PAID FAMILY LEAVE RESOURCES
NEW JERSEY PAID FAMILY LEAVE
There are currently two programs for paid family (and medical) leave in New Jersey: NJ Family Leave Insurance and Temporary Disability Insurance.
Family Leave Insurance, also known as FLI, is paid leave that facilitates parents taking time off from work to bond with a new child, whether by birth, fostering or adoption, or to care for a seriously ill loved one, and to deal with issues related to domestic or sexual violence.
Temporary Disability Insurance, also known as TDI, is paid leave for one’s own non-work-related injury, illness, or other disability, including pregnancy and medical recovery from birth.
Both programs provide 85% of workers’ average weekly wage, up to a maximum weekly benefit of $903 for 2022 and is adjusted annually. New Jersey workers contribute a fraction of their earnings to both the FLI program and the TDI program.
To be eligible, you must work in New Jersey and meet minimum gross earnings requirements. For 2022, you must have worked 20 weeks earning at least $240 weekly, or have earned a combined total of $12,000 in the base year period, which is approximately the 18 month period before taking the leave.
Both the FLI and TDI programs were improved when Governor Murphy signed an expansion bill into law on February 19, 2019. However, some of the improvements did not go into effect until 2020.
New Jersey FAMILY LEAVE INSURANCE (FLI): Since July 1, 2020, FLI provides workers with either 12 continuous weeks or 56 intermittent days of paid leave over a 12 month period. Most workers take FLI to bond with a new child, whether by birth, adoption or fostering, in the first year after birth or placement. Bonding FLI leave is available for both parents, not just the birth parent in the case of a child birth within the family.
The benefit is now also available to take leave to care for most familial relatives AND to care for any loved one, who are the equivalent of a family relationship, that have a serious health condition. When caring for a seriously ill loved one a medical care provider must certify the condition in the application for benefits.
Additionally and IMPORTANTLY, workers can receive FLI benefits when taking leave to deal with issues related to domestic and sexual violence, and to care for loved ones dealing with these same issues. You do not need a medical care provider to certify this type of leave, however you may need to provide some evidence of the need for leave which your employer must keep confidential.
Workers now have the choice to use their own paid time off before accessing FLI, previously employers could require their employees to take up to two weeks of their paid time off before accessing FLI.
Currently, workers with more than one job can take leave from one job and receive FLI benefits while continuing to work their other.
New Jersey TEMPORARY DISABILITY INSURANCE (TDI): is available for up to 26 weeks in a 12-month period for non-work related disability. Some employer provide TDI (or often referred to as SDI) through a private plan. Ask you employer what they provide. Both a private and state TDI program must provide paid leave for time your medical care provider CERTIFIES you are unable to work. Standard TDI leave for pregnancy can begin 4 weeks before your due date continues after giving birth for either 6 weeks for a vaginal birth and 8 weeks for a cesarian. The time could be extended if your medical care provider certifies additional time before giving birth or for your recovery period — and this can even include coping with postpartum depression.
If your employer has a private TDI plan, it must provide equal or better than what the state provides. The state does oversee employer’s private plans (typically through an insurance company) to ensure compliance. If denied private TDI/SDI benefits you can contact the state Department of Labor appeal. Municipal, county (teachers) and federal employees are typically NOT eligible for TDI.
Other details about Paid Family Leave in New Jersey
You may have the explicit right to return to work when taking leave under the Federal Family and Medical Leave Act (FMLA) and the NJ Family Leave Act (FLA). The FLA currently covers workers at businesses with 50 or more employees, this changes to include business with 30 or more employees on June 30, 2019.
Employers may not retaliate against employees who request TDI or FLI benefits. Employers who fail to provide the DOLWD with information to process a claim causing a delay, may be required to additional penalties. (effective February 19, 2019)
You can find the entire text of the laws HERE. To apply for both TDI and FLI benefits click HERE.
This information has been shared thanks to the work and resources from the NJ Time to Care Coalition, which is a diverse group that includes advocacy, union, research, faith, senior, women's, and community-based organizations, working to improve programs and policies to ensure that all working families have paid time to care. They provide more resources on their social media accounts on FACEBOOK TWITTER INSTAGRAM. You can also email them HERE or call 973-368-5112.
