Paid medical leave program plagued with delays

Applications for the state’s Paid Family and Medical Leave ballooned from 5,000 in December, to 7,000 in January, then 10,000 in February because of COVID-19, according to the CEO of the program that received $3.8 million from the State Bond Commission on Thursday to help deal with administrative backlogs.

Andrea Barton Reeves, head of the program that began paying benefits in January, said that even though the Connecticut Paid Leave Authority doesn’t pay for COVIDrelated illnesses unless infections reach the definition of serious health conditions, each application had to be reviewed and processed.

That, combined with a relatively new staff at the Atlanta-based Aflac, the program’s $25-million-ayear administrator, caused delays. “We have apologized profusely because we know we can do better,” Reeves said.

“The law is complex,” she said. “We knew that there was a significant learning curve with new staff that had just joined Aflac, and they stood that operation up in about six months so they could be ready to take claims in December, which is what we wanted to have happen.”

She said that there were enough employees at Aflac to process the estimated 5,000 monthly claims.

“Essentially a 100-percent increase over those claims is not something that we were staffed for,” she said, stressing that Aflac has shifted claims experts from other parts of the company to assist with the backlog and the multimonth training process.

Reeves also admitted that the authority hasn’t done a good-enough job in informing the public about what they need to apply for a claim.

“In some instances we had people just filing their driver’s licenses or their medical certification form,” she said. “There is actually a series of forms and information we need in order to make a decision. So when we were able to do a deeper dive into the claims we realized that some of the delays were because of the volume, but some of the delays were because the files weren’t completed.”

She said the program, funded by one-half-of-onepercent payroll deductions, is well-funded, and the $3.8 million would be used as part of the fund-recovery system for non-compliance by employers.

“I think many did not realize that if you have more than one employee, you are responsible for paying into this system,” said state Rep. Holly Cheeseman, who as a top Republican on the legislative Finance Committee, is a member of the bond commission.

Reeves said there are about 139,000 employers registered with the program, with about 5,000 left to join. “We’ve done that not by imposing penalties, not by browbeating employers, because we know that they were in the midst

of a pandemic and no one needed to be treated that way,” she said. “We simply reached out over and over again.”

She said that employers opposed to the program will be the toughest to get to comply, which Reeves expects to contact through other state records and eventually seek payments and interest for noncompliance.

While $50 million was authorized by the General Assembly for the noncompliance budget line, the authority has taken only $16.8 million including Thursday’s allocation of $3.8 million, Reeves said. Projections for payments to claims were set at $230 million for the first six months, but the actual payments will be about $100 million by the end of June or start of July, she said.

The average number of weeks taken by beneficiaries is 6.1, while the actuarial estimate was 8.1 weeks, she said.

Requirements include that applicants have worked 12 continuous weeks with a covered employer; and have earned at least $2,325 in the highest quarter of the first four or five recently completed quarters. For minimum wage workers, the leave benefit is $494 a week. Other benefits depend on the amount people are paid. Someone who earns a gross annual salary of $60,000 would see a $780 weekly benefit for up to 12 weeks.