Equivalent Plan Reporting

Equivalent Plan Reporting

Paid Leave Oregon's equivalent plan reports are due Jan. 31, 2025. You must file a report for each Business Identification Number (BIN) unless you have a policy that covers multiple BINs.

Employer-Administered and Self-Insured Plans

Enter information and send an Equivalent Plan Report for each BIN.

Fully Insured Plans

Enter information and send an Equivalent Plan Report for each policy. You can file one report for more than one BIN if your policy covers multiple BINs. You must list all BINs separated by commas. You must send a separate Equivalent Plan Report if you changed insurance carriers within the year.

Important! All fields marked with a red asterisk (*) are required fields. You can’t submit the form if you don't fill in all the required fields. You can leave a field blank if it’s not required.

Family Leave – Leave for employees caring for a family member with a serious health condition.

Bonding Leave – Leave for people caring for and bonding with a child during the first year after birth or caring for a child who is placed in their home through adoption or foster care.

Medical Leave – Leave for an employee's serious health condition or two additional weeks of leave for an employee’s limitations related to pregnancy.

Safe Leave – Leave for survivors or the parents of survivors of sexual assault, domestic violence, harassment, bias crimes, or stalking.

If you have questions, contact the Employer Programs Unit at 833-854-0166 (option 3) or use the Contact Us Form at paidleave.oregon.gov with "Equivalent Plans for Employers" as the subject.

A. Equivalent Plan Reporting Period

What is the reporting period for your equivalent plan?*

Enter the reporting period using the MM/DD/YYYY-MM/DD/YYYY format.

Example:

If your equivalent plan started on Sep. 3, 2023, and is effective through the end of 2024, the reporting period is 09/03/2023-12/31/2024.

If your equivalent plan started on Jan. 1, 2024, and is effective through the end of 2024, the reporting period is 01/01/2024-12/31/2024.

Important! Reporting periods due Jan. 31, 2025, must include information through the end of Dec. 31, 2024 (if the plan ended earlier, use the last effective date of the equivalent plan).

B. General Information

Enter the first and last name of the primary point of contact.*

Enter the phone number of the primary point of contact.*

Phone

Enter the email address of the primary point of contact.*

If not English, what is the preferred language of the primary point of contact?

Enter the type of equivalent plan.*

Select the type of equivalent plan you administer.

Select

Do you use a third-party administrator to help administer your employer or self-insured plan?

Yes

Enter the name of the third-party administrator.

What is the name of the insurance carrier?*

Choose the name of the insurance carrier that administers your fully insured equivalent plan.

Select or enter value

What is the name of the business?*

Important! You must complete a separate form for each business entity, if the corporation has multiple entities.

Enter the Federal Employer Identification Number (FEIN) OR the Business Identification Number (BIN) for each entity, if applicable.*

The BIN is an 8-digit number with a dash (example: 1234567-8). A FEIN is a 9-digit number that the Internal Revenue Service (IRS) assigns in this format: 12-3456789.

Important: You must complete a separate form for each business entity if there is a corporation with multiple entities. Only list one FEIN or BIN in each form.

Enter the group policy number.*

Important! Enter information and send an Equivalent Plan Report for each policy. List only one policy number as it appears from your insurance carrier.

Example: ABC12345678

Enter the Federal Employer Identification Number (FEIN) OR the Business Identification Number (BIN) (but not both)*

The BIN is an 8-digit number with a dash (example: 1234567-8). A FEIN is a 9-digit number the IRS assigns in this format: 12-3456789.

Example: You can file one report for multiple FEINs or BINS, if the policy covers multiple FEINs or BINS.

If the group policy covers multiple entities of a corporation, separate the FEIN or BINs with a comma in the text box below.

What is the estimated number of covered employees under this equivalent plan?*

If the number changes throughout the year, put the average number of covered employees, rounded to the nearest whole number.

C. Total Benefit Applications Received

Important! Use whole numbers in this section.

Bonding Leave*

Enter the total benefit applications received during the reporting period for bonding leave.

Family Leave*

Enter the total benefit applications received during the reporting period for family leave.

Medical Leave*

Enter the total benefit applications received during the reporting period for medical leave.

Safe Leave*

Enter the total benefit applications received during the reporting period for safe leave.

D. Total Benefit Applications Approved

Important! Use whole numbers in this section.

Bonding Leave*

Enter the total benefit applications approved during the reporting period for bonding leave.

Family Leave*

Enter the total benefit applications approved during the reporting period for family leave.

