Oregon Paid Family and
Medical Leave (OR PFML)
Oregon Paid Family and Medical Leave (OR PFML) provides wage replacement benefits to eligible employees who need time off from work for qualifying reasons. Employees may be eligible if they are sick or hurt and cannot work, including during pregnancy. Employees may also be eligible to take leave to bond with a new child, care for a family member who has a serious health condition or to address domestic violence, sexual assault, harassment, stalking, or bias crimes.
Employers can participate in the state-run program (Paid Leave Oregon), or they can self-insure or fully insure an equivalent plan.
MetLife offers self-insured and fully insured OR PFML plans.
Benefit Overview
Mandated Coverage & Employee Eligibility
HintLeave Reason, Duration, Job Protection
HintCost of Coverage and Contributions
HintBenefit Payments
HintEmployers are required to offer OR PFML benefits if they have at least one employee working in Oregon and may do so either through the state-run program, or through a fully insured or self-insured equivalent plan.
All employees working for a covered employer are eligible for benefits if they have earned at least $1,000 from working in Oregon in the previous year. Individual employees are not able to opt out of the program.
Independent contractors, self-employed workers, volunteers, work study program students, and federal/tribal government employees are several types of workers that are excluded. However, the self-employed, independent contractors, or tribal governments may opt in to the state-run program.
Eligible employees can receive part of their pay and job protection*, if they need to take time off for certain reasons. Job protection may also be provided through other federal or state laws such as the federal Family and Medical Leave Act (FMLA).
An employee may be eligible for a total of up to 12 weeks of PFL, PML and paid safe leave combined.
Medical Leave can be taken for up to 12 weeks to:
- address a personal serious health condition or injury, including organ or bone marrow donations (an extra 2 weeks for pregnancy, childbirth, or a related medical limitation)
Family Leave can be taken for up to 12 weeks to:
- bond with a new child (during the first year after birth, adoption, or foster care placement)
- Starting January 1, 2025, paid family leave may also be taken for activities related to the legal process required for foster child placement or child adoption
- care for a family member with a serious health condition
Safe Leave can be taken for up to 12 weeks to:
- to address safety concerns, such as domestic violence, stalking, bias crimes, or sexual assault for an eligible employee or a dependent child
Leave can be taken all at once, intermittently, or on a reduced leave schedule. The minimum increment that can be taken is one workday. An employee may need to provide proof of the need for an intermittent leave.
* Job protection may apply if an employee has been employed for 90 consecutive calendar days with their current employer prior to taking paid leave for an OR PFML qualifying reason.
Beginning January 1, 2025, the maximum employee contribution is 0.6% of an employee's taxable wages, or $1,056.60. In 2025, Oregon’s employee taxable wage base is determined by the Social Security taxable maximum, or $176,100.
Equivalent plan insurance premiums may differ, however, state covered payroll caps apply. Employee maximum contributions for an equivalent plan cannot be more than what they would pay for the state-run program. Employers fund the balance of the premium for insured equivalent plans.
MetLife can also provide claim administration for self-insured private plans. Employers are allowed to collect payroll contributions up to the state’s maximums and use the funds to pay benefits. Service fees paid to support the operating costs for state approved self-insured plans are the employer’s responsibility.
Please visit the state program’s website for the latest state rates and additional state plan information.
The benefit amount an employee can receive depends on how much money they make weekly compared to others in Oregon.
The maximum weekly benefit is $1,568.60.
Here’s how benefits are calculated:
- If an employee’s average weekly wage is equal or less than 65% of Oregon’s average weekly wage, an employee can receive 100% of their average weekly pay.
- If an employee’s average weekly wage is more than 65% of Oregon’s average weekly wage, an employee can receive 65% of Oregon’s average weekly wage plus half of their average weekly pay that exceeds that amount, but no more than $1,568.60.
The state of Oregon’s average weekly wage is $1,307.17 through June 2025.
Key Dates
- Contribution rates are effective, and the maximum employee contribution will be 0.6% of their taxable wages, or $1,056.60
Applying for a MetLife Equivalent Plan & Employer Requirements
To obtain a proposal from MetLife, you or your broker must create a census of your eligible Oregon workforce and send it to MetLife. This census template was developed for your convenience.
