NEW YORK PAID FAMILY LEAVE (100% Employee Paid)

1 P age NEW YORK PAID FAMILY LEAVE (100% Employee Paid) Effective January 1, 2018, the New York Paid Family Leave Benefits Law (PFL) provides wage replacement and job protection to eligible employees working in New York to help them bond with their child, care for a close relative with a serious health condition, or help relieve family pressures when a family member is called to active military service (e.g. a qualifying exigency). PFL benefits will be funded exclusively through employee contributions deducted from payroll beginning approximately January 1, 2018 or the employee s first day of employment, whichever is later. Participation in the PFL program is mandatory for all employees, except for those individual eligible for a waiver (explained below). PFL will be Phased in Over a 4-year Period of Time Employees may take the maximum benefit length in any given 52-week period. The amount of PFL time available to eligible employees will be phased-in over a period of 4 years. The maximum benefit is 8 weeks during the first year (2018), 10 weeks during the second and third years (2019 and 2020), and 12 weeks the fourth (2021) and subsequent years. An employee shall only be entitled to a maximum number of family leave benefits permissible in a 52-consecutive week period, even where such employee begins employment with a different covered employer during the 52- consecutive week period. The 52-week time period is calculated measuring backwards from each day for which PFL is taken. PFL may be taken in daily or weekly increments. In the event that an employee also collects New York State Disability Leave Benefits (DBL) for his/her own disability, the maximum amount of time that can be taken for both DBL and PFL can total no more than 26 weeks during the 52-week time period. Example: If both spouses work for the Company, the Company may deny PFL to one spouse if both employees have requested to take PFL during the same period of time to bond with the same child. However, both spouses could take PFL at different times to bond with the same child.

2 P age Employee Eligibility Full-time Employee Part-time Employee When Employee Will be Eligible to Take PFL An employee regularly scheduled to work at least 20 hours per week is eligible to take PFL after he/she has been employed with the Company for 26 consecutive work weeks. An employee regularly scheduled to work less than 20 hours per week is eligible to take PFL after working for the Company for 175 days. Comments If they have not worked 26 weeks for the Company and start regularly working less than 20 hours per week for that covered employer, they will become eligible after 175 days worked. Note: Time spent on paid time off or vacation will count towards an employee s eligibility determination, provided deductions were taken during that period of paid time off or vacation. However, time that an employee spends on NYS disability leave or unpaid leave will not be counted towards an employee s eligibility determination. Waivers Employees have the opportunity to waive PFL benefits under the following limited circumstances: The employee s regular work schedule is 20 or more hours per week, but the employee will not work for the Company for 26 consecutive weeks. The employee s regular work schedule is less than 20 hours per week and the employee will not work for the Company for 175 days during a consecutive 52-week period. If an employee elects to waive PFL coverage, the Company will not take PFL payroll deductions from that employee. However, if an employee elects to waive PFL coverage and his/her regular schedule changes such that he/she works for either 26 consecutive weeks or 175 days in a consecutive 52-week period, the employee s waiver will be automatically revoked under the law. When such a waiver is revoked, the Company will notify the employee regarding his/her contribution obligations. Thereafter, the Company may begin taking PFL payroll deductions from the employee, including any retroactive amounts from the employee s date of hire or the amount necessary to prevent the Company from having to pay the applicable PFL insurance premium. Qualifying Reasons for Leave Under PFL Eligible employees may apply to take PFL for the qualifying reasons set forth below. CARING: To provide care for the employee s child (regardless of age), parent (including parent-inlaw), grandparent, grandchild, spouse and/or domestic partner with a serious health condition. Note: The employee must be in close and continuing proximity to the care recipient. This means present at the same location as the family member during the majority of the employment period from which leave has been taken. Travel necessitated for the purpose of securing medication or to arrange care for the family The term family member as used in this provision includes: the employee s child - regardless of age (biological, adoptive, foster, child of domestic partner) a spouse a domestic partner the employee s parent (biological, adoptive, foster, step, parent-in-law, person who stood in loco parentis when employee was a child) a grandparent a grandchild

