FAMILY Act in plain language
Sec. 1: Short title
This section states that the Act may be referred to as the Family and Medical Insurance Leave Act or the FAMILY Act.
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1. Short title This Act may be cited as the Family and Medical Insurance Leave Act or the FAMILY Act .
Sec. 2: Definitions
This section defines the terms used throughout the Act. A caregiving hour is a 1-hour period during which a person engaged in qualified caregiving; within any benefit period, a person cannot count more caregiving hours than 12 times the number of hours in their regular workweek, and that regular workweek is based on the hours the person regularly worked per week for all employers combined or as a self-employed person (or regularly worked, if they are no longer working or their hours have been reduced), measured during the month before their benefit period begins, or an earlier month if needed for someone no longer working or working reduced hours. The Commissioner means the Commissioner of Social Security. The Deputy Commissioner means the official who heads the Office of Paid Family and Medical Leave created by Section 3. An eligible individual is a person who is entitled to a benefit under Section 4 for a specific month, once that person has filed an application for that month. The national average wage index has the meaning already given to that term in section 209(k)(1) of the Social Security Act. Qualified caregiving means any activity other than regular employment that a person engages in for a qualifying reason. A qualifying reason includes: any reason that would entitle an employee to leave under the Family and Medical Leave Act of 1993's provisions for the birth of a child, the placement of a child with the employee for adoption or foster care, or a qualifying exigency arising from a family member's covered active duty service in the armed forces; caring for the person's own qualified family member who has a serious health condition; the person's own serious health condition that leaves them unable to do their regular job; or the person, or their qualified family member, being a victim of family violence or a qualifying act of violence, where the leave is for the person to do (or to help their qualified family member do) any of the following because of that violence: seek, receive, or secure counseling; seek or secure temporary or permanent relocation, or take steps to secure an existing home; seek, receive, or follow up on help from a victim services organization; seek legal help or attend legal proceedings, including preparing for or taking part in related administrative, civil, or criminal proceedings; seek medical care for a physical or psychological injury or disability caused or made worse by the violence; enroll in a new school or care arrangement; or take other steps needed to protect or restore the physical, mental, emotional, spiritual, or economic well-being of the person or their family member. A qualified family member includes a spouse (including a domestic partner in a civil union or other state-recognized domestic partnership) or that spouse's parent; a child of any age or that child's spouse; a parent or that parent's spouse; a sibling or that sibling's spouse; a grandparent, a grandchild, or the spouse of either; and any other person related by blood or affinity whose relationship with the individual is the equivalent of a family relationship. Serious health condition has the meaning already given in section 101(11) of the Family and Medical Leave Act of 1993. If a person is currently taking leave from a job covered by a legacy state's comprehensive paid leave program, as defined later in this Act, that time counts as regular employment rather than qualified caregiving, so it does not count toward this Act's benefit; a person who is no longer employed is treated the same way and excluded from qualified caregiving, in proportion to the share of their workweek that was in a job covered by a legacy state's program. For purposes of these definitions: child means, regardless of age, a biological, foster, or adopted child, a stepchild, the child of a domestic partner, a legal ward, or the child of someone standing in loco parentis; a domestic partner is another person with whom the individual is in a committed relationship, meaning a relationship between two people who are each at least 18 years old, who are each the other's sole domestic partner, and who share responsibility for a significant measure of each other's common welfare, including relationships of any sex that a state legally recognizes as a marriage or similar relationship such as a civil union or domestic partnership; dating violence, domestic violence, sexual assault, sex trafficking, and stalking each have the meanings given those terms in section 40002(a) of the Violence Against Women Act of 1994, except that for domestic violence, the reference to the jurisdiction receiving grant funding instead means the jurisdiction where the victim lives or where the employer is located; parent means a biological, foster, or adoptive parent, a stepparent, a parent-in-law, the parent of a domestic partner, or a legal guardian or other person who stood in loco parentis when the employee was a child; a qualifying act of violence means dating violence, domestic violence, family violence, sexual assault, sex trafficking, stalking, other gender-based violence or harassment, or an act or pattern of conduct in which a person causes or threatens bodily injury or death to another, brandishes or uses a firearm or other dangerous weapon against another, or uses or threatens force to cause bodily injury or death; spouse has the meaning given by the marriage laws of the state where the marriage took place; and a victim services organization is a nonprofit, nongovernmental organization that helps or advocates for victims of qualifying acts of violence, including rape crisis centers, organizations running prevention or treatment programs, organizations operating shelters or providing counseling, and legal services organizations. Self-employment income has the same meaning already given that term in section 211(b) of the Social Security Act. State means any state, the District of Columbia, or any US territory or possession. Wages has the meaning given in section 3121(a) of the Internal Revenue Code, but only for purposes of the Medicare (Hospital Insurance) taxes, not the Social Security tax (without regard to one specific exception in that section of the tax code), and also includes railroad retirement compensation and unemployment compensation as those terms are defined elsewhere in that Code.
