Sec. 130001. Comprehensive Paid Leave
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The Social Security Act is amended by adding at the end the following: The table of contents for this title is as follows: Sec. 2201. Table of contents. Sec. 2202. Entitlement to comprehensive paid leave benefits. Sec. 2203. Benefit amount. Sec. 2204. Benefit determination and payment. Sec. 2205. Appeals. Sec. 2206. Accurate payment. Sec. 2207. Funding for benefit payments, grants, and program administration. Sec. 2208. Funding for State administration option for legacy States.
Sec. 2209. Reimbursement option for employer-sponsored comprehensive paid leave benefits. Sec. 2210. Definitions. Every individual who— has filed an application for a comprehensive paid leave benefit in accordance with section 2204(a); has, or anticipates having, at least 4 caregiving hours in a week ending at any time during the period that begins 90 days before the date on which such application is filed or not later than 90 days after such date; has wages or self-employment income at any time during the period— beginning with the most recent calendar quarter that ends at least 4 months prior to the beginning of the individual’s benefit period specified in subsection (b); and ending with the month before the month in which such benefit period begins; and has at least the specified amount of wages and self-employment income during the most recent 8-calendar quarter period that ends at least 4 months prior to the beginning of the individual’s benefit period specified in subsection (b), shall be entitled to such a benefit for each month during such benefit period, except as otherwise provided in this section.
For purposes of paragraph (4), the specified amount for individuals whose benefit period begins in calendar year 2024 shall be $2,000, and the specified amount for individuals whose benefit period begins in any calendar year after 2024 shall equal the specified amount applicable for the calendar year preceding such calendar year, or, if larger, the product of $2,000 and the quotient obtained by dividing the national average wage index (as defined in section 2210) for the second calendar year preceding such calendar year by the national average wage index (as so defined) for 2022.
Except as provided in paragraph (2), the benefit period specified in this subsection is the period beginning with the month in which ends the 1st week in which the individual has at least 4 caregiving hours and otherwise would meet the criteria specified in paragraphs (1), (2), (3), and
(4)of subsection
(a)and ending at the end of the month in which ends the 52nd week ending during such period. In the case of an application for benefits under this section with respect to an individual who has at least 4 caregiving hours in a week at any time during the period that begins 90 days before the date on which such application is filed, the benefit period specified in this subsection is the period beginning with the later of— the month in which ends the 1st week in which the individual has at least 4 caregiving hours; or the 1st month that begins during such 90-day period, and ending at the end of the month in which ends the 52nd week ending during such period. Notwithstanding paragraphs
(1)and (2), no benefit period under this title may begin with any month beginning before January 2024. For purposes of this title, the term caregiving hour means a 1-hour period during which the individual engaged in qualified caregiving (determined on the basis of information filed with the Commissioner pursuant to subsection
(c)of section 2204). For purposes of this subsection, the term qualified caregiving means any activity engaged in by an individual in lieu of work (during the hours that constitute the individual’s regular workweek (within the meaning of section 2203(d))), other than for monetary compensation, for a qualifying reason (as defined in section 2210). For purposes of subparagraph (A), an activity shall be considered to be engaged in by an individual for monetary compensation if, for the time during which the individual was so engaged, the individual received— wages from an employer; self-employment income; or any form of cash payment made by an employer for purposes of providing the individual with paid vacation, paid sick leave, or any other form of paid time off (but not including any such form of cash payment to the extent that the sum of such cash payment and any comprehensive paid leave benefits under section 2202 does not exceed 100 percent of the individual’s regular rate of pay (as determined under section 7(e) of the Fair Labor Standards Act of 1938)). For purposes of subparagraph (A), an activity engaged in by an individual shall not be considered to be engaged in in lieu of work if, for the time during which the individual was so engaged, the individual is taking leave from covered employment under an employer-sponsored program (as defined in section 2209(g)). For purposes of subparagraph (A), an activity engaged in by an individual shall not be considered to be engaged in in lieu of work if, for the time during which the individual was so engaged, the individual is taking leave from covered employment under the law of a legacy State (as defined in section 2208(c)). In the case of an individual who is no longer employed, such individual shall be treated, for purposes of the preceding sentence, as taking leave from covered employment under the law of a legacy State (as so defined) with respect to the portion of the time during which the individual was so engaged corresponding to the share of the individual’s regular workweek (within the meaning of 2203(d)) that was in covered employment under the law of a legacy State (as so defined). No caregiving hours of an individual may be credited under section 2203(c) to the week during which the individual dies. An individual who has been found to have used false statements or representation to secure benefits under this section shall be ineligible for benefits under this section for a 5-year period following the date of such finding. The amount of the benefit to which an individual is entitled under section 2202 for a month shall be an amount equal to the sum of the weekly benefit amounts for each week ending during such month. The weekly benefit amount of an individual for a week shall be equal to the product of the individual’s weekly benefit rate (as determined under subsection (b)) multiplied by a fraction— the numerator of which is the number of caregiving hours of the individual credited to such week (as determined in subsection (c)); and the denominator of which is the number of hours in a regular workweek of the individual (as determined in subsection (d)). For purposes of this section, an individual’s weekly benefit rate shall be an amount equal to the sum of— 90.138 percent of the individual’s average weekly earnings to the extent that such earnings do not exceed the amount established for purposes of this subparagraph by paragraph (2); 73.171 percent of the individual’s average weekly earnings to the extent that such earnings exceed the amount established for purposes of subparagraph