3 P age member, or other such deviations determined to be reasonably related to providing care, shall satisfy this definition. Providing care in this provision may include: necessary physical care, emotional support, visitation, assistance in treatment, transportation, arranging for a change in care, assistance with essential daily living matters and personal attendant services. BONDING: To bond with the employee s child following the child s birth, adoption or placement in foster care. A serious health condition is an illness, injury, impairment, or physical or mental condition that either involves: inpatient care in a hospital, hospice, or residential care facility; or continuing treatment or continuing supervision by a health care provider. Note: Cosmetic treatments (e.g., plastic surgery) are not eligible conditions unless inpatient hospital care is required or complications develop. Ordinarily, unless complications arise, the common cold, the flu, ear aches, upset stomach, minor ulcers, headaches other than migraine, routine dental or orthodontia problems, periodontal disease, etc., are examples of conditions that do NOT meet the definition of a serious health condition. In the case of adoption or placement, PFL may be taken prior to the adoption or placement if the employee s absence is necessary for the placement or adoption to proceed. PFL taken for these circumstances must be used within one year of the first day of leave, or within one year of the adoption / placement, whichever is earlier. PREPARING: To prepare for, or attend to, a qualifying exigency arising out of a family member s military service. In the case of the birth of a newborn child, PFL taken to bond with the child must be used within the first year following the child s birth. The term family member as used in this provision shall include: the employee s spouse, domestic partner, child or parent who is currently on active duty or has been notified of an impending call to active duty in the Armed Forces of the United States. Qualifying exigency shall have the same meaning and interpretation under PFL as the term is currently used under the federal Family and Medical Leave Act ( FMLA ). Questions regarding the definition or application of qualifying exigency should be directed to the Human Resources Department. NOTE: PFL is not available for the employee s own disability or serious health condition. Disability, FMLA or a non-fmla medical leave may be available in those circumstances. Please see the Company s Short-Term Disability, FMLA or other non-fmla medical leave policies for additional information. NOTE: PFL will run concurrently with leave under the FMLA where the reason for leave qualifies under both PFL and FMLA. In these cases, employees will be required to comply with all applicable employee requirements (e.g., application, certification, notice, etc.) under both policies. Accordingly, employees should also review and refer to the Company s FMLA Policy. If an employee s need for leave qualifies under both PFL and FMLA, but the employee declines to apply for PFL benefits (despite being notified that the reason for leave is a PFL-qualifying reason), any leave taken by the employee for such reason will nevertheless be counted against the employee s PFL allotment.

4 P age PFL Benefits Levels Employees do not continue to receive their full pay from the Company during PFL. Rather, they will receive a partial wage replacement benefit payment which will be paid directly from the Company s insurance carrier. Benefit levels are set by state law as a percentage of the employee s average weekly income, which will be capped as a percentage of the NY state average weekly wage. Benefit levels will be phased-in over a period of 4 years as follows: Benefit Stage Effective Date* Maximum Length of Paid Leave** Within a 52-Week Calendar Period Payable % of Employee s Average Weekly Wage (AWW) January 1, 2018 8 Weeks 50% Maximum Benefit Amount (whichever is less) OR To the Maximum % (Cap) of NYS AWW* 50% (capped at $652.96 for 2018) January 1, 2019 10 Weeks 55% 55% January 1, 2020 10 Weeks 60% 60% January 1, 2021 12 Weeks 67% 67% *In the years following 2018, NYS will make an annual determination (most likely during the fall) about the benefit cap amounts that will be used / applied in the next calendar year (i.e., beginning January 1 st ). If PFL leave spans across calendar years, the employee s benefit amount / rate is set at the time the PFL leave begins and does not increase during the leave period. Intermittent Leave PFL may be taken on either a weekly or intermittent basis (i.e., separate blocks of time). Intermittent PFL must be used in full-day increments. If an employee takes intermittent FMLA in partial day increments for a reason that also qualifies for PFL, and the employee is paid and works at least part of a day, the Company will track the hours taken against the employee s FMLA allotment. When the partial day increments taken total the number of hours in the employee s regular work day, the Company will deduct one day of PFL from the employee s available PFL allotment. Employee Notice Requirements Employees must provide the Company (and customer) with notice regarding the need for PFL before the start of the leave; notice should be given to the Benefits Department. Employees are required to provide sufficient information and notice to inform the Company of the qualifying event, the anticipated timing, and the duration of leave. When the necessity for PFL is foreseeable (i.e., planned medical treatments / appointments, to bond with a child, a qualifying exigency, etc.), employees must provide the Company and customer with not less than 30 days advance notice, or as soon as the need for leave becomes known.