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2. Definitions In this Act: (1) Caregiving hour (A) In general The term caregiving hour means, with respect to an individual, a 1-hour period during which the individual engaged in qualified caregiving. (B) Limitations With respect to any benefit period, an individual may not exceed a number of caregiving hours equal to 12 times the number of hours in a regular workweek of the individual (as determined under subparagraph (C)). (C) Number of hours in a regular workweek For purposes of this Act, the number of hours in a regular workweek of an individual shall be the number of hours that the individual regularly works in a week for all employers or as a self-employed individual (or regularly worked in the case of an individual who is no longer working or whose total weekly hours of work have been reduced) during the month before the individual’s benefit period begins (or prior to such month, if applicable in the case of an individual who is no longer working or whose total weekly hours of work have been reduced). (2) Commissioner The term Commissioner means the Commissioner of Social Security. (3) Deputy Commissioner The term Deputy Commissioner means the Deputy Commissioner who heads the Office of Paid Family and Medical Leave established under section 3(a). (4) Eligible individual The term eligible individual means an individual who is entitled to a benefit under section 4 for a particular month, upon filing an application for such benefit for such month. (5) National average wage index The term national average wage index has the meaning given such term in section 209(k)(1) of the Social Security Act ( 42 U.S.C. 409(k)(1) ). (6) Qualified caregiving (A) In general The term qualified caregiving means any activity engaged in by an individual, other than regular employment, for a qualifying reason. (B) Qualifying reason (i) In general For purposes of subparagraph (A), the term qualifying reason means any of the following reasons for taking leave: (I) Any reason for which an eligible employee would be entitled to leave under subparagraph (A), (B), or (E) of paragraph (1) of section 102(a) of the Family and Medical Leave Act of 1993 ( 29 U.S.C. 2612(a) ). (II) In order to care for a qualified family member of the individual, if such qualified family member has a serious health condition. (III) Because of a serious health condition that makes the individual unable to perform the services required under the terms of their regular employment. (IV) Because the individual, or a qualified family member, is a victim of family violence or a qualifying act of violence, if the leave is for the individual to do any of the following or to assist the individual’s qualified family member to, as a result of such violence, do any of the following: (aa) Seek, receive, or secure counseling. (bb) Seek or secure temporary or permanent relocation or take steps to secure an existing home. (cc) Seek, receive, or follow up on assistance from a victim services organization or agency providing services to victims. (dd) Seek legal assistance or attend legal proceedings, including preparation for or participation in any related administrative, civil, or criminal legal proceedings or other related activities. (ee) Seek medical attention for physical or psychological injury or disability caused or aggravated by the qualifying act of violence. (ff) Enroll in a new school or care arrangement. (gg) Take other steps necessary to protect or restore their physical, mental, emotional, spiritual, and economic well-being or the well-being of a qualified family member recovering from a qualifying act of violence. (ii) Qualified family member; serious health condition In this subparagraph: (I) Qualified family member The term qualified family member means, with respect to an individual— (aa) a spouse (including a domestic partner in a civil union or other registered domestic partnership recognized by a State) or a parent of such spouse; (bb) a child (regardless of age) or a child’s spouse; (cc) a parent or a parent’s spouse; (dd) a sibling or a sibling’s spouse; (ee) a grandparent, a grandchild, or a spouse of a grandparent or grandchild; and (ff) any other individual who is related by blood or affinity and whose association with the employee is equivalent of a family relationship. (II) Serious health condition The term serious health condition has the meaning given such term in section 101(11) of the Family and Medical Leave Act of 1993 ( 29 U.S.C. 2611(11) ). (iii) Treatment of individuals covered by legacy State comprehensive paid leave program (I) In general For purposes of subparagraph (A), an activity engaged in by an individual shall not be considered as other than regular employment if, for the time during which the individual was so engaged, the individual is taking leave from covered employment under the law of a legacy State (as defined in section 4(c)). (II) Unemployed In the case of an individual who is no longer employed, such individual shall be treated, for purposes of clause (i), as taking leave from covered employment under the law of a legacy State (as so defined) with respect to the portion of the time during which the individual was engaged in an activity for a qualifying reason corresponding to the share of the individual’s workweek that was in covered employment under the law of a legacy State (as so defined). (C) Other definitions For purposes of this paragraph: (i) Child The term child means, regardless of age, a biological, foster, or adopted child, a stepchild, a child of a domestic partner, a legal ward, or a child of a person standing in loco parentis. (ii) Domestic partner (I) In general The term domestic partner , with respect to an individual, means another individual with whom the individual is in a committed relationship. (II) Committed relationship defined The term committed relationship means a relationship between 2 individuals, each at least 18 years of age, in which each individual is the other individual’s sole domestic partner and both individuals share responsibility for a significant measure of each other’s common welfare. The term includes any such relationship between 2 individuals, including individuals of the same sex, that is granted legal recognition by a State or political subdivision of a State as a marriage or analogous relationship, including a civil union or domestic partnership. (iii) Dating violence The term dating violence has the meaning given the term in section 40002(a) of the Violence Against Women Act of 1994 ( 34 U.S.C. 12291(a) ). (iv) Domestic violence The term domestic violence has the meaning given the term in section 40002(a) of the Violence Against Women Act of 1994 ( 34 U.S.C. 12291(a) ), except that the reference in such section to the term jurisdiction receiving grant funding shall be deemed to mean the jurisdiction in which the victim lives or the jurisdiction in which the employer involved is located. (v) Parent The term parent means a biological, foster, or adoptive parent of an employee, a stepparent of an employee, parent-in-law, parent of a domestic partner, or a legal guardian or other person who stood in loco parentis to an employee when the employee was a child. (vi) Qualifying act of violence The term qualifying act of violence means an act, conduct, or pattern of conduct that could constitute any of the following: (I) Dating violence. (II) Domestic violence. (III) Family violence. (IV) Sexual assault. (V) Sex trafficking. (VI) Stalking. (VII) Other forms of gender-based violence or harassment. (VIII) An act, conduct, or pattern of conduct— (aa) in which an individual causes or threatens to cause bodily injury or death to another individual; (bb) in which an individual exhibits, draws, brandishes, or uses a firearm, or other dangerous weapon, with respect to another individual; or (cc) in which an individual uses, or makes a reasonably perceived or actual threat to use, force against another individual to cause bodily injury or death. (vii) Sexual assault The term sexual assault has the meaning given the term in section 40002(a) of the Violence Against Women Act of 1994 ( 34 U.S.C. 12291(a) ). (viii) Sex trafficking The term sex trafficking has the meaning given the term in section 40002(a) of the Violence Against Women Act of 1994 ( 34 U.S.C. 12291(a) ). (ix) Spouse The term spouse , with respect to an employee, has the meaning given such term by the marriage laws of the State in which the marriage was celebrated. (x) Stalking The term stalking has the meaning given the term in section 40002(a) of the Violence Against Women Act of 1994 ( 34 U.S.C. 12291(a) ). (xi) Victim services organization The term victim services organization means a nonprofit, nongovernmental organization that provides assistance to victims of qualifying acts of violence or advocates for such victims, including— (I) a rape crisis center; (II) an organization carrying out a prevention or treatment program for qualifying acts of violence; (III) an organization operating a shelter or providing counseling services; and (IV) a legal services organization or other organization providing assistance through the legal process. (7) Self-employment income The term self-employment income has the same meaning as such term in section 211(b) of such Act ( 42 U.S.C. 411(b) ). (8) State The term State means any State of the United States or the District of Columbia or any territory or possession of the United States. (9) Wages The term wages has the meaning given such term in section 3121(a) of the Internal Revenue Code of 1986 for purposes of the taxes imposed by sections 3101(b) and 3111(b) of such Code (without regard to section 3121(u)(2)(C) of such Code), except that such term also includes— (A) compensation, as defined in section 3231(e) of such Code for purposes of the Railroad Retirement Tax Act; and (B) unemployment compensation, as defined in section 85(b) of such Code.