(A)but do not exceed the amount established for purposes of this subparagraph by paragraph (2); and 53.023 percent of the individual’s average weekly earnings to the extent that such earnings exceed the amount established for purposes of subparagraph
(B)but do not exceed the amount established for purposes of this subparagraph by paragraph (2). For individuals whose benefit period under this title begins in calendar year 2024, the amount established for purposes of subparagraphs (A), (B), and
(C)of paragraph
(1)shall be 1/52 of $15,080, $34,248, and $62,000, respectively. For individuals whose benefit period under this title begins in any calendar year after 2024, each of the amounts so established shall equal the corresponding amount established for the calendar year preceding such calendar year, or, if larger, the product of the corresponding amount established with respect to the calendar year 2024 and the quotient obtained by dividing— the national average wage index (as defined in section 2210) for the second calendar year preceding such calendar year, by the national average wage index (as so defined) for calendar year 2022. Each amount established under subparagraph
(B)for any calendar year shall be rounded to the nearest $1, except that any amount so established which is a multiple of $0.50 but not of $1 shall be rounded to the next higher $1. For purposes of this subsection, an individual’s average weekly earnings, as calculated by the Commissioner, shall be equal to the quotient obtained by dividing— the total of the wages and self-employment income received by the individual during the 8-calendar quarter period described in section 2202(a)(4); by 104. For purposes of determining the wages and self-employment income of an individual with respect to an application for benefits under section 2202, the Commissioner shall make such determination on the basis of data provided to the Commissioner from the National Directory of New Hires pursuant to section 453(j)(12) and self-employment income information provided to the Commissioner pursuant to section 6103(l)(23) of the Internal Revenue Code of 1986, except that the Commissioner shall also consider any more recent or additional evidence of wages or self-employment income the individual chooses to additionally submit. The number of caregiving hours of an individual credited to a week as determined under this subsection shall equal the number of caregiving hours of the individual occurring during such week, except that— such number may not exceed the number of hours in a regular workweek of the individual (as determined in subsection (d)); no caregiving hours may be credited to a week in which fewer than 4 caregiving hours of the individual occur; no caregiving hours of the individual may be credited to the individual’s waiting period, consisting of the first week during an individual’s benefit period in which at least 4 caregiving hours occur (regardless of whether the individual received any form of cash payment for the purpose of providing the individual with paid vacation, paid sick leave, or any other form of paid time off from the individual’s employer during such week in accordance with section 2202(c)(2)(B)(iii)); and the total number of caregiving hours credited to weeks during the individual’s benefit period may not exceed the product of 4 multiplied by the number of hours in a regular workweek of the individual (as so determined). For purposes of this section, the number of hours in a regular workweek of an individual shall be the number of hours that the individual regularly works in a week for all employers or as a self-employed individual (or regularly worked in the case of an individual who is no longer working or whose total weekly hours of work have been reduced) during the month before the individual’s benefit period begins (or prior to such month, if applicable in the case of an individual who is no longer working or whose total weekly hours of work have been reduced). Any person may submit applicable paid leave information with respect to an individual, including, as applicable, the individual’s representative, the individual’s employer, or any relevant authority identified under section 2204(b)(2). For purposes of this subsection, the term applicable paid leave information means, with respect to an individual, any information submitted to the Commissioner with respect to the comprehensive paid leave benefits of the individual, including any initial application, periodic benefit claim report, appeal, and any other information submitted in support of such application, report, or appeal. An individual seeking benefits under section 2202 shall file an application with the Commissioner containing at least the information described in subsection (b). Any information contained in an application for benefits under section 2202, or in a periodic benefit claim report filed with respect to such benefits, shall be presumed to be true and accurate, unless the Commissioner demonstrates by a preponderance of the evidence that information contained in the application or periodic benefit claim report is false, except that the Commissioner shall mandate procedures to validate the identity of such individual. An application for a comprehensive paid leave benefit filed by an individual shall include— an attestation that the individual has, or anticipates having, at least 4 caregiving hours in a week ending at any time during the period that begins 90 days before the date on which such application is filed or not later than 90 days after such date; at the option of the Commissioner, a certification, issued by a relevant authority identified under regulations issued by the Commissioner, that contains such information as the Commissioner shall specify in regulations as necessary to affirm the circumstances giving rise to the need for such caregiving hours, which shall be no more than is required for reasonable documentation (as defined in section 2210); an attestation from the individual that notice of the individual’s need to be absent from work during such caregiving hours has been provided, not later than 7 days after such need arises, to the individual’s employer (except in cases of hardship or other extenuating circumstances or if the individual does not have (or no longer has) an employer); pay stubs or such other evidence as the individual may provide demonstrating the individual’s wages or self-employment income during the period described in section 2202(a)(3), except that the Commissioner may waive this requirement in any case in which such evidence is otherwise available to the Commissioner; and an attestation from the individual stating the number of hours in a regular workweek of the individual (within the meaning of section 2203(d)). In the case of an individual who applies for a comprehensive paid leave benefit in the anticipation of caregiving hours occurring after the date of application, the certification described in paragraph (2), the attestations described in paragraphs
