Pregnancy and Parental Leave Benefit Policy

The Pregnancy and Parental Leave Benefit Program (PPLBP) was established under the 2004 Physician Services Framework Agreement. Under the 2007 Reassessment, the PPLBP eligibility requirements were expanded to allow physicians who receive similar benefits from an employer or through Employment Insurance (EI) to be eligible for a top up or supplemental payment under the PPLBP that is the difference between the amount they receive from their employer and/or EI and the amount payable under the PPLBP.

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Purpose

The Pregnancy and Parental Leave Benefit Program supports leave for eligible physician parents of a newborn or newly adopted child.

Eligibility Criteria

To be eligible, a physician must meet each of the following criteria:

1. Reside in Ontario.
2. a. Be licensed to practice medicine in Ontario, by the College of Physicians and Surgeons of Ontario (CPSO), during the full 26 weeks immediately before the start date of your pregnancy or parental leave, or

   b. Completed residency in Ontario during the 26 weeks immediately before the start date of the pregnancy or parental leave

3. Have not entered into an agreement with the Ministry that provides any other similar pregnancy or parental leave benefits under that agreement.
4. Earn less than $2,600.00 per week in gross eligible income during the leave.

Pregnancy and Parental Leave Benefit Policy

Pregnancy and Parental Leave Timelines

Pregnancy

Birth mothers may begin their leave as early as 5 weeks before their expected date of delivery.

• If the birth mother is advised by her attending physician/midwife to stop working early due to health concerns, she may start her leave earlier than 5 weeks before the expected date of delivery. A letter from the attending physician/midwife must be included in the application submission that confirms the date she was advised to stop working due to these health concerns.

Parental

Other parents, including birth fathers, non-birth mothers and parents expecting a child via surrogacy or adoption may begin their leave as early as the child’s birth date or adoption placement date. Benefits will not be issued for leave taken prior to the birth or in the case of adoption, the adoption placement date.

Stillbirth

In the event of a stillbirth, only the birth mother may be eligible for up to 17 weeks of benefits provided that she meets the program eligibility criteria and carried the child to at least 23 weeks gestation prior to the loss. Birth mothers may begin their leave as early as 5 weeks before their expected date of delivery.

• If the birth mother is advised by her attending physician/midwife to stop working early due to health concerns, she may start her leave earlier than 5 weeks before the expected date of delivery. A letter from the attending physician/midwife must be included in the application submission that confirms the date she was advised to stop working due to these health concerns.

All leaves must by completed within 12 months of the child joining the parent. No further benefit will be paid after this date.

Benefit Amount

Subject to all other provisions of the PPLBP, an eligible physician is entitled to pregnancy or parental benefits of 75% of his/her average weekly gross eligible earnings (OHIP – insured clinical services) in Ontario in the 12-month period immediately preceding the start date of the PPLBP leave, to a maximum of $1,300.00 per week.

If an eligible physician has not been licensed to practise medicine in Ontario for the full 12 months prior to the start date of the leave, the PPLBP will pay 75% of the physician's average weekly gross eligible earnings over the period of time she/he was licensed to practise in Ontario immediately preceding the start date of the PPLBP leave, to a maximum of $1,300.00 per week.

OHIP-insured clinical services refer to services that are paid under the OHIP Payment System and meet all the applicable requirements listed in the OHIP Schedule of Benefits. If a physician is paid directly by their workplace, the services they provided could have been eligible for payment under the OHIP Payment System, had their workplace not paid them directly.

Eligible Earnings Include:

• Fee for service billings (excluding technical fees)
• Remuneration from an Alternate Funding Arrangement (AFA)
  • For specialists, this means all payments of any kind received under any Alternate Payment Plan (APP) or Alternate Funding Plan (AFP) or under the Academic Health Science Centre (AHSC) AFP
  • For primary care physicians, this includes all payments received through primary-care agreements, including billings, base rate and comprehensive care payments, bonuses, premiums, and other incentives
• Salary from an employer for the provision of insured clinical services
• Income earned as a resident
• All other medical professional income remunerated through OHIP or through an employer for insured clinical services, including locum payments, sessional payments, stipends or supplements received from a hospital, community agency/organization, LHIN, long-term care facility, ministry, government agency or, in the case of specialists, received under a Primary Health Care Agreement

