New JerseyNew JerseyDepartmentDepartment

ofofLabor and Workforce Labor and Workforce

DevelopmentDevelopment

DivisionDivision

ofof

Temporary Disability InsuranceTemporary Disability Insurance

Disability CoverageDisability Coverage

Rhode IslandRhode Island

CaliforniaCalifornia

New JerseyNew Jersey

New YorkNew York

HawaiiHawaii

Puerto RicoPuerto Rico

New Jersey ProgramNew Jersey Program

Established in 1948Established in 1948

Modeled After California & Rhode IslandModeled After California & Rhode Island

Compromise Between Business & Compromise Between Business & LaborLabor– Business – Private CoverageBusiness – Private Coverage– Labor – State CoverageLabor – State Coverage

What is Temporary Disability What is Temporary Disability Insurance?Insurance?

Temporary - Short Term BenefitsTemporary - Short Term Benefits

Disability - Disability - Non-Work Related Illness or Non-Work Related Illness or

InjuryInjury

Insurance - ProtectionInsurance - Protection

Who is Covered?Who is Covered?

All Those Covered for Unemployement All Those Covered for Unemployement Insurance With the Following Exceptions:Insurance With the Following Exceptions:

– Local Government (Optional)Local Government (Optional)

– Federal GovernmentFederal Government

– Out-of-State EmploymentOut-of-State Employment

The Division of Temporary Disability The Division of Temporary Disability Insurance Oversees Three Programs:Insurance Oversees Three Programs:

State PlanState Plan

Private PlanPrivate Plan

Disability During UnemploymentDisability During UnemploymentDisabilities beginning more than 14 days after the Disabilities beginning more than 14 days after the last date of work in covered employmentlast date of work in covered employment

State Plan OperationsState Plan Operations

State Plan EligibilityState Plan Eligibility

Covered Wages in Base Covered Wages in Base YearYear– Base Week RequirementBase Week Requirement

2014 = $145*2014 = $145*

– Alternative Earnings TestAlternative Earnings Test2014 = $7,300*2014 = $7,300*

Unable to WorkUnable to Work

Medical CertificationMedical Certification

Benefit CalculationBenefit Calculation

Benefit CalculationBenefit Calculation– 2/3 of the Average Weekly 2/3 of the Average Weekly

WageWage

– Average Weekly Wage is Average Weekly Wage is based on earnings in the 8 based on earnings in the 8 calendar weeks immediately calendar weeks immediately prior to start of disabilityprior to start of disability

Weekly Benefit RateWeekly Benefit Rate– 2014 = $5952014 = $595

Maximum EntitlementMaximum Entitlement– 2014 = $15,4702014 = $15,470

Claims Processing GoalsClaims Processing Goals

69% of claims determined within 14 days.69% of claims determined within 14 days.

88% of claims determined within 28 days.88% of claims determined within 28 days.

*To avoid processing delays, the application *To avoid processing delays, the application form should be completed by the claimant, form should be completed by the claimant, the doctor, and the employer.the doctor, and the employer.

Benefit LimitationsBenefit Limitations

Waiting WeekWaiting Week

Criminal ActsCriminal Acts

Gross MisconductGross Misconduct

Workers’ CompensationWorkers’ Compensation

Labor DisputesLabor Disputes

Special IssuesSpecial Issues

PregnancyPregnancy

Drug AbuseDrug Abuse

Alcohol AbuseAlcohol Abuse

Protection of the Trust FundProtection of the Trust Fund

Independent Medical ExaminationsIndependent Medical Examinations

Staff PhysicianStaff Physician

Cross-match With Unemployment Cross-match With Unemployment InsuranceInsurance

Benefit ChargesBenefit Charges– Are Determined by Most Recent Covered Are Determined by Most Recent Covered

EmployerEmployer

Federal Tax RequirementsFederal Tax Requirements– Since 1982, TDI Third Party PaySince 1982, TDI Third Party Pay

