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Employee FAQs

Family Medical Leave Act (FMLA)

Insurance Benefits (FMLA, Hospital Leave, Disability Benefit)

Family Medical Leave Act (FMLA)

What is FMLA and what is its purpose?
FMLA stands for Family Medical Leave Act of 1993.  Its purpose is to allow employees to balance their work and family life by taking reasonable paid/unpaid leave for certain qualifying reasons.

Who is eligible for leave under FMLA?
To be eligible for FMLA leave, an employee must have been employed for at least I year (includes any previous employment in the past 7 years and must have worked at least 1,250 hours in the 12-month period preceding the start date of intended leave.

What conditions qualify under FMLA?
You may be eligible for FMLA for the following conditions:

  • Your own serious health condition
  • The birth of your child
  • Care of your newborn
  • Placement of a child with you for adoption or foster care
  • To care for a spouse parent or child with a serious health condition (child must be under 18 or incapable of self-care due to a physical or mental disability).

Are grandparents, siblings, in-laws or other relatives covered under FMLA?
Grandparents, brothers, sisters, aunt, uncles, cousins and in-laws are not covered under the FMLA law unless the person is a legal ward of the employee.

What is a serious health condition?
A serious health condition means an illness, injury, impairment or physical or mental condition that involves one of the following:

  • Inpatient cares (an overnight stay in the hospital and any follow-up treatment.
  • A period of incapacity of more than three consecutive calendar days that also involves either:
  • Treatment by a healthcare provider two or more times within 30 days of the first day of incapacity or
  • Treatment by a healthcare provider at least once (in-person visit) that results in a regiment of continuing treatment under the supervision of the healthcare provider.  The in-person visit must take place within 7 days of the first day of incapacity.
  • Chronic conditions, which require periodic visits to a healthcare provider over an extended period of time (at least 2 times per year).
  • Permanent, long term conditions
  • Conditions that require multiple treatments
  • Any period of incapacity because of pregnancy or prenatal care.

How much notice must an employee give prior to requesting FMLA?
 If the leave is foreseeable, you must give a 30-day notice, if the leave is not foreseeable, you must notify your manager and Leave Management as soon as practicable, usually within two business days.

How do I apply for FMLA leave?
Call the Leave management Specialist at 750-5033.               

How do I know if my leave is approved?
You will receive an FMLA approval letter and the FMLA guidelines.    

Are my benefits maintained while on FMLA?
Yes, your benefits will continue as if you are continuously working.                          

What do I need to do to return from FMLA leave?
Be sure that Leave Management has a release from your treating physician and if you are out for 30 days or longer, you will need to schedule a drug screen with Employee Health.

What is the best way to avoid any problems or conflicts while I am on FMLA?
The best way to avoid any potential conflict is:

  • To communicate with your manager and Leave Management.
  • Try to work out a schedule that best meets your need for leave and the needs of your department.
  • Review all documents provided by Leave Management to ensure you understand your rights and responsibilities while on FMLA.

 

Insurance Benefits
FMLA
Hospital Leave
Disability Benefit

Insurance Benefits – FMLA

How can I add my baby to my health insurance?
If you are on FMLA for maternity leave, you still need to notify Human Resources – Benefits area, to add your new baby to the health insurance. Human Resources does not have access to patient records to automatically add your new dependent. When you enroll your baby, you will need to provide a copy of the birth certificate or the hospital crib card. Make sure to add your baby within 30 days of the birth date, otherwise, you will have to wait until annual Open Enrollment.

Can I keep my insurance benefits while I am out on FMLA?
Your benefits will remain the same while you are on FMLA. You can continue them at the same employee rate that you pay as an active employee.

How do I pay for my benefits while I am out on FMLA?
As long as you have paid time available, you will receive a payroll check each pay period. Your benefit premiums will be deducted as they are when you are working. 

If your paid time ends before you return from FMLA, you can pay your benefit premiums to DCH by sending a check made payable to DCH to Human Resources-Benefits. Other options for payment are cash payment or credit card at the DCH Cashier’s Office.

You have a benefits premium payment schedule in your FMLA packet. The benefit premiums you owe each pay period and when they are due have been circled for you.

