Yes. Insurance coverage may be continued up to two weeks after termination of employment.

The qualifying reasons for NJ TDB include all of the following reasons:

Disability resulting from:

• Accident or sickness not arising outside of the course of employment.
• Donation of any organ or bone marrow by the covered individual.
• Pregnancy as certified by a treating physician’s certification for up to 4-6 weeks before the expected date of birth and up to 6-8 weeks after the date of birth normally (8-10 for a Cesarean section) and extended for complications.
• To cope with being a victim of domestic and sexual violence.
• Cosmetic surgery if reconstructive in nature or necessary to correct a disabling condition.

The Taxable Wage base for benefits and contributions is $161,400 (107 times the State Average Weekly Wage).

The State Average Weekly Wage is $1,465.42 and is updated annually.

New Jersey refers to this as the period of disability. This equates to 26 weeks.

Yes. Any successive periods of TDB separated by no more than 14 days from the prior period of disability caused by the same or related condition is deemed one continuous period of disability.

Yes. Partial disability on a continuous basis can be taken, but this requires the permission of the employer.

• First, total disability and receipt of full benefits for at least 7 consecutive days, is required.
• Then, permitted for 8 weeks. Medical documentation from a qualified health care provider may extend this time period to 12 weeks. However, the provider’s support for the extension must be memorialized in writing.

NJ TDB will be prorated in accordance with the actual time taken as leave compared to the covered individual’s typical workweek hours. The sum of the wages earned on a reduced work schedule, and the temporary disability benefits received, rounded to the next lower multiple of $1.00, will equal the weekly benefit amount the individual would have been paid if totally unable to perform the duties of employment due to disability.

NJ TDB generally does not provide job protection. However, organ and bone marrow donors are afforded protection and must be restored to an equivalent position with their employer once their disability ends. Otherwise, protection may be afforded under FMLA to care for the individual’s own illness or injury.

• If the sum of the TDB benefit and wages paid by the employer, including accrued paid leave, exceeds 100% of average weekly wages, TDB benefits are not payable.
• For any period during which the employee receives continued pay as described above in the section titled “Other Income Amount offsets”, the TDI benefit amount will be reduced.
• Employers are not prohibited from requiring employees to use paid time off before claiming their NJ TDB, but employers may not require employees to use their New Jersey earned sick leave.
• State employees: may be required to use up to two weeks of accrued sick time before receiving NJ TDB, but may not be required to use their last week of sick time, before receiving NJ TDB.

Yes. Insurance coverage may be continued up to two weeks after termination of employment.

Additionally, if the period of family leave begins more than 14 days after the last day of covered employment and there is a separation from employment, the individual may be eligible for benefits under the Family Leave During Unemployment program. The individual must meet all requirements for unemployment benefits, except that they are not required to show availability for work. If the individual is on an approved leave of absence from covered employment, the individual may be eligible for benefits under the State Plan Family Leave Insurance Program.

The qualifying reasons for NJ FLI include all of the following reasons:

• To bond with a child during the first 12 months after the child’s birth, or during the first 12 months after the placement of the child with the covered individual for adoption.
  • For bonding claims after the birth of a child, the applicant or the applicant’s spouse, domestic partner, or civil union partner must be the biological parent of the child.
• To care for a family member with a serious health condition that is supported by a certification from a health care provider.
• To cope with domestic and sexual violence, including:
  • Seeking medical attention, therapy, victim advocacy or legal services.
  • Safety planning or escaping abuse, such as staying in a domestic violence shelter.
  • Attending or preparing for court.
  • Recovering at home.

The Taxable Wage base for benefits and contributions is $161,400 (107 times the State Average Weekly Wage).

The State Average Weekly Wage is $1,465.42 and is updated annually.

365 consecutive days from the first day of leave.

No. However, a claim may be extended for the same reason with completion of a FL-3 form Insurance Continued Claim Certification form.

Yes. Claims may be filed for consecutive weeks, for intermittent weeks, or for intermittent days during a 12-month period, beginning with the first date of the claim.

Intermittent leave in full day increments is permitted for up to 56 days in a 12-month period.

Increments are for a full day, and so one-seventh of the corresponding weekly benefit amount.

NJ FLI generally does not provide job protection. Protection may be afforded under FMLA, New Jersey Family Leave Act (NJFLA) and NJ SAFE Act.

During receipt of sick or vacation pay, NJ FLI benefits are not payable.

An employer cannot require an employee to use company-paid time off. If an employee chooses to use accrued sick or vacation time, it will not reduce the maximum duration of leave that they are entitled to.

• Complete the state of New Jersey’s application for Temporary Disability Insurance (form DP-1) with your broker.
• Submit the completed DP-1 form to us.
• We will send the DP-1 and policy documents to the state of New Jersey’s Division of Temporary Disability Insurance.
• The state of New Jersey will issue a Certificate of Approval.
• Thereafter, we will issue a policy and posting notice.
• We will forward these documents to your broker, who in turn will forward them to you.
• Our standard effective date begins on the first day of the next calendar quarter (whether transferring to us from a state plan or private plan).

All private plans must first be approved by the Division of Temporary Disability Insurance. Private plans must have the same, if not more, liberal benefit amounts, eligibility requirements and duration of payments as the state plan. It is important to note that under a private plan, the cost cannot be more for an employee than it is under the state plan. Additionally, private plan disability benefits may be subject to Social Security (FICA) and federal income taxes.

SEMI-ANNUAL AND ANNUAL REPORTS

The New Jersey Administrative Code, Sections 12:18-2.29, 2.30, and 2.31 requires that insurance companies, self-insured employers, and union welfare funds file semi-annual and annual reports showing the temporary disability claims activity under their approved private plan(s).

The semi-annual and annual report forms, together with instructions, are mailed to Symetra by the Approvals Unit at the appropriate time. The reports must then be completed and emailed to: TDIECU@dol.nj.gov. The two semi-annual reports must be completed showing the number of new claims filed during the six-month periods ending June 30 and December 31, the number of claims accepted during those periods, and the gross amount of private plan benefits paid during those periods.

The annual report must be completed showing claims activity for the entire calendar year. The information requested includes gross premiums earned, total administrative costs of operating the private plans, and total amount of temporary disability benefits paid under the approved private plan.

Reporting periods follow calendar quarters and are aligned with the reporting periods for unemployment insurance. Reports must be submitted by the last day of the month following the end of the calendar quarter.