FML/PFML
What does FML do for the member?
What is protect your job?
Where do you go to make a note on a claim and what button do you click?
Diary Incoming Call
Where Would I go to update the phone number, Email and mailing address?
three dots -Quick edit will take full edit
In the event the caller would like to file for STD only but based on the ER products located in the CSS – Workbook “Telephonic List Tab” the ER has FMLA as well What JA is this
STD Member Advocate STD Reference Guide The MA will initiate the Telephonic Claim in Leave source and initiate the STD claim in OnBase, In the additional note section on the new STD claim the MA will document the Leave ID number associated with the new STD claim
What will the book on the banner of leave source tell you ?
ER rules
Can a member file a Cont. FML with STD for their spouse’s health condition?
NO
Member was admitted to the hospital on 5/1/2026 and released on 5/7/2026 ER is Wood Real Estate Investors , member would like to file a HIPP, Can he and what would your response be?
NO unless pushy
Member calls wants to start a leave because he has to take his mother to doctors appts 2 time a week, What type of leave would this be and why
Intermittent leave -the days are not consecutive
What JA would show you how to file a STD claim
How To File A STD Claim
If caller says if I have a grace period , My obgyn cant complete the forms until June 18, Can the caller have an extension or grace period, where would you go to see this info?
ER rule book
Where can you find incoming documents for FML claims?
What is LD claims
What three templates would you use if the member requested a payment request and funding DD
TPC, Payment Request, DD form
What steps would you take when completing a call?
Worklist notes acet
Member is showing to have a pending claim and would like to schedule a RTC with CS, Where would I go and who would I reach out or schedule the RTC for ?
3 People Css Workbook
Member calls in and needs to be transferred to DRMS -you follow the steps and when you finish the transfer call what must you do
Send transfer template to TL at EOS
If a claimant is calling in about their LTD claim and in the Diary Tab you notice “This is a DRMS managed claim” and the claimant is asking for claim status, what would you need to do?
advise of DRMS number /warm transfer/create misdirect
Member calls in and states that she has had a heart attack and was just released from the hospital, during her stay at the hospital she found out she had Chronic Renal failure/ ER World Wide Port Nutritional Supplements / What Claims would you be able to assist her with ?
Open ended Questions CI HIPP FMLA /STD
Where would you go to create a new leave for a member and if they have CONT FMLA with STD for the EE’s own health condition what intake would they use ?
Add Leave date and Disability intake
Member has an open claim and would like to schedule with CS , where would you go ?
4 people CSS workbook
What would you need to do if the Er is non telephonic?
Send request for forms with the template in FPS one note
If a member calls about State Paid Leaves, and she wants the phone number for her state of Oregon where can we find information this information and
What is Css workbook for Paid state leave
If the caller is inquiring about a Benefit Assist Claim that has already been set up, what JA would you use for this?
Benefit Assist Inbound Call Guide KM1715149
Were would you go to see the payments for a leave claim
on base
Member has benefit questions and he has not been assigned a claim specialist? Where would you go and what would you do ?
CSS workbook /Benefits rtc with Helen
Member calls in and states that they are having problems using the portal what JA would you use if the caller received the message -
There is a technical issue that prevented your info from being submitted."
FP Member Services Common Portal Issues - Job Aid