How do I know when I need to begin paying for my benefits?
When you exhaust your paid time and do not receive a payroll check or your payroll check is not sufficient to cover your benefit deductions, this means that your insurance benefits have not been paid for that pay period. The premiums are due biweekly on the pay date for each pay period.

When you do not receive a payroll check, you may call a Benefits representative in Human Resources at 759-6782 to confirm that benefit premiums have not been paid. You can then send a check made payable to DCH to Human Resources at the address at the top of your Benefits Premium Payment Schedule.

What do I have to do to return to work after FMLA?
Return your physician’s release form to Employee Health at least 2 weeks before your intended return to work date. If you have been out longer than 30 days, you will need to make an appointment with Employee Health for a drug screen. Your results must be cleared through Employee Health before your return to work. Employee Health telephone number to make your appointment is 759-7698.

If your physician’s release has restrictions, it will have to be cleared through Employee Health before your return to work. You may not be able to return to work if you have restrictions on your release form.

What happens if I cannot return to work when my FMLA time is exhausted?
If you are not able to return to work at the end of your FMLA, and if you have no paid time available, you may be eligible for Hospital Leave, or you may be administratively removed from payroll if you do not qualify for Hospital Leave. Hospital Leave may continue for an additional 3 months following FMLA. If you are removed from payroll, you will be considered for re-employment.

Insurance Benefits – Hospital Leave

Do I have insurance benefits while I am on Hospital Leave?
At the end of the month in which you go on Hospital Leave, your insurance benefits at the employee rate will end. You will be sent paperwork to your home address explaining how to continue your coverage on COBRA. If you elect COBRA to continue your health, dental, vision coverage and/or a spending account, you will be billed and pay directly to the insurance company for medical, Blue Cross dental, and vision insurance. If you elect COBRA for CompBenefits dental and/or a spending account, you will be billed and pay to DCH. The premium rate on COBRA is the full monthly premium including any employer contribution.

What do I have to do to return to work after Hospital Leave?
Return your physician’s release form to Employee Health at least 2 weeks before your intended return to work date. Then, you will need to contact Employment at 759-7701 to determine if there is a position available for you. If there is a position, you will need to make an appointment with Employee Health at 759-7698 for your drug screen. Your results must be cleared through Employee Health before your return to work. You must also attend a Monday morning Benefits Sign-up class to re-elect your benefits after Hospital Leave. The Employment Recruiter will make arrangements for you to attend the Sign-up class. The benefits that you had at the time you began your Hospital Leave are not automatically reinstated upon your return.

If your physician’s release has restrictions, it will have to be cleared through Employee Health before your return to work. You may not be able to return to work if you have restrictions on your release form.

Procedure to Apply For Disability Benefits

To report a short term or long term disability claim, call UNUM  Telephonic Claim Reporting service at 1-888-673-9940.

If your claim is for short term disability, you may call in your claim as soon as you receive the information. If your claim is for long term disability, the waiting period is 90 days before benefits begin. You should wait to call in your claim until you are reasonably sure that you will be out for longer than 90 days.

  • You must provide the following information:
  • Your name and Social Security number
  • Your complete address and phone number
  • Your physician’s name and phone number
  • Your last day worked and first day absent from work due to illness or injury
  • Your employer’s name – DCH Healthcare Authority Policy # 294018
  • Additional questions about yourself, your physician and your medical condition

You will be given your claim number and a contact number for your case manager at UNUM.

The UNUM will ask you to sign the medical authorization on the information sheet  provided. Fax this form to 1-800-447-2498  authorizing the release of medical information by your physician to UNUM.

Short-term disability benefit payments will not begin until your PTO/Sick time is paid out. If you have short-term disability, you will not be eligible to also receive H.E.L.P. donations.

If you are approved for short-term disability benefits, are receiving payments, and you remain disabled for 90 days or longer, your claim will automatically continue as a long-term disability claim for the duration of your illness or injury as determined by UNUM.

Waiver of Life Insurance Premiums: If you are considered disabled by UNUM for six months or longer, you may be eligible for a waiver of your term life insurance premiums. At that time UNUM will automatically submit your information to the Group Life Claims department if you are receiving long term disability benefits.




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