Puerto Rico Seguro
Incapacidad No
Ocupacional Temporal (SINOT)
Puerto Rico Seguro Incapacidad No Ocupacional Temporal (SINOT), or Temporary Non-Occupational Disability Insurance, provides wage replacement benefits to eligible employees who need time off from work as a result of a disability caused by an illness or injury that is not related to employment or to a car accident. In addition, it provides dismemberment and death benefits to an insured workers’ dependents.
Employers can participate in the Puerto Rico-run program (SINOT), or they can self-insure or fully insure a voluntary plan.
MetLife provides fully insured PR SINOT plans.
Benefit Overview
Mandated Coverage & Employee Eligibility
HintLeave Reason, Duration, Job Protection
HintCost of Coverage and Contributions
HintBenefit Payments
HintAll employers, including public corporations, that have at least one employee working in Puerto Rico are required to offer PR SINOT benefits and may do so through the Puerto Rico-run program, or through a fully insured or self-insured voluntary plan.
Employees may be eligible for PR SINOT benefits if they work for a covered employer and have earned at least $150 in the first four of the last 5 calendar quarters.
Eligible employees can receive part of their pay if they need to take time off for their own medical health condition that is not work or car accident related.
PR SINOT also provides benefits for dismemberment and death of employees and their dependents.
Employees may be eligible for up to 26 weeks of leave per year, with a 7-day waiting period. If the employee is hospitalized, the waiting period may not be required.
The maximum employee contribution is 0.30% of the employee’s salary, up to a maximum salary of $9,000 per year.
Private plan insurance premiums may differ, however, payroll caps determined by Puerto Rico apply. Employee maximum contributions for a private plan cannot be more than what they would pay for the Puerto Rico-run program. Employers fund the balance of the premium for insured private plans.
Please visit Puerto Rico's program’s website for the latest Puerto Rico plan rates and additional plan information.
The maximum weekly benefit is 65% of an employee’s average weekly wage, up to $113 for non-agricultural workers, and $55 for agricultural workers.
If a leave is for fewer than seven (7) days, the benefit payment will be equal to one-seventh (1/7) of the weekly benefit amount for each day of leave.
The following dismemberment benefits are payable to employees whose injuries due to an accident or illness results in any of the losses stated below:
- Total and permanent loss of sight in both eyes, $4,000
- Loss of both feet at or above the ankle, $4,000
- Loss of both arms at or above the wrist, $4,000
- Loss of one arm and one leg, $4,000
- Loss of one arm at or above the wrist, $3,000
- Loss of one leg at or above the ankle, $3,000
- Loss of one hand or one foot, $2,500
- Total and permanent loss of sight in one eye, $2,500
- Loss of at least 3 fingers or 3 toes, $2,000
The death benefit is $4,000, divided among the deceased employee’s direct dependents, plus any benefits owed to the deceased employee.
Key Dates
- All private plans must be filed with Puerto Rico by April 30 for a July 1 effective date of the same year
Applying for a MetLife Private Plan & Employer Requirements
To obtain a quote from MetLife, you or your broker must create a census of your eligible Puerto Rico workforce and send it to MetLife.
MetLife offers fully insured PR SINOT private plans.
MetLife will issue a state approved PR SINOT policy for fully insured plans.
Gather all documents and complete all forms necessary and apply. Your MetLife representative can provide you with the appropriate forms. To submit your plan, visit Puerto Rico's site.
Private plans must be filed with and approved by the Puerto Rico Department of Labor (DOL). All private plans must have an effective date of July 1. For a private plan to be effective July 1 of the current year, it must be filed with the DOL no later than April 30. Failure to file by April 30 will result in the private plan not being approved for the current plan year.
Note: If a plan is transferring from one private carrier to another, the effective date of the transfer must still be July 1. The documents must still be filed with the Puerto Rico DOL no later than April 30.
Once approved, please provide MetLife with a copy of your state approved PR SINOT private plan.
MetLife will send you an employee notice which you are required to share with your employees.
Cancellation of or changes to a private plan
After 1 year of being in effect, you may cancel a private plan by providing written notice to Puerto Rico. For plans where the employee does not contribute to the premium, the request must be made by April 30 for a July 1 change or termination. For contributory plans, the majority of employees (50%+1) must agree to the change or termination and any change or termination could take place at the beginning of the calendar quarter.
Taking a Leave
Filing for Benefits with MetLife
HintSupporting Claim Documentation
HintCoordination of Benefits
HintStep 1: An employee should notify their employer of the need for a leave as soon as possible.
Step 2: An employee should file a claim no later than two months from the date the disability began.
- Certification of a Disability/Serious Health Condition form filled out by the employee and their healthcare provider, or
- A doctor’s note or Attending Physician Statement (APS) that includes the same information as the Certification form
Employees may be eligible for more than one leave.
PR SINOT benefits and the federal Family & Medical Leave Act (FMLA) benefits can be used at the same time and should be used at the same time, when applicable.
MetLife’s claims team will reach out to the employer to coordinate dates of the company leave that directly overlap with PR SINOT.
MetLife representatives can help review and document employer paid benefits that may overlap with PR SINOT.
Note: There may be additional leaves that MetLife does not administer. Employers may be responsible for providing additional leaves for their employees. Employers should consult their own employment attorneys to identify changes to their other employer-sponsored paid and unpaid leave plans.
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As of December 20, 2024