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USA Operations Centers Family Leave Medial Absence (FMLA) May 2017
As this policy is reviewed, please note the following States/areas for which exceptions exist:
State and Municipal Leave information can be located in the State and Municipal Leave Policy.
The Family and Medical Leave Act (FMLA) provides eligible employees up to 12 weeks of time off within a rolling 12-month period for the following:
Incapacity due to pregnancy, prenatal medical care or child birth;
To care for the employee’s child after birth, or placement for adoption or foster care;
To care for the employee’s spouse, son, daughter or parent, who has a serious health condition;
Serious health condition that makes the employee unable to perform the employee’s job; or
Military Qualifying Exigency.
Further, the FMLA provides up to 26 weeks of time off within a rolling 12-month period for military caregiver leave to care for a covered servicemember with a serious injury or illness who is the employee’s spouse, son, daughter, parent or next of kin.
Leave under the FMLA shall run concurrently with any applicable Joyner leaves. Leave under the FMLA shall be unpaid unless it otherwise qualifies for paid status under an applicable Joyner paid leave.
Eligibility
To qualify for leave under the FMLA, the employee must meet all of the following eligibility requirements:
The employee must have worked for the company for 12 months or 52 weeks. The 12 months or 52 weeks need not have been consecutive. Separate periods of employment will be counted.
The employee must have worked at least 1,250 hours, as determined under the Fair Labor Standards Act (FLSA), during the 12-month period immediately before the start of the leave. Time spent on paid or unpaid leave does not constitute hours worked and shall not be counted in determining the 1,250 hours eligibility test for an employee under FMLA.
Note: Employees who previously provided services to Joyner as an employee of another employer before becoming Joyner employees may be eligible for FMLA protected leave based in part upon service and hours worked for their prior employer.
To determine eligibility, employees should contact the Joyner third party Health Services Carrier.
Definitions
Immediate Family Member:
Spouse - husband or wife as defined or recognized under state law for purposes of marriage in the state in which the marriage was entered into, including common law marriage or same-sex marriage in states where such marriages are recognized.
Parents - biological, adoptive, step or foster father or mother, or those who stood in loco parentis*.
Son or daughter - biological, adopted or foster child, a stepchild, a legal ward or a child for whom the employee stands in loco parentis*, provided that for the purposes of leave taken for birth or adoption or to care for an Immediate Family Member with a Serious Health Condition, the child must be under age 18, or age 18 or older and incapable of self-care because of a mental or physical disability at the time FMLA leave is to commence.
*Persons who are in loco parentis include those with day-to-day responsibilities to care for and financially support a child, or in the case of an employee, who had such responsibility for the employee when the employee was a child. A biological or legal relationship is not necessary.
Serious Health Condition
An illness, injury, impairment or physical or mental condition involving any of the following:
Any period of incapacity or treatment connected with inpatient care in a hospital, hospice, or residential medical care facility.
An absence exceeding three consecutive calendar days from work, school, or other regular daily activities that includes continuing treatment* by a health care provider. To qualify as continuing treatment:
The individual must visit a health care provider twice for the same condition with the first visit occurring within seven days of the start of the incapacity and both visits occurring within 30 days of the beginning of incapacity, or the individual must visit a health care provider once with a treatment regimen prescribed. The visit must take place within seven days of the start of the incapacity.
*Note: Continuing treatment does not include over-the-counter medications, bedrest, drinking fluids, exercise or similar activities.
Any period of incapacity due to pregnancy or prenatal care.
A period of incapacity which is permanent or long-term due to a condition for which treatment may not be effective. (e.g., Alzheimer’s or the terminal stages of a disease).
An absence to receive multiple treatments (including any period of recovery therefrom) following restorative surgery due to an accident or illness or for a condition that would likely result in a period of incapacity of more than three consecutive calendar days in the absence of treatment, (e.g., cancer (chemotherapy), kidney disease (dialysis)).
Incapacity or treatment due to a chronic serious condition. A chronic health condition is any period of incapacity which:
Requires periodic visits for treatment by a health care provider (at least two visits in a 12-month period), and
Continues over an extended period of time (including recurring episodes of a single underlying condition), and
May cause episodic rather than a continuing period of incapacity (e.g., asthma, diabetes, epilepsy, etc.)
Treatment means an in-person visit to a health care provider.
In the absence of complications, the following are not considered serious health conditions:
Cosmetic treatment, colds, flu, earaches, upset stomach, minor ulcers, headache other than migraine, routine dental or orthodontia problems, and periodontal disease.
Military Family Leave Entitlements
Eligible employees whose spouse, son, daughter or parent is on covered active duty or called to covered active duty status may use their 12-week leave entitlement to address certain qualifying exigencies. Qualifying exigencies may include attending certain military events, arranging for alternative childcare, addressing certain financial and legal arrangements, attending certain counseling sessions, and attending post-deployment reintegration briefings.