(3)and (5), and the evidence described in paragraph
(4)may be provided after the 1st week in which at least 4 such caregiving hours occur. Except as provided in paragraph (2), not later than 60 days (or such longer period as may be provided in any case in which the Commissioner determines that good cause exists for an extension) after the end of each month during the benefit period of an individual entitled to benefits under section 2202, the individual shall file a periodic benefit claim report with the Commissioner. Such periodic benefit claim report shall specify the caregiving hours of the individual that occurred during each week that ended in such month. No periodic benefit claim report shall be required with respect to any week in which fewer than 4 caregiving hours occurred. In the case of an application filed by an individual for a comprehensive paid leave benefit with a benefit period that begins, in accordance with section 2202(b)(2), with a month that ends before the date on which such application is filed, the individual may include with such application the information described in the second sentence of paragraph
(1)with respect to each week in the benefit period that ends before such date. The Commissioner shall determine, with respect to an individual applying for benefits under section 2202, the initial entitlement and the benefit period in accordance with such section, and the weekly benefit rate, average weekly earnings, and the number of hours in a regular workweek in accordance with section 2203. On the basis of the information filed with the Commissioner pursuant to subsection (c), the Commissioner shall determine, with respect to an individual for each week ending in a month, the number of caregiving hours to be credited to such week in accordance with section 2203(c). If more than one type of circumstance gives rise to the need for caregiving hours during the individual’s benefit period, such caregiving hours shall be credited to weeks within the benefit period in accordance with section 2203(c) regardless of circumstance. Not later than 15 days after the making of a determination under subsection (d)(2) with respect to the number of caregiving hours of an individual to be credited to weeks ending in a month, the Commissioner shall certify payment of the comprehensive paid leave benefit for such month to be made to such individual, and the Secretary of the Treasury shall make such payment in accordance with the certification of the Commissioner of Social Security. The Commissioner shall have full power and authority to make rules and regulation, including interim final regulations, and to establish procedures, not inconsistent with this title, which are necessary and appropriate to carry out this title. An individual shall have the right— to appeal to the Commissioner any determination made with respect to— comprehensive paid leave benefits under section 2202; and comprehensive paid leave benefits under an employer-sponsored program described in section 2209 whose appeal to the employer (or administering entity) pursuant to subsection (b)(1)(B)(iii)(I) of such section results in a determination unfavorable to the individual; and to have the appeal heard in a timely manner by a decisionmaker who was not the initial decisionmaker and who reviews any additional evidence submitted. Any determination by the Commissioner on an appeal under this section shall be a final determination. Whenever the Commissioner determines that more or less than the correct amount of payment has been made to any individual under this title, the Commissioner shall promptly notify the individual of such determination and inform the individual of the right to appeal such determination in accordance with the provisions of section 2205. Proper adjustment or recovery shall be made as follows: With respect to payment to an individual of less than the correct amount, the Commissioner shall promptly pay the balance of the amount due to such underpaid individual. With respect to payment to an individual of more than the correct amount, the Commissioner shall decrease any payment for a month under section 2202 to which such overpaid individual is entitled (except that no such payment may be decreased in any manner that results in weekly benefit amounts for each week ending during such month that are less than the lower of the weekly benefit amounts for each such week as determined for such individual under section 2203(a) or the amount specified in clause
(ii)with respect to such weekly benefit amounts of the individual), or shall require such overpaid individual to refund the amount in excess of the correct amount, or shall apply any combination of the foregoing. The amount specified in this clause with respect to a weekly benefit amount of an individual for a week is an amount equal to the weekly benefit amount that would be determined for the individual for such week under section 2203(a) if the individual’s weekly benefit rate (as determined under section 2203(b)) were equal to the applicable dollar amount as determined under subclause (II). For purposes of subclause (I), the applicable dollar amount is— with respect to a weekly benefit amount determined for a week ending in a month in calendar year 2024, $315; and with respect to a weekly benefit amount determined for a week ending in a month in any calendar year after 2024, the corresponding amount established with respect to a weekly benefit amount determined for a week ending in a month in the calendar year preceding such calendar year or, if larger, the product of the corresponding amount specified in item
