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Family Medical Leave Administration Program

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Presentation on theme: "Family Medical Leave Administration Program"— Presentation transcript:

1 Family Medical Leave Administration Program

2 This change will take place on January 1, 2014
CareWorks USA CareWorks USA will administer the Family Medical Leave Benefit for Butler University This change will take place on January 1, 2014

3 What to Expect When Partnering with CareWorks USA
Fair and consistent administration of FMLA Compliance with FMLA regulations Streamlined process and ease of administration Simplified reporting through a 24/7 toll-free number Accurate FMLA tracking Employee satisfaction

4 What is FMLA? The Family Medical Leave Act of 1993 known as FMLA, is a federal law allowing eligible employees of a covered employer to take job-protected leave, for up to a total of 12 work weeks in any 12-month period for: Birth of a child. Adoption and foster care. Care of a spouse, child or parent with a serious health condition. The employee’s own serious health condition. Care of a spouse, child, parent or next of kin with a serious injury or illness incurred or exacerbated within 5 years of active duty in the Armed Forces (up to 26 weeks). Qualifying exigency arising out of the fact that a spouse, child or parent is on active duty in the Armed Forces or is deployed to a foreign country.

5 Eligibility Requirements - FML
Employed for 12 months (does not have to be consecutive time). 1,250 actual hours worked preceding the date of the requested leave. Available FML hours. Qualifying condition certified by a health care provider or meeting military family leave entitlement.

6 Serious Health Condition
A medical condition that renders an employee unable to perform the essential functions of his/her job: Incapacity of more than three days with treatment. Hospital Care. Pregnancy. Chronic conditions requiring treatment. Permanent or long term conditions. Multiple treatments.

7 12 Month Calculation The Butler University uses a Rolling Calendar Back Calculation This method looks back over the last 12 months from the date of the request, adds all FMLA time the employee has used during the previous 12 months and subtracts that total from the employee’s 12-week leave allotment.

8 12 Month Calculation Example:
John has been employed by Butler University since October 15, He needs to have surgery and will need to take 12 weeks of FMLA leave beginning on June 1, 2014. Actions: CareWorks USA reviews John’s record for the last 12 months (May 31, 2013 – June 1, 2014). It shows that John has not taken any FMLA leave in the last 12 months. Since there is no FMLA leave to deduct from John’s 12-week entitlement, John is entitled to the full 12 weeks of FMLA leave for his surgery.

9 How Does The Program Work?
Customized program materials are available for all employees.

10 Existing Leaves of Absence
Employees with current FMLA approvals will be transitioned to CareWorks USA. Employees will not be required to complete new certification paperwork. CareWorks USA will fully adopt the current FMLA certifications. Employees who have approved intermittent leaves must call their Supervisor and CareWorks USA to report every intermittent absence.

11 New Leaves of Absence Employee reports off of work to his/her Supervisor. The employee must also call CareWorks USA to report a new claim that may qualify for FMLA. CareWorks USA will send an notification to the Supervisor and Human Resources Department to notify of the request for leave. Employee must call CareWorks USA and report his/her absence to his/her Supervisor each time work is missed for an Intermittent FML.

12 Claim Packet A claim packet will be mailed to the employee’s home within 2 business days from the date of request for leave. The packet will include: FMLA Rights and Responsibilities Letter FMLA Certification Forms Medical Release Return to Work Release Forms to be returned to CareWorks USA within 15 days of receipt.

13 Claim Packet-continued
CareWorks USA will call the employee between days 8-10 of the 15 day timeframe if documentation is not returned. Health care provider will need to complete the medical certification form. If completed forms are not received, leave request may be denied and any absent time may be unexcused.

14 Determination Made Medical certification form is reviewed by Absence Management Specialist and RN. Additional information will be obtained if necessary. Approval/Denial of claim determined. Employee is notified via letter of claim status. Supervisor and Human Resources Representative is notified via of claim determination. Employee is contacted by CareWorks USA throughout absence for claim updates and to ensure a smooth transition back to work.

15 Employee’s Responsibilities
Notify your supervisor of your absence Call CareWorks USA to report your absence and/or make request for FMLA For Intermittent FMLA, must notify supervisor and CareWorks USA of any FMLA absence. Once packet is received, submit required paperwork by the due date provided in CareWorks USA correspondence For FMLA an employee must provide 30 days advance notice, unless the leave is not foreseeable. In this case, notice must be provided as soon as practical.

16 Employee’s Responsibilities
Employee must attempt to schedule intermittent leave so not to disrupt operations. For employee’s own serious medical condition, employee must submit completed Return to Work Certification to CareWorks USA prior to returning to work.

17 CareWorks USA’s Administrative Role
New FMLA initiation Certification packet sent to employee Employer notified of new FMLA request Medical Review Documentation review by CareWorks USA RN and any needed clarification made with medical provider Leave designation (Approval or Denial) Documentation of FMLA time utilized by employee Leave closure once employee returns to work or leave expires Answer questions for employees and supervisors

18 Coordination of Benefits
FMLA WILL run concurrent with any Workers’ Compensation absence or Short Term Disability Claim. Employees are required to use their available Paid Time Off (PTO) while on leave. FMLA is an unpaid job protection and the employees’ paid time will provide compensation during the leave of absence. Employees WILL BE responsible to pay their Insurance Premium contribution while out on unpaid FMLA.

19 Contact CareWorks USA Contact CareWorks USA if you have:
An absence of more than 3 days for medical reason and/or family care. Continued absences for the same reason and/or condition. Continued absences for a qualifying family member. Multiple doctor visits and/or treatments. Anything you suspect that may qualify for FMLA.

20 Thank You!

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