Taxable Under FIT & FICATaxable Under FIT & FICAFICA Deducted From BenefitsFICA Deducted From BenefitsYear End Statement Sent to Employer for (W2) Year End Statement Sent to Employer for (W2) preparationpreparation

Not taxable for NJ State Income TaxNot taxable for NJ State Income Tax

State Plan FundingState Plan Funding

Employer RatesEmployer Rates– Start-up Rate = Start-up Rate =

0.0050%0.0050%

– Experience Rating Experience Rating After Three Years = After Three Years =

0.10% to 0.75%0.10% to 0.75%

– 2014 Contributions = 2014 Contributions = $31.50 to $236.25$31.50 to $236.25

Worker RateWorker Rate– .0036% on the first .0036% on the first

$31,500$31,500

– 2014 Max. Employee 2014 Max. Employee Contributions = Contributions = $119.70$119.70

Based on Taxable Wages

2014 Taxable Wage Base = $31,500

Private Plan,Private Plan,Disability During Disability During UnemploymentUnemployment

&&Customer ServicesCustomer Services

Coverage OptionsCoverage Options

State Plan Coverage Is Automatic for Most Workers

But

Workers May Be Covered by an Employer’s Approved Private Plan Instead.

Private Plan CoveragePrivate Plan Coverage

Approximately 6,100 Private PlansApproximately 6,100 Private Plans

Covering Approximately 905,000 workersCovering Approximately 905,000 workers

State Plan oversees the administration of State Plan oversees the administration of all private plansall private plans

Supplemental Plans permitted on Supplemental Plans permitted on voluntary basisvoluntary basis

Third TDI Program Third TDI Program Disability During UnemploymentDisability During Unemployment

Disability Begins More Than 14 Days After Disability Begins More Than 14 Days After Last Day of Covered Employment.Last Day of Covered Employment.

Eligibility Same As U.I. (But Unable to Do Eligibility Same As U.I. (But Unable to Do Any Work).Any Work).

Federal Tax RequirementsFederal Tax Requirements

Not Subject to FICANot Subject to FICA

Considered Income by IRSConsidered Income by IRS

New Jersey LWD Sends Form 1099G to New Jersey LWD Sends Form 1099G to Claimant for Tax YearClaimant for Tax Year

Note:Note:Not taxable for NJ State Income TaxNot taxable for NJ State Income Tax

Claims ProcessingClaims Processing

Claims come in through fax or mail and Claims come in through fax or mail and are sorted and imaged into our systemare sorted and imaged into our system

Our mainframe system randomly assigns Our mainframe system randomly assigns the claim to an examiner, and when all 3 the claim to an examiner, and when all 3 parts of the claim have been received, the parts of the claim have been received, the examiner processes that claim within 14 examiner processes that claim within 14 days and a determination of eligibility is days and a determination of eligibility is sent to the claimantsent to the claimant

Claims ProcessingClaims Processing

If more information is needed, the If more information is needed, the examiner will contact the claimant, doctor, examiner will contact the claimant, doctor, or employer via phone or mail to request or employer via phone or mail to request the informationthe information

Payments for eligible claims are made via Payments for eligible claims are made via a Bank of America debit card which is a Bank of America debit card which is mailed to the claimant and is valid for all mailed to the claimant and is valid for all UI, TDI, and FLI benefits paid for 4 yearsUI, TDI, and FLI benefits paid for 4 years

Customer Service SectionCustomer Service Section609-292-7060609-292-7060

20 - 30 Agents who have the ability to view 20 - 30 Agents who have the ability to view claim imagesclaim images

Conversant System for inquiryConversant System for inquiry

50,000 Conversant Calls Per Week50,000 Conversant Calls Per Week

7,000 Agent Calls Per Week7,000 Agent Calls Per Week

Temporary Disability InsuranceTemporary Disability InsuranceWebsiteWebsitewww.nj.gov/laborwww.nj.gov/labor

Go to Temporary DisabilityGo to Temporary Disability

Provides general information on all three program areasProvides general information on all three program areas