MetLife offers self-insured and fully insured OR PFML plans that have been approved by the state.
Review the state’s Equivalent Plan Guidebook for more information.
If fully insured, MetLife will issue a state approved OR PFML policy.
If self-insured, you will need to work with your own employment counsel to define your OR PFML plan to submit to the state for approval. Review the state’s Equivalent Plan Guidebook for more information about what your self-insured plan should include.
Create an account in Frances Online, Oregon’s payroll reporting site.
To apply, you will need:
- The Business Identification Number (BIN), Federal Employer Identification Number (FEIN), or Employer Identification Number (EIN), and the employer name, address, and contact information.
- $250 application fee
- A copy of either the self-insured plan or the fully insured policy
- Complete all required sections of the equivalent plan application questionnaire. You can preview the document prior to completing it in Frances Online or it can be submitted by mail along with your fee and supporting documents.
- For fully insured plans (sample), you’ll need insurance carrier contact information, as well as the policy start and end date.
- For a self-insured plan (sample), you’ll need to provide proof of sufficient assets and obtain a surety bond or an irrevocable letter of credit with the Oregon Employment Department named as the payee or beneficiary, issued by an insured institution.
Important: The application process and fee requirements outlined above must be completed for each BIN registered in the state that has Oregon workers. One submission will not be sufficient if you have multiple BINs.
Potential equivalent plan effective dates are the first day of the calendar quarter after state approval. For example, January 1st, April 1st, July 1st, or October 1st. Additionally, the application questionnaire, fee, and supporting documents must be submitted in Frances Online or by mail at least 30 days before the start of a new calendar quarter. If further information is needed, Paid Leave Oregon will notify the contact person listed on the pplication. Once their review is complete, they directly determine the final effective date for the fully insured or self-funded equivalent plan. MetLife will adjust the start date of our fully insured policy to match the state's effective date if needed.
Within 30 days of submission, the state will send you an equivalent plan decision. If your plan is approved, the notice will indicate your plan effective date and your contribution exemption date which is when you are no longer required to send quarterly Paid Leave contributions to the state. If an equivalent plan application is denied, information about requesting an appeal should be provided within the decision letter.
- For a fully insured plan: Provide a copy of your equivalent plan approval letter to your MetLife representative. Claim administration may be delayed or impacted if we do not receive your approval letter timely.
- For a self-insured plan: Provide a copy of your equivalent plan approval letter and state approved voluntary plan to your MetLife representative.
You must notify all of your employees (not simply those that are eligible) upon hire, when remote work is assigned, and each time the policy or procedure changes. Be sure to notify all employees that you will be offering their OR PFML benefits through an equivalent plan with MetLife and when this change will start. Your MetLife representative can provide a MetLife Notice of Rights poster/flyer to help you meet this requirement. It should be displayed in each building or worksite in an area accessible to and regularly frequented by employees, and the notice should be in the language that you typically use to communicate with staff. For remote workers, it must be provided by hand, electronically, or by regular mail.
Additionally, if you are moving to a MetLife equivalent plan from the state-run program, employees who have an open claim with Paid Leave Oregon will need to transition their claim to MetLife because the state will end their paid leave benefits on the equivalent plan start date. You will receive further guidance during your product implementation process if you have impacted employees.
Reporting requirements
The state requires the following two types of reports:
- Combined Payroll Reports (submitted quarterly) - this tax report is completed directly by you or your third-party administrator (TPA) because it is for multiple tax programs such as unemployment insurance in addition to Oregon PFML. For more information, please review Oregon Department of Revenue’s instruction guide.
- Form 132 - Employee Detail Report
- Form OQ – Oregon Combined Quarterly Report
- Annual Equivalent Plan/Benefit Usage Report - this report is submitted each year for equivalent plan customers only. Paid Leave Oregon requires the completed report to be submitted directly by you on or before January 31st. However, MetLife will give you the claim data by mid-January for Section 1 (Benefit Utilization). Once received, you will complete all required sections of the report template. The completed report will then be submitted to Paid Leave Oregon by uploading it to your Frances Online account or by mail.
- 2023 Equivalent Plan Effective Dates - If your equivalent plan began in 2023, your first reporting period will be from your plan start date through December 31, 2024. All subsequent years will be for the previous calendar year only (i.e. January 1 - December 31).
