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.