Families First Coronavirus Response Act
Benefits Frequently Asked Questions
P&C Frequently Asked Questions
Families First Coronavirus Response Act (7)
The new Act requires employers with fewer than 500 employees to provide paid leave for some employees related to the coronavirus (COVID-19) pandemic, among other measures.
The new Act will take effect on April 1, 2020.
If a company already offers paid time off or sick leave, does the employee have to use that prior to using the paid sick leave provided by the Families First Coronavirus Response Act?
No, an employer may not require an employee to use other paid leave provided by the employer before the employee uses the paid sick time under the Families First Coronavirus Response Act. However, prior to the effective date of the act, employees should use their available PTO, vacation, or sick time. An employee may elect to substitute any accrued vacation leave, personal leave, or medical or sick leave, as well as sick or family leave mandated by state and local government.
Employees can qualify for Emergency Sick Leave and/or Emergency Family and Medical Leave under this act.
Emergency Sick Leave must be made available to workers who are symptomatic or are under an order or advice to quarantine or self-isolate, who have to care for a family member under such an order or advice, or who have a child whose school or child care provider or facility has closed or is unavailable due to the coronavirus.
Emergency Family and Medical Leave must be made available when an employee is unable to work or telework due to school or child care closures related to the coronavirus.
The Employer will pay the leave benefits and then receive a credit against payroll taxes for each calendar quarter an amount equal to 100 percent of the qualified sick leave wages paid by the employer within that calendar quarter.
Employers with fewer than 50 employees may qualify for exemption from the requirement to provide leave on account of school closings or child care unavailability if the leave requirements would jeopardize the viability of the business as a going concern; the Department of Labor is expected to publish regulations about this exemption in the future.
If an employee is out on one of the required leave benefits in the Families First Coronavirus Response Act, is that employee eligible for health insurance benefits?
Yes, the employee is eligible for medical insurance while on Emergency Paid Sick Leave and Emergency Family Medical Leave under this act.
In addition, the company would qualify for a credit for any amount paid or incurred by the employer to provide and maintain a group health plan, but only to the extent that such amounts are excluded from the gross income of the employees.
Benefits Frequently Asked Questions (3)
If an individual is diagnosed with coronavirus, ADA services would evaluate medical information to determine disability under ADA or any state equivalent laws. Individuals who are quarantined without a diagnosis and not sick, generally, would not be considered disabled. The EEOC has published guidance for employers on specific workplace practices and inquiries related to COVID-19.
Is an individual who is quarantined but not sick or diagnosed with the coronavirus considered disabled?
No, disability carriers do not consider quarantined workers to be disabled. Unless they have a medical condition that meets the policy’s definition of disability.
An employee is considered disabled when they meet the definition of disability outlined in their policy. Your carrier would assess the claim to determine eligibility for benefits based on the terms of your policy, the same as the carrier would for any illness.
P&C Frequently Asked Questions (2)
Policies are frequently tailored to the needs of individual companies, meaning exclusions and limits vary. Therefore we suggest you speaking with your service team with any questions you may have. There are a few general points worth mentioning …Contagious disease coverage for business interruption (BI) is not commonly available since the SARS outbreak in 2003, which shares many similarities with the Wuhan virus outbreak. Even if coverage is available, there is usually a sublimit or restrictive terms. Most policies trigger coverage for BI only after a direct physical loss.
Again, every policy is worded differently and therefore it is imperative you discuss your specific situation with your team at KMRD. Also keep in mind, it is your obligation to ultimately prove a true loss of income which cannot be recovered in subsequent months. We will be your advocate but your carrier will make the ultimate decision on whether they believe coverage can be triggered.
For obvious reasons this is a fluid situation and there have been no specific rulings to date. Insurance carriers, third party administrators and risk managers must rely upon precedent, similar cases and relevant fact patterns to develop case management strategies, to address the issues as they arise, and to develop reasonable prevention strategies. In addition to “injuries,” Workers’ Compensation Acts provide compensation for “diseases” that are occupational in nature.
Specific diseases that have been associated with workplace exposures include Black Lung, Asbestosis and Hepatitis. Diseases not specifically enumerated by state law may also be covered if the industry’s exposure is substantially higher than the general population. This is why we do not typically see seasonal influenza workplace “injuries.” We strongly recommend reaching out to someone on your team to discuss your specific scenario.