Non-Eligible Earnings Include:

• Workplace Safety and Insurance Board (WSIB)
• Insurance companies (i.e. Blue Cross)
• Drug/pharmaceutical companies
• Private and third-party billings
• University Health Insurance Program (UHIP)
• Funding for Electronic Medical Records (EMR)
• Research and teaching stipends, not paid as part of an Alternate Payment Plan (APP) or Alternate Funding Plan (AFP) or under the Academic Health Science Centre (AHSC) AFP
• Uninsured services (i.e. sick notes, insurance forms, missed appointment fees, medical records transfer fees, etc.)
• Earnings from another jurisdiction (i.e. Manitoba or Quebec)
• Northern and Rural Recruitment and Retention Initiative (NRRRI) and Northern Physician Retention Initiative (NPRI) payments
• Income for administrative work and committee duties
• Pregnancy and Parental Leave Benefits from prior leave (i.e. EI, PPLBP, employer based, etc.)

Income Earned While Receiving Pregnancy or Parental Leave Benefits

An eligible physician who is receiving benefits from the PPLBP may earn gross Eligible Earnings up to $1,300.00 a week. Any amount above $1,300.00 a week will be deducted from the benefit entitlement. Physicians in a capitation-based model (i.e. Family Health Organization) can use their capitation payments to pay for locum coverage for clinical services rendered to patients. This can be claimed as a deduction during the PPLBP leave. A signed letter from the locum(s) must be submitted with the monthly Part 3 – Declaration of Earned Income form to confirm coverage dates and weekly locum payments.

Top-Up to Other Maternity, Pregnancy or Parental Leave Benefits

An eligible physician who qualifies to receive maternity/pregnancy or parental leave- related benefits or payments from their employer or through EI at any time is entitled to a top up payment from the PPLBP that is the difference between the amount(s) received from the employer and/or EI and the amount payable under the PPLBP. This top-up will be applied even if the physician receives their EI/employer benefits before, during, or after their PPLBP benefits. An “employer benefit” refers to any income, stipend, or payments paid to a physician from their workplace, group, or partnership for the purposes of being on a maternity, pregnancy, or parental leave.

For example:

PPLBP Leave Dates	April 1, 2022 to July 28, 2022
PPLBP Weekly Benefits:	$1,300.00
Employer Benefits:	-$200.00
EI Weekly Benefits:	- $638.00
Weekly PPLBP Top-up Amount:	$462.00

Payment

Payments will be made by cheque by the 15^th of the month. Cheques will be addressed to the physician’s name registered in CPSO and not to their medical professional corporation’s name. The Ministry may withhold the final payment until all documentation is received.

Benefits are considered taxable income. No deductions will be taken from benefit payments for income tax, Canada Pension Plan or Employment Insurance. In February, the Ministry will email you a summary letter of the PPLBP benefits issued to you in the previous calendar year.

Application Submission Deadline

The complete, signed application and all supporting documents must be received within 12-months of the child joining the parent. Incomplete and/or unsigned supporting documents received after this deadline will not be processed, and no benefits will be issued.

PPLBP will confirm receipt of the application via email within 15 business days of the submission date. If you do not receive an email within this time period, please follow up with the program.

Submit your application and any supporting documents in PDF or JPEG format to pplbp@ontario.ca.

Note: It is the physician applicant’s responsibility to ensure that they understand the program policies and that their application is submitted on time, whether they are submitting it themselves or through a third-party.

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Frequently Asked Questions

The following questions and answers summarize the essential features of the PPLBP but do not provide full details or cover every circumstance. Please refer to the Guidelines for additional information.

• Eligibility
• Taking Your Leave
• Applying for PPLBP Benefits
• Calculating the PPLBP Benefit
• Declaring Earned Income While You Are On Leave
• Receiving My Benefits

If you have any questions, please e-mail PPLBP@ontario.ca.

Eligibility

I am working in a fellowship in Ontario. Am I eligible for PPLBP benefits?

You are eligible if you meet the eligibility criteria listed in the Program Policies, your fellowship is in Ontario and you are providing clinical services in this fellowship.

I am incorporated and pay myself a salary. Does this affect my eligibility to receive PPLBP benefits? 