Sec. 3: Office of Paid Family and Medical Leave
This section creates a new Office of Paid Family and Medical Leave inside the Social Security Administration, headed by a Deputy Commissioner whom the Commissioner appoints. Acting through the Deputy Commissioner, the Commissioner must: hire staff for the office and make employment decisions about them; issue any regulations needed to carry out the Act; enter cooperative agreements with other agencies and departments so the program runs efficiently; decide who is eligible for benefits under Section 4; calculate each eligible person's monthly benefit amount and make timely payments to them; set up and maintain a system of records for administering Section 4; work to prevent fraud and abuse involving these benefits; provide information on request about eligibility rules, the claims process, benefit amounts, maximum payable benefits, notice requirements, nondiscrimination rights, confidentiality, and how leave under this Act coordinates with other laws, collective bargaining agreements, and employer policies; give employers an annual notice to pass on to employees about the availability of these benefits; publish an annual public report on how many people received benefits, what they used them for, and how usage rates break down by gender, race, ethnicity, and income level; and design outreach and education that fits different cultures and languages to increase how many eligible people use the benefits. Despite any other law, the Commissioner must give the Deputy Commissioner whatever data the Commissioner decides the Deputy Commissioner needs to carry out these duties. The Commissioner and the heads of other federal agencies must make good-faith efforts to reach data-sharing agreements that let the Deputy Commissioner carry out these duties. Within 12 months after the Act becomes law, the Commissioner must report to Congress on which federal databases contain information necessary to carry out the Act, including what congressional action would be needed to let the Commissioner access those databases, and on whether it is feasible to speed up the review of benefit applications and the payment of monthly benefits, including the effects of writing shorter statutory deadlines for those reviews and payments into law.
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3. Office of Paid Family and Medical Leave (a) Establishment of Office There is established within the Social Security Administration an office to be known as the Office of Paid Family and Medical Leave. The Office shall be headed by a Deputy Commissioner who shall be appointed by the Commissioner. (b) Responsibilities of Deputy Commissioner The Commissioner, acting through the Deputy Commissioner, shall be responsible for— (1) hiring personnel and making employment decisions with regard to such personnel; (2) issuing such regulations as may be necessary to carry out the purposes of this Act; (3) entering into cooperative agreements with other agencies and departments to ensure the efficiency of the administration of the program; (4) determining eligibility for family and medical leave insurance benefits under section 4; (5) determining benefit amounts for each month of such eligibility and making timely payments of such benefits to entitled individuals in accordance with such section; (6) establishing and maintaining a system of records relating to the administration of such section; (7) preventing fraud and abuse relating to such benefits; (8) providing information on request regarding eligibility requirements, the claims process, benefit amounts, maximum benefits payable, notice requirements, nondiscrimination rights, confidentiality, coordination of leave under this Act and other laws, collective bargaining agreements, and employer policies; (9) annually providing employers a notice to inform employees of the availability of such benefits; (10) annually making available to the public a report that includes the number of individuals who received such benefits, the purposes for which such benefits were received, and an analysis of utilization rates of such benefits by gender, race, ethnicity, and income levels; and (11) tailoring culturally and linguistically competent education and outreach toward increasing utilization rates of benefits under such section. (c) Availability of data Notwithstanding any other provision of law, the Commissioner shall make available to the Deputy Commissioner such data as the Commissioner determines necessary to enable the Deputy Commissioner to effectively carry out the responsibilities described in subsection (b). (d) Datasharing The Commissioner and the heads of Federal agencies shall make good faith efforts to enter into datasharing agreements to enable the Deputy Commissioner to effectively carry out the responsibilities described in subsection (b). (e) Report to Congress Not later than 12 months after the date of enactment of this Act, the Commissioner shall submit to Congress a report including information on the following: (1) Databases maintained by Federal agencies that contain information necessary to carry out the purposes of this Act, including information on any congressional action needed to permit the Commissioner to access such databases for such purposes. (2) The feasibility of expediting the review of applications under paragraph (1) of section 4(f) and the payment of monthly benefit payments under paragraph (2) of such section, including the effects of establishing shorter time frames for such reviews and payment in statute.
Sec. 4: Family and Medical Leave Insurance benefit payments
This section creates the paid family and medical leave insurance benefit and sets the rules for who gets it, how much it pays, and how it is administered. To be entitled to a benefit for a month, a person must have filed an application; must have been engaged in qualified caregiving, or expect to be, during the period that runs from 90 days before the application is filed to 30 days after; must have had wages or self-employment income at some point between the most recent calendar quarter ending at least 4 months before the person's benefit period begins and the month before the benefit period begins; and must have had at least a specified amount of wages and self-employment income during the most recent 8-calendar-quarter period ending at least 4 months before the benefit period begins. That specified amount is $2,000 for a benefit period beginning in 2026, and for later years it is whichever is larger of the prior year's specified amount or $2,000 multiplied by the ratio of the national average wage index for the second calendar year before the new year to the national average wage index for 2024. The monthly benefit amount equals a benefit rate multiplied by a fraction. The benefit rate is the greater of the minimum monthly benefit amount or the lesser of the person's monthly benefit rate and the maximum monthly benefit amount. The monthly benefit rate is calculated from the person's average monthly earnings, which is one-twelfth of the wages and self-employment income from whichever of the last 3 calendar years was highest, using three tiers: 85 percent of average monthly earnings up to a first dollar threshold, plus 69 percent of earnings above that threshold and up to a second threshold, plus 50 percent of earnings above that second threshold and up to a third threshold. For a person whose benefit period begins in 2026, those three thresholds are $1,257, $3,500, and $6,200; for later years, each threshold equals whichever is larger of the prior year's threshold or the 2026 threshold multiplied by the growth in the national average wage index from 2024 to the second calendar year before the new year, rounded to the nearest dollar (with amounts that are an exact multiple of 50 cents rounded up). For a person who first becomes eligible for these benefits in the first full calendar year after enactment, the maximum monthly benefit is $4,000 and the minimum monthly benefit is $580; for people who first become eligible in a later year, both the maximum and minimum are recalculated by multiplying that first-year amount by the ratio of the national average wage index for the second calendar year before the person's first eligibility year to the national average wage index for the second calendar year before that first full year after enactment. The fraction is the person's caregiving hours for the month divided by the product of their regular workweek hours and the number of workweeks, including partial workweeks, in the month, and this fraction cannot exceed 1. If a person has fewer than 4 caregiving hours in a month, they are treated as having zero caregiving hours for that month, so no benefit is paid for it. A benefit for a month is