(aa)with respect to a weekly benefit amount determined for a week ending in a month in calendar year 2024 multiplied by the quotient obtained by dividing— the national average wage index (as defined in section 2210) for the second calendar year preceding such calendar year, by the national average wage index (as so defined) for 2022. In any case in which more than the correct amount of payment for comprehensive paid leave benefits under section 2202 has been made, there shall be no adjustment of payments to, or recovery from, any individual who was without fault in connection with the overpayment if such adjustment or recovery would defeat the purpose of this title or would impede efficient or effective administration of this title, or if such individual relied on the receipt or expected payment of comprehensive paid leave benefits under section 2202 to make a financial decision. In considering whether an individual is without fault, the Commissioner shall take into account the individual’s age and any physical impairment or mental impairment (including intellectual disability), limited English proficiency, low levels of literacy skills, educational limitations, and any other circumstances that may render the individual not at fault. Any person who knowingly makes a false statement, misrepresents a fact, or omits material information in connection with an application for benefits under section 2202 or a periodic benefit claim report under section 2204 shall be subject to a civil monetary penalty of not more than the amount determined under paragraph
(2)for a calendar year for each such statement, misrepresentation, or omission. The amount determined under this paragraph for a calendar year shall be the amount that would be in effect for such calendar year if such penalty— had been first established in the amount of $5,000 in calendar year 1994; and had been initially adjusted for inflation in calendar year 2016. No person or entity who— knowingly and willfully makes or causes to be made any false statement or representation of a material fact in any application for any benefit under this title, at any time knowingly and willfully makes or causes to be made any false statement or representation of a material fact for use in determining rights to any such benefit, having knowledge of the occurrence of any event affecting
(i)his initial or continued right to any such benefit, or
(ii)the initial or continued right to any such benefit of any other individual in whose behalf he has applied for or is receiving such benefit, conceals or fails to disclose such event with an intent fraudulently to secure such benefit either in a greater amount or quantity than is due or when no such benefit is authorized, having made application to receive any such benefit for the use and benefit of another and having received it, knowingly and willfully converts such benefit or any part thereof to a use other than for the use and benefit of such other person, or conspires to take any action described in any of subparagraphs
(A)through (C), may represent, or submit evidence on behalf of, an individual applying for, or receiving, benefits under this title. An exclusion under this paragraph shall be effective with respect to services furnished to any individual on or after the effective date of the exclusion. Nothing in this paragraph may be construed to preclude consideration of any medical evidence derived from services provided by a health care provider before the effective date of the exclusion of the health care provider under this subsection. The Commissioner shall immediately redetermine the entitlement of an individual to comprehensive paid leave benefits under section 2202 if there is reason to believe that fraud or similar fault was involved in the application of the individual for such benefits. When redetermining the entitlement, or making an initial determination of entitlement, of an individual under this title, the Commissioner shall disregard any evidence if there is reason to believe that fraud or similar fault was involved in the providing of such evidence. For purposes of paragraph (1), similar fault is involved with respect to a determination if— an incorrect or incomplete statement that is material to the determination is knowingly made; or information that is material to the determination is knowingly concealed. If, after redetermining pursuant to this subsection the entitlement of an individual to comprehensive paid leave benefits, the Commissioner determines that there is insufficient evidence to support such entitlement, the Commissioner may terminate such entitlement and may treat benefits paid on the basis of such insufficient evidence as overpayments. In addition to amounts otherwise available, there are appropriated, out of any funds in the Treasury not otherwise appropriated, such sums as may be necessary to pay benefits under section 2202 and for grants under sections 2208 and 2209. In addition to amounts otherwise available, there is appropriated, out of any funds in the Treasury not otherwise appropriated, $1,500,000,000 for fiscal year 2022 and $1,590,700,000 for each subsequent fiscal year (subject to paragraph (2)) for timely and accurate administration of all sections of this title, including costs related to necessary customer service, staffing, technology, training, data sharing, identity validation, technical assistance to legacy States under section 2208 and employers or employer-designated third party administrators under section 2209, public education and outreach to potential beneficiaries, and research for the purpose of ensuring full and equitable access to the programs under this title. For each fiscal year after 2024, there shall be substituted for the dollar amount specified in paragraph
(1)for such fiscal year an amount equal to the larger of the dollar amount in effect under this subsection for the fiscal year preceding such fiscal year or the product of $1,590,700,000 multiplied by the ratio of— the national average wage index (as defined in section 2210) for the most recent calendar year that ends before the beginning of such preceding fiscal year, to the national average wage index (as so defined) for 2021. No funds made available for the administration of title II may be used to carry out the paid leave program established under this title. In addition to amounts otherwise available, there is appropriated for fiscal year 2022, out of any funds in the Treasury not otherwise appropriated, $500,000,000, to remain available until expended, for administrative expenses described in subsection (b)(1) during fiscal year 2024 or any subsequent fiscal year, except that such amount shall not be available in any fiscal year unless the Commissioner determines that the number of applications filed during such fiscal year for comprehensive paid leave benefits under section 2202(a) will exceed the number that were anticipated to be filed during such fiscal year (as determined by the Commissioner) by 20 percent or more. In each calendar year beginning with calendar year 2025, the Commissioner shall make a grant to each State that, for the calendar year preceding such calendar year, was a legacy State and that met the data sharing requirements of subsection (e), in an amount equal to the lesser of— an amount, as estimated by the Commissioner, equal to the total amount of comprehensive paid leave benefits that would have been paid under section 2202 (including the costs to the Commissioner to administer such benefits, not to exceed (for purposes of estimating such total amount under this paragraph) 7 percent of the total amount of such benefits paid) to individuals who received paid family and medical leave benefits under a State law described in paragraph
