Paid Family and Medical Leave Workforce Notice (2026)
Instructions for Use
This notice satisfies the written-notice requirement of the Massachusetts Paid Family and Medical Leave law (M.G.L. c. 175M; 458 CMR 2.04). Human Resources delivers it and captures the acknowledgment.
When to deliver this notice:
- At hire. Within 30 days of an employee's first day of employment.
- Annually, on rate changes. When the Department of Family and Medical Leave announces new contribution rates or benefit amounts (announced each fall, effective January 1), deliver the updated notice to all employees at least 30 days before the change takes effect. This document is revised each year to carry the new figures; deliver the current published version.
- Remediation re-issue. Deliver to all current employees whenever acknowledgment records are incomplete, so that a signed acknowledgment exists on file for every employee.
How to deliver:
- Confirm the notice on file is the current published version and that the year in the title matches the calendar year of the rates it prints.
- Deliver through the HRIS with electronic signature capture, or on paper with a wet signature. Electronic delivery and acknowledgment are permitted.
- If the employee does not return a signed acknowledgment within 30 days, complete the employer delivery record at the bottom of the acknowledgment section. The law requires the company to show its effort to deliver the notice; a completed delivery record preserves that evidence when no signature is returned.
Notice of Paid Family and Medical Leave Benefits
Massachusetts law provides paid family and medical leave benefits to workers in the Commonwealth. Benefits are administered by the Massachusetts Department of Family and Medical Leave (DFML) and funded through payroll contributions. This notice explains the benefits available to you, the contributions you and Applied Behavioral Analysis Services, LLC (ABAS) make, and how to file a claim.
Your Benefits
As a covered individual, you may be eligible for:
- Up to 20 weeks of paid medical leave per benefit year to manage your own serious health condition.
- Up to 12 weeks of paid family leave per benefit year to bond with a child during the first 12 months after birth, adoption, or foster placement.
- Up to 12 weeks of paid family leave per benefit year to care for a family member with a serious health condition.
- Up to 12 weeks of paid family leave per benefit year to manage family affairs when a family member is on active duty in the armed forces.
- Up to 26 weeks of paid family leave per benefit year to care for a family member who is a covered servicemember with a serious injury or illness incurred in the line of duty.
The combined maximum is 26 weeks of paid leave per benefit year. Leave may be taken on a continuous, intermittent, or reduced-schedule basis where the law allows.
The weekly benefit is calculated from your average weekly wage and the state average weekly wage. For leave beginning in calendar year 2026, the maximum weekly benefit is $1,230.39.
Your Job Is Protected
Taking paid family or medical leave does not put your job at risk. When you return from leave you must be restored to your previous position or an equivalent position, with the same status, pay, employment benefits, and seniority. Your employer must continue to provide for and contribute to your employment-related health insurance benefits during your leave. It is unlawful for any employer to discriminate or retaliate against you for exercising your rights under the PFML law.
Contributions for Calendar Year 2026
ABAS participates in the state PFML plan and had 25 or more covered individuals in the prior calendar year, so both ABAS and its employees contribute. The total contribution rate for 2026 is 0.88% of eligible wages, up to the Social Security taxable maximum ($184,500 for 2026), divided as follows:
| Contribution | Rate | Who pays |
|---|---|---|
| Medical leave | 0.70% of eligible wages | ABAS pays 0.42% (60%); up to 0.28% (40%) is deducted from your wages |
| Family leave | 0.18% of eligible wages | Deducted from your wages |
Employer Information
| Field | Entry |
|---|---|
| Employer name | Applied Behavioral Analysis Services, LLC (ABAS) |
| Mailing address | 432 State Street, Belchertown, MA 01007 |
| Federal Employer Identification Number (FEIN) | 86-1158371 |
How to File a Claim
Apply for benefits directly with DFML, not with ABAS:
- Notify Human Resources of the anticipated start date of your leave, the anticipated length, and the type of leave, at least 30 days in advance where practicable, or as soon as practicable.
- Apply online at paidleave.mass.gov or call DFML at (833) 344-7365.
Department of Family and Medical Leave Contact
| Channel | Detail |
|---|---|
| Department of Family and Medical Leave, P.O. Box 838, Lawrence, MA 01842 | |
| Phone | (833) 344-7365 (Monday through Friday, 8:00 a.m. to 4:30 p.m.) |
| Online | www.mass.gov/DFML (program information and contact form); paidleave.mass.gov (applications) |
For a full explanation of PFML benefits, see the Paid Family and Medical Leave section of the ABAS Employee Handbook and M.G.L. c. 175M.
Acknowledgment of Receipt
Massachusetts law gives you the opportunity to acknowledge or decline to acknowledge receipt of this notice. Check one box, then sign and date. Signing acknowledges that you received this information; it is not a waiver of any right and does not indicate agreement or disagreement with the program.
☐ I acknowledge receipt of this Notice of Paid Family and Medical Leave Benefits.
☐ I decline to acknowledge receipt of this notice.
| Field | Entry |
|---|---|
| Employee name (print) | |
| Signature | |
| Date |
Employer Delivery Record
Human Resources completes this block only when no signed acknowledgment is returned within 30 days of delivery. It records the company's effort to provide the notice, as the regulations require.
| Field | Entry |
|---|---|
| Employee name | |
| Date notice delivered | |
| Delivery method | ☐ HRIS electronic delivery ☐ Email ☐ Paper, in person ☐ Paper, by mail |
| Delivered by (role/title) | |
| Follow-up attempts and dates |
Form Realization and Fallback
This is the canonical, authoritative version of Form CFM-006, maintained in the compliance documentation. It defines the content, fields, and acknowledgment structure that any realization of the notice must capture.
ABAS may deliver this notice through an electronic realization: the HRIS document-delivery and e-signature workflow, email with electronic acknowledgment, or a web form. Any electronic realization must carry the same content, print the current calendar year's rates, and carry the form identifier CFM-006, so policies and procedures refer to the notice by its identifier rather than to any one channel.
The documented form here is always available as a fallback. It can be printed and completed on paper whenever an electronic channel is unavailable.
The Department of Family and Medical Leave publishes its own employer notice templates each year in English and other languages. A current-year DFML template, completed with the employer information above, may be delivered alongside or in place of this realization; the acknowledgment must still be captured and retained. Alternate-language versions given to employees must match the content of this canonical form or the DFML template for the same year.
Retention
Signed acknowledgments, declinations, and employer delivery records are the company's evidence of compliance with the PFML notice requirement and are retained for the duration of employment plus three years:
- Human Resources retains each employee's acknowledgment (or the completed employer delivery record) in the employee's personnel file in the HRIS.
- Human Resources confirms to the Compliance Officer, at each annual re-issue and at each new-hire delivery, that acknowledgment capture is complete; gaps are tracked to closure.
- When notice content changes (new rates, new benefit amounts), the prior year's acknowledgments remain on file; a fresh acknowledgment is captured for the new notice.