- 2024 Equivalent Plan Effective Dates - If your equivalent plan began in 2024, your reporting period each year will be from your plan start date or January 1 through December 31 of that calendar year.
Renewing your MetLife equivalent plan
Your fully insured MetLife policy will renew automatically on its anniversary date unless you or MetLife provide at least a 30 day advance written cancelation notice. During the renewal time period, you may receive a renewal letter and rate change information (if applicable), but we will not issue another copy of your policy documents automatically. Therefore, it is important to save your original issued policy documents for your records.
When your OR PFML policy renews, you may also need to consider if it impacts employee contributions if applicable. Annually, the state releases updates to employee contribution rates, and adjustments to the Social Security wage cap will be made. If you collect contributions from your employees, you must adjust the payroll deductions accordingly.
If we need to make significant updates to your OR PFML fully insured policy, we will refile it with the Oregon Department of Consumer and Business Services (DCBS). Once approved, we will issue updated policy documents to you for your records.
Reapproving your equivalent plan with Oregon
You will need to submit an application for reapproval each year for the first 3 years of your equivalent plan. Afterward, reapproval will only be needed if you make changes to the plan. Paid Leave Oregon may contact you (see example notice) when it is time to complete the reapproval process.
The reapproval application is due 30 days before the anniversary of your original plan effective date given by Paid Leave Oregon. There will also be a reapproval fee. The amount may vary based on if you have made significant changes to your plan since original approval by the state.
Significant plan changes are considered substantive amendments by the state and will require a $250 application fee per BIN.
Minor or no plan changes are called non-substantive amendments by the state and will require a $150 application fee per BIN. If you have a fully insured equivalent plan and MetLife has not made changes to the policy documents, your fee is likely to be $150. However, Paid Leave Oregon assesses and determines the final fee amount.
For a list of example substantive and non-substantive changes, review the Equivalent Plan Guidebook. Paid Leave Oregon will confirm how much your reapproval fee will be for each BIN.
For your fully insured equivalent plan, log into Frances Online or submit by mail your reapproval for an equivalent plan application (sample), fee, and current policy documents per BIN. If you plan to complete this process via Frances Online, we have step by step online portal instructions for review. Important Note: Be sure to submit your current policy and endorsement as proof of coverage. MetLife does not provide a new policy automatically when your OR PFML plan renews. The original version given to you is sufficient to share with Paid Leave Oregon during the reapproval process. Once approved, you will need to provide a copy of your state reapproval letter to your MetLife service representative.
Paid Leave Oregon may cancel your equivalent plan for failure to file for reapproval.
For a self-insured plan, log into Frances Online or submit by mail your reapproval equivalent plan application (sample), fee, proof of solvency, and state approved employer administered plan (include any plan changes if applicable) per BIN.
Per state regulations, solvency documentation can be submitted by providing proof of sufficient assets, a bond, or irrevocable letter of credit.
After Paid Leave Oregon accepts your reapproval application submission, provide an updated copy of your state reapproved voluntary plan to your MetLife representative.
Paid Leave Oregon may cancel your self-insured equivalent plan for failure to file for reapproval.
Taking a Leave
Filing for Benefits with MetLife
HintSupporting Claim Documentation
HintCoordination of Benefits
HintStep 1: An employee should notify their employer verbally or in writing at least 30 days before paid leave begins*. If the leave is unexpected, the employee must give verbal notice within 24-hours of the leave followed by a written notice within 3 days.
* The employer may require written notice and indicate this in their employee handbook or other human resources materials.
Step 2: An employee should file a claim up to 30 days in advance of the leave. If the leave is unforeseeable, claims may be submitted up to 30 days after the leave has begun.
Step 3: MetLife will gather any additional necessary information from the employer or employee to complete the claim. MetLife must make reasonable effort to make a decision and issue the first benefit payment within two weeks after receiving the claim or the first day of leave, whichever is later.
Step 4: If an employee’s claim is denied, they have 60 calendar days from the date of the claim denial letter to appeal to MetLife. If the appeal is denied, the appeal decision letter will include instructions about the state’s dispute resolution process.
Employees must provide specific documents for each claim. It is important to submit paperwork to the doctor as soon as possible. It might take the doctor’s office two weeks or more to complete the paperwork. In some cases, a statement confirming the relationship between the employee and the family member may also be requested.