reduced, under rules the Commissioner will write, by the amount of certain other benefits the person receives for that month, including periodic workers' compensation benefits for total or partial disability under a federal or state law or plan, and periodic unemployment benefits under a federal or state law or plan. The benefit period is normally the 12-month period that starts on the first day of the first month in which the person meets the application-and-caregiving requirements and would meet the wage-history requirements if those requirements were applied using that 12-month period instead of the regular benefit period. If a person applies for benefits for caregiving they already engaged in at some point during the 90 days before they apply, the benefit period instead starts on the later of the first day of the month the caregiving began or the first day of the first month that begins during that 90-day period, and it ends 365 days after that start date. An application for benefits must include: a statement that the person was engaged in qualified caregiving, or expects to be, during the period from 90 days before the application to 30 days after it; if the caregiving is because of a serious health condition of the person or a qualified family member, a certification from the treating health care provider confirming that statement, containing no more information than the Family and Medical Leave Act of 1993 already requires for a comparable certification; if the caregiving is for any other qualifying reason, a certification from a relevant authority, as the Commissioner will specify by regulation, confirming the circumstances behind that reason; and an attestation that the person's employer has been given written notice of the person's intent to take the leave, or, if the person has no employer, that the Commissioner has been given that notice. A person is not eligible for a benefit under this section for any month for which they are entitled to: Social Security disability insurance benefits under section 223 of the Social Security Act, or a similar permanent disability program under a law or plan of a state or a political subdivision or instrumentality of a state; monthly Social Security benefits under section 202 of the Social Security Act based on their own disability; or Supplemental Security Income under title XVI of the Social Security Act based on being determined a disabled individual. A person convicted of a violation under section 208 of the Social Security Act, or found to have used false statements to get benefits under this section, is ineligible for benefits under this section for one year following the date of that conviction. On eligibility, the Commissioner must notify an applicant of the initial eligibility determination, and of the estimated benefit for a month with four caregiving hours, as soon as practicable after receiving the application. A person may ask for review of an initial denial within 20 days of receiving notice of it, a period that may be extended for good cause, and the Commissioner must then notify the person of a final eligibility determination as soon as practicable. On monthly payments, the Commissioner must pay, or explain why it will not pay, a person's monthly benefit claim within 20 days after receiving that month's claim report, and the claim report itself must be filed within 15 days after the month ends. If the Commissioner decides not to pay for a month, or pays based on fewer caregiving hours than the person reported, the person may ask for review within 20 days of the notice, again extendable for good cause, and the Commissioner must issue a final payment determination, and pay any additional amount owed, within 20 days of that request. Both the application and each monthly claim report are presumed true and accurate unless the Commissioner shows by a preponderance of the evidence that the application contains false information. A monthly benefit claim report is the person's report to the Commissioner, filed within 15 days after the month ends, of how many caregiving hours they had that month. All of the Commissioner's final determinations under this review process can be appealed using the same procedures that already apply to Social Security benefit determinations under section 205 of the Social Security Act. This section does not preempt or override any state or local law that lets a state or local government provide similar paid family and medical leave benefits, and nothing in the Act reduces an employer's obligation to honor any contract, collective bargaining agreement, or benefit plan that provides greater paid leave rights than this Act does. It is unlawful for any person to interfere with, restrain, deny, or retaliate against someone for exercising or trying to exercise a right under this section, including by firing or otherwise discriminating against someone because they applied for, said they intended to apply for, or received these benefits, or by using an application for or receipt of these benefits as a negative factor in an employment decision. It counts as unlawful interference for an employer to fail, once a person's leave under this section ends, to restore them to their old position or an equivalent one with equivalent benefits, pay, and other terms, and to fail to maintain the person's group health plan coverage during the leave at the level it would have been at had the person kept working continuously. It is also unlawful for an employer to fire or discriminate against someone for opposing a practice this section makes unlawful, or for any person to fire or discriminate against someone because that person filed a charge, or started or helped start a proceeding, under or related to these employment protections, or because that person gave or is about to give information, or testified or is about to testify, in an inquiry or proceeding relating to any right provided under this section. Any adverse action taken against an employee within 12 months of that employee taking leave for which they received a benefit under this section is presumed, subject to rebuttal, to be unlawful retaliation. The requirements to restore an employee to their position and to maintain their health benefits do not apply to an employee during their first 90 days on the job with a given employer. A person who violates these protections is liable to any affected employee for damages equal to lost wages, salary, benefits, or other compensation, or, if none were lost, for the employee's actual monetary losses caused by the violation, such as the cost of paying for care, up to a cap of 60 days of wages or salary; plus interest on that amount at the prevailing rate; plus an equal amount again as liquidated damages, unless the violator proves to the court's satisfaction that the violation was in good faith with reasonable grounds for believing it was lawful, in which case the court may reduce the liquidated-damages portion. The violator is also liable for equitable relief such as employment, reinstatement, or promotion. An affected employee may sue in federal or state court on their own behalf or on behalf of themselves and other similarly situated employees, and the court must award reasonable attorney's fees, expert witness fees, and other costs on top of any judgment. An employee's right to sue on behalf of themselves or others ends once the Commissioner files a court action seeking to stop further delay in paying them, or seeking to recover damages owed to them, unless that Commissioner action is later dismissed without prejudice at the Commissioner's own request. The Commissioner may separately sue in court to recover these damages; any amount recovered is held in a special account and paid out to the affected individuals, and any part that cannot be paid out within 3 years goes into the Federal Family and Medical Leave Insurance Trust Fund. Any action under this enforcement scheme must be brought within 3 years of the last event that is part of the violation, and an action by the Commissioner is considered to begin on the date the complaint is filed. Federal district courts also have jurisdiction, in an action brought by the Commissioner for good cause shown, to stop violations, including by ordering payment of withheld wages, salary, benefits, or other compensation plus interest, or to award other appropriate equitable relief such as employment, reinstatement, or promotion. This section also applies several existing Social Security Act provisions, found in sections 204, 205, 206, and 208 of that Act, to these benefit payments in the same way those provisions already apply to regular Social Security benefit payments under title II of that Act. Applications for these benefits may not be filed until 18 months after the Act becomes law.