5 P age If the need for PFL is not foreseeable because of a medical emergency, change in circumstances or lack of advance knowledge, the employee must notify the Company and customer as soon as practicable under the circumstances. If an employee fails to provide 30 days advance notice of foreseeable PFL and provides no reasonable excuse for the delay, the Company s insurance carrier may partially deny the claim for a period of up to 30 days from the date the notice is given. If leave is taken on an intermittent basis, the employee must provide notice as soon as is practicable before each day taken as intermittent leave. When the need for PFL is foreseeable, including intermittent leave, employees are encouraged to consult with the customer and the Benefits Department regarding leave scheduling so as to minimize operational disruptions to both the Company and the customer. Applying for PFL Benefits Employees needing PFL should notify the Benefits Department. In order to receive income replacement benefits while on PFL, an employee must submit a claim form to the Company s PFL insurance carrier using the applicable Request for Paid Family Leave forms. The claim form(s) will provide details regarding the documentation that will be required to support the request for PFL benefits. These forms may be obtained from the Benefits Department. Employees are responsible for timely filing their own PFL claim(s) with the Company s insurance carrier. While employees have 30 days from the date PFL is taken to file the claim, employees should consider filing the claim as quickly as possible to ensure prompt payment of PFL benefits if the claim is ultimately approved. The Company will not file a claim on an employee s behalf. In addition, an employee will not receive any PFL benefits until the claim has been fully submitted and approved by the insurance carrier. The insurance carrier has 18 days, from the date of submission, to make this decision. If the leave is also FMLA-qualifying, and the individual is an eligible employee under the FMLA, the employee must also apply for FMLA pursuant to the Company s FMLA Policy. An employee who is absent from work and whose PFL claim is later denied by the insurance carrier, may be authorized for leave, if eligible, under the Company s other leave of absence policies. If the employee is not eligible under any other leave of absence policy, the employee will be required to apply any accrued, unused PTO or vacation time (as applicable). If the employee does not have any accrued, unused PTO or vacation time (as applicable), the employee s absence may be treated as unexcused and subject to the Company s attendance policy.

6 P age PFL Supporting Documentation When filing a PFL claim, an employee will be required to submit supporting documentation to the Company s insurance carrier, as detailed below: Qualifying Documentation Needed PFL Reason Childbirth Foster Care Adoption Serious Health Condition (for family member) Active Military Duty Deployment Birth Mother Second Parent Document(s) Birth certificate; or Documentation of pregnancy or birth from a health care provider Birth certificate naming them as parent; or May submit a Voluntary Acknowledgement of Paternity or a Court Order of Filiation naming the employee as a parent; or Birth documentation from the birth mother s health care provider and either a marriage certificate or evidence of a civil union or domestic partnership to demonstrate the relationship to the birth mother; or Other documentary evidence of parental relationship to the child, to be evaluated on a case-by-case basis by the carrier. Document Must Include Mother s name and The child s due date or birth date Requires the submission of a letter of placement issued by a county or city Department of Social Services or local voluntary agency. If a second parent is not named in the documentation, a copy of the document, plus a document verifying the relation to the parent named in the foster care placement will be needed. A court document finalizing adoption, or, for PFL taken before the adoption is complete, a document showing that the adoption process is underway. Examples of proof of a pending adoption include: a signed statement from an attorney, adoption agency or adoption-related social service provider that the employee is in the process of adopting a child. A medical certification, completed by the care recipient s health care provider. An authorization for personal health disclosure form is required by the HIPAA Privacy Rule and must be completed by the care recipient and retained on file with the health care provider in order to submit the required medical information. Either a PFL-5 Military Qualifying Event certification or a US Department of Labor Certificate of Qualifying Exigency for Military Family Leave. These forms include: (1) Military documentation of the family member s deployment or impending deployment (active duty orders or other notice from the military), and (2) Documentation of the reason for leave.

7 P age Use of Paid Time Off (PTO) An employee has the option to supplement his/her PFL benefit with accrued paid time off or vacation in order to receive full pay. In no event can the combination of PFL benefits and paid time off or vacation result in the receipt of more than 100% of an employee s regular wages. Maintenance of Health Benefits (where applicable) While an employee is out of work on an approved PFL, the Company will maintain the employee s health benefits as if the employee continued to be actively employed. Specifically, the Company will continue to pay its portion of the group health insurance premium (where applicable) while the employee is on PFL. The employee will be responsible for continuing to contribute his/her portion of the health insurance premium(s) and is expected to make arrangements with the Benefits Department to ensure timely payment. If payment is more than 30 days late, the employee s health insurance coverage may be dropped for the duration of PFL. The Company will provide 15 days notice prior to terminating coverage. If health insurance lapses because an employee has not made the required premium payments or the employee chooses not to retain health plan coverage during paid family leave, upon the employee s return from paid family leave, the employee s benefits will be restored to the coverage/benefits equivalent to those the employee would have had if paid family leave had not been taken and premium payment(s) had not been missed, including family or dependent coverage. Employees taking paid family leave are NOT entitled to accrue seniority or other benefits during their leave as if they had never taken leave. Restoration of Employment An employee who returns to work at the conclusion of an approved period of PFL will be restored to the same position or to a comparable position (with comparable pay, benefits and other terms and conditions of employment). If the employee has exhausted all weeks of available PFL and is still unable to return to work, the employee is no longer provided with any job restoration rights under PFL, unless other job protections apply (e.g., FMLA). Appeal Rights If an employee s request for PFL has been denied by the insurance carrier, the employee has the right to appeal the determination through an arbitration proceeding. Information regarding the appeal process is available from the insurance carrier.

