Eric Gulko Quoted on Paid Family Medical Leave (BBJ)

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Sometimes, a private plan may offer more flexibility for people wanting to leverage the state's new Paid Family Medical Leave Act. According to President and Founder of Innovo Benefit Group, Eric Gulko, policy holders should look at their options, including private plans. Just beware that even with private carriers the application process could be perceived as cumbersome. The article, written for Boston Business Journal, is shared below with its original content.

Jessica Bartlett, Reporter

Prior to her daughter’s birth, Sarah Aspinwall thought she'd done everything right to take time off under the state's new Paid Family Medical Leave Act.

Yet when she got home from the hospital, she discovered she had applied for her leave in the wrong order. She was subsequently denied part of it. After she appealed and finally got approved, it was still weeks before she would get a paycheck.

Several weeks after Massachusetts unveiled its new family leave program, which became available to employees in January, new parents across the state say the application process is confusing. Many users say it has taken a month or more after they were approved to get a paycheck, undermining the intent of the law that was passed in 2018.

“I applaud Massachusetts for doing this,” said Aspinwall, who works in administration at Boston Children’s Hospital. “But I think about people who truly live paycheck to paycheck. This is a benefit I’m glad they can use, but I can’t imagine sitting around waiting for a check from the state and having bills to pay.”

The Paid Family and Medical Leave Act promises workers across Massachusetts up to 20 weeks of medical leave and up to 12 weeks of family leave. Employers can either go through a state program, into which they began paying in October 2019, or they can choose a plan administered through a private insurer. Employees who are new parents were allowed access to the benefit starting January 2021. People applying for the benefit to care for a loved one will be eligible starting July 1.

But since January, employee complaints about the public option have become more and more common. A Facebook page for the state Department of Family and Medical Leave showed 17 complaints on one post, mostly from parents waiting to be paid. A second post announcing a town hall presentation on how to apply garnered another eight responses from parents demanding to know when they would see their paychecks.

A spokesman for the state's Department of Family and Medical Leave did not respond to multiple requests for comment. The director of the department, William Alpine, also did not respond to a request for comment.

Crying babies, overdrawn bank accounts

Thirty-year-old Jessie Presbie first ran into problems applying because even though she works in Massachusetts, she lives in Connecticut. But even after receiving approval on Jan. 1, following weeks of back and forth, she said she didn’t receive a paycheck until Jan. 26. She also said her bi-weekly payments have never arrived on time, leaving her worried week to week.

Presbie said she spends much of her daughter’s nap time on hold with the state just to make sure she will receive her benefit, and that she now feels that much of her parental leave has been stolen from her.

“I spent many phone calls in tears and crying to the strangers, knowing that they couldn’t help me, but at that point not knowing what else to do,” she said. “This program was established and started to help people be home to take care of themselves, their loved ones, a new baby … not to have to wake up in the morning and cry tears of frustration because their account is overdrawn and they have a new baby in their arms and they don’t know what to do.”

'Bonding leave'

Julie Micheli’s leave was approved by the state on Jan. 13, just days before her time off was set to begin on Jan. 17. Nine weeks later, the 37-year-old nurse at Baystate Medical Center said she still hasn’t received a single paycheck. 

Six weeks into her leave she found out the state had her bank account number incorrect, which was causing issues with direct deposits. Despite notifying the state, nothing has been fixed, she said, and no paper checks have been mailed. She worries that she'll never be paid, saying that she has resorted to dipping into savings to get by.

“It has really been so frustrating and upsetting,” she said. “I have been in tears on numerous phone calls pleading with someone to help me and fix the situation. Nine weeks later and nothing has been resolved.”

Aspinwall ran into her own problems applying. She discovered after her daughter’s birth that all the dates she'd entered in the application couldn’t be changed after the fact. The South Boston mother initially submitted paperwork for “bonding leave,” which entitles all new parents for up to 12 weeks of paid time off, but not medical leave, which would entitle her to another 12 weeks per her doctor’s orders, she said. It wasn't until she was on the phone with customer service, she added, that she learned she had filed them in the wrong order. When she then applied for medical leave, she was subsequently denied, Aspinwall said. It took an appeal to get both leaves approved.

Still, Aspinwall’s paycheck for medical leave wouldn’t arrive for three weeks, she said. Her husband, who had a separate application into the state for bonding leave, didn't receive a paycheck for a month after his approval.

Aspinwall credited customer service representatives for helping her resolve the issues, but she described the process as a burden on new parents. She considers herself fortunate to have the privilege of not being completely reliant on the paychecks.

“That’s incredibly stressful to be worrying about,” Aspinwall said. “I’m glad the state is doing this, and giving a lot of people who wouldn't have received any benefit the ability to leverage this. But paperwork- and process-wise, it has a lot to be desired.”

Insurance brokers

Some insurance brokers who help employers find insurers to administer the new family leave benefit say they've heard similar complaints from clients. David Shore, senior vice president of enterprise strategy and risk management for Borislow Insurance, said one mom — one of six parents who called him asking for help getting paid from the state — was so desperate for her paycheck she considered giving up on parental leave.

“We get calls from people who say, 'I can’t advance this with the state. If you don’t, I will have to go back to work,'” Shore said.

Brokers also confirm clients are experiencing long delays. Eric Gulko, president of Innovo Benefit Group and a board member of the Massachusetts Association of Health Underwriters, said some clients have gotten paid in a matter of days, while others have had to wait three to four weeks.

"Whenever any entity — state or otherwise — gets into a new line of business, it has to be expected that there may be a learning curve in the beginning," Gulko said.

Rob DiMase, a partner with Sentinel Benefits and Financial Group, said that a majority of their clients purchased family-leave coverage through private insurers, and haven’t seen the same problems. Yet DiMase wasn’t totally surprised by the issues, given the state's problematic health-insurance website rollout in 2015, and more recent problems with the coronavirus vaccination-scheduling tool. Rolling out the new benefit and website in the middle of a pandemic didn’t help, DiMase said.

Shore said the state’s issues may become exacerbated in July, when the benefit expands to the next phase, to allow for people caring for family members with serious health issues. 

“If the state is having an issue paying these bonding claims, no one knows why. We don't know if it’s volume or a systems problem,” Shore said. “But what’s going to happen in July when the volume ticks up again?