19 Del. Admin. Code § 1401-5.0

Current through Reigster Vol. 28, No. 6, December 1, 2024

Section 1401-5.0 - Amount of benefits

5.1 Standard benefit calculation. Weekly benefit payments shall be calculated by the online portal system on the following basis:

5.1.1 Average weekly wage. This is the "starting point" for the calculation. Take the average gross (before any deductions for taxes, premiums, or any other cause) weekly wages for the 52 weeks prior to the submission of the claims application. If the employee is salaried, divide the employee's gross wages by 52 weeks to obtain the average weekly wage.

5.1.2 Benefit percentage and maximum weekly benefit. To determine the weekly benefit, multiply the average weekly wage by the benefit percentage, which is currently 0.8 (80%). If the result of the benefit calculation is above the current maximum benefit, the weekly benefit amount shall be limited to the current maximum benefit.

5.1.3 Preservation of the Fund balance. At the Secretary of Labor's discretion, the benefit percentage may be reduced to a level sufficient to maintain the solvency of the Fund on the effective date specified by the Secretary of Labor. The reduced benefit percentage will then stay in effect for the next 52 weeks. This will only be done to protect the integrity of the Fund. Notice will be provided by the Division to all employers in the Fund at least 90 days before any change in the benefit percentage occurs. Employers shall provide notice to their employees within 30 days from the date the employers were notified by the Division of this change.

5.2 Inflation indexing the maximum benefit amount. Beginning on January 1, 2028, the maximum weekly benefit amount may be increased in line with the inflation rate of the prior year. Before December of 2027 (for the 2028 calendar year) and prior to every December thereafter, the Division will issue the maximum benefit amount that shall be used for the applicable calendar year. Unless the Act states otherwise, the inflation measure to be used in the Division's calculation will be the Consumer Price Index for all Urban Consumers, Philadelphia-Camden-Wilmington Metropolitan area, published by the Bureau of Labor Statistics of the United States Department of Labor. The maximum benefit for each calendar year shall be rounded to the nearest $5.00 increment.

5.3 The Division has determined that benefits shall be calculated for a covered individual with more than 1 source of wages as follows:

5.3.1 If an employee is working multiple jobs at the time of the qualifying event, each employer, insurance carrier, or third-party administrator must review the employee's claims application based on the information about that particular job.

5.3.2 The applicable private or public plans will pay an approved claim as a separate claim.

5.3.3 If the State is the payer on multiple claims, it may combine the benefit payments into a single, bi-weekly payment. However, the program requires that employees may not receive combined income-replacement benefits in excess of the employee's most recent wages.

5.4 If the employer has not submitted the required wage information, then the Division will accept the required wage information (12 months of wages and proof of hours requirement preceding the submission of an application for benefits) from the employee. The wage information must be uploaded into the Division's online portal supported by the appropriate documentation to verify the employee's missing weekly wages, subject to the Division's approval.

5.5 FICA Limits. The required contribution is subject to the FICA limits each year as established by the Internal Revenue Service. Once the employee's wage reaches the FICA limit in any given year, the employer and employee's required contributions will cease for that particular year and will restart at the next calendar year.

5.6 Delaware wages. As the State of Delaware has no jurisdiction over wages earned outside of its boundaries and has no authority to require contributions on wages earned outside of the State, PFML insurance program benefits will be calculated only on the basis of wages earned within the State of Delaware.

19 Del. Admin. Code § 1401-5.0

28 DE Reg. 147 (8/1/2024) (Final)