Private Plans

Here’s what you need to know about Private Plans

Colorado Paid Family and Medical Leave Insurance (FAMLI) coverage is mandatory for all employers with one or more employees working in Colorado. Employers have the option to meet FAMLI obligations by using an approved Private Plan. 

All employers must first register with the Division, then they may apply to use a Private Plan. Once your Private Plan is approved, employers are required to pay premiums until the effective date of the Private Plan. That effective date will be no earlier than 60 calendar days after the Private Plan application was submitted. An approved Private Plan may be in the form of either self-insurance or a policy from  an insurance carrier approved by the State. Employers applying for Private Plan approval must:

• Pay a $500 administration fee. 
• Provide proof of purchase of a state-approved carrier plan or a completed Self-Insured Private Plan template, proof of surety bond, and benefit claim forms.
• Provide a copy of their Employee Notification with an effective date no earlier than 60 calendar days from the date the Private Plan application is submitted.

In order to be approved by the Division, a Private Plan must cover all employees and provide employees with the same or better benefits, protections and rights as the state plan, including but not limited to:

• Offer at least the same duration of benefits. 
• Offer at least the same wage replacement for each week of benefits. 
• Include no additional requirements or conditions. 
• Deduct no more from employee paychecks as the state plan. 
• Provide for the confidentiality of employee information related to FAMLI benefits, and the information kept separate from all other employment records.
• Comply with all requirements established by the FAMLI Division.  

Quarterly and Annual Summaries

The Private Plan administrator must submit quarterly summaries of the previous calendar quarters [7 CCR 1107-5.12.3]. The Private Plan administration summaries must be submitted by the last day of the month immediately following the end of the calendar quarter addressed by the summaries. Summaries are due on the last day of the month following the end of each quarter. The 2024 schedule is:

• Q1: March 30, 2024 
• Q2: June 30, 2024
• Q3: September 30, 2024
• Q4: December 31, 2024

After the Private Plan has been active for three years, the plan administrator will need to submit only an annual summary, due on January 30th of each year, unless otherwise requested by the Division.

If a requested summary is not submitted by the deadline, the Division may withdraw its approval of the Private Plan.

For more information, see the section Quarterly and Annual Summaries. 

Annual Maintenance Fee and Material Changes

Starting in January of 2025, employers with approved Private Plans will be subject to an annual maintenance fee based on FAMLI Division costs specific to each employer. The maintenance fee is the calculation of costs that include (but are not limited to) costs to return the employer to the FAMLI program, audit the current plan, and administer any appeals related to the plan. Employers may also apply to change their approved Private Plan, which may increase the annual maintenance fee. 

The FAMLI Act requires employers to reimburse the FAMLI Division for the costs of administering Private Plans. 

For more information, see the section Material Change To An Approved Private Plan. 

Termination of Private Plan

The Division can withdraw approval for a Private Plan when the terms or conditions of the plan have been violated. Employers may also terminate their insurance plan and return to the state FAMLI program before the end of their eight-year opt-out period. 

For more information, see the section Termination of a Private Plan. 

Employee Notification

Employers are required to notify their employees of their decision to use a Private Plan instead of the state plan at least 30 days before the effective date of the approved plan.

For more information, see the section Employee Notification. 

FAQs

We have a dedicated section on our Employers FAQ page that answers many users' frequently asked questions.

Private Plans In Depth

Quarterly and Annual Summaries

Employers with a state-approved carrier plan should confirm with their carrier plan administrator that this information will be submitted to the Division on their behalf. If the state-approved carrier plan administrator IS submitting this information to the Division on the employer’s behalf, the employer need not submit these summaries. If the state-approved carrier plan administrator IS NOT submitting this information to the Division on the employer’s behalf, the employer must submit their summary using the Reporting Template and instructions provided below.

Approved Plan Carriers must submit their summary in a .csv file using the Reporting Template see the instructions provided below. Administrators of Approved Plan Carriers may aggregate data for Private Plans in the form of an insurance policy that covers multiple employers. Additional instructions are included in the Template. 

• The file-naming convention is YYYYQQ_CarrierName.csv
  • Example: 2024Q1_CarrierName.csv
• Amendments to information can be reported in a separate file with the next quarterly filing. 
• Final amendments to any quarterly filing within a calendar year must be submitted by March 1st of the following calendar year.
• Email your file to: CDLE_FAMLI_PrivatePlans@state.co.us with the subject “YYYYQQ Private Plan Reporting.”

Employers with an Approved Plan Carrier submitting their own summary must submit their summary in a .csv file using the Reporting Template and instructions provided below. Additional instructions are included in the template. 