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4. Family and Medical Leave Insurance benefit payments (a) In general (1) Requirements Every individual who— (A) has filed an application for a family and medical leave insurance benefit in accordance with subsection (d); (B) was engaged in qualified caregiving, or anticipates being so engaged, during the period that begins 90 days before the date on which such application is filed and ends 30 days after such date; (C) has wages or self-employment income at any time during the period— (i) beginning with the most recent calendar quarter that ends at least 4 months prior to the beginning of the individual’s benefit period specified in subsection (c); and (ii) ending with the month before the month in which such benefit period begins; and (D) has at least the specified amount of wages and self-employment income during the most recent 8-calendar quarter period that ends at least 4 months prior to the beginning of the individual’s benefit period specified in subsection (c), shall be entitled to such a benefit for each month in such benefit period. (2) Specified amount For purposes of paragraph (1)(D), the specified amount shall be— (A) if the benefit period begins in calendar year 2026, $2,000; and (B) if the benefit period begins in any calendar year after 2026, an amount equal to the greater of— (i) the specified amount applicable for the preceding calendar year; or (ii) an amount equal to the product of— (I) $2,000; multiplied by (II) an amount equal to the quotient of— (aa) the national average wage index for the second calendar year preceding such calendar year; divided by (bb) the national average wage index for 2024. (b) Benefit amount (1) In general Except as otherwise provided in this subsection, the benefit amount to which an individual is entitled under this section for a month shall be an amount equal to the product of— (A) the greater of— (i) the lesser of— (I) an amount equal to the monthly benefit rate determined under paragraph (2); and (II) the maximum benefit amount determined under paragraph (3); and (ii) the minimum benefit amount determined under paragraph (3); and (B) the quotient (not greater than 1) obtained by dividing the number of caregiving hours of the individual in such month by the product of— (i) the number of hours in a regular workweek of the individuals; and (ii) the number of workweeks (including partial workweeks) in such month. (2) Monthly benefit rate (A) In general For purposes of this subsection, the monthly benefit rate of an individual shall be an amount equal to the sum of— (i) 85 percent of the individual’s average monthly earnings to the extent that such earnings do not exceed the amount established for purposes of this clause by subparagraph (B); (ii) 69 percent of the individual’s average monthly earnings to the extent that such earnings exceed the amount established for purposes of clause (i) but do not exceed the amount established for purposes of this clause by subparagraph (B); and (iii) 50 percent of the individual’s average monthly earnings to the extent that such earnings exceed the amount established for purposes of clause (ii) but do not exceed the amount established for purposes of this clause by subparagraph (B). (B) Amounts established (i) Initial amounts For individuals whose benefit period begins in calendar year 2026, the amount established for purposes of clauses (i), (ii), and (iii) of subparagraph (A) shall be $1,257, $3,500, and $6,200, respectively. (ii) Wage indexing For individuals whose benefit period begins in any calendar year after 2026, each of the amounts so established shall equal the corresponding amount established for the calendar year preceding such calendar year, or, if larger, the product of the corresponding amount established with respect to the calendar year 2026 and the quotient obtained by dividing— (I) the national average wage index for the second calendar year preceding such calendar year, by (II) the national average wage index for calendar year 2024. (iii) Rounding Each amount established under clause (ii) for any calendar year shall be rounded to the nearest $1, except that any amount so established which is a multiple of $0.50 but not of $1 shall be rounded to the next higher $1. (C) Average monthly earnings For purposes of this subsection, the average monthly earnings of an individual shall be an amount equal to 1/12 of the wages and self-employment income of the individual for the calendar year in which such wages and self-employment income are the highest among the most recent 3 calendar years. (3) Maximum and minimum benefit amounts (A) In general For individuals who initially become eligible for family and medical leave insurance benefits in the first full calendar year after the date of enactment of this Act, the maximum monthly benefit amount and the minimum monthly benefit amount shall be $4,000 and $580, respectively. (B) Wage indexing For individuals who initially become eligible for family and medical leave insurance benefits in any calendar year after such first full calendar year the maximum benefit amount and the minimum benefit amount shall be, respectively, the product of the corresponding amount determined with respect to the first calendar year under subparagraph (A) and the quotient obtained by dividing— (i) the national average wage index for the second calendar year preceding the calendar year for which the determination is made, by (ii) the national average wage index for the second calendar year preceding the first full calendar year after the date of enactment of this Act. (4) Minimum caregiving hours In a case in which the number of caregiving hours of an individual for a month is less than 4, the individual shall be deemed to have zero caregiving hours for such month. (5) Reduction in benefit amount on account of receipt of certain benefits A benefit under this section for a month shall be reduced by the amount, if any, in certain benefits (as determined under regulations issued by the Commissioner) as may be otherwise received by an individual. For purposes of the preceding sentence, certain benefits include— (A) periodic benefits on account of such individual’s total or partial disability under a workmen’s compensation law or plan of the United States or a State; and (B) periodic benefits on account of an individual’s employment status under an unemployment law or plan of the United States or a State. (c) Benefit period (1) In general Except as provided in paragraph (2), the benefit period specified in this subsection is the 12-month period that begins on the 1st day of the 1st month in which the individual— (A) meets the criteria specified in subparagraphs (A) and (B) of subsection (a)(1); and (B) would meet the criteria specified in subparagraphs (C) and (D) of such subsection if such subparagraphs were applied by substituting such 12-month period for each reference to the individual's benefit period. (2) Retroactive benefits In the case of an application for benefits under this section for qualified caregiving in which the individual was engaged at any time during the 90-day period preceding the date on which such application is submitted, the benefit period specified in this subsection shall begin on the later of— (A) the 1st day of the 1st month in which the individual engaged in such qualified caregiving; or (B) the 1st day of the 1st month that begins during such 90-day period, and shall end on the date that is 365 days after the 1st day of the benefit period. (d) Application An application for a family and medical leave insurance benefit shall include— (1) a statement that the individual was engaged in qualified caregiving, or anticipates being so engaged, during the period that begins 90 days before the date on which the application is submitted or within 30 days after such date; (2) if the qualified caregiving described in the statement in paragraph (1) is engaged in by the individual because of a serious health condition (as defined in subclause (II) of section 2(5)(B)(ii)) of the individual or a qualified family member (as defined in subclause (I) of such section) of the individual, a certification, issued by the health care provider treating such serious health condition, that affirms the information specified in paragraph (1) and contains such information as the Commissioner shall specify in regulations, which shall be no more than the information that is required to be stated under section 103(b) of the Family and Medical Leave Act of 1993 ( 29 U.S.C. 2613(b) ); (3) if such qualified caregiving is engaged in by the individual for any other qualifying reason (as