(1)or
(3)of subsection
(b)during the calendar year preceding such calendar year if the State had not been a legacy State for such preceding calendar year; or an amount equal to the total cost of paid family and medical leave benefits under a State law described in paragraph
(1)or
(3)of subsection
(b)for the calendar year preceding such calendar year, including— any paid family and medical leave benefits provided by an employer (whether directly, under a contract with an insurer, or provided through a multiemployer plan) as described in subsection (d); and the full cost to the State of administering such law (except that such cost may not exceed 7 percent of the total amount of paid family and medical leave benefits paid under such State law). In any case in which, during any calendar year, the Commissioner has reason to believe that a State will be a legacy State and meet the data sharing requirements of subsection
(e)for such calendar year, the Commissioner may make estimated payments during such calendar year of the grant which would be paid to such State in the succeeding calendar year, to be adjusted as appropriate in the succeeding calendar year. For purposes of this section, the term legacy State for a calendar year means a State with respect to which the Commissioner determines that— the State has enacted, not later than the date of enactment of this title, a State law that provides paid family and medical leave benefits; for any calendar year that begins before the date that is 3 years after the date of enactment of this title, the State certifies to the Commissioner that the State intends to remain a legacy State and meet the data sharing requirements of subsection
(e)at least through the first calendar year that begins on or after such date; and for any calendar year that begins on or after such date, a State law of the State provides for a State program to remain in effect throughout such calendar year that provides comprehensive paid family and medical leave benefits (which may be paid directly by the State or, if permitted under such State law, by an employer pursuant to such State law)— for at least 4 full workweeks of leave during each 12-month period to at least all of those individuals in the State who would be eligible for comprehensive paid leave benefits under section 2202 (without regard to section 2202(c)(2)(D)), except that the State shall provide such benefits for leave from employment by the State or any political subdivision thereof, and may elect to provide such benefits for leave from any other governmental employment; at a wage replacement rate that is at least equivalent to the wage replacement rate under the comprehensive paid leave benefit program under section 2202 (without regard to section 2202(c)(2)(D)). For purposes of this title, the term covered employment under the law of a legacy State means employment (or self-employment) with respect to which an individual would be eligible to receive paid family and medical benefits under the State law of a State, as described in paragraph
(1)or
(3)of subsection (b), during any period during which such State is a legacy State. Notwithstanding any provision of section 2209, in the case of a State that permits paid family and medical leave benefits to be provided by an employer (whether directly, under a contract with an insurer, or provided through a multiemployer plan) pursuant to a State law described in paragraph
(1)or
(3)of subsection (b)— such benefits shall be considered, for all purposes under this title, paid family and medical leave benefits under the law of a legacy State; and leave for which such benefits are paid shall be considered, for all such purposes, leave from covered employment under the law of a legacy State. In any case in which paid family and medical leave benefits are provided by one or more employers (whether directly, under a contract with an insurer, or provided through a multiemployer plan) in a legacy State pursuant to a State law described in paragraph
(1)or
(3)of subsection (b), the State, upon the receipt of any grant amount under subsection (a), may distribute an appropriate share of such grant to each such employer. As a condition of receiving a grant under subsection
(a)in a calendar year, a State shall enter into an agreement with the Commissioner under which the State shall provide the Commissioner— with information, to be provided periodically as determined by the Commissioner, concerning individuals who received a paid leave benefit under a State law described in paragraph
(1)or
(3)of subsection (b), including each individual’s name, information to establish the individual’s identity, dates for which such paid leave benefits were paid, the amount of such paid leave benefit, and, to the extent available, such other information concerning such individuals as necessary for the purpose of carrying out this section and section 2202(c)(2)(D); not later than July 1 of such calendar year, the amount described in subsection (a)(2) for the calendar year preceding such calendar year; and such other information as needed to determine compliance with grant requirements. Nothing in this section shall be construed to prohibit a legacy State or an employer providing benefits pursuant to a legacy State law from providing paid family and medical leave benefits that exceed the requirements described in this section. For each calendar year beginning with calendar year 2024, the Commissioner shall make a grant to each employer that is an eligible employer for such calendar year in an amount equal to— in the case of an eligible employer sponsoring a comprehensive paid leave benefit program with respect to which benefits are awarded and paid under a contract with an insurer (or through a multiemployer plan), an amount (not to exceed the employer’s expenditures for such program) equal to the lesser of— 90 percent of the product of— the projected national average cost per individual of