• The file-naming convention is YYYYQQ_FAMLI ID_EmployerName.csv
  • Example: 2024Q1_123456789_EmployerName.csv
  • Your FAMLI ID can be found on your MyFAMLI+ Employer account.
• Amendments to information can be reported in a separate file with the next quarterly filing. 
• Final amendments to any quarterly filing within a calendar year must be submitted by March 1st of the following calendar year.
• Email your file to: CDLE_FAMLI_PrivatePlans@state.co.us with the subject “YYYYQQ Private Plan Reporting.”

Employers with a Self-Insured Private Plan must submit their summary in a .csv file using the Reporting Template and instructions provided below. Additional instructions are included in the template.

• The file-naming convention is YYYYQQ_FAMLI ID_selfinsured.csv
  • Example: 2024Q1_123456700_selfinsured.csv
  • Your FAMLI ID can be found on your MyFAMLI+ Employer account.
• Amendments to information can be reported in a separate file with the next quarterly filing. 
• Final amendments to any quarterly filing within a calendar year must be submitted by March 1st of the following calendar year.
• Email your file to: CDLE_FAMLI_PrivatePlans@state.co.us with the subject “YYYYQQ Private Plan Reporting.”

Summary & Amended Summary Submission Schedule:

	Q1 Submit by 4/30 (5/31 for 2024)	Q2  Submit by 7/31	Q3 Submit by 10/31	Q4 Submit by 1/31	Finalized amendments due by 3/1
File to submit per quarter:	2024Q1_0123456789 _Self-Insured.csv	2024Q2_0123456789 _Self-Insured.csv	2024Q3_0123456789 _Self-Insured.csv	2024Q4_0123456789 _Self-Insured.csv
File Includes:	Summary of information from Jan 1 - Mar 31	Aggregated summary of information from Jan 1 - Jun 30	Aggregated summary of information from Jan 1 - Sept 31	Aggregated summary of information from Jan 1 - Dec 31
Additional file to submit an amendment to a previous quarterly summary:		2024Q1_Amend_ 0123456789_Self-Insured.csv	2024Q2_Amend_ 0123456789_Self-Insured.csv	2024Q3_Amend_ 0123456789_Self-Insured.csv	2024Q4_Amend_ 0123456789_Self-Insured.csv
Amended File Includes:		Amended summary of information from Jan 1 - Mar 31	Amended aggregated summary of information from Jan 1 - Jun 30	Amended aggregated summary of information from Jan 1 - Sept 31	Amended aggregated summary of information from Jan 1 - Dec 31

Download Reporting Template

Benefit Overpayments

The private plan administrator must notify the FAMLI Division of any benefits overpayments totaling $25 or more. A copy of the overpayment determination letter sent to claimants must be submitted to the Division at least quarterly as described above for Private Plan Quarterly Administration Summaries [7 CCR 1107-6.5.2].

Mail copies of the overpayment determination letters:

Division of Family and Medical Leave Insurance
Attn: Overpayments and Recovery
PO BOX 2330
Denver, CO 80202-2330

Individual copies of the determinations can also be sent to the FAMLI Division as they are sent to claimants. 

Material Change to an Approved Private Plan 

What qualifies as a material change?

• Moving from one DOI-approved Private Plan to another involves changing the insurance carrier responsible for administering the plan.
• Moving from a Self-Insured Private Plan to a DOI-approved Private Plan, or vice versa.
• Voluntary/Involuntary termination of an approved Private Plan and returning to the FAMLI plan.
• Making any other changes to an approved Private Plan:
  • Adjustments to contributions, benefits, coverage, or policy that reduce benefits or leave;
  • Increasing claims adjudication timeframes;
  • Increasing benefits payment timeframes; or
  • Increasing the information collected from employees to apply for or receive benefits.

What documents are required for a material change? 

• For all material changes, except when the employer is returning to FAMLI, the employer must provide the following:
  • A detailed explanation of all changes; and
  • A statement describing how the changes will not reduce benefits or impose new requirements beyond those in the state plan.
• If the employer is changing DOI-approved carriers or switching from a Self-Insured Private Plan to a DOI-approved Private Plan, the employer must provide:
  • The employees’ posted notice showing the new plan effective date (when employees can file a claim with the new carrier).
  • A copy of a letter or email to or from the old carrier stating the end date of the old plan.
  • And one of the following from the new carrier:
    • Copy of the policy
    • Proof of purchase
    • A commitment letter
• For a DOI-approved Private Plan switching to a Self-Insured Private Plan, the employer must provide all documents required for the Self-Insured Private Plan.
• For any other changes to an approved Private Plan — such as adjustments to contributions, benefits, coverage, or policy — the document that was changed must be provided.

How to notify the Division of the material change? 