If you have benefited from these programs or have been negatively impacted by lack of access to them please help make a difference by sharing YOUR STORY HERE!
NEW YORK PAID FAMILY LEAVE
Resources coming soon.
FEDERAL PAID FAMILY LEAVE
Resources coming soon.
IT IS YOUR RESPONSIBILITY TO READ ALL OUR SCHEDULING, INSURANCE AND PAYMENT POLICIES
INSURANCE BILLING
YOU ARE RESPONSIBLE FOR INFORMING US OF ANY INSURANCE COVERAGE CHANGES FOR YOU AND YOUR BABY
IT IS YOUR RESPONSIBILITY TO CHECK WITH YOUR INSURANCE COMPANY IF YOU ARE COVERED FOR LACTATION SERVICES. CHECK UNDER NPI 1457969412 OR 1710273859. GET A CALL REFERENCE NUMBER AND WRITE DOWN THE DATE.
ONCE YOUR BABY IS BORN, WE HAVE TWO CLIENTS THAT WE PROVIDE SERVICES FOR AND WE BILL FOR BOTH FOR EACH CONSULT. ANY CONSULT THAT INVOLVES ASSESSMENT, RECOMMENDATIONS AND A CARE PLAN FOR YOUR BABY AND YOU WILL BE BILLED TO YOUR INSURANCE FOR EACH OF YOU.
AETNA MEMBERS/CLIENTS
Even if Aetna tells you that you are covered 100 percent, Aetna has drastically changed their lactation coverage since March 2024. They no longer cover six consults. They now cover six codes, TOTAL! Each consult is billed as two codes which means you, the parent, will have a total of three consults. Every “free” class you took online has deducted from your allowed of six TOTAL codes per year. They are no longer covering your child(ren)’s services as preventive, which means that their portion of the consult will go towards deductible or if they have met their deductible it will incur a small cost-share. Any ‘Patient Responsibility’ amount will be charged to the card you have on file. If your card is not valid, you will be notified and if the invoice is not paid, there will be a $100 processing fee added and your account will be forwarded for collection services.
If only your baby is covered under Aetna and you, the lactating parent, are not covered under Aetna, you MUST book a self-pay consult. If your baby is not on the lactating parent’s Aetna plan you must book the baby not on plan appointment and you must pre-pay the appropriate fee for each appointment.
We do not offer tele-health for Aetna clients.
CIGNA MEMBERS/CLIENTS
If your baby is not under your Cigna plan, you will have to pay a fee for their portion of the services for every consult. If only your baby is covered under Cigna, you will need to book and pay Self-Pay.
ANTHEM + BCBS MEMBERS/CLIENTS
It is your responsibility to check with Lactation Network to ensure that you are covered for lactation services. Every prenatal consult has a $35 booking convenience fee and every initial after birth consult has a $75 booking convenience fee both of which are due at the time of booking.
TELE-HEALTH DISCLAIMER
We only offer tele-health for Cigna, UHC, Self-Pay and Anthem + BCBS members approved through The Lactation Network. All tele-health consults are thirty minutes.
There are inherent limitations because a digital suckling assessment and a physical breast/chest can not be completed. Potential risks to the technology used for telehealth, are beyond the control of the provider, including interruption of connectivity, unauthorized access, and other technical difficulties.
CANCELLATION POLICY
Appointments canceled with less than 48 hour notice will be charged the FULL consult fee which is not covered by insurance. ALL fees for services are non-refundable and expire 60 days after the original purchase. The payment and no refund policy is SEPARATE from the cancellation policy. Refunds will NOT be issued once you book. Each client is responsible for all fees associated with each consult. Payment is charged at the time the appointment is scheduled. By scheduling your consult, you grant me permission to communicate with your insurance company regarding the services provided to you and to your child(ren).
Rental agreements: no refunds will be issued for any unused part of the rental terms. All equipment must be returned the day prior to the scheduled new charge in order to avoid being charged for a new rental term.