providing comprehensive paid leave benefits under section 2202 as determined by the Commissioner for such calendar year under subsection (c)(3) (or, in the case of a calendar year during which the eligible employer sponsored such comprehensive paid leave benefit program for only a fraction of the year, an equal fraction of such projected national average cost); multiplied by the number of eligible employees (within the meaning of subsection (b)(1)(A) and pro-rated for part-time eligible employees) whose employment is covered employment under the employer-sponsored program (as defined in subsection (g)) for such calendar year (or, in the case of a calendar year during which the eligible employer sponsored such comprehensive paid leave benefit program for only a fraction of the year, for such fraction of the year); and 90 percent of the total premiums paid to the insurer (or contributions paid to the multiemployer plan) by the eligible employer under such contract (or such plan) for such calendar year (or such fraction thereof) for the coverage under such contract (or such plan) of eligible employees of the employer; and in the case of an eligible employer sponsoring a self-insured comprehensive paid leave benefit program with respect to which benefits are awarded and paid directly by the employer (or by a third party administrator on behalf of the employer), an amount equal to 90 percent of— the amount of benefits paid under the program for such calendar year to eligible employees of the employer for up to 4 weeks of leave per eligible employee; or if lesser, the product of the national average weekly benefit amount paid under section 2203(a) during such calendar year multiplied by the number of weeks of leave (up to 4 per eligible employee) paid by the employer for all eligible employees under the program for the calendar year. For purposes of subsection (a), an eligible employer for a calendar year is an employer (other than the Federal Government or the government of any State (or political subdivision thereof) that is a legacy State for such calendar year under section 2208) that satisfies all of the following requirements: The employer has one or more employees during such calendar year whose employment with such employer is not covered employment under the law of a legacy State (as defined in section 2208(c)) (in this section referred to as eligible employees ). As a condition of the grant, the employer agrees— that, on return from leave under the program described in subparagraph (C)(ii), the eligible employee taking such leave will— be restored by the employer to the position of employment held by the eligible employee when the leave commenced; or be restored to an equivalent position with equivalent employment benefits, pay, and other terms and conditions of employment; to maintain coverage for the eligible employee under any group health plan (as defined in section 2210) for the duration of such leave at the level and under the conditions coverage would have been provided if the eligible employee had continued in employment continuously for the duration of such leave; in any case in which an eligible employee receives an adverse determination from the employer (or administering entity) with respect to comprehensive paid leave benefits under the program described in subparagraph (C)(ii)— to provide opportunity for the eligible employee to appeal such adverse determination to the employer (or administering entity); and in any case in which the eligible employee elects to appeal the results of such initial appeal to the Commissioner pursuant to section 2205(a)(1)(B) and the final decision of the Commissioner is in the eligible employee’s favor, to provide for the payment of such comprehensive paid leave benefits in addition to the costs to the Commissioner of such secondary appeal; to provide annual notice to all eligible employees stating that their employment is covered employment under an employer-sponsored program (as defined in subsection (g)) and informing them of the right to appeal any adverse determination with respect to comprehensive paid leave benefits under the program described in subparagraph (C)(ii); and not to impose any fee on any eligible employee related to ensuring coverage, or to the receipt of comprehensive paid leave benefits, under the program described in subparagraph (C)(ii). Not later than the certification deadline specified in paragraph (2)(A) for such calendar year, the employer— notifies the Commissioner that the employer intends to seek a grant under this section for such calendar year; certifies to the Commissioner that the employer will have in effect during such calendar year a comprehensive paid leave benefit program that meets the requirements of subsection
(c)and, not later than the submission deadline specified in paragraph (2)(B) for such calendar year, provides all documentation relating to such program as the Commissioner may request; and pays an application fee to the Commissioner in accordance with this subparagraph, such amounts to remain available to the Commissioner without further appropriation, in addition to amounts otherwise available, to administer this section and appeals described in section 2205(a)(1)(B). In the case of an initial application, the application fee under this subparagraph shall be $500 for an employer with 50 or fewer employees, $1,000 for an employer with more than 50 but fewer than 500 employees, and $2,000 for an employer with 500 or more employees. In the case of a renewed application, the application fee under this subparagraph shall be $200. The comprehensive paid leave benefit program referred to in subparagraph (C)(ii) is subsequently approved by the Commissioner as meeting all applicable requirements. At the time of application for such grant for each calendar year, the employer— submits to the Commissioner— an attestation that the comprehensive paid leave benefit program referred to in subparagraph (C)(ii) will remain in effect during the whole of such calendar year (or, in the case of a program not in effect at the beginning of such calendar year, an attestation that such program will remain in effect until the end of such calendar year); and with respect to each eligible employee of the employer whose employment is covered employment under the employer-sponsored program (as defined in subsection (g)) for such calendar year, the eligible employee’s name, information to establish the eligible employee’s identity, and in the case of a part-time eligible employee (for purposes of determining the number of eligible employees (pro-rated for part-time eligible employees) covered under the program for such calendar year under subsection (a)(1)(B)), the number of hours the eligible employee regularly works in a week; and agrees to submit information to the Commissioner as described in subsection (e). The employer agrees to retain all records relating to the employer’s comprehensive paid leave benefit program for not less than 3 years. As a condition of the grant, the employer (or administering entity) does not— interfere with, restrain, or deny the exercise of, or the attempt to exercise, any right provided under the program described in subparagraph (C)(ii); or discharge, or in any other manner discriminate against, any eligible employee for opposing any practice prohibited by such program. In the case of a comprehensive paid leave benefit program of an employer with respect to which benefits are awarded and paid directly by the employer (or by a third party administrator on behalf of the employer)— such employer employs at least 50 eligible employees; and such benefits are guaranteed by a surety bond held by the employer. The certification deadline specified in this subparagraph for a calendar year is the date that is 90 days before the beginning of the calendar year, or, if later, the date that is 90 days before a plan described in paragraph (1)(C)(ii) first goes into effect. The submission deadline specified in this subparagraph for a calendar year is the date that is 45 days before the beginning of the calendar year, or, if later, the date that is 45 days before a plan described in paragraph (1)(C)(ii) first goes into effect. A comprehensive paid leave benefit program shall not be considered to meet the requirements of this subsection unless such program consists of a written employer policy in accordance with paragraph
(2)that provides for the payment, through one or more employee benefit plans, of family and medical leave benefits (in addition to any paid vacation, paid sick leave, or paid consolidated leave otherwise provided), which may be guaranteed through an insurer or provided through a multiemployer plan and which may be administered by an insurer, multiemployer plan, or by another third-party entity, that includes each element described in subparagraphs
(A)through
(H)of paragraph (2), and under which the employer provides for each of the following: Each of the additional grant conditions described in subsection (b)(1)(B). Each of the requirements described in subsection (b)(1)(G). Submission of information to the Commissioner as described in subsection (e). As a condition of a grant under this section, the written employer policy referred to in paragraph
(1)shall provide comprehensive paid leave benefits— to all eligible employees of the employer, regardless of length of service, job type, membership in a labor organization, seniority status, or any other employee classification; at a wage replacement rate that is at least as great as the wage replacement rate that an eligible employee would receive under the comprehensive paid leave benefit program under section 2202 (without regard to section 2202(c)(2)(C)); for a total number of weeks of paid leave that is at least as great as the total number of weeks of paid leave that an eligible employee would receive under such program (without regard to such section); for all qualifying reasons (as described in subparagraphs (A), (B), and
(C)of section 2210(6)), regardless of any pre-existing medical conditions; for leave which may be taken intermittently or on a reduced leave schedule; that does not impose any fee on any eligible employee related to ensuring coverage for, or to the receipt of, such benefits; which must be paid not less frequently than monthly; and for which any information contained in an application for such benefits shall be presumed to be true and accurate, unless the employer (or administering entity) demonstrates by a preponderance of the evidence that information contained in the application is false. Not later than October 1 of the calendar year before each calendar year beginning with 2024, the Commissioner shall determine and publish the projected national average cost per individual of providing comprehensive paid leave benefits under section 2202 for such calendar year, such cost to be determined by dividing the total cost of benefits under such section for such calendar year (including the costs to the Commissioner to administer such benefits, not to exceed (for purposes of calculating the national average cost under this paragraph) 7 percent of the total amount of such benefits paid) by the number of individuals— who have wages or self-employment income at any time during such calendar year; and whose employment in a regular workweek (within the meaning of section 2203(d)) includes employment that is not covered employment under an employer-sponsored program (as defined in subsection
(g)of this section) or covered employment under the law of a legacy State (as defined in section 2208(c)). A grant paid under this section for a calendar year to an eligible employer described in subsection (a)(1) shall be paid by the Commissioner not later than 30 days after the beginning of such calendar year. A grant paid under this section for a calendar year to an eligible employer described in subsection (a)(2) shall be paid by the Commissioner not later than March 31 of the calendar year succeeding such calendar year. In any case in which an eligible employer seeking a grant under this subsection for a calendar year fails to submit all required documentation by the submission deadline for such calendar year as required under subsection (b)(2)(B)— the grant for such calendar year for such employer shall not be paid until 45 days after the date of payment otherwise specified in paragraph
(1)or (2), as applicable; and the amount of such grant shall be reduced by 2 percent for each 7 days by which such submission deadline is exceeded. As a condition of receiving a grant under subsection
