What is FMLA?
The FMLA entitles eligible employees of covered employers to take unpaid, job-protected leave for specified family and medical reasons with the continuation of group health insurance coverage under the same terms and conditions as if the employee had not taken leave.
An eligible employee is one who:
- Has worked for the employer for at least 12 months.
- Has at least 1,250 hours of service for the employer during the 12 month period immediately preceding the leave
- Works at a location where the employer has at least 50 employees
within 75 miles.
If you're not eligible please reach out to your HR Generalist. They will be able to discuss other options.
Three Main Uses
How Do I Request FMLA?
STEP 1: Please notify your school leader and HR Generalist that you will are requesting FMLA leave of absence. Your HR Generalist will follow up within five days with your FMLA checklist and notice of eligibility, rights and responsibility form.
STEP 2: Print the two forms below (Certificate of Health Care Provider & Short Term Disability Claim). Please have your physician fill out the necessary sections.
STEP 3: Fax or email the completed forms to your HR Generalist at (616) 785-8455.
STEP 4: Once all paperwork is received your HR Generalist will review your request. Once the request is reviewed you will be receiving a determination letter via email.
Below are some important terms of your leave application. Please review them carefully:
- If your status changes please contact your HR Generalist as soon as possible, stating the need for the change along with the frequency and length of the time required.
- If you are approved to receive short-term disability, an employee must use PTO and/or vacation time for the first seven days of short-term disability unless it is an injury. If you do not have PTO days, this time will be unpaid.
- If you are approved to receive short-term disability, the benefit amount is 66.67% of your pre-disability earnings subject to the plan's maximum weekly benefit. The maximum weekly benefit is $750.
- For further information about the policy and procedures, please reference your Choice employee manual.
QUESTIONS? Please reach out to your HR Generalist. We are happy to help you!