New Jersey Administrative Code
Title 12 - LABOR AND WORKFORCE DEVELOPMENT
Chapter 21 - FAMILY LEAVE INSURANCE BENEFITS
Subchapter 2 - PRIVATE PLANS
Section 12:21-2.2 - Benefits

Universal Citation: NJ Admin Code 12:21-2.2

Current through Register Vol. 56, No. 18, September 16, 2024

(a) An employee shall not be entitled to any benefits from the Fund with respect to any period of family leave commencing while he or she is covered under a private plan.

(b) An employee shall not be paid any benefits for family leave insurance benefits during unemployment, 43:21-3 and 4, for any period of family leave commencing while he or she is a "covered individual" as defined in 43:21-27(b)(2).

(c) The benefits provided by a private plan shall be set forth in the plan both as to eligibility requirements and amounts payable.

(d) If application for benefits is made under the State plan or family leave insurance benefits during unemployment and it is determined that the claim should have been made under a private plan, an employee shall not be deprived of benefits under the private plan for failure to file a timely claim for benefits provided that:

1. The application to the State plan would have constituted a timely filed claim to the private plan if it had been then made; and

2. Proof of entitlement to family leave insurance benefits is furnished under such private plan within the period required therein or within 30 days after the employee has notice that the claim should have been made under the private plan.

(e) If an employee is overpaid benefits under a private plan, the amount of such overpayment shall not be deducted from the amount of benefits to which he or she may be entitled under the State plan or under 43:21-3 and 4 as an unemployed claimant for a subsequent period of family leave. If an employee is overpaid benefits under the State plan, the amount of such overpayment shall not be deducted from the amount of benefits to which he or she may be entitled under a private plan, or under 43:21-3 and 4 as an unemployed claimant for a subsequent period of family leave.

(f) An employee's maximum family leave insurance benefit entitlement under a private plan for a given 12-month period shall be reduced by the number of days of family leave insurance benefits that have been paid to the employee during that 12-month period under the State plan or under 43:21-3 and 4 as an unemployed claimant.

(g) If the benefits claimed by an employee under a private plan are denied, such denial shall be by a written notice to the employee, giving the reason therefor and stating the employee's appeal rights as provided under 12:18-2.6 and 1:12A. Upon the issuance of such notice, the Division shall be immediately furnished with a copy of the claim and the notice of denial, or facsimiles thereof.

(h) The private plan shall provide for payment of benefits to employees weekly, biweekly, or at such intervals as the employee is customarily paid wages, unless otherwise approved by the Director.

(i) No reduction in the amount or duration of benefits or increase in the rate of employee contributions shall be made without prior approval of the Division. Approval shall be given if the Division finds that the plan, after such modification, continues to meet the requirements of the Act and this chapter and, if the employees are to contribute toward the cost of such modified plan, that a majority of the employees covered by the plan have agreed to the modification by written election (by ballot or otherwise) in accordance with this chapter.

1. The Division shall be given prompt notice of any change to a private plan, which change does not affect nor alter the provisions of the plan, and, therefore, does not require approval under this section.

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