(a)for a calendar year, an employer shall provide the Commissioner with information, at such times and in such manner as required by the Commissioner, concerning eligible employees who received a paid leave benefit under the comprehensive paid leave benefit program of the employer, including each eligible employee’s name, information to establish the eligible employee’s identity, dates for which such paid leave benefits were paid, the amount of such paid leave benefit, and, to the extent available, such other information concerning such eligible employees as needed for the purpose of carrying out this section and section 2202(c)(2)(C), and for otherwise carrying out the provisions of this title. The Commissioner shall conduct periodic reviews of employers receiving grants under this section (and of entities administering such programs). The Commissioner may withdraw approval of the comprehensive paid leave benefit program of an employer in any case in which the Commissioner finds that the employer (or administering entity) has violated any requirement of this section, may require the employer to repay the full amount of such grant, and may disqualify an employer from receiving subsequent grants (or an administering entity from administering programs) under this section in the case of repeated violations. In any case in which the Commissioner determines that a pattern exists with respect to an employer (or administering entity) in which the employer (or administering entity) has incorrectly denied claims for paid leave benefits under the employer-sponsored program and such claims have subsequently been approved by the Commissioner pursuant to an appeal described in section 2205(a)(1)(B), the Commissioner may impose penalties on the employer (or administering entity), which may include requiring the employer to repay the full amount of such grant and a reduction in, or disqualification from, receiving subsequent grants (or an entity from administering programs) under this section. In the case of a third-party entity administering a comprehensive paid leave benefit program of an employer, such entity shall notify such employer in any case in which a penalty is imposed under this subsection on the administering entity not later than 30 days after the date on which such penalty has been imposed. In any case in which the Commissioner determines that a pattern of misconduct exists with respect to an entity administering benefits under this section for multiple employers, the Commissioner may disqualify such entity from administering employer-sponsored programs receiving subsequent grants under this section. An employer (or administering entity) with respect to which a penalty is imposed under this subsection may appeal such decision to the Commissioner only if such appeal is filed with the Commissioner not later than 60 days after the date of such decision. For purposes of this title, the term covered employment under an employer-sponsored program — means employment with an eligible employer sponsoring a comprehensive paid leave benefit program that meets the requirements of subsection
(c)during a calendar year for which the eligible employer receives a grant under subsection (a); and does not include covered employment under the law of a legacy State (as defined in section 2208(c)). Nothing in this section shall be construed to prohibit an eligible employer from providing paid family and medical leave benefits that exceed the requirements described in this section. For purposes of this title: The term Commissioner means the Commissioner of Social Security. With respect to any reference in this title to an individual’s eligibility or ineligibility for comprehensive paid leave benefits under section 2202(a) for a month, an individual shall be considered to be eligible for such benefits for such month if, upon filing an application for such benefits for such month, the individual would be entitled to such benefits for such month. The term group health plan has the meaning given such term in section 5000(b)(1) of the Internal Revenue Code of 1986. The term multiemployer plan has the meaning given such term in section 3(37) of the Employee Retirement Income Security Act of 1974 ( 29 U.S.C. 1002(37) ). The term national average wage index has the meaning given such term in section 209(k)(1). The term ‘qualifying reason’ means, with respect to any determination of whether an individual is engaged in qualified caregiving under section 2202(c)(2)(A), any of the following: A reason described in subparagraph
(A)or
(B)of section 102(a)(1) of the Family and Medical Leave Act of 1993 ( 29 U.S.C. 2612(a)(1) ) (applied for purposes of this paragraph as if the individual involved were the employee referred to in such section). In order to care for a qualified family member of the individual, if such qualified family member has a serious health condition. For purposes of clause (i)— the term qualified family member means, with respect to an individual— a spouse (including a domestic partner in a civil union or other registered domestic partnership recognized by a State) and a spouse’s parent; a child and a child’s spouse; a parent and a parent’s spouse; a sibling and a sibling’s spouse; a grandparent, a grandchild, or a spouse of a grandparent or grandchild; and any other individual who is related by blood or affinity and whose association with the individual involved is equivalent of a family relationship; and the term serious health condition has the meaning given such term in section 101(11) of the Family and Medical Leave Act of 1993 ( 29 U.S.C. 2611(11) ) . Because of a serious health condition (as defined in subparagraph (B)(ii)(II)) that makes the individual unable to satisfy the requirements needed to continue receiving (or in the case of an individual no longer employed, to resume receiving) the wages or self-employment income described in section 2202(a)(3). The term reasonable documentation means the information that is required to be stated under subsection
(b)of section 103 of the Family and Medical Leave Act of 1993 ( 29 U.S.C. 2613 ). The term self-employment income has the meaning given the term in section 1402(b) of the Internal Revenue Code of 1986 for purposes of the taxes imposed by section 1401(b) of such Code. For purposes of section 2202(a) and 2203(b)(3), the Commissioner shall determine rules for the crediting of self-employment income to calendar quarters, under which— in the case of a taxable year which is a calendar year, self-employment income shall be credited equally to each quarter of such calendar year; and in the case of any other taxable year, such income shall be credited equally to the calendar quarter in which such taxable year ends and to each of the next three or fewer preceding quarters any part of which is in such taxable year. The term State means any State of the United States or the District of Columbia or any territory or possession of the United States. The term wages has the meaning given such term in section 3121(a) of the Internal Revenue Code of 1986 for purposes of the taxes imposed by sections 3101(b) and 3111(b) of such Code (without regard to section 3121(u)(2)(C) of such Code), except that such term also includes— compensation, as defined in section 3231(e) of such Code for purposes of the Railroad Retirement Tax Act; and unemployment compensation, as defined in section 85(b) of such Code. The term week means a 7-day period beginning on a Sunday. .
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