Your incorporation status will not affect your eligibility for the PPLBP. When filling out your application package, you must declare the gross eligible earnings your corporation received under your name in the 12-month period immediately before your leave start date. During your leave, you must declare income earnings paid to your corporation under your name and not the salary you are withdrawing. Income earnings must be declared based on the service date, not the payment received date.

I experienced a pregnancy loss. Am I eligible for PPLBP benefits?

Birth mothers who experience a stillbirth and carried the child to at least 23 weeks gestation prior to the loss can apply for pregnancy leave benefits as long as she meets the eligibility criteria. Either a letter from the attending physician/midwife confirming the loss or a copy of the certified stillbirth certificate must be included in the application submission.

I am expecting a child through a surrogate. Am I eligible for PPLBP benefits?

Physicians who meet the eligibility criteria and who are expecting a child through a surrogate can apply for parental leave benefits to start when the child is born.

I started my leave prior to the April 1, 2022, policy changes. Am I eligible to receive the increase in PPLBP benefit of $1,300.00/week (formerly $1,035.45/week)?

Only physicians that start their leave from April 1, 2022, onwards will be eligible for the increase in PPLBP benefit of $1,300.00/week. Pregnancy and parental leave with a start date prior to April 1, 2022, are not eligible for the policy changes.

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Taking Your Leave

What is the difference between pregnancy and parental leave?

Pregnancy leave is for birth mothers only. Parental leave is for birth fathers, non-birth mothers and parents expecting a child via surrogacy or adoption. The maximum benefit is 17 weeks for all physicians.

My physician/midwife has advised me to stop working early for health reasons. How does this affect my pregnancy leave?

If your physician/midwife advised you to stop working early in your pregnancy due to concerns for you or your child's health, you may apply to start your pregnancy leave early. When submitting your application, you will need to include a letter from your attending physician/midwife that confirms these health concerns and the date you were advised to stop working on.

Do I have to take my pregnancy leave in consecutive weeks?

No, leave can be taken in non-consecutive weeks but must be taken for minimum two weeks at a time from Sunday to Saturday increments.

Can I start my parental leave benefits before my child was born or before the adoption placement date?

No, parental leave must be taken any time after the birth of your child or after your adopted child first comes into your care. The earliest that parental leave can start is the birth date or, in the case of an adoption, the adoption placement date.

Do I have to take my parental leave in consecutive weeks?

No, your 17 weeks of parental leave do not have to be taken in consecutive weeks. If you choose to take parental leave in non-consecutive weeks, the leave must be taken in seven-day increments from Sunday to Saturday after the birth date and minimum two weeks at a time. All parental leave must be completed within 12 months of the child joining the parent.

My child was born mid-week and I would like to take non-consecutive parental leave starting on the date of birth. How can I apply for this if my weeks must be from Sunday to Saturday after the birth date?

If your child was born mid-week, as an exception, you may start your non-consecutive parental leave on the date your child was born and take the first consecutive portion of your leave in seven-day increments. Once there is a break in your leave, your remaining weeks must be taken from Sunday to Saturday.

As an example, if your child was born on a Wednesday, you may claim the first consecutive weeks of your leave in seven-day increments from Wednesday to Tuesday starting the date your child was born. Once there is a break in your leave, all remaining weeks must be taken from Sunday to Saturday.

My partner is also a physician. Can we both apply for separate PPLBP leave?

Yes. If both parents are physicians and meet the eligibility requirements, both parents can apply for their own 17 weeks of PPLBP leave. You and your partner can take your leaves at the same time or consecutively and must submit separate applications.

My partner will not be taking the full 17 weeks of parental leave. Can I transfer my partner’s unclaimed weeks to my leave?

No, unclaimed weeks are not transferrable between partners. The maximum PPLBP benefits for all physicians is 17 weeks.

I am a birth mother. Can I apply for both pregnancy and parental leave for a total of 34 weeks?

Effective April 1, 2022, all physicians will be eligible for up to 17 weeks of PPLBP leave.

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Applying for PPLBP Benefits

I have submitted my application before the 12-month deadline. However, the PPLBP has determined my application to be incomplete and/or missing information. Can I resubmit the revised supporting documents after the 12-month deadline?

No further documents will be accepted or processed after the 12-month deadline. You are strongly encouraged to submit your documents as early as possible once you are on leave to allow a timely review, including the submission of incomplete/missing documents if applicable.

