Claims and Paid Leave Benefits Under Maryland FAMLI Program

Quick Hits

• Starting no later than January 3, 2028, the FAMLI program will provide most Maryland employees with up to twelve weeks of paid leave for certain family and medical reasons, with a possible additional twelve weeks of leave for parental bonding, per application year.
• The program is funded through employer and employee payroll contributions, which will commence on January 1, 2027, and be administered by the MDOL’s FAMLI Division.
• The final regulations address, among other things, the claims process and paid leave benefits.

Background on the Law and Final Regulations

As discussed in further detail in Part I of this series, Maryland enacted the FAMLI program in 2022, to provide most employees with up to twelve weeks of paid family and medical leave (plus up to twelve additional weeks for parental leave) within a twelve-month period. After several legislatively mandated delays, employer and employee contributions are set to begin on January 1, 2027, with benefits commencing no later than January 3, 2028.

The MDOL’s final regulations, effective March 30, 2026, are organized into five chapters—General Provisions, Contributions, Equivalent Private Insurance Plans (EPIPs), Claims, and Dispute Resolution—and largely preserve the proposed regulatory framework with certain refinements. The final regulations can be found in Title 9, Subtitle 42 of the Code of Maryland Regulations, COMAR 09.42.01-.05.

Key provisions of the regulations related to the claims process and paid leave benefits are summarized below. Part I of this series addressed important definitions, the creation of online employer accounts, and mandatory notices. Part III covers EPIPs and dispute resolution.

Applications, Supporting Documentation, and Claim Updates

Eligible employees may file an application for benefits within sixty days before the anticipated start date of leave and no later than sixty days after the start date. The sixty-day filing deadline may be waived for good cause, up to one year from the commencement of leave.

The final regulations detail the required documentation for each type of qualifying event, including certification(s) from licensed health care providers for medical conditions, proof of relationship for bonding and caregiving, and confirmation of active-duty service for qualifying exigencies. A claimant applying for uniformed services caregiving leave must also provide documentation from the United States government establishing the service member’s status. The FAMLI Division may require claimants to attest that the information in their applications is true and that there are no disqualifying criteria.

Employers have five business days to respond to notice of an employee’s submitted claim application. If no employer response is received within that period, the claim application is deemed to be complete. If the employer challenges eligibility, the Division or EPIP will investigate, after which the claim is treated as complete. The Division may also request supplemental data from the employer. If benefits are approved and issued and an employer subsequently provides disqualifying information after the five-day window, the recipient retains benefits already received, but continuation of benefits will cease, and job and anti-retaliation protections apply only for the period from approval to revocation.

Employees must update material information within ten days, or as soon as practicable with good cause, including changes to the basis, start date, duration, or end date of leave, or whether the claimant has begun to receive workers’ compensation or unemployment insurance benefits. Failure to update may result in delay, underpayment, overpayment, or denial of benefits. Claims may also be withdrawn; if leave has already begun, only the actual leave taken will count against the employee’s FAMLI balance for the application year.

Duration and Timing of Leave

Employees may receive up to twelve weeks of FAMLI benefits and leave per employer per application year, with a potential additional twelve weeks where a claimant’s initial period of their own medical leave is followed by bonding leave, or vice versa, within the same year.

Bonding leave must be taken within twelve months of the birth or placement of a child. Leave may also be used in anticipation of the placement of a child for the purposes of attending court appearances, legal and placement agency appointments, counseling and medical appointments, and travel, provided they are substantiated by required documentation.

A licensed health care provider must document the time period required for the serious health condition of the employee, their family member, or a service member. If the family member for whom the employee is caring dies, benefits continue until seven days after the death or the previously approved end date, whichever is sooner, and the covered individual must provide notice of the death to the state within seventy-two hours. In essence, the final regulations provide for a form of bereavement leave that was not explicitly contemplated in the FAMLI statute.

Leave may be taken on a continuous or intermittent basis. Claimants approved for intermittent leave must submit benefit requests within five business days of leave being taken unless good cause can be shown. Intermittent leave may not be taken in increments of fewer than four hours unless the claimant’s scheduled shift is shorter. Benefits will not be issued for requests that significantly exceed the expected duration and frequency listed on the medical certification without an updated certification. Approved intermittent leave applications expire after one year, and a new claim application is required if the employee continues to need leave for the qualifying event.