defined in section 2(5)(B)(i)), a certification, issued by a relevant authority determined under regulations issued by the Commissioner, that affirms the circumstances giving rise to such reason; and (4) an attestation from the applicant that his or her employer has been provided with written notice of the individual’s intention to take family or medical leave, if the individual has an employer, or to the Commissioner in all other cases. (e) Ineligibility; disqualification (1) Ineligibility for benefit An individual shall be ineligible for a benefit under this section for any month for which the individual is entitled to— (A) disability insurance benefits under section 223 of the Social Security Act ( 42 U.S.C. 423 ) or a similar permanent disability program under any law or plan of a State or political subdivision or instrumentality of a State (as such terms are used in section 218 of the Social Security Act ( 42 U.S.C. 418 )); (B) monthly insurance benefits under section 202 of such Act ( 42 U.S.C. 402 ) based on such individual's disability (as defined in section 223(d) of such Act ( 42 U.S.C. 423(d) )); or (C) benefits under title XVI of such Act ( 42 U.S.C. 1381 et seq. ) based on such individual’s status as a disabled individual (as determined under section 1614 of such Act ( 42 U.S.C. 1382c )). (2) Disqualification An individual who has been convicted of a violation under section 208 of the Social Security Act ( 42 U.S.C. 408 ) or who has been found to have used false statements to secure benefits under this section, shall be ineligible for benefits under this section for a 1-year period following the date of such conviction. (f) Review of eligibility and benefit payment determinations (1) Eligibility determinations (A) In general The Commissioner shall provide notice to an individual applying for benefits under this section of the initial determination of eligibility for such benefits, and the estimated benefit amount for a month in which four caregiving hours of the individual occur, as soon as practicable after the application is received. (B) Review An individual may request review of an initial adverse determination with respect to such application at any time before the end of the 20-day period that begins on the date notice of such determination is received, except that such 20-day period may be extended for good cause. As soon as practicable after the individual requests review of the determination, the Commissioner shall provide notice to the individual of a final determination of eligibility for benefits under this section. (2) Benefit payment determinations (A) In general The Commissioner shall make any monthly benefit payment to an individual claiming benefits for a month under this section, or provide notice of the reason such payment will not be made if the Commissioner determines that the individual is not entitled to payment for such month, not later than 20 days after the individual’s monthly benefit claim report for such month is received. Such monthly report shall be filed with the Commissioner not later than 15 days after the end of each month. (B) Review If the Commissioner determines that payment will not be made to an individual for a month, or if the Commissioner determines that payment shall be made based on a number of caregiving hours in the month inconsistent with the number of caregiving hours in the monthly benefit claim report of the individual for such month, the individual may request review of such determination at any time before the end of the 20-day period that begins on the date notice of such determination is received, except that such 20-day period may be extended for good cause. Not later than 20 days after the individual requests review of the determination, the Commissioner shall provide notice to the individual of a final determination of payment for such month, and shall make payment to the individual of any additional amount not included in the initial payment to the individual for such month to which the Commissioner determines the individual is entitled. (3) Burden of proof An application for benefits under this section and a monthly benefit claim report of an individual shall each be presumed to be true and accurate, unless the Commissioner demonstrates by a preponderance of the evidence that information contained in the application is false. (4) Definition of monthly benefit claim report For purposes of this subsection, the term monthly benefit claim report means, with respect to an individual for a month, the individual’s report to the Commissioner of the number of caregiving hours of the individual in such month, which shall be filed not later than 15 days after the end of each month. (5) Review All final determinations of the Commissioner under this subsection shall be reviewable according to the procedures set out in section 205 of the Social Security Act ( 42 U.S.C. 405 ). (g) Relationship with State law; employer benefits (1) In general This section does not preempt or supersede any provision of State or local law that authorizes a State or local municipality to provide paid family and medical leave benefits similar to the benefits provided under this section. (2) Greater benefits allowed Nothing in this Act shall be construed to diminish the obligation of an employer to comply with any contract, collective bargaining agreement, or any employment benefit program or plan that provides greater paid leave or other leave rights to employees than the rights established under this Act. (h) Employment and benefits protection and enforcement (1) Employment and benefits protection (A) In general (i) Prohibited acts It shall be unlawful for any person to interfere with, restrain, deny, or retaliate against an individual because of the exercise of, or the attempt to exercise, any right provided under this section, including through— (I) discharging or in any other manner discriminating against (including retaliating against) an individual because the individual has applied for, indicated an intent to apply for, or received family and medical leave insurance benefits; or (II) using the application for or the receipt of such benefits as a negative factor in an employment action. (ii) Restoration to position It shall be interference with the right of an individual for purposes of clause (i) for an employer of the individual to, upon the conclusion of any leave for which the individual received a family and medical leave insurance benefit under this section, fail to— (I) restore the individual to the position of employment held by the individual when the leave commenced; or (II) restore the individual to an equivalent position with equivalent employment benefits, pay, and other terms and conditions of employment. (iii) Maintenance of health benefits It shall be interference with the right of an individual for purposes of clause (i) for an employer of the individual to fail to maintain, for the duration of any leave for which the individual received a family and medical leave insurance benefit under this section, coverage of the individual under any group health plan (as defined in section 5000(b)(1) of the Internal Revenue Code of 1986) at the level and under the conditions coverage would have been provided if the individual had continued in employment continuously for the duration of such leave. (B) Opposing unlawful practices It shall be unlawful for any employer to discharge or in any other manner discriminate against any individual for opposing any practice made unlawful by this subsection. (C) Interference with proceedings or inquiries It shall be unlawful for any person to discharge or in any other manner discriminate against any individual because such individual— (i) has filed any charge, or has instituted or caused to be instituted any proceeding, under or related to this subsection; (ii) has given, or is about to give, any information in connection with any inquiry or proceeding relating to any right provided under this section; or (iii) has testified, or is about to testify, in any inquiry or proceeding relating to any right provided under this section. (D) Rebuttable presumption of retaliation Any adverse action (including any action described in subparagraph (C) or (D)) taken against an employee within 12 months of the employee taking any leave for which the individual received a family and medical leave insurance benefit under this section shall establish a rebuttable presumption that the action of the employer is retaliating against such employee in violation of subparagraph (A)(i). (E) Non-application for new hires Clauses (ii) and (iii) of subparagraph (A) shall not apply to any individual