8 P age Protection from Discrimination and Retaliation The Company will not discriminate and/or retaliate against any employee for inquiring about, applying for, or using PFL benefits. Employees who believe they have experienced discrimination and/or retaliation should immediately notify their supervisor, the Benefits Department, the Human Resources Department or any other member of Company management. Fraud An employee who fraudulently obtains PFL, or who uses PFL in an improper manner, is subject to disciplinary action, up to and including termination. Questions An employee who has questions concerning PFL is encouraged to contact the Benefits Department at 1-800- 568-8310 or email benefitsdepartment@aleroninc.com for more information, clarification and/or appropriate guidance.

OPTIONAL: If completed, you must print out and return to the Benefits Department by FAX at 716-631-1033 or by email to benefitsdepartment@aleroninc.com. EMPLOYEE OPT-OUT OF PAID FAMILY LEAVE BENEFITS Information on the option to opt-out of paid family leave and directions for completing this form can be found on page 2. Employer Information 1. EMPLOYER'S LEGAL NAME, INCLUDING (DBA/AKA/TA) 2. ADDRESS 4. EMPLOYER FEIN 3. CITY, STATE and ZIP CODE 5. TELEPHONE NUMBER Employee Information 6. EMPLOYEE NAME 7. HOME ADDRESS 8. CITY, STATE and ZIP CODE 9. TELEPHONE NUMBER Employment Information 10. AVERAGE NUMBER OF HOURS WORKED PER WEEK (BASED ON LAST 8 WEEKS) 12. IS THIS JOB TEMPORARY? YES NO 11. AVERAGE NUMBER OF DAYS WORKED PER WEEK (BASED ON LAST 8 WEEKS) IF YES, HOW LONG IS THE JOB EXPECTED TO LAST? Employee Affirmation 1. I would like to waive paid family leave coverage at this time because (select one): I regularly work 20 hours or more per week, but will not work 26 consecutive weeks (6 months) for this employer. I regularly work less than 20 hours per week, but will not work 175 days in 52 consecutive weeks (a year) for this employer. 2. I understand that this waiver is revoked if my work schedule changes and it is anticipated I will work more than 20 hours per week for 6 months, or will work less than 20 hours per week but at least 175 days in a 52 consecutive week period (1 year). 3. I understand that this waiver is OPTIONAL AND REVOCABLE. (a) My employer may not force me to opt out of paid family leave benefits. (b) I may decide later to revoke this waiver even if my schedule does not change. 4. I also understand if this waiver is revoked (either by me or by a change in my work schedule), my employer may take retroactive deductions for the period of time I was covered by this waiver, and this period of time counts towards my eligibility for paid family leave. Certification I certify to the best of my knowledge the foregoing statements are complete and true. Employer's Signature: Date Signed: Employee's Signature: Date Signed: Please note: Employer must keep a copy of the fully executed waiver on file for as long as the employee remains in employment with the covered employer. PFL-WAIVER (9-17) Page 1 of 2 If you need assistance, contact the Paid Family Leave Helpline at (844)-337-6303 www.ny.gov/paidfamilyleave

Opting Out of Paid Family Leave (12 NYCRR 380-2.6) (a) An employee of a covered employer shall be provided the option to file a waiver of family leave benefits: (i) When his or her regular employment schedule is 20 hours or more per week but the employee will not work 26 consecutive weeks, or (ii) When his or her regular employment schedule is less than 20 hours per week and the employee will not work 175 days in a 52 consecutive week period. (b) Within eight weeks of any change in the regular work schedule for an employee that requires the employee to continue working for 26 consecutive weeks or 175 days in a 52 consecutive week period, any waiver filed under this section shall be deemed revoked. An employee of a covered employer whose waiver has been revoked shall be obligated to begin making contributions to the cost of family leave benefits, including any retroactive amounts due from date of hire, pursuant to Section 209 of the Workers' Compensation Law, as soon as the employee is notified by the covered employer of such obligation. (c) The covered employer shall keep a copy of the fully executed waiver on file to be produced at the request of the Chair, for as long as the employee remains in employment with the covered employer. (d) An employee as described in Subsection (a) of this Section who elects not to enter into a waiver shall make regular family benefit contributions for the full duration of his or her employment with the covered employer, and the covered employer shall be obligated to provide family leave benefits for such employee when he or she is eligible pursuant to this Title. Calculating Average Hours/Days Worked To determine the average number of hours worked per week: Add all hours worked for the past 8 weeks then divide the total by 8. To determine the average number of days worked per week: Add all days worked for the past 8 weeks then divide the total by 8. Example: Week Worked Hours Worked Days Worked Week1 16 2 Week 2 24 3 Week 3 16 2 Week 4 16 2 Week 5 8 1 Week 6 24 3 Week 7 16 2 Week 8 8 1 Total 128 16 Divide by 8 Divide by 8 Average Per Week 16 2 PFL-WAIVER (9-17) Page 2 of 2