Ability to download claim form (DS-1)Ability to download claim form (DS-1)

Claimants can access State Plan claim information via Web Claimants can access State Plan claim information via Web Services linkServices link

Ability to contact the Division via e-mail.Ability to contact the Division via e-mail.– Claim specific information not available via e-mail due to security issuesClaim specific information not available via e-mail due to security issues

Ability to file an appeal via e-mailAbility to file an appeal via e-mail

We are creating a web based application expected to launch late We are creating a web based application expected to launch late this year this year

AppealsAppeals

State PlanState Plan

Disability During UnemploymentDisability During Unemployment

Private PlanPrivate Plan

Questions?Questions?

FAMILY LEAVE INSURANCE

Department of Labor and Workforce Development

Division of Temporary Disability Insurance

GENERAL INFORMATION

Signed into law May 2, 2008 Claim filing began July 1, 2009

– care of a seriously ill family member– bonding with a newborn or newly adopted child.

GENERAL INFORMATION

2nd State to implement Family Leave Insurance– California (2004)– Washington (delayed 2015)

FLI is a benefit entitlement program not a leave entitlement program

No employment protection provision to hold job. Employees may have rights under other laws including NJFLA and FMLA

COVERAGE

Workers covered under the New Jersey Unemployment Compensation Law, including government entities

All businesses, regardless of the size

Employees may be covered under:– the State Plan or an approved Private Plan– Family Leave During Unemployment (leave

begins more than 14 days after the last day of work)

Information regarding the type of coverage provided by an employer must be posted at the worksite

PROGRAM FUNDING

100% funded by employee contributions through payroll deductions

No employer contributions

New tax rate for 2014 is 0.001% of taxable wage base. Varies annually based on fund balance, claim activity and administrative costs.

The taxable wage base changes each year. In 2014 the taxable wage base is $31,500. The maximum contribution in 2014 is $31.50

CARE OF A FAMILY MEMBER

Benefits are payable for care of a family member with a serious health condition supported by a certification provided by a health care provider

Family Member

– child (biological, adopted, foster, stepchild, legal ward of a covered individual, child of a domestic/civil union partner who is less than 19 years or age or over 19 and incapable of self care)

– spouse– domestic/civil union partner– parent (biological, foster, adoptive, stepparent or legal guardian)

Claims may be filed for 6 consecutive weeks, Intermittent weeks or 42 intermittent days

BONDING

Benefits are payable for bonding with a newborn or newly adopted child during the first 12 months after the birth or adoption

Claim must be for:– Continuous period greater than seven days– Non consecutive periods greater than seven days if

permitted by the employer

FAMILY LEAVE INSURANCE FACTS

An employer can require an employee to use up to two weeks of paid time off (State of NJ requires)

The maximum allowance may be reduced by up to two weeks of any paid time off if the employer requests the reduction

Claimant must give the employer notice of family leave– care of family member

reasonable and practicable notice unless time of leave is unexpected or unforeseeable.

15 days for leave on an intermittent basis– bonding

30 days notice

FAMILY LEAVE INSURANCE FACTS

A formal appeal can be filed by an employee or employer who disagrees with a determination

The maximum payable is 6 weeks of benefits in a 12 month period. The 12 month period is the 365 consecutive days beginning with the first day a claim is established

STATE PLAN COVERAGE

STATE PLAN ELIGIBILITY

Covered Wages in Base Year– Base Week Requirement

2014 – 20 weeks with earnings of $145or more

– Alternative Earnings Test2014 - $7,300 during the base year period.