during the 90-day period beginning with the day the individual begins work for an employer. (2) Civil action by an individual (A) Liability Any person who violates paragraph (1) shall be liable to any individual employed by such person who is affected by the violation— (i) for damages equal to the sum of— (I) the amount of— (aa) any wages, salary, employment benefits, or other compensation denied or lost to such individual by reason of the violation; or (bb) in a case in which wages, salary, employment benefits, or other compensation have not been denied or lost to the individual, any actual monetary losses sustained by the individual as a direct result of the violation, such as the cost of providing care, up to a sum equal to 60 calendar days of wages or salary for the individual; (II) the interest on the amount described in subclause (I) calculated at the prevailing rate; and (III) an additional amount as liquidated damages equal to the sum of the amount described in subclause (I) and the interest described in subclause (II), except that if a person who has violated paragraph (1) proves to the satisfaction of the court that the act or omission which violated paragraph (1) was in good faith and that the person had reasonable grounds for believing that the act or omission was not a violation of paragraph (1), such court may, in the discretion of the court, reduce the amount of the liability to the amount and interest determined under subclauses (I) and (II), respectively; and (ii) for such equitable relief as may be appropriate, including employment, reinstatement, and promotion. (B) Right of action An action to recover the damages or equitable relief prescribed in subparagraph (A) may be maintained against any person in any Federal or State court of competent jurisdiction by any individual for and on behalf of— (i) the individual; or (ii) the individual and other individuals similarly situated. (C) Fees and costs The court in such an action shall, in addition to any judgment awarded to the plaintiff, allow a reasonable attorney's fee, reasonable expert witness fees, and other costs of the action to be paid by the defendant. (D) Limitations The right provided by subparagraph (B) to bring an action by or on behalf of any individual shall terminate— (i) on the filing of a complaint by the Commissioner in an action under paragraph (5) in which restraint is sought of any further delay in the payment of the amount described in subparagraph (A)(I) to such individual by the person responsible under subparagraph (A) for the payment; or (ii) on the filing of a complaint by the Commissioner in an action under paragraph (3) in which a recovery is sought of the damages described in subparagraph (A)(I) owing to an individual by a person liable under subparagraph (A), unless the action described in clause (i) or (ii) is dismissed without prejudice on motion of the Commissioner. (3) Action by the Commissioner (A) Civil action The Commissioner may bring an action in any court of competent jurisdiction to recover the damages described in paragraph (2)(A)(I). (B) Sums recovered Any sums recovered by the Commissioner pursuant to subparagraph (A) shall be held in a special deposit account and shall be paid, on order of the Commissioner, directly to each individual affected. Any such sums not paid to an individual because of inability to do so within a period of 3 years shall be deposited into the Federal Family and Medical Leave Insurance Trust Fund. (4) Limitation (A) In general An action may be brought under this subsection not later than 3 years after the date of the last event constituting the alleged violation for which the action is brought. (B) Commencement An action brought by the Commissioner under this subsection shall be considered to be commenced on the date when the complaint is filed. (5) Action for Injunction by Commissioner The district courts of the United States shall have jurisdiction, for cause shown, in an action brought by the Commissioner— (A) to restrain violations of paragraph (1), including the restraint of any withholding of payment of wages, salary, employment benefits, or other compensation, plus interest, found by the court to be due to an individual; or (B) to award such other equitable relief as may be appropriate, including employment, reinstatement, and promotion. (i) Applicability of certain Social Security Act provisions The provisions of sections 204, 205, 206, and 208 of the Social Security Act shall apply to benefit payments authorized by and paid out pursuant to this section in the same way that such provisions apply to benefit payments authorized by and paid out pursuant to title II of such Act. (j) Effective date for applications Applications described in this section may be filed beginning 18 months after the date of enactment of this Act.
Sec. 5: Funding for State administration option for legacy States
This section lets states that already run their own comprehensive paid family and medical leave programs, called legacy states, receive federal grants instead of having their residents use the federal benefit directly. Starting in calendar year 2027, the Commissioner must give a grant to each state that was a legacy state in the prior year and met the data-sharing requirements described below. The grant equals the lesser of two amounts: an estimate of what the federal program under Section 4 would have paid to that state's paid-leave recipients the prior year if the state had not been a legacy state, including administration costs capped at 7 percent of the benefits paid; or the actual total cost of the state's paid leave benefits the prior year, including benefits paid directly by employers, insurers, or multiemployer plans under the state's law, plus the state's cost of administering the law, also capped at 7 percent of the benefits paid. If the Commissioner has reason to believe a state will qualify as a legacy state and meet the data-sharing requirements for a given year, the Commissioner may pay the state estimated grant amounts during that year, to be adjusted the following year. A legacy state, for a calendar year, is a state that: enacted a state paid family and medical leave law by the date this Act is enacted; for any year before the date 3 years after enactment, certifies to the Commissioner that it intends to remain a legacy state and meet the data-sharing requirements through at least the first calendar year starting on or after that 3-year date; and, for any year on or after that 3-year date, has a state law under which a state program remains in effect all year providing comprehensive paid family and medical leave benefits, paid directly by the state or by an employer under state law, that gives at least 12 full workweeks of leave in each 12-month period to essentially everyone in the state who would qualify for the federal comprehensive benefit under Section 4, not counting one definitional exception that the bill cross-references here but does not clearly identify from the text alone, except that the state must cover its own employees and those of its political subdivisions and may choose to cover other government employees, and that replaces wages at a rate at least as generous as the federal program's rate under Section 4, again not counting that same unclear cross-referenced exception. Covered employment under the law of a legacy state means a job, or self-employment, for which a person would qualify for paid family and medical leave benefits under that state's law during a period when the state is a legacy state. If a legacy state's law lets employers provide the paid leave benefits themselves, directly, through an insurance contract, or through a multiemployer plan, those employer-provided benefits count for all purposes of this Act as legacy-state benefits, and the leave for which they are paid counts as leave from covered employment under the legacy state's law; and if one or more employers provide the benefits that way, the state may pass along an appropriate share of its federal grant to those employers. As a condition of getting a grant, a state must agree to give the Commissioner, periodically as the Commissioner decides: each recipient's name, information to confirm their identity, the dates their paid leave benefit covered, and the amount of that benefit, plus any other available information the Commissioner needs to run this section and a related provision in the Act's definitions that this bill cross-references; by July 1 of the year, the amount needed to true up the prior year's estimated payments; and any other information needed to check that the state is meeting the grant requirements.
