concurrently, with any leave taken
pursuant to the federal Family and
Medical
Leave Act and/or the
28-41-36.
Certification of eligibility for leave. – (a) An individual who exercises his or
her right to leave covered by the temporary caregiver
insurance program under this chapter shall
file a certificate form with all information required by
the department.
(b) For leave for
reason of caring for a seriously ill family member, an employee shall
file a certificate with the department that shall contain:
(1) A diagnosis and
diagnostic code prescribed in the international classification of
diseases, or where no diagnosis has yet been obtained, a
detailed statement of symptoms;
(2) The date if
known, on which the condition commenced;
(3) The probable
duration of the condition;
(4) An estimate of
the amount of time that the licensed qualified health care provider
believes the employee is needed to care for the family member;
(5) A statement that
the serious health condition warrants the participation of the
employee to provide care for his or her family member.
"Warrants the participation of the
employee" includes, but is not limited to, providing
psychological comfort, arranging third-party
care for the family member as well as directly providing,
or participating in the medical and
physical care of the patient; and
(6) A certificate
filed to establish medical eligibility of the serious health condition of the
employee's family member shall be made by the family member's
treating licensed qualified
heath care provider.
(7) In the case of a
parent, or persons who are in loco parentis caring for the serious
health condition of a foster care child, the employee shall
submit all required information in
accordance with this section, with a written request to the
department of children, youth and
families for the release of medical information by the child's
treating licensed qualified health
care provider. The department of children, youth and
families shall transmit the requested
medical information, pending all properly submitted forms, to
the department of labor and
training, within ten (10) business days of request. In the
absence of the requested transmitted
medical information by the department of children, youth and
families within ten (10) business
days, the employee may request the licensed qualified
healthcare provider to directly transmit the
medical eligibility of the serious health condition to the
department of labor and training.
Payment shall not be delayed, in accordance with all
provisions of chapter 39-41, as a result of
delays by the department of children, youth and families in
transmitting medical information.
(c) The department
shall develop a certificate of eligibility form for leave in the case of
bonding as defined herein, for the birth of a newborn child
of the employee or the employee's
domestic partner, or the placement of a child with the
employee in connection with the adoption
or foster care of the child by the employee or domestic
partner, or persons in loco parentis.
Information shall include the following:
(1) A birth
certificate, certificate of adoption, or other competent evidence showing the
employee or the employee's domestic partner, or persons in
loco parentis is the parent of the child
within twelve (12) months of the child's adoption, birth or
placement for adoption or foster care
with the employee.
28-41-37.
Determination of a Claim.-- (a) In
accordance with section 28-41-16, upon
the filing of a claim, the director shall promptly
examine the claim and on the basis of facts found
by the director and records maintained by the
department, the claim shall be determined to be
valid or invalid, if the claim is determined to be valid,
the director shall promptly notify the
claimant as to the week with respect to which benefits shall
commence, the weekly benefit
amount payable, and the maximum duration of those benefits.
If the claim is determined to be
invalid, the director shall likewise notify the claimant and
any other interested parties of that
determination and the reasons for it. if
the processing of the claim is delayed for any reason, the
director shall notify the claimant, in writing, within three (3)
weeks of the date the application for
benefits is filed of the reason for the delay. Unless the
claimant or any other interested party,
within fifteen (15) days, requests a hearing before the
board of review, the determination with
reference to the claim is final. However, for good cause shown
the fifteen (15) day period may be
extended after notification by the director has been mailed to
his or her last known address, as
provided in this section. At any time within one year from the
date of a monetary determination,
the director, upon request of the claimant or on his or
her own motion, may reconsider his or her
determination if he or she finds that an error in computation or
identity has occurred in
connection with it or that additional wages pertinent to the
claimant's status have become
available, or if that determination has been made as a result
of a nondisclosure or
misrepresentation of a material fact.