Can I submit my application package before my child is born?

If you are the birth mother, you may submit your application package no earlier than 2 weeks before you plan on going on leave. If there are changes to your application after it is submitted and before you begin your leave, you must email pplbp@ontario.ca immediately and submit a revised application package.

If you are applying for parental leave, please submit your application after your child is born or after the adopted child was placed in your care for the first time. The earliest you may start your parental leave is the child's birth date or adoption placement date. Applications for parental leave must include this date before it can be processed.

Please note that due to how benefits are calculated, applications are not approved until after you have started your leave.

Do I need to complete the Part 2 – Income Confirmation form?

This will depend on your pre-leave income earnings. To calculate your weekly PPLBP benefit entitlement, a Part 2 – Income Confirmation form must be completed to verify all non-fee for service income sources that you earned in the 12-month period immediately before your leave start date. This form is not required for direct fee for service billings or Professional Association of Residents of Ontario (PARO) salary earnings.

When completing this form, please ensure income is verified for the correct 12-month pre-leave period. For example: Leave Start Date: April 15, 2022, Part 2 needed for the service dates: April 15, 2021 to April 14, 2022.

Instead of a Part 2 – Income Confirmation form, can I submit a T4, Record of Employment, bank statement or letter from my employer to verify my earnings?

No, you must submit a Part 2 – Income Confirmation signed by your AFA administrator, group lead, office manager or employer. All other personal financial documents will not be accepted.

Will my benefits be paid retroactively if I submit my application package after I started my leave?

As long as your completed application is received by the 12-month submission deadline, your PPLBP benefits can be paid retroactively beginning when your leave first started.

I don't know when I will be starting my leave. Can I still submit an application package?

No, you cannot submit your application without a start date. You will need to know the start date of your leave before submitting your application package. Incomplete applications will not be processed.

I will be taking my parental leave in non-consecutive weeks. Where do I declare the weeks of my leave?

The weeks you are on leave and your income earnings for those weeks must be declared on Part 3 – Declaration of Earned Income, "Income Earned by Week" section. Do not include your earnings for the dates you are not on leave. All weeks that are declared will be processed as part of your non-consecutive parental leave.

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Calculating the PPLBP Benefit

How much will my benefit be while I am on leave?

Your pregnancy or parental leave benefits will be calculated as 75% of your average weekly gross eligible earnings in Ontario for the 12-month period immediately before the start date of your pregnancy leave or parental leave.

For example: Leave Start Date: April 15, 2022, verified income used for the service dates from April 15, 2021 to April 14, 2022. The maximum benefit is $1,300.00 per week.

If you have not been licensed to practice medicine in Ontario during the full 12-months prior to your leave, your benefits will be calculated based on the actual period of time you have been licensed to practice medicine in Ontario immediately prior to your leave.

Note: to be eligible, you must have been licensed during the full 26-weeks immediately before your leave start date.

Below is an example of a wage table explaining how the benefits are calculated based on different 12-month gross eligible earnings:

Wage Table

12-month Gross Eligible Earnings	Weekly Average (divide 52 weeks)	75% of Weekly Average	Weekly PPLBP Benefit *max $1,300.00/week
$50,000.00	$50,000.00 / 52 = $961.54	$961.54 * 75% = $721.15	$721.15
$75,000.00	$75,000.00 / 52 = $1,442.31	$1,442.31 * 75% = $1,081.73	$1,081.73
$90,133.00	$90,133.00 / 52 = $1,733.33	$1,733.33 * 75% = $1,300.00	$1,300.00
$200,000.00	$200,000.00 / 52 = $3,846.15	$3,846.15 * 75% = $2,884.62	$1,300.00

How much do my 12-month earnings need to be to receive the maximum PPLBP benefit?

To receive the maximum benefit of $1,300.00 per week, your gross eligible earnings during the 12-month period immediately preceding your PPLBP leave start date must be $90,133.00 or greater.

How do I declare my income earnings if I am billing fee for service but my group pays me a salary from my billings?

You must declare your gross fee for service billings before deductions. Income that is attributed to a physician's OHIP billing number is deemed as income that was earned by the physician, regardless of any internal group payment arrangements.

How will receiving Employment Insurance (EI) benefits and/or Employer benefits affect my PPLBP benefits?