Medical Leave*

Enter the total benefit applications approved during the reporting period for medical leave.

Safe Leave*

Enter the total benefit applications approved during the reporting period for safe leave.

E. Total Benefit Applications Denied

Important! Use whole numbers in this section.

Bonding Leave*

Enter the total benefit applications denied during the reporting period for bonding leave.

Family Leave*

Enter the total benefit applications denied during the reporting period for family leave.

Medical Leave*

Enter the total benefit applications denied during the reporting period for medical leave.

Safe Leave*

Enter the total benefit applications denied during the reporting period for safe leave.

F. Total Workdays of Leave Taken

Important! Use whole numbers in this section.

Bonding Leave*

Enter the total number of workdays taken during the reporting period for bonding leave.

Family Leave*

Enter the total number of workdays taken during the reporting period for family leave.

Medical Leave*

Enter the total number of workdays taken during the reporting period for medical leave.

Safe Leave*

Enter the total number of workdays taken during the reporting period for safe leave.

G. Total Benefits Paid

Important! Use whole numbers in this section.

Enter the combined total benefits paid for all leave types during the reporting period*

Enter the total benefits paid during the reporting period for bonding leave, if known.

Enter the total benefits paid during the reporting period for family leave, if known.

Enter the total benefits paid during the reporting period for medical leave, if known.

Enter the total benefits paid during the reporting period for safe leave, if known.

H. Additional Application Reporting

Enter the number of benefit applications cancelled before leave began.*

Enter the number of appeals received after a denial was issued.*

Enter the number of employees who appealed their denial and were granted benefits.*

Enter the number of employees who appealed their denial and were denied benefits.*

I. Financial Report

Important: Round to the nearest whole dollar.

Enter the total amount of employee contributions withheld.*

Enter 0 if you didn't withhold contributions from employees' wages.

Enter the total administrative costs.*

Per 471-070-2200(1), "administrative costs" means the costs incurred by an employer directly related to administering an equivalent plan which include, but are not limited to, cost for accounting, recordkeeping, insurance policy premiums, legal expenses, and labor for human resources’ employee interactions related to the equivalent plan. Administrative costs do not include rent, utilities, office supplies or equipment, executive wages, cost of benefits, or other costs not immediately related to the administration of the equivalent plan.

J. Claims Filed by Gender

How many claims were filed by employees who identified as male?

How many claims were filed by employees who identified as female?

How many claims were filed by employees who preferred not to provide gender information?

K. Approved Leave by Age

Enter the total number of approved leaves taken by covered employees for the age brackets below.

Under 20 years old

20-29 years old

30-39 years old

40-49 years old

50-59 years old

60-69 years old

70+ years old

L. Approved Leave by Earnings

Enter the total number of approved leaves taken by covered employees that fit in the earnings bracket for the year during the reporting period.

Under $10,000

$10,000-$19,999

$20,000-$29,999

$30,000-$39,999

$40,000-$49,999

$50,000-$59,000

$60,000-$69,999

$70,000-$79,999

$80,000-$89,999

$90,000-$99,999

$100,000 or more

M. Approved Leave Additional Information

Important! The average duration, or the length of leave, is the average total weeks of leave all covered employees took for each leave type. Do not round, use exact number.

Example: If the covered employees worked five days on average and took five weeks and three days of bonding leave, you would enter 5.6 (3 days divided by 5 days = .6).

Bonding Leave

Enter the average duration of approved consecutive leave for bonding leave.

Family Leave

Enter the average duration of approved consecutive leave for family leave.

Medical Leave

Enter the average duration of approved consecutive leave for medical leave.

Safe Leave

Enter the average duration of approved consecutive leave for safe leave.

Important! Round to the nearest whole dollar for this section.

Bonding Leave

Enter the average weekly benefit amount paid to employees taking bonding leave on a consecutive leave schedule.

Family Leave

Enter the average weekly benefit amount paid to employees taking family leave on a consecutive leave schedule.

Medical Leave

Enter the average weekly benefit amount paid to employees taking medical leave on a consecutive leave schedule.

Safe Leave

Enter the average weekly benefit amount paid to employees taking safe leave on a consecutive leave schedule.

Enter the average days from initial application to issue payment.

Enter the average days from final decision to issue payment.

Enter the average days from leave start date to issue payment.

N. Denied Leave Additional Information

Enter the total number of applications denied leave for not meeting eligibility requirements.

Enter the total number of applications denied leave for insufficient verification documentation.

Enter the total number of applications denied leave for other reasons.

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