Benefit Calculations: Continuous and Intermittent Leave

The final regulations establish a two-tier wage replacement formula for continuous leave. If the claimant’s average weekly wage is 65 percent or less of the state average weekly wage, benefits equal 90 percent of the claimant’s average weekly wage. For claimants earning above that threshold, benefits are the sum of 90 percent of the claimant’s average weekly wage up to 65 percent of the state average weekly wage and 50 percent of the amount above that threshold, up to the maximum weekly benefit amount.

For intermittent leave, one “week” of benefits equals the number of hours worked during the highest-earning quarter of the previous four completed calendar quarters divided by thirteen. The hourly benefit rate is calculated by dividing the weekly benefit amount by those average hours, and benefits are paid for actual hours of intermittent leave taken. The benefit amount for intermittent leave is calculated using the state average weekly wage and maximum weekly benefit amount in effect on the anchor date. On or before January 1 of each year, every open and active intermittent leave claim will be readjusted based on the new maximum weekly benefit amount.

Coordination With Other Benefits

The final regulations allow for the reduction of FAMLI eligibility by an employee’s federal Family and Medical Leave Act (FMLA) use if the FMLA leave also qualified for FAMLI, the employer notified the employee of their potential FAMLI eligibility, and the employee did not apply.

For alternative FAMLI purpose leave or AFPL (i.e. employer-provided leave specifically designated as a separate bank of time off for medical leave, family leave, qualified exigency leave, or under a disability policy, that is not leave provided under an EPIP), an employer may require concurrent use if the leave meets all of the following criteria: it is specifically designed to fulfill a FAMLI purpose, it is paid, it is not accrued, it is not subject to repayment, it is not available for general purposes, and it is available without a requirement to exhaust another form of leave. The employer must provide advance written notice of this requirement. Similar to FMLA, if the employee is notified of required concurrent use and fails to apply for FAMLI, the employee’s FAMLI’s eligibility is reduced by the amount of APFL taken. When both FAMLI and AFPL are used concurrently, FAMLI is primary and AFPL may supplement up to 100 percent of the employee’s average weekly wage. The employer may deduct the full amount of time taken from the recipient’s AFPL balance even if the recipient received only partial wage replacement. Importantly, an employee’s decision to use AFPL concurrently does not negate job protection or anti-retaliation provisions.

General-purpose paid leave (i.e., employer-provided paid leave, such as general paid time off, personal leave, vacation leave, or sick leave, that is not AFPL or leave provided under an EPIP) may not be required to be substituted for FAMLI leave. It may supplement FAMLI benefits only by mutual written agreement between the employer and the employee; however, the employee may use paid sick leave before FAMLI benefits without such an agreement.

Employees generally may not receive FAMLI benefits while receiving unemployment insurance benefits or workers’ compensation wage replacement, except for permanent partial disability benefits.

Payments, Overpayments, and Fraud

The first benefit payment must be issued within five business days after approval of a complete claim application or the start of leave, whichever is later, with subsequent payments at least every two weeks. If there is an overpayment, a written notice will be sent to the claimant, and the claimant has thirty days to agree to repay or request a waiver. Repayment may be sought for erroneous payments, willful misrepresentation, or where a claim is rejected after benefits were paid. Waivers may be granted where there was no knowingly false statement, nondisclosure, or misrepresentation, or where repayment would be against equity and good conscience or would otherwise be administratively inefficient. If a waiver is denied, the claimant may file a request for reconsideration. If an EPIP seeks monetary reimbursement of an overpayment, it must notify the Division simultaneously with its notice to the claimant.

If fraud is proven after benefits were approved and issued, any benefits paid are treated as an overpayment, and job and anti-retaliation protections do not apply.

Next Steps

The final regulations took effect on March 30, 2026. Employers may wish to begin preparing for the contribution obligations beginning January 1, 2027, and for the commencement of benefits no later than January 3, 2028. This may involve reviewing available paid leave benefits under existing policies and plans and determining if adjustments may be desirable.

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