Base Year is the 52 weeks immediately prior to the week in which the family leave claim begins

BENEFIT DURATION

6 Weeks during a 12 month period (365 consecutive days beginning with the first day of a valid first claim)

First Claim is the claim for Family Leave Insurance benefits initially filed. It begins the running of the 12 month period

BENEFIT CALCULATION

Weekly Benefit Rate– 2/3 of the Average Weekly Wage up to the maximum weekly

benefit rate. The maximum WBR for 2014 is $595– Average Weekly Wage is based on earnings in the 8 calendar

weeks immediately prior to start of family leave– Weekly Benefits Rate will be the same as for State Plan

temporary disability claim if family leave claim is filed immediately after the State Plan temporary disability claim

Daily Rate– 1/7 of the weekly benefit rate

Benefit Limitations

Waiting Week (no waiting week if the State Plan Family Leave Insurance Claim is immediately after the State Plan temporary disability insurance claim)

Pensions reduce entitlement, dollar for dollar, if the most recent employer contributed to the pension benefit

OTHER BENEFIT PROVISIONS

No benefits are payable if:

– Receiving Temporary Disability Benefits

– Receiving Workers’ Compensation Benefits

– Receiving benefits from a disability or cash sickness program or similar law of any state or the federal government.

– Receiving Unemployment Benefits

– Receiving Full Paid Time Off

– Working

OTHER BENEFIT PROVISIONS

No benefits are payable if:

– not in covered employer within 14 days of the last day worked

– not under the care of a health care provider– involved in a Labor Dispute

– discharged for Gross Misconduct

– employee of an educational institution and benefits are claimed between academic year or terms or during a school-wide recess when claimant has a reasonable assurance of returning to work

Tax Information

Subject to Federal Income Tax– Claimant can request that 10% of weekly benefits

rate be withheld

Not Subject To:– FICA– State Income Tax

1099G mailed to claimant by Division

Program statistics

211,560 eligible claims since 7-1-2009 Bonding claims 81% Care claims 19% 7.5% claimants work for State of NJ 21% of claims PTO reduction 77% claims determined in 14 days or less 91% approval rate

Program statistics

Volume running below original OLS estimates

22% of bonding claims processed through web center automation

Program challenges

Intermittent FLI care & bonding claims Confusion with FMLA & NJ FLA Early claim submission Paid Time Off reduction Integration with Private Plan TDI carriers Adoption & custody issues Claims from employees of educational

institutions

Ineligible claims

Intermittent bonding Invalid relationships School employees during school wide

recess Typical reasons (insufficient wages, failure

to provide information, etc.)

APPLYING FOR BENEFITS

Application can be obtained:– by writing to the Division of Temporary Disability Insurance, PO

Box 387, Trenton, NJ 08625-0387

– telephoning Customer Service Section 609-292-7060

– website – www.nj.gov/labor

Claimants who receive State Plan temporary disability benefits will receive instructions after giving birth for filing a transitional bonding claim

Applications should not be filed until the family leave period begins

CUSTOMER SERVICE

Conversant System for general topics and claim specific information is now available

Agent Assistance – during business hours609-292-7060

Website www.nj.gov/labor– Contains general program information – Applications and informational pamphlets can be downloaded– Claimants can view State Plan claim details or file a transitional

bonding claim via the Web Services link.

Questions?

WHAT DOES ALL OF THIS MEAN FOR THE SAFE

ACT?

The SAFE ACT

• provides an unpaid leave of absence, for a period not to exceed 20 days in a 12-month period, to address circumstances resulting from domestic violence or a sexually violent offense

• the employee must have worked at least 1,000 hours

during the immediately preceding 12-month period

• the employee must have worked for an employer in the State that employs 25 or more employees

Leave may be taken by an employee who is a victim of domestic violence, or a victim of a sexually violent offense. Leave may also be taken by an employee whose child, parent, spouse, domestic partner, or civil union partner is a victim of domestic violence or a sexually violent offense.

The SAFE Act is a leave entitlement program. TDI and FLI are benefit entitlement programs. Just like a period of FMLA-covered unpaid leave, you must qualify for TDI or FLI benefits during this period.

Eligibility Requirements

Issues to Watch for TDI/FLI Claims• No intermittent days allowed for TDI• Must provide medical certification • The waiting week is only triggered when

you have been out of work for 22 days.• Must meet wage requirements • This is replacement for lost wages- so if

your employer pays you, we won’t

Questions?