Mandated paid leave and other state law trends to watch in 2024 

Monitoring ant hills in a front or back yard can be an ongoing task, a homeowner’s version of Whac-A-Mole. A similar theme applies to state-mandated paid leave and health benefits. Constant monitoring, assessment and proactive action are essential, especially as the 2024 legislative cycle approaches. Here’s an overview of what you will need to watch out for next year. 

Spotlight is on paid leave 

Expect more legislation creating new mandates or revising existing laws related to paid family and medical leave (PFML) and accrued paid time off or accrued paid sick and safe leave. Current trends include securing paid leave for family bereavement, miscarriage or other pregnancy loss, and organ donation. These laws require extensive administration, coordination and communication, especially for multistate employers and those with established employer-provided paid leave policies.  

Some states may take the less intrusive route of allowing group paid family leave insurance policies to be sold, like Alabama, Arkansas, Florida, Tennessee, Texas and Virginia did recently. In 2024, pay particular attention to Georgia, Hawaii, Indiana, Louisiana, Missouri, New Mexico, Oklahoma, Vermont and Virginia. 

Watch for PFML implementation guidance in states with new programs, like Delaware, Maine, Maryland and Minnesota. Monitor local jurisdictions considering requirements related to accrued paid sick and safe leave or paid time off (PTO) for any reason.   

Other areas to watch 

1. Pharmacy benefit managers. Assess how bills restricting pharmacy benefit managers (PBM) activities affect fully insured and self-funded plans. Pay attention to developments related to the ERISA preemption case, Pharm. Care Mgmt. Ass’n v. Mulready. Calculate the potential cost impact of PBM changes required by state law. 
2. Telehealth. Keep an eye on two divergent trends. Many states are looking for ways to expand use of out-of-state providers to address physician shortages, particularly in behavioral health. Others are restricting telehealth services, particularly for prescriptions, abortion and gender-affirming care for minors.  
3. Coverage mandates. Track how state coverage mandates affect fully insured policies, even those issued in elsewhere if they cover state residents. Evaluate how state laws restricting or banning certain medical care affects access to covered benefits for participants. If you employ a significant number of temporary employees, be mindful of the trend to set minimum pay and benefit standards for this group. 

The importance of staying current

Examine your overall leave strategy in light of state and local requirements. For example, an employer’s sick leave policy may violate state rules on accruals or carryovers. Stay abreast of major legislative developments in states where you have employees. Regularly discuss these issues with your benefit advisors and vendors to stay ahead of changes. Finally, consider how to increase engagement with state and local lawmakers, perhaps through regional business groups.  

For more information about state-mandated paid leave and other state law trends, see our GRIST: Top 10 health, leave benefit compliance and policy issues in 2024.