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5. Funding for State administration option for legacy States (a) In general (1) Payments to legacy States In each calendar year beginning with calendar year 2027, the Commissioner shall make a grant to each State that, for the calendar year preceding such calendar year, was a legacy State and that met the data sharing requirements of subsection (e), in an amount equal to the lesser of— (A) an amount, as estimated by the Commissioner, equal to the total amount of comprehensive paid leave benefits that would have been paid under section 4 (including the costs to the Commissioner to administer such benefits, not to exceed (for purposes of estimating such total amount under this subparagraph) 7 percent of the total amount of such benefits paid) to individuals who received paid family and medical leave benefits under a State law described in paragraph (1) or (3) of subsection (b) during the calendar year preceding such calendar year if the State had not been a legacy State for such preceding calendar year; or (B) an amount equal to the total cost of paid family and medical leave benefits under a State law described in paragraph (1) or (3) of subsection (b) for the calendar year preceding such calendar year, including— (i) any paid family and medical leave benefits provided by an employer (whether directly, under a contract with an insurer, or provided through a multiemployer plan) as described in subsection (d); and (ii) the full cost to the State of administering such law (except that such cost may not exceed 7 percent of the total amount of paid family and medical leave benefits paid under such State law). (2) Estimated payments In any case in which, during any calendar year, the Commissioner has reason to believe that a State will be a legacy State and meet the data sharing requirements of subsection (e) for such calendar year, the Commissioner may make estimated payments during such calendar year of the grant which would be paid to such State in the succeeding calendar year, to be adjusted as appropriate in the succeeding calendar year. (b) Legacy State For purposes of this section, the term legacy State for a calendar year means a State with respect to which the Commissioner determines that— (1) the State has enacted, not later than the date of enactment of this Act, a State law that provides paid family and medical leave benefits; (2) for any calendar year that begins before the date that is 3 years after the date of enactment of this Act, the State certifies to the Commissioner that the State intends to remain a legacy State and meet the data sharing requirements of subsection (e) at least through the first calendar year that begins on or after such date; and (3) for any calendar year that begins on or after such date, a State law of the State provides for a State program to remain in effect throughout such calendar year that provides comprehensive paid family and medical leave benefits (which may be paid directly by the State or, if permitted under such State law, by an employer pursuant to such State law)— (A) for at least 12 full workweeks of leave during each 12-month period to at least all of those individuals in the State who would be eligible for comprehensive paid leave benefits under section 4 (without regard to section 2(5)(C)), except that the State shall provide such benefits for leave from employment by the State or any political subdivision thereof, and may elect to provide such benefits for leave from any other governmental employment; and (B) at a wage replacement rate that is at least equivalent to the wage replacement rate under the comprehensive paid leave benefit program under section 4 (without regard to section 2(5)(C)). (c) Covered employment under the law of a legacy State For purposes of this Act, the term covered employment under the law of a legacy State means employment (or self-employment) with respect to which an individual would be eligible to receive paid family and medical benefits under the State law of a State, as described in paragraph (1) or (3) of subsection (b), during any period during which such State is a legacy State. (d) Employer-Provided benefits in a legacy State (1) Treatment for purposes of this title In the case of a State that permits paid family and medical leave benefits to be provided by an employer (whether directly, under a contract with an insurer, or provided through a multiemployer plan) pursuant to a State law described in paragraph (1) or (3) of subsection (b)— (A) such benefits shall be considered, for all purposes under this Act, paid family and medical leave benefits under the law of a legacy State; and (B) leave for which such benefits are paid shall be considered, for all such purposes, leave from covered employment under the law of a legacy State. (2) Distribution of grant funds In any case in which paid family and medical leave benefits are provided by 1 or more employers (whether directly, under a contract with an insurer, or provided through a multiemployer plan) in a legacy State pursuant to a State law described in paragraph (1) or (3) of subsection (b), the State, upon the receipt of any grant amount under subsection (a), may distribute an appropriate share of such grant to each such employer. (e) Data sharing As a condition of receiving a grant under subsection (a) in a calendar year, a State shall enter into an agreement with the Commissioner under which the State shall provide the Commissioner— (1) with information, to be provided periodically as determined by the Commissioner, concerning individuals who received a paid leave benefit under a State law described in paragraph (1) or (3) of subsection (b), including— (A) each individual’s name; (B) information to establish the individual’s identity; (C) dates for which such paid leave benefits were paid; (D) the amount of such paid leave benefit; and (E) to the extent available, such other information concerning such individuals as necessary for the purpose of carrying out this section and section 2(5)(C); (2) not later than July 1 of such calendar year, the amount needed to adjust payments as described in subsection (a)(2) for the calendar year preceding such calendar year; and (3) such other information as needed to determine compliance with grant requirements.
Sec. 6: Regulations
This section requires the Commissioner, working with the Secretary of Labor, to write the regulations needed to carry out the Act. In writing them, the Commissioner must consider input from a volunteer advisory body of no more than 15 people, made up of subject-matter experts and officials who run state paid family and medical leave programs, and must take those state programs into account when proposing regulations. The advisory body's members are appointed as follows: 5 by the President, 3 by the majority leader of the Senate, 2 by the minority leader of the Senate, 3 by the Speaker of the House of Representatives, and 2 by the minority leader of the House of Representatives.
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6. Regulations The Commissioner, in consultation with the Secretary of Labor, shall prescribe regulations necessary to carry out this Act. In developing such regulations, the Commissioner shall consider the input from a volunteer advisory body comprised of not more than 15 individuals, including experts in the relevant subject matter and officials charged with implementing State paid family and medical leave insurance programs. The Commissioner shall take such programs into account when proposing regulations. Such individuals shall be appointed as follows: (1) Five individuals to be appointed by the President. (2) Three individuals to be appointed by the majority leader of the Senate. (3) Two individuals to be appointed by the minority leader of the Senate. (4) Three individuals to be appointed by the Speaker of the House of Representatives. (5) Two individuals to be appointed by the minority leader of the House of Representatives.
Sec. 7: GAO Study
This section requires the Comptroller General, as soon as practicable after calendar year 2026 and every 5 years after that, to send Congress a report on the family and medical leave insurance benefits paid under Section 4 during the covered period, which is calendar year 2026 for the first report and the preceding 5 calendar years for each later report. Each report must identify: the total number of benefit applications filed during the period and the average number of days between when an application is received and when the initial eligibility determination is made; the total number of requests to review an initial denial of eligibility and the average number of days between the review request and the final eligibility determination; the total number of monthly benefit claim reports filed and the average number of days between when a claim report is received and when the initial determination on it is made; the total number of requests to review an initial adverse determination on a monthly claim report and the average number of days between that review request and the final determination; any excessive delay found in any of those timeframes, including its causes and whether it correlates with claimant demographics, industry sector, or qualifying reason; and any additional data that would need to be collected during the application process to produce this report.
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7. GAO Study (a) Study As soon as practicable after calendar year 2026, and every 5 years thereafter, the Comptroller General shall submit to Congress a report on family and medical leave insurance benefits paid under section 4 for any month during the covered period. The report shall include the following: (1) An identification of the total number of applications for such benefits filed for any month during the covered period, and the average number of days occurring in the period beginning on the date on which such an application is received and ending on the date on which the initial determination of eligibility with respect to the application is made. (2) An identification of the total number of requests for review of an initial adverse determination of eligibility for such benefits made during the covered period, and the average number of days occurring in the period beginning on the date on which such review is requested and ending on the date on which the final determination of eligibility with respect to such review is made. (3) An identification of the total number of monthly benefit claim reports for such benefits filed during the covered period, and the average number of days occurring in the period beginning on the date on which such a claim report is received and ending on the date on which the initial determination of eligibility with respect to the claim report is made. (4) An identification of the total number of requests for review of an initial adverse determination relating to a monthly benefit claim report for such benefits made during the covered period, and the average number of days occurring in the period beginning on the date on which such review is requested and ending on the date on which the final determination of eligibility with respect to such review is made. (5) An identification of any excessive delay in any of the periods described in paragraphs (1) through (4), including— (A) a description of the causes for such delay; (B) information any correlation in such delay to claimant demographics, industry sector, or qualifying reason. (6) An identification of any additional data that needs to be collected as part of the application process for benefits to produce the report required under this section. (b) Covered period In this section, the term covered period means— (1) with respect to the report due as soon as practicable after calendar year 2026, such calendar year; and (2) with respect to the report due every 5 years thereafter, the 5-calendar year period ending on December 31 of the year prior to the year in which such report is due.