If you have or will be receiving EI and/or employer benefits at any time during your leave from your workplace, you will be eligible for a top-up from this program. This top-up is calculated as the difference between the gross weekly amount of your EI/employer benefits and your weekly PPLBP  benefit entitlement. This top-up will be applied even if you receive your EI/employer benefits before, during or after your PPLBP  benefits, not just when it overlaps with your PPLBP leave. For example, if your EI benefits start later than your PPLBP leave, you will still receive a top-up for your full PPLBP leave if the EI benefits are 17 or more weeks in total.

Please note: you will not be eligible for a top-up if your EI and/or employer benefits are more than your weekly PPLBP benefit entitlement, even if you receive these other benefits at an earlier or later time than your PPLBP  leave.

My partnership is providing me with a stipend to support my maternity leave, but I am not an employee. Is this stipend still considered as an employer benefit?

Yes, any income, stipend, or payments that your workplace, group, or partnership will provide to you for the purposes of being on a maternity, pregnancy, or parental leave is considered as an “employer benefit” and will be topped up by the PPLBP .

The EI Program is withholding my first two weeks of benefits. Will I receive my full PPLBP entitlement for these first two weeks?

If you are receiving EI benefits payments for the same number of weeks you are receiving PPLBP benefits, you will receive a top-up from the PPLBP for your full leave no matter when your EI benefits start.

Am I eligible to receive more PPLBP benefits if I am having a twin, triplets, etc.?

No. The number of weeks and the maximum benefit amount do not change for a multiple birth or adopting more than one child at a time.

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Declaring Earned Income While You Are On Leave

Can I earn money while I am taking pregnancy or parental leave?

Yes, all physicians may earn up to $1,300.00 per week (gross income) during their PPLBP  leave for providing OHIP-covered clinical services during their leave. Your PPLBP  benefits will be reduced, dollar for dollar, if you earn more than $1,300.00 per week during the leave. Physicians who earn $2,600.00 per week or more during their leave will not be eligible for PPLBP  benefits due to high income earnings.

While I am on leave, I will be receiving delayed payments for services I provided before I started my leave. How will this affect my PPLBP benefits?

Delayed payments for clinical services that were provided before your leave will not affect your PPLBP benefits. Income earnings must be declared based on the date of service, not the date that payment is received.

I'm receiving a monthly payment during my leave. How do I declare the weekly amount?

To declare the weekly amount of monthly payments, please divide the earnings by the number of days the payment covers to determine the daily amount and then multiply by 7. For example, a payment that was for the full month of January would be divided by 31 (i.e. 31 days in January) and then multiplied by 7 (i.e. 7 days in a week).

I am incorporated and pay myself a salary.  What should I declare as my earnings while I am on leave?

You must declare all eligible earnings your corporation receives under your name for services you provide while you are on leave. Do not declare the salary you are withdrawing from your corporation.

There will be some months where I will not be taking any leave for my non-consecutive parental leave. Do I need to submit a Part 3 – Declaration of Earned Income for those months?

No, you only need to submit a Part 3 – Declaration of Earned Income for the weeks you are on leave. Do not include your earnings for the dates you are not on leave. All weeks that are declared will be processed as part of your non-consecutive parental leave.

I work in a capitation-based model and will be using my on-going capitation earnings to pay for locum coverage. Can I deduct this amount from my capitation earnings?

Yes, you may deduct the payments you make directly to a locum solely from your capitation earnings. To claim this deduction, your weekly gross capitation earnings and your weekly deduction for locum coverage must be declared on your monthly Part 3 - Declaration of Earned Income form. A signed letter must be submitted from your locum to confirm the coverage dates and the weekly payment amount for clinical services provided.

Can I deduct overhead expenses from my weekly earnings while I am leave?

No, overhead expenses cannot be deducted. Only payments made directly to a locum for providing coverage for clinical services can be deducted using capitation earnings.

How do I complete the Part 3 Declaration of Earned Income Form to declare my capitation payments during my leave?

To declare weekly earnings, physicians in primary care models must review their monthly RA, divide their capitation amount by the number of days in the month this payment covers to determine the daily capitation amount, then multiply the daily capitation amount by the number of days in the declared week of leave to determine the weekly capitation amount. If there has been an adjustment to the capitation for previous months, this should not be included in the total earnings for the month.