FMLA also includes a special leave entitlement that permits eligible employees to take up to 26 weeks of leave to care for a covered servicemember during a single 12-month period. A covered servicemember is: (1) a current member of the Armed Forces, including a member of the National Guard or Reserves, with a serious injury or illness incurred in the line of duty for which the service member is (i) undergoing medical treatment, recuperation or therapy, (ii) otherwise in outpatient status, or (iii) otherwise on the temporary disability retired list, for a serious injury or illness**; or (2) a veteran who was discharged or released under conditions other than dishonorable at any time during the five-year period prior to the first date the eligible employee takes FMLA leave to care for the covered veteran, and who is undergoing medical treatment, recuperation, or therapy for a serious injury or illness.
**The FMLA definitions of “serious injury or illness” for current servicemembers and veterans are distinct from the FMLA definition of “serious health condition”.
Protections Provided by the FMLA
The FMLA protects employees who take qualified leaves from discrimination or adverse employment action, allows employees to maintain any health benefits they may be entitled to receive, and provides for certain re-employment rights upon the employee’s return to work.
FMLA protected leave cannot be considered in:
Performance management measures, such as counseling memos, recommendations for termination, or other disciplinary action.
Attendance-related counseling or other disciplinary actions. All performance management evaluations involving attendance should not include FMLA protected leave, or consider lost production due to such leave.
Evaluating an employee’s attendance record or performance. This includes, but is not limited to:
Employee Performance Results Tools Employee-initiated requests for transfer Job postings
Amount of Leave Available
Except for FMLA protected leave provided under Military Family Leave, the amount of FMLA protected leave available shall be measured using a "rolling" 12-month period. Under this method, each time an employee takes FMLA protected leave, the remaining leave entitlement would be any balance of the 12 weeks which has not been used during the immediately preceding 12 months.
Employee Status and Benefits During Leave
While an employee is on leave, the company will continue the employee's health benefits during the leave period at the same level and under the same conditions as if the employee had continued to work. Employees are required to make the same contributions toward such health benefits as they would have if they continued working.
Intermittent Leave or a Reduced Work Schedule
The employee may take FMLA leave in 12 consecutive weeks, may use the leave intermittently (take a day periodically when needed over the year) or, under certain circumstances, may use the leave to reduce the workweek or workday, resulting in a reduced hour schedule. In all cases, the leave may not exceed a total of 12 workweeks (or 26 workweeks to care for an injured or ill servicemember over a 12-month period).
For the birth, adoption or foster care of a child, the company and the employee must mutually agree to the schedule before the employee may take the leave intermittently or work a reduced hour schedule. However, such mutual agreement is not required for intermittent leave required by the serious health condition of the mother or newborn child. Leave for birth, adoption or foster care of a child must be taken within one year of the birth or placement of the child.
If an employee needs leave intermittently or on a reduced leave schedule for planned medical treatment, then the employee must make a reasonable effort to schedule the treatment so not to unduly disrupt Joyner’s operations.
FMLA Administration (Third Party)
Joyner has retained a third party vendor, a health services company, to administer Joyner’s FMLA policy. On behalf of Joyner, the vendor will:
Review requests for FMLA protection
Evaluate designated absences for FMLA protection
Determine eligibility under FMLA
Provide the employee with an eligibility notice, rights and responsibilities, and designation notice
Request and evaluate certifications
Track FMLA protected absences
Communicate FMLA information to employees and supervisors
Procedures for Notifying Supervisor/Management of Leaves Under FMLA
When the need for FMLA leave is not foreseeable, employees who are going to be absent from work must contact their supervisor/management within one hour from the beginning of work unless instructed otherwise, or as soon thereafter as practicable.
When the need for FMLA leave is foreseeable, employees who are going to be absent from work must contact their supervisor/management regarding their absence at least 30 days in advance of the leave. When 30 days’ notice is not practicable, the employee must provide notice as soon as practicable.
When the need for FMLA is due to a qualifying reason for which the health servies company (third party) previously approved intermittent leave, the employee must specifically reference either the qualifying reason for leave or the need for FMLA leave. These absences must be reported to the third party within 48 hours from the start of the absence.
Employees must provide sufficient information for Joyner to determine if the leave may qualify for FMLA protection and the anticipated timing and duration of the leave. Sufficient information may include that the employee is unable to perform job functions, the employee is pregnant or has been hospitalized overnight, the family member is under the continuing care of a health care provider, or circumstances supporting the need for military family leave. Employees also must inform Joyner if the requested leave is for a reason for which FMLA leave was previously taken or certified. Employees also may be required to provide a certification and periodic recertification supporting the need for leave.
Contacting the Health Services Provider (Third Party) to Submit a FMLA Request
Employees should request FMLA leave by contact the Health Services Provider (Third Party). An Intake Specialist will explain the process and provide information about eligibility for Family and Medical Leave and your rights and responsibilities under the FMLA, as well as further instructions regarding the request.
