One of the most important aspects of preparing for and heading out on leave is understanding your leave pay. Leave pay can include multiple different sources of income and it's not always straightforward how it all comes together! Here, we hope to help you understand exactly how you can expect to be paid while out on leave.

Currently, all paid leave policies are inclusive of state and/or private insurance benefit programs. This means that throughout an employer paid leave or during the employer paid portions of your leave, your employer will top off any state or private insurance benefits available to get your pay to 100% of your typical income.

If your leave plan is showing full pay, your employer will top up your pay based upon estimations of benefits you’ll receive from applicable state and insurance programs. For example, if we expect 60% of your normal pay to come from state and insurance programs, your employer would provide the remaining 40% to ensure that you receive full pay.*

However, it typically takes up to 2-6 weeks for your claims to be finalized, submitted and for the state and insurance programs to process, approve, and begin distributing benefits. As a result, while claims are being processed, you would only be receiving partial pay from your employer. If your pay sources in your leave are only state and/or insurance programs, then you would be unpaid while waiting for your claims to process and issue benefits. You can read more about the pay sources in the next section.

Once your claims are approved, you will receive payment for all covered dates leading up to your approval by each applicable benefit provider. Payments may be made in one flat sum for the full duration of coverage or once approved, you may begin to receive weekly or biweekly payments for future covered dates. Once you have begun receiving your benefit payments, you can utilize the Pay Verification tool in your dashboard to confirm that the benefit rate received aligns with the estimations made.

*Percentage figures may vary based upon program benefit maximums and your current salary. For more information throughout your leave around the amounts coming in from each source, please see the "Your Payments" section in your Cocoon dashboard.

Every leave may differ slightly, but there are three common sources of pay during leave: your employer, your employer's short-term disability insurance provider, and your state.

Depending on your leave type, you may receive funds from all or none of these sources. To see your income sources throughout different portions of your leave, you can click into your leave timeline in your Cocoon dashboard.

To see which state or private insurance carrier your claims will be filed with, click into the Your tasks section in your dashboard:

State benefits are wage replacement programs that provide partial pay for certain types of leaves (for instance, time taken due to personal injury or disability, pregnancy, bonding, or to care for a family member with a serious health condition).

Private insurance benefits provide wage replacement for disability related leaves for the covered individual only. For example, if your employer has a short term disability policy with a private insurance carrier, you may be eligible for benefits throughout a medical leave or throughout the disability portion of parental leave. However, if you are a non-birthing parent who is eligible for wage replacement benefits, these would be provided only by a Paid Family Leave state program, not via STD coverage under private insurance.

The most common wage replacement figure by state and/or insurance program is 60%. This figure can vary as each program maintains different maximum weekly benefit rates.

For employer paid sections of leave, your employer will provide the remaining ~40% to reach your total, typical income.

The standard claim processing time is between 2-4 weeks, varying slightly by carrier or state.

Before your disability claim filing is considered complete, your medical provider must complete the Physician section of your claim and certify your disability dates. The most common reason for a delayed disability claim is unresponsive medical providers or an incomplete medical certification. It can often be incredibly helpful to inform your provider of the need and importance of their involvement ahead of time.

For more information on what constitutes a complete certification, please see the following articles:

For disability claims:

Once your provider has certified all applicable claims, our team will finalize the claim. Upon finalization, it typically takes between 2-4 weeks for claims to be decisioned. Upon approval, benefits should start to arrive within 7 days.

For paid family leave claims (non birthing parents):

Our team will submit your PFL claim once you upload your proof of relationship document to your Cocoon dashboard. PFL claims take 2-3 weeks on average to be decisioned. Upon approval, benefits should start to arrive within 7 days.

For paid family leave claims (birthing parents):

Once the disability section of your leave is complete, there may be an additional Paid Family Leave program that is applicable for pay coverage during the bonding section of your leave. Our team will finalize and submit this claim once your short term disability claim is complete and has fully paid out.

PFL claims take 2-3 weeks on average to be decisioned. Upon approval, benefits should start to arrive within 7 days.

When your benefits start to arrive, we request that you upload a screenshot or scan of your benefit payment and/or the Explanation of Benefits to the Pay Verification Tool in your Cocoon dashboard. This helps our team (and you!) ensure all estimations made were accurate and that you are receiving your full expected pay between all sources. Once you’ve received your last payment, you will receive an email from Cocoon prompting you to verify your payments as well as the date range for your leave. This will allow us to verify not only that your benefit rate is accurate, but that you've received payment for the full expected duration of covered dates.

For more information around verifying your benefit payments, please see this article around benefit verification.

To qualify for state and/or private insurance benefits, there must be evidence of a loss of wages as a result of disability or protected circumstances. Leave pay programs serve to act as wage replacement, rather than as additional benefits. If your employer was providing 100% of your wages throughout your leave, your state and/or insurance claims would be disqualified. If benefits had already been received, the entities would issue overpayment notices and require repayment.