OAR 471-070-1350: Benefits: Active Benefit year and Benefit Draw Down

(1) If the department determines that a claimant has been covered under at least one equivalent plan in the 12 months prior to their requested Paid Leave Oregon-covered leave start date, the department may request information as described in OAR 471-070-1320. (2) If a claimant received benefits under an equivalent plan in the 12 months prior to their requested Paid Leave Oregon-covered leave start date, the start of the claimant’s Paid Leave benefit year is the Sunday immediately prior to the claimant’s leave start date under the equivalent plan. (a) If the claimant received benefits under more than one equivalent plan during the prior 12 months, the start of the claimant’s Paid Leave benefit year is the earliest equivalent plan benefit year start date. (b) If a claimant received Paid Leave benefits and then took leave under an equivalent plan before the Paid Leave benefit year ended, the claimant’s Paid Leave benefit year start date does not change if the claimant applies for Paid Leave benefits again in the same benefit year. (3) To ensure that a claimant does not receive more than the maximum leave and benefit amount allowed in a Paid Leave benefit year under ORS 657B.020, the department will reduce the remaining leave weeks and monetary benefits in the claimant’s Paid Leave Oregon benefit year by the amount of leave a claimant took under an equivalent plan in the 12 months prior to their requested Paid Leave start date or, by the amount of leave the claimant took from an equivalent plan employer during the current Paid Leave benefit year, if the claimant only took leave under an equivalent plan, but not under Paid Leave Oregon. (4)(a) The claimant and each equivalent plan employer or plan administrator must report the leave the claimant took under the equivalent plan in the 12 months prior to the claimant’s requested Paid Leave start date, if requested by the department. (b) If the claimant took intermittent leave, the claimant and employer or administrator must report the total leave days for each week since the start of the claimant’s equivalent plan benefit year, or since the date the department last requested this information about the claimant’s leave, whichever is later. (5) If the claimant or the equivalent plan employer or administrator fails to provide the requested information within the timeframe described in OAR 471-070-1320 and OAR 471-070-2230 the department may: (a) Calculate the number of leave days the claimant took under each equivalent plan using the information available to the department; and (b) Impose a penalty for employer violation of equivalent plan requirements and terminate the equivalent plan in accordance with ORS 657B.220, ORS 657B.925 and OAR 471-070-2450. (6) If the claimant, employer or administrator provide additional information after the claimant’s remaining Paid Leave benefits have been reduced that demonstrates the claimant is entitled to a different amount of leave, the department may recalculate the claimant’s remaining leave. (7) If the information provided by the claimant and the equivalent plan employer or administrator conflicts, the department may request additional information to establish facts relating to the claimant’s leave under the equivalent plan. (8) If the claimant took intermittent leave under an equivalent plan, any reduction of the remaining weeks of leave in the claimant’s Paid Leave benefit year is calculated by adding the total number of reported leave days the claimant took under an equivalent plan and dividing that by the average number of work days the claimant works in a work week for all employers at the time the claimant applies for Paid Leave benefits. “Work day” and “work week” have the meaning provided in OAR 471-070-1000 and OAR 471-070-1040. Example 1: Liam applies for Paid Leave benefits. At the time Liam applies for Paid Leave benefits, Liam works only for a state plan employer, but in the past 12 months Liam worked for an employer with an equivalent plan. Six months before applying for Paid Leave benefits, Liam took 10 days of intermittent leave under the equivalent plan. When Liam applies for Paid Leave benefits, Liam on average works 5 days per work week. The remaining weeks of leave in Liam’s Paid Leave benefit year will therefore be reduced by two weeks (10 days of leave under the equivalent plan / 5 work days average worked per work week). (9) The department will not reduce the amount of leave available to the claimant in a given week by more than the average number of work days the claimant works in a work week for all employers at the time the claimant applies for Paid Leave benefits. Example 2: Maryam applies for Paid Leave benefits. Maryam has a state plan employer and two equivalent plan employers and on average works 7 days per work week for all employers. Three months before applying for Paid Leave benefits, Maryam received benefits under the two equivalent plans. In one work week, Maryam took 6 days of intermittent leave from one equivalent plan employer and 3 days of intermittent leave from the other employer, for a total of 9 days of leave. Maryam’s remaining weeks of leave in the Paid Leave benefit year will be reduced by one week (7 days), because the total number of reported leave days under the equivalent plans exceeds the average number of work days Maryam works per work week for all employers (9 days of leave reported under an equivalent plan > 7 days average worked for all employers per work week). (10) The department shall notify the claimant and each equivalent plan employer if the claimant’s remaining weeks of leave in the Paid Leave benefit year were reduced based on the reported number of leave weeks or days taken under the equivalent plan.