Employees requesting FMLA leave by contacting the Health Services Provider (Third Party) must also notify their supervisor/management as required under Procedures for Notifying Supervisor/Management of Leaves under FMLA.
Eligibility Notification and Designation Determination
When an employee contacts the Health Services Provider (Third Party) to request that Joyner designate certain leave as protected by the FMLA or Joyner, otherwise acquires knowledge that an employee’s leave may be for an FMLA-qualifying reason, the Health Services Provider will, within five business days absent extenuating circumstances, notify the employee of the employee’s eligibility to take FMLA-protected leave. Eligibility will be determined and notice of eligibility provided at the commencement of the first instance of leave for each FMLA-qualifying reason in the applicable 12-month period.
Cigna’s Acknowledgment/Eligibility Notice will be mailed to the employee’s home address. This letter serves as the FMLA Eligibility Notice and informs the employee of his or her eligibility for FMLA protected leave. The employee’s rights and responsibilities under FMLA are explained in this communication and a copy of the FMLA Notice of Rights and Responsibilities is enclosed with the letter. The letter will also include a Certification of Health Care Provider for Employee’s Serious Health Condition, Certification of Health Care Provider for Family Member’s Serious Health Condition or Certification of Qualifying Exigency for Military Family Leave. The applicable medical certification is to be completed by the employee and the employee’s health care provider and returned to Cigna. The Qualifying Exigency certificate is to be completed by the employee.
When health services provider has enough information to determine if leave is being taken for an FMLA-qualifying reason, the health services provider will notify the employee within five business days, absent extenuating circumstances, whether the leave will be designated and counted as FMLA-protected leave. Cigna’s designation decision shall be based solely on the information provided by the employee or the employee’s spokesperson and the applicable certifications.
Documenting and Tracking
FMLA leaves will be documented & tracked by the Health Services Provider.
Employees may view their own information at online in the employee portal.
Supervisors may view this information at online in the management portal.
The Health Services provider will also communicate FMLA information to employees by U.S. mail.
Supervisors will receive FMLA information from the Health Services Provider by e-mail.
Health Services Provider approved FMLA dates can also be viewed in the Time Management tool (select “Reports” then “Custom Protected Leave Report”. Employees subject to the Attendance Policy will also see FMLA protected dates on their timesheet.
FMLA approved time runs concurrent with Joyner absence types. The time off may be paid or unpaid depending on the circumstances of the leave. Please refer to Time Away From Work polices for additional information.
Employees should request FMLA leave by contacting the Health Service Provider (Third Party).
Employees must also notify their supervisor/management as required under Procedures for Notifying Supervisor/Management of Leaves under FMLA.
When the need for FMLA is due to a qualifying reason for which the Health Services Provder previously approved intermittent leave, the employee must specifically reference either the qualifying reason for leave or the need for FMLA leave. These absences must be reported to the Health Services Provider within 48 hours from the start of the absence. Employees can report the absence by contacting the health services provider. If after business hours or on weekends, there is an option to leave a message to report the absence.
Employees must provide sufficient information for Joyner and/or The Health Service Provider to determine if the leave may qualify for FMLA protection and the anticipated timing and duration of the leave. Employees also must inform Joyner and/or The Health Service Provider if the requested leave is for a reason for which FMLA leave was previously taken or certified.
Employees may be required to provide the Health Services Provider with certification and periodic recertification supporting the need for leave.
Employees requesting FMLA protection for scheduled overtime hours should contact Joyner. If the Health Services Provider is unable to consider the overtime hours, the employee should complete the FMLA Designation - Overtime Hours form on Joyner Forms for further review.
The supervisor must contact the Health Services Provider as soon as he/she acquires sufficient information to reasonably determine that an employee’s leave may be for an FMLA-qualifying reason (see Overview). Note: The employee merely calling in “sick” without providing more information indicating that the employee’s leave is for an FMLA-qualifying reason and the supervisor having not otherwise acquired such information will not obligate the supervisor to contact Cigna.
The supervisor will ensure FMLA designation requests are directed to the Health Services Provider.
The Health Services Provider will advise both the employee and supervisor of the FMLA designation decision. FMLA leaves will be documented & tracked on the Health Service Provider system. Supervisors may view this information at online.
When situations arise where "docking" an exempt employee's pay for partial day FMLA protected absences may be warranted, the employee should complete the Payroll Unpaid Absence Report for Exempt Employees found on Joyner Forms and forward to his/her supervisor. If approved, the supervisor will advise the employee and forward the form to HREC. The supervisor will ask the employee to respond back confirming he/she understands the time off requested is approved and will not be paid.
Human Resources should read and become familiar with the FMLA policy.
Human Resources may advise management on the proper application of the FMLA policy. Emphasis should be placed on FMLA's impact on:
Time-off policies
Documentation of attendance records, including Performance Results Tools, job postings, transfer request forms, and attendance programs
Performance management, including counseling memos pertaining to absenteeism