For an employee's own serious health condition (when an employee is sick or hurt and cannot work for an extended period):
- Certification of a Serious Health Condition form filled out by an employee and their healthcare provider, or
- A doctor’s note or Attending Physician Statement (APS) that includes the same information as the Certification of Serious Health Condition form and/or any other reasonable information or documentation necessary to adjudicate the claim.
For child bonding for a newborn:
- A copy of the child’s government issued birth certificate, or
- A consular report of birth abroad, or
- A document from the child’s or pregnant parent’s healthcare provider stating child’s date of birth, or
- Court issued documents establishing paternity or guardianship,
- A Voluntary Acknowledgment of Paternity signed and witnessed by a hospital representative within 5 calendar days of birth date, or
- Another document approved by state law to show proof of birth
For child bonding for adoption or foster care placement:
- A copy of adoption papers or court documents finalizing the adoption, that includes child's date of birth and adoption date, or
- Documentation from the child’s healthcare provider, or
- Foster/adoption agency paperwork containing adoption or placement
- If an employee is not the parent named in the court documents (in loco parentis), the employee may also be asked to provide proof verifying their relationship to the in loco parentis named in the court ocumentation. This could be a marriage certificate, civil union papers, or something showing the employee is in a domestic partnership.
For leave to care for a family member with a serious health condition, including medical events related to pregnancy or childbirth:
- Certification of a Serious Health Condition form filled out by the employee and their family member’s healthcare provider, or
- A doctor’s note or APS that includes the same information as the Certification of Serious Health Condition form
For Safe Leave (when an employee or dependent children experience safety issues caused by domestic violence, harassment, sexual assault, bias crimes, or stalking):
- A copy of a federal agency or state, local or tribal police report, or
- A copy of a protective order or other evidence from a federal, state, local or tribal court, administrative agency, school’s Title IX Coordinator, or the employee’s attorney, or
- Other documentation to support the need for safe leave such as proof of care from a victim service organization or relocation due to safety, or
- The Paid Leave Oregon Safe Leave Verification Form, or
- Another document approved by state law for this purpose
Employees may be eligible for more than one leave.
OR PFML benefits and the federal Family & Medical Leave Act (FMLA) benefits can be used at the same time and should be used at the same time, when applicable. Employees who experience a pregnancy, childbirth, or medically related limitation during the absence may receive two (2) additional paid weeks which are classified as medical leave for a total of 14 paid weeks.
An employee cannot receive paid leave benefits for periods when they are also receiving workers’ compensation benefits specifically for lost wages or unemployment benefits. However, if the employee is receiving workers’ compensation benefits but the payments do not include lost wages (e.g., only for medical expenses, survivor benefits, etc.), they remain eligible for OR PFML.
OR PFML benefits and the Oregon Family Leave Act (OFLA) cannot be taken at the same time. In limited circumstances (pregnancy disability or care for a seriously ill child) where an employee may be eligible for both programs, it is their choice which program to use for the qualifying absence.
An employer may require employees to use OR PFML benefits and short-term or long term disability benefits at the same time. If the employee chooses not to apply for OR PML, their STD/LTD benefits may be impacted.
MetLife’s claims team will reach out to the employer to coordinate dates of the company leave that directly overlap with the state leave. If permitted by the state, employers with similar or ‘like’ benefits may also request reimbursement from MetLife at this time because it must be initiated prior to the PFML benefit being paid to the employee. If not already noted, the claims team may also document the employer’s reimbursement preference so that it is on file for future claims.
MetLife representatives can help review employer paid benefits that may overlap with the state leave. They can help document overlaps and preferred contact and action when the overlap happens.
Note: There may be additional leaves that MetLife does not administer. Employers may be responsible for providing additional leaves for their employees. Employers should consult their own employment attorneys to identify changes to their other employer-sponsored paid and unpaid leave plans.
Need more information?
FAQs
A spouse, registered domestic partner, sibling, child, child-in-law, child of your registered domestic partner, grandparent, grandchild, parent, parent-in-law or parent of your domestic partner, or any individual related by blood or affinity whose close association with you is the equivalent of a family relationship.
As of December 06, 2024