The monthly RA will report the previous month’s earnings, for example: the May RA will provide the April earnings, June RA reports May earnings, etc.

Example: May RA shows capitation payments of $22,000.00 and $2,400.00 in access bonus for the month of April.

• Capitation: $22,000.00 divided by 30 days is $733.33 per day. $733.33 multiplied by 7 days is $5,133.31 per week.
• Access Bonus: $2,400.00 divided by 30 days is $80.00 per day. $80.00 multiplied by 7 days is $560.00 per week.

Based a start date of April 1, 2022, structure of the month would be as follows:

• Friday, April 1 to Saturday, April 2, 2022 = 2 days
• Sunday, April 3 to Saturday, April 9, 2022 = 7 days
• Sunday, April 10 to Saturday, April 16, 2022 = 7 days
• Sunday, April 17 to Saturday, April 23, 2022 = 7 days
• Sunday, April 24 to Saturday, April 30, 2022 = 7 days

The Part 3 form would be completed as follows:

INCOME
	Week 1	Week 2	Week 3	Week 4	Week 5
	April 1, 2022	April 3, 2022	April 10, 2022	April 17, 2022	April 24, 2022
	April 2, 2022	April 9, 2022	April 16, 2022	April 23, 2022	April 30, 2022
	($)	($)	($)	($)	($)
Capitation	$1,466.66	$5,133.31	$5,133.31	$5,133.31	$5,133.31
Access Bonus	$160.00	$560.00	$560.00	$560.00	$560.00

As noted above, capitation payments must be declared on a separate line from other income earnings (i.e. billings, bonuses, premiums, incentives, etc).

If you are in a capitation-based primary care model (i.e. FHO) and will be using your capitation payments to pay for locum coverage during the leave, this can be claimed as a deduction by declaring the weekly amount that will be paid to the locum(s) in the row labelled “Locum Coverage Payment.”

A signed letter must be submitted from the locum(s) to verify coverage dates and the weekly payments they will receive for the clinical services provided. A monthly locum letter must be submitted if the locum payments will change each week. The locum payment deductions declared on Part 3 forms cannot exceed the payment amounts confirmed in the signed locum letter and cannot exceed the weekly amount of the declared capitation payment.

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Receiving My Benefits

How long will it take to process my application?

Processing times depend on when your application is received and how complete your documents are. A confirmation email will be sent when your application is received to clarify any missing details or to provide you with the next steps of the application process.

When will I receive my first benefit cheque?

This will depend on when your application is received, how complete your documents are, and when your application is approved. Applications that are approved and have a Part 3 – Declaration of Earned Income on file by the 28th of the month will have the first cheque mailed by the 15th of the next month. For example, an application must be approved and have a Part 3 form on file by January 28th to receive a benefit cheque on February 15^th.

For audit purposes, you will not be able to complete and submit a Part 3 – Declaration of Earned Income form to verify your actual income earnings until you receive your Remittance Advice, you are paid for the clinical services you provided during your leave, or you know your EI and/or employer benefit details.

Can my PPLBP  benefit cheques be issued to my medicine professional corporation?

PPLBP  benefit cheques are issued to the physician who is taking the pregnancy or parental leave, not to medicine professional corporations.

Do I need to provide a void cheque to PPLBP office to receive my benefit payments?

No, PPLBP benefits are not paid through direct deposits. Benefit payments are made by cheques and mailed to the home address provided in your Part 1 – Application form.

I will not receive a copy of my child's birth registration for 6-8 weeks. When is the latest I can send it in? Can I submit a copy of the hospital record instead of my child's birth registration?

You must submit a copy of the child's birth registration or adoption placement by the end of your pregnancy or parental leave through PPLBP or by your 12-month deadline. Personal hospital records, newborn records, or hospital discharge papers will not be accepted as birth registration.

Acceptable forms:

• Birth Certificate
• Certified Statement of Live Birth
• Written confirmation from the attending physician/midwife
• Certificate of Adoption (for adoptions only)
• Stillbirth Certificate/Death Certificate (if applicable)

Are PPLBP benefits taxable?

Yes, benefits are taxable. In February, the Ministry will provide you with a summary via email of the benefits it has paid you in the previous calendar year.

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Email: pplbp@ontario.ca