(b) If an appeal is
duly filed, benefits with respect to the period prior to the final decision,
if it is found that those benefits are payable, shall be
paid only after the decision. If an appeal
tribunal affirms a decision of the director, or the board of
review affirms a decision of an appeal
tribunal allowing benefits, those benefits shall be paid
regardless of any appeal which may
subsequently be taken.
28-41-38.
Confidential Health Information.-- Information
pursuant to any individual's
temporary disability claim or temporary caregiver insurance
claim shall be held confidential in
accordance with chapters 39-41, section 28-39-19, 5-37.3, and
all applicable state and federal
regulations.
28-41-39. Powers
and Duties.-- The director of the
department of labor and training
shall have the following powers and duties:
(1) To promulgate
regulations relative to the operation of the temporary caregiver
insurance program;
(2) To create all
necessary applications and certificates to fulfill the purposes of this
section;
(3) To disseminate
information regarding the program to
shall carry out a public education program to inform
workers and employers about the availability
of benefits under the temporary caregiver insurance
program. The director may use a proportion
of the funds collected for the temporary caregiver
insurance program in a given year to pay for
the public education program and/or funding received from
other sources for the purpose of
educating the public about their benefits. Outreach information
shall be available in English and
other languages; and
(4) To inform
due to the employee's own sickness, injury, or pregnancy,
or the employee's need to provide care
for any sick or injured family member or new child. The
notice shall be given by every eligible
employer to each new employee hired on or after January 1,
2014, and to each employee taking
leave from work on or after January 1, 2014 due to
pregnancy or the need to provide care for any
sick or injured family member or new child. The director
shall require each employer to post and
maintain information regarding the program in accordance with
section 28-41-15.
28-41-40.
Fraud and Misrepresentation of Benefits. -- (a)
The temporary caregiver
insurance program shall be part of the temporary disability
insurance fund. If the director finds
that any individual falsely certifies the medical
condition of any person in order to obtain family
temporary disability insurance benefits, with the intent to
defraud, whether for the maker or for
any other person, the director shall assess a penalty
against the individual in the amount of
twenty-five percent (25%) of the benefits paid as a result of
the false certification. Unless
otherwise specified to the contrary, all of the provisions of
chapters 39 through 41 of this title
shall apply to the temporary caregiver insurance program.
(b) If a physician
or other qualified health care provider licensed by a foreign country is
under investigation by the department for assisting in the
filing of false claims and the department
does not have the legal remedies to conduct a criminal
investigation or prosecution in that
country, the department may suspend the processing of all
further certifications until the licensed
qualified health care provider fully cooperates and continues
to cooperate with the investigation.
A qualified health care provider licensed by and
practicing in a foreign country who has been
convicted of filing false claims with the department shall be
barred indefinitely from filing a
certificate in support of a temporary disability insurance or
temporary caregiver insurance claim
in the state of
28-41-41.
Criminal Prosecution. -- All criminal actions
for any violation of chapter 39 -
41 of this title, or any rule or regulation of the
department shall be prosecuted by the attorney
general, or by any qualified member of the
director and approved by the attorney general to institute and
prosecute that action.
28-41-42.
Receipt of Federal Funds. -- To the extent that
funds are made available by
the federal government, under title III of the Social
Security Act, (42 U.S.C. 501 et seq.), or
otherwise for such purpose, the expenses of administering
chapter 39-41 of this title shall be paid
from those funds, provided that this section shall not be
considered to permit any expenditure of
funds from the employment security administration account
contrary to section 28-42-29. In the
event that the Social Security Act is amended to permit
funds granted under Title III to be used to
pay expenses of administering a sickness compensation
law, such as chapter 39-41 of this title,
then from and after the effective date of that amendment,
the expenses of administering those
chapters shall be paid out of the employment security
administration account or any other account
or fund in which funds granted under Title III are
deposited.
SECTION 2. This act shall take effect upon passage.
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LC00173/SUB B
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