Family Medical Leave Administration Services

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Family Medical Leave Act (FMLA)
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Presentation transcript:

Family Medical Leave Administration Services

CareWorks Absence Management partnered Leave of Absence CareWorks Absence Management partnered with Butler University to provide administration services for their leave of absence program. On the following slides, we will review What is FMLA? Review the Leave of Absence Process When to refer an employee to CareWorks Absence Management Protected Health Information Questions Proprietary & Confidential 2

Proprietary & Confidential 3 What is FMLA? The Family Medical Leave Act, also known as FMLA, is a federal law allowing eligible employees to take unpaid leave that protects their job and benefits for up to a total of 12 weeks in a 12 months period for: Birth of child Adoption and/or foster care Care of a spouse, child or parent with a serious health condition An 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 due to a spouse, child or parent on active or reserve duty in the Armed Forces being deployed to a foreign country Proprietary & Confidential 3

FMLA Eligibility Requirements Employed for 12 months, AND does not have to be consecutive time 1,250 actual hours worked in the 12-month period preceding the date of the requested leave, AND Employed at a worksite where 50 or more employees are employed within 75 miles of that worksite, AND Available FMLA hours, AND Qualifying condition certified by a health care provider or meeting the military family leave eligibility Proprietary & Confidential 4

What is a Serious Health Condition? A medical condition that renders an employee unable to perform the essential functions of his or her job, such as: Incapacity of more than three days with treatment Incapacity is defined as an inability to work, attend school or perform other regular daily activities due to the serious health condition, treatment therefore, or recovery therefrom. (825.113(b)) In patient Hospital care Pregnancy Chronic conditions requiring treatment (e.g., asthma, diabetes, epilepsy, etc.) Permanent or long term conditions (e.g., Alzheimer’s , severe stroke, terminal states of a disease, etc.) Multiple treatments (e.g., dialysis, chemotherapy, physical therapy, etc.) Proprietary & Confidential 5

FMLA 12-Month Calculation Butler University is currently using the 12 Month Rolling Backward Calendar Calculation CareWorks Absence Management will add up the employee’s FMLA usage over the 12 months preceding the date leave is to begin and subtract that amount of time from the 12 week total allowed to determine the employee’s available FMLA time. Proprietary & Confidential 6

Proprietary & Confidential 7 Types of FMLA Leave An eligible employee is entitled to up to 12 weeks of leave under FMLA in a 12 month period for a qualifying reason. Leave under FMLA may be taken in the following ways: Continuous leave: a block of days taken continuously eg., Surgery or birth of a baby Intermittent leave: hours or days taken in separate blocks of time due to a single qualifying reason. eg., Physical Therapy one time per week for 6 weeks Reduced schedule: the employee works a reduced number of hours per workweek or per day eg., Released to return to work for only 6 hours per day Proprietary & Confidential 7

How will the FMLA process work? For new FMLA Leave Cases: Employees will continue to report absences following their normal reporting procedures. The employee will then call CareWorks Absence Management to report an absence/file a new claim that may qualify for leave. CareWorks Absence Management will verify FMLA eligibility, send applicable paperwork, review medical certification, designate the FMLA and notify the HR Representative & Supervisor. CareWorks Absence Management will send an email notification to the HR Representative & Supervisor each time work is missed for a claim. For intermittent leaves, employees must call their supervisor and CareWorks Absence Management to report every intermittent absence as indicated per policy. Proprietary & Confidential 8

Employee’s Responsibilities Report FMLA absences to their supervisor/manager. For new FMLA claims, call CareWorks Absence Management to report an absence after missing 3+ days for an FMLA qualifying reason. For FMLA, an employee must provide 30 days advance notice, unless the leave is unforeseeable. In this case, notice must be provided as soon as practical. At all times, employees must follow the employer’s call-in procedures. For FMLA leave taken on an intermittent basis, employees must attempt to schedule leave so that employer’s operations are not disrupted. Provide medical certification from their healthcare provider to CareWorks Absence Management within required timeframe. Per the employer’s policy, employees must continue to follow call-in procedures for reporting absences and remain in contact with the employer during the period of leave. Proprietary & Confidential 9

Manager’s Responsibilities Refer employees to CareWorks if they are absent for any of the below reasons. Absence of more than three (3) days for a medical reason and/or family care. Absences that appear to relate to chronic conditions or multiple absences for the same reason and/or condition. Multiple doctor visits and/or treatments. Absence related to a previously protected medical related issue. Anything you suspect that may be a qualifying reason for leave Establish, communicate, and enforce the department’s policies and procedures consistently between FMLA and non-FMLA absences. Review time to make sure that any time reported to you has also been reported to CareWorks. Ensure employees on approved FMLA leave do not resume any work activities until CareWorks receives a Return to Work (RTW) Medical Release. RTW releases may be obtained for a continuous FMLA absence Proprietary & Confidential 10

What to expect from CareWorks Dedicated specialist will handle leave requests, gather required documents and communicate with the employee the HR representative & the supervisor throughout the leave duration. CareWorks will verify the employee’s eligibility for FMLA and any applicable state leave laws. Medical certifications will be reviewed by an Absence Specialist to ensure consistency and accuracy of requests. The Absence Specialist will contact the healthcare provider if there is a medical release on file and there are questions or if more information is needed. CareWorks will report leave hours to HR & the supervisor and notify them of any approved leaves and any need to know changes in leave status. Proprietary & Confidential 11

Example of an email notification Proprietary & Confidential 12

Proprietary & Confidential 13 Employee Portal Our Employee Portal provides a convenient and secure site for employees to view leave and absence information. You can visit https://timeoff.careworksabsence.com or call our customer service team to create your secure account Real Time claim status View all Documentation Displays hours available for your leaves Interactive Messaging with representative FAQ Support Intermittent Time Reporting Proprietary & Confidential 13

Additional helpful materials Proprietary & Confidential 14

Protected Health Information An employee’s PHI is protected information by HIPAA and should not be discussed in the workplace. A supervisor/manager may need to discuss an employee’s leave with him/her, however, may only ask questions relating to the workplace: OK to ask…. How long do you expect to be absent? Will your absence require intermittent time away from work or a continuous time period? Have you contacted CareWorks Absence Management? Proprietary & Confidential 15

Protected Health Information The supervisor/manager should not ask any questions related to the medical diagnosis of the employee or his/her family member: Do not ask: What condition do you or your family member have? What have you been diagnosed with? What are you or your family member seeing the doctor for? If the employee does share their information with you please do not share it with anyone else, as this information should be kept confidential due to HIPAA Proprietary & Confidential 16

Please contact CareWorks Absence Management at CareWorks Contact Information Please contact CareWorks Absence Management at 1-888-436-9530 with any questions or concerns regarding FMLA. Please note that all calls are recorded for quality assurance. Proprietary & Confidential 17