• The employer must notify the Division in writing of any material change to an approved Private Plan at least 60 calendar days before the change is to take effect.
  • The written notification must be sent via email to CDLE_FAMLI_PrivatePlans@state.co.us
  • The written notification shall include: 
    • A detailed explanation of all material changes; and 
    • A statement describing how the material changes do not reduce benefits or impose new requirements beyond what would be provided and required under the FAMLI program 

Material Change Fees and Fines:

• Material changes should be approved before they take effect. If the employer fails to provide the requested documents or notify the Division 60 days before the change takes effect, the material change will be denied.
• A misuse of a denied material change can lead to additional fines from the Division and/or revocation of the approved Private Plan.
• All material changes are subject to additional account maintenance fees.

Termination of a Private Plan

If an employer elects to return to the FAMLI plan, either voluntary or involuntary, they must remain on the state plan for at least three years. If the employer wishes to return to a Private Plan before the three years is complete, they must pay the FAMLI the amount that would have been remitted to the FAMLI Division during that three-year period. 

If a Self-Insured Private Plan is terminated voluntarily or involuntarily, FAMLI will collect the entire surety-bond amount by executing on the bond, collecting the amount directly from the employer, or a combination of the two methods. The Division will also have the employer surrender their Private Plan separate account balance. These collected amounts will be deposited into the FAMLI fund, and if applicable, will be credited toward the employer’s FAMLI premium obligations under Section 5.17 of 7 CCR 1107-5 5.17.

Voluntary Termination

Employers may choose to end their Private Plan early and return to the FAMLI program at any point during their Private Plan effective period. To do so they must:

• Notify the Division at least 30 days prior to the proposed termination date by emailing CDLE_FAMLI_PrivatePlans@state.co.us,
• Notify their employees of the termination at least 30 days prior to the proposed termination date.
• Provide the Division with proof of employee notification of termination.
• Email: CDLE_FAMLI_PrivatePlans@state.co.us.

Employers must retain their Private Plan coverage through the termination date. If they do not, they will be assessed a fine per employee, per each day the employee was not covered. The fine amount will be the lesser of (a) the daily total premium amount per employee, calculated by using the total annual premium amount paid by the employer and employee, divided by 365 or $500.00. For more information please see 7 CCR 1107-5 5.14.

Involuntary Termination

The Division reserves the right to revoke an employer’s Private Plan approval at any time when the terms or conditions of the plan have been violated. The Division will info the employer in writing of any violations or compliance issues discovered at the time of revocation. No more than seven days after the day the employer was sent the notification of revocation, the employer must notify all employees of the revocation. The employer is allowed to appeal the withdrawal of their Private Plan approval. The reasons for revocation are, but not limited to:

• Failure to pay benefits consistent with the requirements of the FAMLI Act and its regulations.
• Failure to pay benefits consistent with the Private Plan, when the Private Plan provides benefits greater than the FAMLI Act.
• Failure to maintain a surety bond in line with the FAMLI Act and its regulations.
• Misuse of Private Plan money including:
  • Use of Private Plan funds outside of the administration of benefit payments
  • Transferring Private Plan funds to an account not exclusively used for Private Plan funds
• Failure to submit reports or maintain compliance with the FAMLI Act and its regulations.
• Failure to pay the annual maintenance fee; or
• Failure to otherwise comply with the FAMLI Act and its regulations.

For more information please see 7 CCR 1107-5 5.16.

Employee Notification

Notifications must be a written notice and may be delivered to employees electronically, in person, or via mail. For employees starting work within 30 days of the effective date, employers must deliver the written notice upon hire.

The written notice must include: 

1. The effective date of the approved Private Plan; which is the date the employees can file claims with the new carrier.
2. A description of the Private Plan’s wage-replacement benefits. 
3. A description of the Private Plan’s leave and employment protection benefits. 
4. A description of how employee eligibility is determined. 
5. A description of how any employee contributions are calculated and collected. 
6. A description of how an employee may file a claim for benefits under the approved Private Plan. 
7. A notification to the employee of the employee’s appeal rights pursuant to the FAMLI Act, and if applicable, of the employee’s optional alternative to appeal a benefits determination to the Private Plan administrator. 
8. Contact information for the FAMLI Division and the plan administrator. 
9. A notification to the employee of the employee’s rights under C.R.S. § 8-13.3-509. 

In addition to delivering the written notice to each of its employees localized in Colorado, an employer must post a notice containing the same information. 

1. The notice must be posted in a conspicuous and accessible place in each establishment where employees are employed. 
2. The notice must be in English, Spanish, or any language that is the first language spoken by at least 5% of the employer’s Colorado workforce. 
3. If the employer does not maintain a physical workplace, or an employee works remotely, the employer may satisfy the posting requirement by sending the notice via email or through a conspicuous posting in a web-based or app-based platform that the employee regularly uses.